St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ TRANSJUG LIVER ACC SET

Facility

$847.67

Hospital Charge Code	41567324
Hospital Revenue Code	270
Min. Negotiated Rate	$296.68
Max. Negotiated Rate	$678.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$466.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$423.84
Rate for Payer: Aetna Government	$423.84
Rate for Payer: Brighton Health Commercial	$635.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$678.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$576.42
Rate for Payer: Group Health Inc Commercial	$423.84
Rate for Payer: Group Health Inc Medicare	$296.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$423.84
Rate for Payer: Hamaspik Choice Inc Medicare	$423.84

ZZ TRANSJUG LVR ACC TIPPS

Facility

$741.71

Hospital Charge Code	41567321
Hospital Revenue Code	270
Min. Negotiated Rate	$259.60
Max. Negotiated Rate	$593.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$407.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$370.86
Rate for Payer: Aetna Government	$370.86
Rate for Payer: Brighton Health Commercial	$556.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$593.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$504.36
Rate for Payer: Group Health Inc Commercial	$370.86
Rate for Payer: Group Health Inc Medicare	$259.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$370.86
Rate for Payer: Hamaspik Choice Inc Medicare	$370.86

ZZ TRANSJUNGLAR LA SET RUPS 100S

Facility

$663.39

Hospital Charge Code	41569203
Hospital Revenue Code	270
Min. Negotiated Rate	$232.19
Max. Negotiated Rate	$530.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$364.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$331.70
Rate for Payer: Aetna Government	$331.70
Rate for Payer: Brighton Health Commercial	$497.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$530.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$451.11
Rate for Payer: Group Health Inc Commercial	$331.70
Rate for Payer: Group Health Inc Medicare	$232.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$331.70
Rate for Payer: Hamaspik Choice Inc Medicare	$331.70

ZZ TRAY/C.V.I.R

Facility

$242.72

Hospital Charge Code	41569205
Hospital Revenue Code	270
Min. Negotiated Rate	$84.95
Max. Negotiated Rate	$194.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$133.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$121.36
Rate for Payer: Aetna Government	$121.36
Rate for Payer: Brighton Health Commercial	$182.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$194.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$165.05
Rate for Payer: Group Health Inc Commercial	$121.36
Rate for Payer: Group Health Inc Medicare	$84.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.36
Rate for Payer: Hamaspik Choice Inc Medicare	$121.36

ZZ TRAY,LUMBAR PUNCTURE,20X3.5

Facility

$47.63

Hospital Charge Code	41568093
Hospital Revenue Code	270
Min. Negotiated Rate	$16.67
Max. Negotiated Rate	$38.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.82
Rate for Payer: Aetna Government	$23.82
Rate for Payer: Brighton Health Commercial	$35.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.39
Rate for Payer: Group Health Inc Commercial	$23.82
Rate for Payer: Group Health Inc Medicare	$16.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.82
Rate for Payer: Hamaspik Choice Inc Medicare	$23.82

ZZ TRNSHP BIL STENT 6F/5/18

Facility

$3,472.88

Service Code	HCPCS C1876
Hospital Charge Code	41569769
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,646.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,910.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,083.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,736.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,996.91
Rate for Payer: EmblemHealth Commercial	$1,736.44
Rate for Payer: Fidelis Medicare Advantage	$3,646.52
Rate for Payer: Group Health Inc Commercial	$1,736.44
Rate for Payer: Group Health Inc Medicare	$1,215.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,736.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,736.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,257.37

ZZ TRNSHP BIL STENT 6F/5/18

Facility

$3,472.88

Service Code	HCPCS C1876
Hospital Charge Code	41569769
Hospital Revenue Code	278
Min. Negotiated Rate	$1,736.44
Max. Negotiated Rate	$1,736.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,736.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,736.44

ZZ TRNSHP BIL STENT 6F/6/18

Facility

$3,472.88

Service Code	HCPCS C1876
Hospital Charge Code	41569768
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,646.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,910.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,083.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,736.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,996.91
Rate for Payer: EmblemHealth Commercial	$1,736.44
Rate for Payer: Fidelis Medicare Advantage	$3,646.52
Rate for Payer: Group Health Inc Commercial	$1,736.44
Rate for Payer: Group Health Inc Medicare	$1,215.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,736.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,736.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,257.37

