St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ SHEATH/PINNACLE/9F/10CM

Facility

$393.36

Service Code	HCPCS C1892
Hospital Charge Code	41569483
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/STRAIGHT/7-30CM/RB

Facility

$77.87

Service Code	HCPCS C1892
Hospital Charge Code	41569484
Hospital Revenue Code	278
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$81.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$42.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
Rate for Payer: Brighton Health Commercial	$46.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.78
Rate for Payer: EmblemHealth Commercial	$38.94
Rate for Payer: Fidelis Medicare Advantage	$81.76
Rate for Payer: Group Health Inc Commercial	$38.94
Rate for Payer: Group Health Inc Medicare	$27.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.94
Rate for Payer: Hamaspik Choice Inc Medicare	$38.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$50.62

ZZ SHEATH/STRAIGHT/7-30CM/RB

Facility

$77.87

Service Code	HCPCS C1892
Hospital Charge Code	41569484
Hospital Revenue Code	278
Min. Negotiated Rate	$38.94
Max. Negotiated Rate	$38.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.94
Rate for Payer: Hamaspik Choice Inc Medicare	$38.94

ZZ SIM GLIDCTH 4FR 100 CM

Facility

$779.63

Service Code	HCPCS C1725
Hospital Charge Code	41567519
Hospital Revenue Code	278
Min. Negotiated Rate	$389.82
Max. Negotiated Rate	$389.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$389.82
Rate for Payer: Hamaspik Choice Inc Medicare	$389.82

ZZ SIM GLIDCTH 4FR 100 CM

Facility

$779.63

Service Code	HCPCS C1725
Hospital Charge Code	41567519
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$818.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$428.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$467.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$389.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$448.29
Rate for Payer: EmblemHealth Commercial	$389.82
Rate for Payer: Fidelis Medicare Advantage	$818.61
Rate for Payer: Group Health Inc Commercial	$389.82
Rate for Payer: Group Health Inc Medicare	$272.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$389.82
Rate for Payer: Hamaspik Choice Inc Medicare	$389.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$506.76

ZZ SIMMONS SIDEWIN CATH 5

Facility

$48.91

Service Code	HCPCS C1725
Hospital Charge Code	41567166
Hospital Revenue Code	278
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$51.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$29.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.12
Rate for Payer: EmblemHealth Commercial	$24.46
Rate for Payer: Fidelis Medicare Advantage	$51.36
Rate for Payer: Group Health Inc Commercial	$24.46
Rate for Payer: Group Health Inc Medicare	$17.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$31.79

ZZ SIMMONS SIDEWIN CATH 5

Facility

$48.91

Service Code	HCPCS C1725
Hospital Charge Code	41567166
Hospital Revenue Code	278
Min. Negotiated Rate	$24.46
Max. Negotiated Rate	$24.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46

ZZ SIMM SIDEWINDER CTH

Facility

$48.91

Service Code	HCPCS C1725
Hospital Charge Code	41567164
Hospital Revenue Code	278
Min. Negotiated Rate	$24.46
Max. Negotiated Rate	$24.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46

ZZ SIMM SIDEWINDER CTH

Facility

$48.91

Service Code	HCPCS C1725
Hospital Charge Code	41567164
Hospital Revenue Code	278
Min. Negotiated Rate	$17.12
Max. Negotiated Rate	$51.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$29.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.12
Rate for Payer: EmblemHealth Commercial	$24.46
Rate for Payer: Fidelis Medicare Advantage	$51.36
Rate for Payer: Group Health Inc Commercial	$24.46
Rate for Payer: Group Health Inc Medicare	$17.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.46
Rate for Payer: Hamaspik Choice Inc Medicare	$24.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$31.79

ZZ SLK BRAID/3.5 MTRIC #K 834

Facility

$102.51

Service Code	HCPCS C1725
Hospital Charge Code	41569012
Hospital Revenue Code	278
Min. Negotiated Rate	$51.26
Max. Negotiated Rate	$51.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.26
Rate for Payer: Hamaspik Choice Inc Medicare	$51.26

ZZ SLK BRAID/3.5 MTRIC #K 834

Facility

$102.51

Service Code	HCPCS C1725
Hospital Charge Code	41569012
Hospital Revenue Code	278
Min. Negotiated Rate	$35.88
Max. Negotiated Rate	$107.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$61.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.94
Rate for Payer: EmblemHealth Commercial	$51.26
Rate for Payer: Fidelis Medicare Advantage	$107.64
Rate for Payer: Group Health Inc Commercial	$51.26
Rate for Payer: Group Health Inc Medicare	$35.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.26
Rate for Payer: Hamaspik Choice Inc Medicare	$51.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.63

ZZ SMARTSTENT #N1060AB 80CM/10MM

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569010
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,906.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: EmblemHealth Commercial	$1,589.02
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SMARTSTENT #N1060AB 80CM/10MM

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569010
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SMARTSTENT #N740AB 7MM/40MM

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569006
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,906.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: EmblemHealth Commercial	$1,589.02
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SMARTSTENT #N740AB 7MM/40MM

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569006
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SMARTSTENT #N840AB 80MM/8MM

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569008
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SMARTSTENT #N840AB 80MM/8MM

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569008
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,906.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: EmblemHealth Commercial	$1,589.02
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SMARTSTENT #N860AB 80CM/8MM/60

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569009
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,906.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: EmblemHealth Commercial	$1,589.02
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SMARTSTENT #N860AB 80CM/8MM/60

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569009
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SMARTSTENT #N940AB 9MM/40MM

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569007
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,906.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: EmblemHealth Commercial	$1,589.02
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SMARTSTENT #N940AB 9MM/40MM

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569007
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SMRT STNT N1040AB 80CM/10MM 40

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569011
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,336.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,747.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,906.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,589.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,827.37
Rate for Payer: EmblemHealth Commercial	$1,589.02
Rate for Payer: Fidelis Medicare Advantage	$3,336.94
Rate for Payer: Group Health Inc Commercial	$1,589.02
Rate for Payer: Group Health Inc Medicare	$1,112.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,065.73

ZZ SMRT STNT N1040AB 80CM/10MM 40

Facility

$3,178.04

Service Code	HCPCS C1876
Hospital Charge Code	41569011
Hospital Revenue Code	278
Min. Negotiated Rate	$1,589.02
Max. Negotiated Rate	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,589.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,589.02

ZZ SNARE KIT 5M 4FR 102CM

Facility

$779.63

Service Code	HCPCS C1773
Hospital Charge Code	41569684
Hospital Revenue Code	278
Min. Negotiated Rate	$389.82
Max. Negotiated Rate	$389.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$389.82
Rate for Payer: Hamaspik Choice Inc Medicare	$389.82

ZZ SNARE KIT 5M 4FR 102CM

Facility

$779.63

Service Code	HCPCS C1773
Hospital Charge Code	41569684
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$818.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$428.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.00
Rate for Payer: Aetna Government	$70.00
Rate for Payer: Brighton Health Commercial	$467.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$389.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$448.29
Rate for Payer: EmblemHealth Commercial	$389.82
Rate for Payer: Fidelis Medicare Advantage	$818.61
Rate for Payer: Group Health Inc Commercial	$389.82
Rate for Payer: Group Health Inc Medicare	$272.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$389.82
Rate for Payer: Hamaspik Choice Inc Medicare	$389.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$506.76

Know your out-of-pocket cost for care.

All Charges