St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ WALL STENT 10X39

Facility

$3,328.74

Service Code	HCPCS C1876
Hospital Charge Code	41569651
Hospital Revenue Code	278
Min. Negotiated Rate	$1,664.37
Max. Negotiated Rate	$1,664.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,664.37
Rate for Payer: Hamaspik Choice Inc Medicare	$1,664.37

ZZ WALL STENT 10X39

Facility

$3,328.74

Service Code	HCPCS C1876
Hospital Charge Code	41569651
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,495.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,830.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,997.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,664.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,914.03
Rate for Payer: EmblemHealth Commercial	$1,664.37
Rate for Payer: Fidelis Medicare Advantage	$3,495.18
Rate for Payer: Group Health Inc Commercial	$1,664.37
Rate for Payer: Group Health Inc Medicare	$1,165.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,664.37
Rate for Payer: Hamaspik Choice Inc Medicare	$1,664.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,163.68

ZZ WALL STENT 10X42

Facility

$3,243.95

Service Code	HCPCS C1876
Hospital Charge Code	41567149
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,406.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,784.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,946.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,621.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,865.27
Rate for Payer: EmblemHealth Commercial	$1,621.98
Rate for Payer: Fidelis Medicare Advantage	$3,406.15
Rate for Payer: Group Health Inc Commercial	$1,621.98
Rate for Payer: Group Health Inc Medicare	$1,135.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,621.98
Rate for Payer: Hamaspik Choice Inc Medicare	$1,621.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,108.57

ZZ WALL STENT 10X42

Facility

$3,243.95

Service Code	HCPCS C1876
Hospital Charge Code	41567149
Hospital Revenue Code	278
Min. Negotiated Rate	$1,621.98
Max. Negotiated Rate	$1,621.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,621.98
Rate for Payer: Hamaspik Choice Inc Medicare	$1,621.98

ZZ WALL STENT 10X49

Facility

$3,328.74

Service Code	HCPCS C1876
Hospital Charge Code	41569649
Hospital Revenue Code	278
Min. Negotiated Rate	$1,664.37
Max. Negotiated Rate	$1,664.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,664.37
Rate for Payer: Hamaspik Choice Inc Medicare	$1,664.37

ZZ WALL STENT 10X49

Facility

$3,328.74

Service Code	HCPCS C1876
Hospital Charge Code	41569649
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,495.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,830.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,997.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,664.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,914.03
Rate for Payer: EmblemHealth Commercial	$1,664.37
Rate for Payer: Fidelis Medicare Advantage	$3,495.18
Rate for Payer: Group Health Inc Commercial	$1,664.37
Rate for Payer: Group Health Inc Medicare	$1,165.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,664.37
Rate for Payer: Hamaspik Choice Inc Medicare	$1,664.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,163.68

ZZ WALL STENT 10X68

Facility

$3,015.74

Service Code	HCPCS C1876
Hospital Charge Code	41567150
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,166.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,658.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,809.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,507.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,734.05
Rate for Payer: EmblemHealth Commercial	$1,507.87
Rate for Payer: Fidelis Medicare Advantage	$3,166.53
Rate for Payer: Group Health Inc Commercial	$1,507.87
Rate for Payer: Group Health Inc Medicare	$1,055.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,507.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,960.23

ZZ WALL STENT 10X68

Facility

$3,015.74

Service Code	HCPCS C1876
Hospital Charge Code	41567150
Hospital Revenue Code	278
Min. Negotiated Rate	$1,507.87
Max. Negotiated Rate	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,507.87

ZZ WALL STENT 10X69

Facility

$5,339.55

Service Code	HCPCS C1876
Hospital Charge Code	41569650
Hospital Revenue Code	278
Min. Negotiated Rate	$2,669.78
Max. Negotiated Rate	$2,669.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,669.78
Rate for Payer: Hamaspik Choice Inc Medicare	$2,669.78

ZZ WALL STENT 10X69

Facility

$5,339.55

Service Code	HCPCS C1876
Hospital Charge Code	41569650
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$5,606.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,936.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$3,203.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,669.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,070.24
Rate for Payer: EmblemHealth Commercial	$2,669.78
Rate for Payer: Fidelis Medicare Advantage	$5,606.53
Rate for Payer: Group Health Inc Commercial	$2,669.78
Rate for Payer: Group Health Inc Medicare	$1,868.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,669.78
Rate for Payer: Hamaspik Choice Inc Medicare	$2,669.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,470.71