ZZ TRNSHP BIL STENT 6F/6/18

Facility

$3,472.88

Service Code	HCPCS C1876
Hospital Charge Code	41569768
Hospital Revenue Code	278
Min. Negotiated Rate	$1,736.44
Max. Negotiated Rate	$1,736.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,736.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,736.44

ZZ TRUWAVE 30CC/24IN

Facility

$90.00

Hospital Charge Code	41566950
Hospital Revenue Code	272
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$72.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.00
Rate for Payer: Aetna Government	$45.00
Rate for Payer: Brighton Health Commercial	$67.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.20
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00

ZZ TURNER PIGTAIL PIX SET

Facility

$117.30

Hospital Charge Code	41567322
Hospital Revenue Code	270
Min. Negotiated Rate	$41.06
Max. Negotiated Rate	$93.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$64.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$58.65
Rate for Payer: Aetna Government	$58.65
Rate for Payer: Brighton Health Commercial	$87.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$93.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$79.76
Rate for Payer: Group Health Inc Commercial	$58.65
Rate for Payer: Group Health Inc Medicare	$41.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.65
Rate for Payer: Hamaspik Choice Inc Medicare	$58.65

ZZ ULTRACLIP COAXIAL NDLE 18X10

Facility

$28.00

Hospital Charge Code	41568501
Hospital Revenue Code	270
Min. Negotiated Rate	$9.80
Max. Negotiated Rate	$22.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.00
Rate for Payer: Aetna Government	$14.00
Rate for Payer: Brighton Health Commercial	$21.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.04
Rate for Payer: Group Health Inc Commercial	$14.00
Rate for Payer: Group Health Inc Medicare	$9.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.00
Rate for Payer: Hamaspik Choice Inc Medicare	$14.00

ZZ ULTRACLIP II US TISSUE MARKER

Facility

$150.00

Hospital Charge Code	41568500
Hospital Revenue Code	270
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$75.00
Rate for Payer: Aetna Government	$75.00
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.00
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

ZZ ULTRA SEL NITNL GDE WR

Facility

$277.13

Hospital Charge Code	41567128
Hospital Revenue Code	270
Min. Negotiated Rate	$97.00
Max. Negotiated Rate	$221.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$138.56
Rate for Payer: Aetna Government	$138.56
Rate for Payer: Brighton Health Commercial	$207.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$221.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$188.45
Rate for Payer: Group Health Inc Commercial	$138.56
Rate for Payer: Group Health Inc Medicare	$97.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.56
Rate for Payer: Hamaspik Choice Inc Medicare	$138.56

ZZ ULTRAVIST 300 100ML

Facility

$34.18

Hospital Charge Code	41568414
Hospital Revenue Code	270
Min. Negotiated Rate	$11.96
Max. Negotiated Rate	$27.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.09
Rate for Payer: Aetna Government	$17.09
Rate for Payer: Brighton Health Commercial	$25.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.24
Rate for Payer: Group Health Inc Commercial	$17.09
Rate for Payer: Group Health Inc Medicare	$11.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.09
Rate for Payer: Hamaspik Choice Inc Medicare	$17.09

ZZ ULTRAVIST 300 150ML

Facility

$51.26

Hospital Charge Code	41568413
Hospital Revenue Code	270
Min. Negotiated Rate	$17.94
Max. Negotiated Rate	$41.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.63
Rate for Payer: Aetna Government	$25.63
Rate for Payer: Brighton Health Commercial	$38.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.86
Rate for Payer: Group Health Inc Commercial	$25.63
Rate for Payer: Group Health Inc Medicare	$17.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.63
Rate for Payer: Hamaspik Choice Inc Medicare	$25.63

ZZ ULTR HVY DUT WR 36-260

Facility

$68.40

Hospital Charge Code	41567130
Hospital Revenue Code	270
Min. Negotiated Rate	$23.94
Max. Negotiated Rate	$54.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.20
Rate for Payer: Aetna Government	$34.20
Rate for Payer: Brighton Health Commercial	$51.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$54.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.51
Rate for Payer: Group Health Inc Commercial	$34.20
Rate for Payer: Group Health Inc Medicare	$23.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.20
Rate for Payer: Hamaspik Choice Inc Medicare	$34.20

