St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ SHEATH 8 25 38

Facility

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567063
Hospital Revenue Code	278
Min. Negotiated Rate	$53.86
Max. Negotiated Rate	$53.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86

ZZ SHEATH 8 25 38

Facility

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567063
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$113.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$64.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.94
Rate for Payer: EmblemHealth Commercial	$53.86
Rate for Payer: Fidelis Medicare Advantage	$113.12
Rate for Payer: Group Health Inc Commercial	$53.86
Rate for Payer: Group Health Inc Medicare	$37.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.02

ZZ SHEATH/8F PINNACLE

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569474
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$413.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$216.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$236.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$196.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$226.18
Rate for Payer: EmblemHealth Commercial	$196.68
Rate for Payer: Fidelis Medicare Advantage	$413.03
Rate for Payer: Group Health Inc Commercial	$196.68
Rate for Payer: Group Health Inc Medicare	$137.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$255.68

ZZ SHEATH/8F PINNACLE

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569474
Hospital Revenue Code	278
Min. Negotiated Rate	$196.68
Max. Negotiated Rate	$196.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68

ZZ SHEATH 9 25 38

Facility

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567064
Hospital Revenue Code	278
Min. Negotiated Rate	$53.86
Max. Negotiated Rate	$53.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86

ZZ SHEATH 9 25 38

Facility

$107.73

Service Code	HCPCS C1892
Hospital Charge Code	41567064
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$113.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$64.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.94
Rate for Payer: EmblemHealth Commercial	$53.86
Rate for Payer: Fidelis Medicare Advantage	$113.12
Rate for Payer: Group Health Inc Commercial	$53.86
Rate for Payer: Group Health Inc Medicare	$37.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.86
Rate for Payer: Hamaspik Choice Inc Medicare	$53.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.02

ZZ SHEATH/BALKIN/6F/30CM/RB

Facility

$111.37

Service Code	HCPCS C1892
Hospital Charge Code	41569475
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$116.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$66.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.04
Rate for Payer: EmblemHealth Commercial	$55.68
Rate for Payer: Fidelis Medicare Advantage	$116.94
Rate for Payer: Group Health Inc Commercial	$55.68
Rate for Payer: Group Health Inc Medicare	$38.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.68
Rate for Payer: Hamaspik Choice Inc Medicare	$55.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$72.39

ZZ SHEATH/BALKIN/6F/30CM/RB

Facility

$111.37

Service Code	HCPCS C1892
Hospital Charge Code	41569475
Hospital Revenue Code	278
Min. Negotiated Rate	$55.68
Max. Negotiated Rate	$55.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.68
Rate for Payer: Hamaspik Choice Inc Medicare	$55.68

ZZ SHEATH/BALKIN/7F/40CM/RB

Facility

$111.37

Service Code	HCPCS C1892
Hospital Charge Code	41569476
Hospital Revenue Code	278
Min. Negotiated Rate	$55.68
Max. Negotiated Rate	$55.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.68
Rate for Payer: Hamaspik Choice Inc Medicare	$55.68

ZZ SHEATH/BALKIN/7F/40CM/RB

Facility

$111.37

Service Code	HCPCS C1892
Hospital Charge Code	41569476
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$116.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$66.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.04
Rate for Payer: EmblemHealth Commercial	$55.68
Rate for Payer: Fidelis Medicare Advantage	$116.94
Rate for Payer: Group Health Inc Commercial	$55.68
Rate for Payer: Group Health Inc Medicare	$38.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.68
Rate for Payer: Hamaspik Choice Inc Medicare	$55.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$72.39

ZZ SHEATH/CHECK-FLO/9F

Facility

$94.88

Service Code	HCPCS C1892
Hospital Charge Code	41569477
Hospital Revenue Code	278
Min. Negotiated Rate	$47.44
Max. Negotiated Rate	$47.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.44
Rate for Payer: Hamaspik Choice Inc Medicare	$47.44

ZZ SHEATH/CHECK-FLO/9F

Facility

$94.88

Service Code	HCPCS C1892
Hospital Charge Code	41569477
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$99.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$52.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$56.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$54.56
Rate for Payer: EmblemHealth Commercial	$47.44
Rate for Payer: Fidelis Medicare Advantage	$99.62
Rate for Payer: Group Health Inc Commercial	$47.44
Rate for Payer: Group Health Inc Medicare	$33.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.44
Rate for Payer: Hamaspik Choice Inc Medicare	$47.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$61.67

