St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ STERO. 11GA APERTURE SLEEVE

Facility

$30.00

Hospital Charge Code	41568715
Hospital Revenue Code	270
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$24.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.00
Rate for Payer: Aetna Government	$15.00
Rate for Payer: Brighton Health Commercial	$22.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.40
Rate for Payer: Group Health Inc Commercial	$15.00
Rate for Payer: Group Health Inc Medicare	$10.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.00
Rate for Payer: Hamaspik Choice Inc Medicare	$15.00

ZZ STERO. 11GA MAMMOTOME PROBE

Facility

$488.00

Hospital Charge Code	41568713
Hospital Revenue Code	270
Min. Negotiated Rate	$170.80
Max. Negotiated Rate	$390.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$244.00
Rate for Payer: Aetna Government	$244.00
Rate for Payer: Brighton Health Commercial	$366.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$390.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$331.84
Rate for Payer: Group Health Inc Commercial	$244.00
Rate for Payer: Group Health Inc Medicare	$170.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$244.00
Rate for Payer: Hamaspik Choice Inc Medicare	$244.00

ZZ STERO. 11GA MAMMOTOME PROBE GU

Facility

$14.40

Hospital Charge Code	41568712
Hospital Revenue Code	270
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$11.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.20
Rate for Payer: Aetna Government	$7.20
Rate for Payer: Brighton Health Commercial	$10.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.79
Rate for Payer: Group Health Inc Commercial	$7.20
Rate for Payer: Group Health Inc Medicare	$5.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.20
Rate for Payer: Hamaspik Choice Inc Medicare	$7.20

ZZ STERO. 11GA MARK SITE-SING SIT

Facility

$174.00

Hospital Charge Code	41568714
Hospital Revenue Code	270
Min. Negotiated Rate	$60.90
Max. Negotiated Rate	$139.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$95.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$87.00
Rate for Payer: Aetna Government	$87.00
Rate for Payer: Brighton Health Commercial	$130.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$139.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$118.32
Rate for Payer: Group Health Inc Commercial	$87.00
Rate for Payer: Group Health Inc Medicare	$60.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.00
Rate for Payer: Hamaspik Choice Inc Medicare	$87.00

ZZ STERO. 1200CC VACUUM CANNISTER

Facility

$12.25

Hospital Charge Code	41568718
Hospital Revenue Code	270
Min. Negotiated Rate	$4.29
Max. Negotiated Rate	$9.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.12
Rate for Payer: Aetna Government	$6.12
Rate for Payer: Brighton Health Commercial	$9.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.33
Rate for Payer: Group Health Inc Commercial	$6.12
Rate for Payer: Group Health Inc Medicare	$4.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.12
Rate for Payer: Hamaspik Choice Inc Medicare	$6.12

ZZ STERO 27GA, 1.5 INCH NEEDLES

Facility

$0.10

Hospital Charge Code	41568719
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.05
Rate for Payer: Aetna Government	$0.05
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05

ZZ STERO. 8GA APERTURE SLEEVE

Facility

$30.00

Hospital Charge Code	41568711
Hospital Revenue Code	270
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$24.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.00
Rate for Payer: Aetna Government	$15.00
Rate for Payer: Brighton Health Commercial	$22.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.40
Rate for Payer: Group Health Inc Commercial	$15.00
Rate for Payer: Group Health Inc Medicare	$10.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.00
Rate for Payer: Hamaspik Choice Inc Medicare	$15.00

ZZ STERO 8GA MAMMOTOME PROBE GUID

Facility

$14.40

Hospital Charge Code	41568708
Hospital Revenue Code	270
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$11.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.20
Rate for Payer: Aetna Government	$7.20
Rate for Payer: Brighton Health Commercial	$10.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.79
Rate for Payer: Group Health Inc Commercial	$7.20
Rate for Payer: Group Health Inc Medicare	$5.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.20
Rate for Payer: Hamaspik Choice Inc Medicare	$7.20

ZZ STERO. 8GA MARK SITE-SING SITE

Facility

$174.00

Hospital Charge Code	41568710
Hospital Revenue Code	270
Min. Negotiated Rate	$60.90
Max. Negotiated Rate	$139.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$95.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$87.00
Rate for Payer: Aetna Government	$87.00
Rate for Payer: Brighton Health Commercial	$130.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$139.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$118.32
Rate for Payer: Group Health Inc Commercial	$87.00
Rate for Payer: Group Health Inc Medicare	$60.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.00
Rate for Payer: Hamaspik Choice Inc Medicare	$87.00