ZZ UNIVERSAL PROC TRAYS

Facility

$58.83

Hospital Charge Code	41567002
Hospital Revenue Code	270
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$47.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.42
Rate for Payer: Aetna Government	$29.42
Rate for Payer: Brighton Health Commercial	$44.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.00
Rate for Payer: Group Health Inc Commercial	$29.42
Rate for Payer: Group Health Inc Medicare	$20.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.42
Rate for Payer: Hamaspik Choice Inc Medicare	$29.42

ZZ URELSIL TVP TRAY 13FR

Facility

$235.00

Hospital Charge Code	41540606
Hospital Revenue Code	272
Min. Negotiated Rate	$82.25
Max. Negotiated Rate	$188.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$129.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$117.50
Rate for Payer: Aetna Government	$117.50
Rate for Payer: Brighton Health Commercial	$176.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$188.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.80
Rate for Payer: Group Health Inc Commercial	$117.50
Rate for Payer: Group Health Inc Medicare	$82.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$117.50
Rate for Payer: Hamaspik Choice Inc Medicare	$117.50

ZZ URESIL GEN PURPOSE DRAIN CATH

Facility

$50.00

Hospital Charge Code	41541155
Hospital Revenue Code	272
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$40.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.00
Rate for Payer: Aetna Government	$25.00
Rate for Payer: Brighton Health Commercial	$37.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.00
Rate for Payer: Group Health Inc Commercial	$25.00
Rate for Payer: Group Health Inc Medicare	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.00
Rate for Payer: Hamaspik Choice Inc Medicare	$25.00

ZZ URESIL GEN PURPOSE DRAIN CATH

Facility

$50.00

Hospital Charge Code	41540611
Hospital Revenue Code	272
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$40.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.00
Rate for Payer: Aetna Government	$25.00
Rate for Payer: Brighton Health Commercial	$37.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.00
Rate for Payer: Group Health Inc Commercial	$25.00
Rate for Payer: Group Health Inc Medicare	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.00
Rate for Payer: Hamaspik Choice Inc Medicare	$25.00

ZZ URESIL TVP TRAY 11FR

Facility

$235.00

Hospital Charge Code	41540605
Hospital Revenue Code	272
Min. Negotiated Rate	$82.25
Max. Negotiated Rate	$188.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$129.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$117.50
Rate for Payer: Aetna Government	$117.50
Rate for Payer: Brighton Health Commercial	$176.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$188.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.80
Rate for Payer: Group Health Inc Commercial	$117.50
Rate for Payer: Group Health Inc Medicare	$82.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$117.50
Rate for Payer: Hamaspik Choice Inc Medicare	$117.50

ZZ URETERAL STENT 8/22

Facility

$365.01

Hospital Charge Code	41567225
Hospital Revenue Code	270
Min. Negotiated Rate	$127.75
Max. Negotiated Rate	$292.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$200.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$182.50
Rate for Payer: Aetna Government	$182.50
Rate for Payer: Brighton Health Commercial	$273.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$292.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$248.21
Rate for Payer: Group Health Inc Commercial	$182.50
Rate for Payer: Group Health Inc Medicare	$127.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$182.50
Rate for Payer: Hamaspik Choice Inc Medicare	$182.50

ZZ URETR STNT W/GLIX 8/22

Facility

$391.23

Hospital Charge Code	41567236
Hospital Revenue Code	270
Min. Negotiated Rate	$136.93
Max. Negotiated Rate	$312.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$215.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$195.62
Rate for Payer: Aetna Government	$195.62
Rate for Payer: Brighton Health Commercial	$293.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$266.04
Rate for Payer: Group Health Inc Commercial	$195.62
Rate for Payer: Group Health Inc Medicare	$136.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.62
Rate for Payer: Hamaspik Choice Inc Medicare	$195.62

ZZ URETR STNT W/GLIX 8/24

Facility

$391.23

Hospital Charge Code	41567237
Hospital Revenue Code	270
Min. Negotiated Rate	$136.93
Max. Negotiated Rate	$312.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$215.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$195.62
Rate for Payer: Aetna Government	$195.62
Rate for Payer: Brighton Health Commercial	$293.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$266.04
Rate for Payer: Group Health Inc Commercial	$195.62
Rate for Payer: Group Health Inc Medicare	$136.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.62
Rate for Payer: Hamaspik Choice Inc Medicare	$195.62

Know your out-of-pocket cost for care.

All Charges