St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ STENT/SYMPHOMY/8MM*60MM

Facility

$2,479.21

Service Code	HCPCS C1876
Hospital Charge Code	41569247
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,603.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,363.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,487.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,239.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,425.55
Rate for Payer: EmblemHealth Commercial	$1,239.60
Rate for Payer: Fidelis Medicare Advantage	$2,603.17
Rate for Payer: Group Health Inc Commercial	$1,239.60
Rate for Payer: Group Health Inc Medicare	$867.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,239.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,239.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,611.49

ZZ STENT/SYMPHONY/10MM*60MM

Facility

$2,479.21

Service Code	HCPCS C1876
Hospital Charge Code	41569244
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,603.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,363.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,487.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,239.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,425.55
Rate for Payer: EmblemHealth Commercial	$1,239.60
Rate for Payer: Fidelis Medicare Advantage	$2,603.17
Rate for Payer: Group Health Inc Commercial	$1,239.60
Rate for Payer: Group Health Inc Medicare	$867.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,239.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,239.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,611.49

ZZ STENT/SYMPHONY/10MM*60MM

Facility

$2,479.21

Service Code	HCPCS C1876
Hospital Charge Code	41569244
Hospital Revenue Code	278
Min. Negotiated Rate	$1,239.60
Max. Negotiated Rate	$1,239.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,239.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,239.60

ZZ STENT/SYMPHONY/8MM*44MM

Facility

$2,479.21

Service Code	HCPCS C1876
Hospital Charge Code	41569242
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,603.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,363.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,487.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,239.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,425.55
Rate for Payer: EmblemHealth Commercial	$1,239.60
Rate for Payer: Fidelis Medicare Advantage	$2,603.17
Rate for Payer: Group Health Inc Commercial	$1,239.60
Rate for Payer: Group Health Inc Medicare	$867.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,239.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,239.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,611.49

ZZ STENT/SYMPHONY/8MM*44MM

Facility

$2,479.21

Service Code	HCPCS C1876
Hospital Charge Code	41569242
Hospital Revenue Code	278
Min. Negotiated Rate	$1,239.60
Max. Negotiated Rate	$1,239.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,239.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,239.60

ZZ STENT/WALLSTENT/0840

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569249
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,520.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,440.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,380.31
Rate for Payer: EmblemHealth Commercial	$1,200.27
Rate for Payer: Fidelis Medicare Advantage	$2,520.57
Rate for Payer: Group Health Inc Commercial	$1,200.27
Rate for Payer: Group Health Inc Medicare	$840.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,560.35

ZZ STENT/WALLSTENT/0840

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569249
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.27
Max. Negotiated Rate	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27

ZZ STENT/WALLSTENT/5MM*55MM/7F

Facility

$2,668.45

Service Code	HCPCS C1876
Hospital Charge Code	41569250
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,801.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,467.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,601.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,334.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,534.36
Rate for Payer: EmblemHealth Commercial	$1,334.22
Rate for Payer: Fidelis Medicare Advantage	$2,801.87
Rate for Payer: Group Health Inc Commercial	$1,334.22
Rate for Payer: Group Health Inc Medicare	$933.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,334.22
Rate for Payer: Hamaspik Choice Inc Medicare	$1,334.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,734.49

ZZ STENT/WALLSTENT/5MM*55MM/7F

Facility

$2,668.45

Service Code	HCPCS C1876
Hospital Charge Code	41569250
Hospital Revenue Code	278
Min. Negotiated Rate	$1,334.22
Max. Negotiated Rate	$1,334.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,334.22
Rate for Payer: Hamaspik Choice Inc Medicare	$1,334.22

ZZ STENT/WALLSTENT/SCHNEIDER1042

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569252
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.27
Max. Negotiated Rate	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27

ZZ STENT/WALLSTENT/SCHNEIDER1042

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569252
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,520.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,440.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,380.31
Rate for Payer: EmblemHealth Commercial	$1,200.27
Rate for Payer: Fidelis Medicare Advantage	$2,520.57
Rate for Payer: Group Health Inc Commercial	$1,200.27
Rate for Payer: Group Health Inc Medicare	$840.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,560.35

ZZ STENT/WALLSTENT/SCHNEIDER 1068

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569251
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,520.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,440.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,380.31
Rate for Payer: EmblemHealth Commercial	$1,200.27
Rate for Payer: Fidelis Medicare Advantage	$2,520.57
Rate for Payer: Group Health Inc Commercial	$1,200.27
Rate for Payer: Group Health Inc Medicare	$840.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,560.35