ZZ STERO. 8GA MMAMOTOME PROBE

Facility

$530.00

Hospital Charge Code	41568709
Hospital Revenue Code	270
Min. Negotiated Rate	$185.50
Max. Negotiated Rate	$424.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$291.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.00
Rate for Payer: Aetna Government	$265.00
Rate for Payer: Brighton Health Commercial	$397.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$424.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$360.40
Rate for Payer: Group Health Inc Commercial	$265.00
Rate for Payer: Group Health Inc Medicare	$185.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$265.00
Rate for Payer: Hamaspik Choice Inc Medicare	$265.00

ZZ STERO. CORETAINERS FOR SPECIME

Facility

$41.00

Hospital Charge Code	41568720
Hospital Revenue Code	270
Min. Negotiated Rate	$14.35
Max. Negotiated Rate	$32.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.50
Rate for Payer: Aetna Government	$20.50
Rate for Payer: Brighton Health Commercial	$30.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.88
Rate for Payer: Group Health Inc Commercial	$20.50
Rate for Payer: Group Health Inc Medicare	$14.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.50
Rate for Payer: Hamaspik Choice Inc Medicare	$20.50

ZZ STERO HAWKINS 2 HARDWIRE 10CM

Facility

$60.00

Hospital Charge Code	41568722
Hospital Revenue Code	270
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Brighton Health Commercial	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00

ZZ STERO HAWKINS 2 HARDWIRE 12.5C

Facility

$60.00

Hospital Charge Code	41568723
Hospital Revenue Code	270
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Brighton Health Commercial	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00

ZZ STERO HOLOGIC NDL GUIDES/UNIT

Facility

$24.00

Hospital Charge Code	41568724
Hospital Revenue Code	270
Min. Negotiated Rate	$8.40
Max. Negotiated Rate	$19.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.00
Rate for Payer: Aetna Government	$12.00
Rate for Payer: Brighton Health Commercial	$18.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.32
Rate for Payer: Group Health Inc Commercial	$12.00
Rate for Payer: Group Health Inc Medicare	$8.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12.00

ZZ STERO. MAMMOTOME VACUUM SET

Facility

$32.80

Hospital Charge Code	41568716
Hospital Revenue Code	270
Min. Negotiated Rate	$11.48
Max. Negotiated Rate	$26.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.40
Rate for Payer: Aetna Government	$16.40
Rate for Payer: Brighton Health Commercial	$24.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.30
Rate for Payer: Group Health Inc Commercial	$16.40
Rate for Payer: Group Health Inc Medicare	$11.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.40
Rate for Payer: Hamaspik Choice Inc Medicare	$16.40

ZZ STERO. MARK SITE 2 (2ND SITE)

Facility

$187.00

Hospital Charge Code	41568717
Hospital Revenue Code	270
Min. Negotiated Rate	$65.45
Max. Negotiated Rate	$149.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$102.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$93.50
Rate for Payer: Aetna Government	$93.50
Rate for Payer: Brighton Health Commercial	$140.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$149.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.16
Rate for Payer: Group Health Inc Commercial	$93.50
Rate for Payer: Group Health Inc Medicare	$65.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.50
Rate for Payer: Hamaspik Choice Inc Medicare	$93.50

ZZ STERO RABINOV SIALOGRAM P-12S

Facility

$70.82

Hospital Charge Code	41568725
Hospital Revenue Code	270
Min. Negotiated Rate	$24.79
Max. Negotiated Rate	$56.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.41
Rate for Payer: Aetna Government	$35.41
Rate for Payer: Brighton Health Commercial	$53.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.16
Rate for Payer: Group Health Inc Commercial	$35.41
Rate for Payer: Group Health Inc Medicare	$24.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.41
Rate for Payer: Hamaspik Choice Inc Medicare	$35.41