ZZ SHEATH LUNDERQUIST

Facility

$53.16

Service Code	HCPCS C1892
Hospital Charge Code	41569472
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$55.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$31.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.57
Rate for Payer: EmblemHealth Commercial	$26.58
Rate for Payer: Fidelis Medicare Advantage	$55.82
Rate for Payer: Group Health Inc Commercial	$26.58
Rate for Payer: Group Health Inc Medicare	$18.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.58
Rate for Payer: Hamaspik Choice Inc Medicare	$26.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.55

ZZ SHEATH LUNDERQUIST

Facility

$53.16

Service Code	HCPCS C1892
Hospital Charge Code	41569472
Hospital Revenue Code	278
Min. Negotiated Rate	$26.58
Max. Negotiated Rate	$26.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.58
Rate for Payer: Hamaspik Choice Inc Medicare	$26.58

ZZ SHEATH/PINNACLE/10F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569478
Hospital Revenue Code	278
Min. Negotiated Rate	$196.68
Max. Negotiated Rate	$196.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68

ZZ SHEATH/PINNACLE/10F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569478
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$413.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$216.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$236.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$196.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$226.18
Rate for Payer: EmblemHealth Commercial	$196.68
Rate for Payer: Fidelis Medicare Advantage	$413.03
Rate for Payer: Group Health Inc Commercial	$196.68
Rate for Payer: Group Health Inc Medicare	$137.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$255.68

ZZ SHEATH/PINNACLE/4F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569479
Hospital Revenue Code	278
Min. Negotiated Rate	$196.68
Max. Negotiated Rate	$196.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68

ZZ SHEATH/PINNACLE/4F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569479
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$413.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$216.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$236.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$196.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$226.18
Rate for Payer: EmblemHealth Commercial	$196.68
Rate for Payer: Fidelis Medicare Advantage	$413.03
Rate for Payer: Group Health Inc Commercial	$196.68
Rate for Payer: Group Health Inc Medicare	$137.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$255.68

ZZ SHEATH/PINNACLE/5F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569480
Hospital Revenue Code	278
Min. Negotiated Rate	$196.68
Max. Negotiated Rate	$196.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68

ZZ SHEATH/PINNACLE/5F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569480
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$413.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$216.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$236.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$196.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$226.18
Rate for Payer: EmblemHealth Commercial	$196.68
Rate for Payer: Fidelis Medicare Advantage	$413.03
Rate for Payer: Group Health Inc Commercial	$196.68
Rate for Payer: Group Health Inc Medicare	$137.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$255.68

ZZ SHEATH/PINNACLE/6F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569481
Hospital Revenue Code	278
Min. Negotiated Rate	$196.68
Max. Negotiated Rate	$196.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68

ZZ SHEATH/PINNACLE/6F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569481
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$413.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$216.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$236.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$196.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$226.18
Rate for Payer: EmblemHealth Commercial	$196.68
Rate for Payer: Fidelis Medicare Advantage	$413.03
Rate for Payer: Group Health Inc Commercial	$196.68
Rate for Payer: Group Health Inc Medicare	$137.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$255.68

ZZ SHEATH/PINNACLE/7F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569482
Hospital Revenue Code	278
Min. Negotiated Rate	$196.68
Max. Negotiated Rate	$196.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68

ZZ SHEATH/PINNACLE/7F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569482
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$413.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$216.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$236.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$196.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$226.18
Rate for Payer: EmblemHealth Commercial	$196.68
Rate for Payer: Fidelis Medicare Advantage	$413.03
Rate for Payer: Group Health Inc Commercial	$196.68
Rate for Payer: Group Health Inc Medicare	$137.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$255.68

ZZ SHEATH/PINNACLE/9F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569483
Hospital Revenue Code	278
Min. Negotiated Rate	$196.68
Max. Negotiated Rate	$196.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.68
Rate for Payer: Hamaspik Choice Inc Medicare	$196.68

Know your out-of-pocket cost for care.

All Charges