ZZ STENT/WALLSTENT/SCHNEIDER 1068

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569251
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.27
Max. Negotiated Rate	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27

ZZ STENT/WALLSTENT/SCHNEIDER1260

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569253
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,520.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,440.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,380.31
Rate for Payer: EmblemHealth Commercial	$1,200.27
Rate for Payer: Fidelis Medicare Advantage	$2,520.57
Rate for Payer: Group Health Inc Commercial	$1,200.27
Rate for Payer: Group Health Inc Medicare	$840.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,560.35

ZZ STENT/WALLSTENT/SCHNEIDER1260

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569253
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.27
Max. Negotiated Rate	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27

ZZ STENT/WALLSTENT/SCHNEIDER1455

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569191
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,520.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,440.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,380.31
Rate for Payer: EmblemHealth Commercial	$1,200.27
Rate for Payer: Fidelis Medicare Advantage	$2,520.57
Rate for Payer: Group Health Inc Commercial	$1,200.27
Rate for Payer: Group Health Inc Medicare	$840.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,560.35

ZZ STENT/WALLSTENT/SCHNEIDER1455

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569191
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.27
Max. Negotiated Rate	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27

ZZ STENT/WALLSTENT/SCHNEIDER1660

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569192
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.27
Max. Negotiated Rate	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27

ZZ STENT/WALLSTENT/SCHNEIDER1660

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569192
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,520.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,440.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,380.31
Rate for Payer: EmblemHealth Commercial	$1,200.27
Rate for Payer: Fidelis Medicare Advantage	$2,520.57
Rate for Payer: Group Health Inc Commercial	$1,200.27
Rate for Payer: Group Health Inc Medicare	$840.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,560.35

ZZ STENT/WALLSTENT/SCHNEIDER860

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569193
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,520.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,440.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,200.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,380.31
Rate for Payer: EmblemHealth Commercial	$1,200.27
Rate for Payer: Fidelis Medicare Advantage	$2,520.57
Rate for Payer: Group Health Inc Commercial	$1,200.27
Rate for Payer: Group Health Inc Medicare	$840.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,560.35

ZZ STENT/WALLSTENT/SCHNEIDER860

Facility

$2,400.54

Service Code	HCPCS C1876
Hospital Charge Code	41569193
Hospital Revenue Code	278
Min. Negotiated Rate	$1,200.27
Max. Negotiated Rate	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.27
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.27

ZZ STEREOTACTIC NEEDLE PROBE

Facility

$520.00

Hospital Charge Code	41569935
Hospital Revenue Code	279
Min. Negotiated Rate	$182.00
Max. Negotiated Rate	$416.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$286.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$260.00
Rate for Payer: Aetna Government	$260.00
Rate for Payer: Brighton Health Commercial	$390.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$416.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$353.60
Rate for Payer: Group Health Inc Commercial	$260.00
Rate for Payer: Group Health Inc Medicare	$182.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$260.00

ZZ STEREOTACTIC TISSUE MARKER

Facility

$166.00

Hospital Charge Code	41569936
Hospital Revenue Code	279
Min. Negotiated Rate	$58.10
Max. Negotiated Rate	$132.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$91.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$83.00
Rate for Payer: Aetna Government	$83.00
Rate for Payer: Brighton Health Commercial	$124.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$132.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.88
Rate for Payer: Group Health Inc Commercial	$83.00
Rate for Payer: Group Health Inc Medicare	$58.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$83.00
Rate for Payer: Hamaspik Choice Inc Medicare	$83.00

ZZ STERI DRAPE 1012

Facility

$12.76

Hospital Charge Code	41567005
Hospital Revenue Code	270
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$10.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.38
Rate for Payer: Aetna Government	$6.38
Rate for Payer: Brighton Health Commercial	$9.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.68
Rate for Payer: Group Health Inc Commercial	$6.38
Rate for Payer: Group Health Inc Medicare	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.38
Rate for Payer: Hamaspik Choice Inc Medicare	$6.38

ZZ STERI DRAPE 1092

Facility

$6.73

Hospital Charge Code	41567006
Hospital Revenue Code	270
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$5.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.36
Rate for Payer: Aetna Government	$3.36
Rate for Payer: Brighton Health Commercial	$5.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.58
Rate for Payer: Group Health Inc Commercial	$3.36
Rate for Payer: Group Health Inc Medicare	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.36
Rate for Payer: Hamaspik Choice Inc Medicare	$3.36

Know your out-of-pocket cost for care.

All Charges