ZZ STERO RABINOV SIALOGRAM P-16S

Facility

$70.82

Hospital Charge Code	41568726
Hospital Revenue Code	270
Min. Negotiated Rate	$24.79
Max. Negotiated Rate	$56.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.41
Rate for Payer: Aetna Government	$35.41
Rate for Payer: Brighton Health Commercial	$53.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.16
Rate for Payer: Group Health Inc Commercial	$35.41
Rate for Payer: Group Health Inc Medicare	$24.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.41
Rate for Payer: Hamaspik Choice Inc Medicare	$35.41

ZZ STERO RABINOV SIALOGRAM P-22S

Facility

$70.82

Hospital Charge Code	41568727
Hospital Revenue Code	270
Min. Negotiated Rate	$24.79
Max. Negotiated Rate	$56.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.41
Rate for Payer: Aetna Government	$35.41
Rate for Payer: Brighton Health Commercial	$53.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.16
Rate for Payer: Group Health Inc Commercial	$35.41
Rate for Payer: Group Health Inc Medicare	$24.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.41
Rate for Payer: Hamaspik Choice Inc Medicare	$35.41

ZZ STOP COCK (MODEL VG1)

Facility

$2.84

Hospital Charge Code	41567507
Hospital Revenue Code	270
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$2.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.42
Rate for Payer: Aetna Government	$1.42
Rate for Payer: Brighton Health Commercial	$2.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.93
Rate for Payer: Group Health Inc Commercial	$1.42
Rate for Payer: Group Health Inc Medicare	$0.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.42
Rate for Payer: Hamaspik Choice Inc Medicare	$1.42

ZZ STRAIG CATH 4/ST/65/35

Facility

$48.55

Hospital Charge Code	41567243
Hospital Revenue Code	270
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$38.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.28
Rate for Payer: Aetna Government	$24.28
Rate for Payer: Brighton Health Commercial	$36.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.01
Rate for Payer: Group Health Inc Commercial	$24.28
Rate for Payer: Group Health Inc Medicare	$16.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.28
Rate for Payer: Hamaspik Choice Inc Medicare	$24.28

ZZ STRAIGHT FLUSH CATHETER

Facility

$97.10

Hospital Charge Code	41567163
Hospital Revenue Code	270
Min. Negotiated Rate	$33.98
Max. Negotiated Rate	$77.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$48.55
Rate for Payer: Aetna Government	$48.55
Rate for Payer: Brighton Health Commercial	$72.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$77.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.03
Rate for Payer: Group Health Inc Commercial	$48.55
Rate for Payer: Group Health Inc Medicare	$33.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.55
Rate for Payer: Hamaspik Choice Inc Medicare	$48.55

ZZ SUB4 BALON 2.5-4/3.8/120

Facility

$1,206.29

Hospital Charge Code	41567200
Hospital Revenue Code	270
Min. Negotiated Rate	$422.20
Max. Negotiated Rate	$965.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$663.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$603.14
Rate for Payer: Aetna Government	$603.14
Rate for Payer: Brighton Health Commercial	$904.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$965.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$820.28
Rate for Payer: Group Health Inc Commercial	$603.14
Rate for Payer: Group Health Inc Medicare	$422.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$603.14
Rate for Payer: Hamaspik Choice Inc Medicare	$603.14

ZZ SUB4 BALON 3.0-2/3.8/120

Facility

$1,206.29

Hospital Charge Code	41567201
Hospital Revenue Code	270
Min. Negotiated Rate	$422.20
Max. Negotiated Rate	$965.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$663.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$603.14
Rate for Payer: Aetna Government	$603.14
Rate for Payer: Brighton Health Commercial	$904.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$965.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$820.28
Rate for Payer: Group Health Inc Commercial	$603.14
Rate for Payer: Group Health Inc Medicare	$422.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$603.14
Rate for Payer: Hamaspik Choice Inc Medicare	$603.14

ZZ SUB4 BALON 3.0-4/3.8/120

Facility

$1,206.29

Hospital Charge Code	41567202
Hospital Revenue Code	270
Min. Negotiated Rate	$422.20
Max. Negotiated Rate	$965.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$663.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$603.14
Rate for Payer: Aetna Government	$603.14
Rate for Payer: Brighton Health Commercial	$904.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$965.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$820.28
Rate for Payer: Group Health Inc Commercial	$603.14
Rate for Payer: Group Health Inc Medicare	$422.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$603.14
Rate for Payer: Hamaspik Choice Inc Medicare	$603.14

Know your out-of-pocket cost for care.

All Charges