ZZ WALL STENT 12MM X 90MM

Facility

$5,623.94

Service Code	HCPCS C1874
Hospital Charge Code	41567346
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$5,905.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,093.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$3,374.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,811.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,233.77
Rate for Payer: EmblemHealth Commercial	$2,811.97
Rate for Payer: Fidelis Medicare Advantage	$5,905.14
Rate for Payer: Group Health Inc Commercial	$2,811.97
Rate for Payer: Group Health Inc Medicare	$1,968.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,811.97
Rate for Payer: Hamaspik Choice Inc Medicare	$2,811.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,655.56

ZZ WALL STENT 12MM X 90MM

Facility

$5,623.94

Service Code	HCPCS C1874
Hospital Charge Code	41567346
Hospital Revenue Code	278
Min. Negotiated Rate	$2,811.97
Max. Negotiated Rate	$2,811.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,811.97
Rate for Payer: Hamaspik Choice Inc Medicare	$2,811.97

ZZ WALL STENT 12X60

Facility

$3,015.74

Service Code	HCPCS C1876
Hospital Charge Code	41567151
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,166.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,658.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,809.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,507.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,734.05
Rate for Payer: EmblemHealth Commercial	$1,507.87
Rate for Payer: Fidelis Medicare Advantage	$3,166.53
Rate for Payer: Group Health Inc Commercial	$1,507.87
Rate for Payer: Group Health Inc Medicare	$1,055.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,507.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,960.23

ZZ WALL STENT 12X60

Facility

$3,015.74

Service Code	HCPCS C1876
Hospital Charge Code	41567151
Hospital Revenue Code	278
Min. Negotiated Rate	$1,507.87
Max. Negotiated Rate	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,507.87

ZZ WALL STENT 14MM X 40MM

Facility

$3,504.77

Service Code	HCPCS C1876
Hospital Charge Code	41567344
Hospital Revenue Code	278
Min. Negotiated Rate	$1,752.38
Max. Negotiated Rate	$1,752.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,752.38
Rate for Payer: Hamaspik Choice Inc Medicare	$1,752.38

ZZ WALL STENT 14MM X 40MM

Facility

$3,504.77

Service Code	HCPCS C1876
Hospital Charge Code	41567344
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,680.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,927.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,102.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,752.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,015.24
Rate for Payer: EmblemHealth Commercial	$1,752.38
Rate for Payer: Fidelis Medicare Advantage	$3,680.01
Rate for Payer: Group Health Inc Commercial	$1,752.38
Rate for Payer: Group Health Inc Medicare	$1,226.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,752.38
Rate for Payer: Hamaspik Choice Inc Medicare	$1,752.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,278.10

ZZ WALL STENT 14X55

Facility

$3,015.74

Service Code	HCPCS C1876
Hospital Charge Code	41567152
Hospital Revenue Code	278
Min. Negotiated Rate	$1,507.87
Max. Negotiated Rate	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,507.87

ZZ WALL STENT 14X55

Facility

$3,015.74

Service Code	HCPCS C1876
Hospital Charge Code	41567152
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,166.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,658.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,809.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,507.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,734.05
Rate for Payer: EmblemHealth Commercial	$1,507.87
Rate for Payer: Fidelis Medicare Advantage	$3,166.53
Rate for Payer: Group Health Inc Commercial	$1,507.87
Rate for Payer: Group Health Inc Medicare	$1,055.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,507.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,960.23

ZZ WALL STENT 16X60

Facility

$3,015.74

Service Code	HCPCS C1874
Hospital Charge Code	41567153
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$3,166.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,658.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,809.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,507.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,734.05
Rate for Payer: EmblemHealth Commercial	$1,507.87
Rate for Payer: Fidelis Medicare Advantage	$3,166.53
Rate for Payer: Group Health Inc Commercial	$1,507.87
Rate for Payer: Group Health Inc Medicare	$1,055.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,507.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,960.23

ZZ WALL STENT 16X60

Facility

$3,015.74

Service Code	HCPCS C1874
Hospital Charge Code	41567153
Hospital Revenue Code	278
Min. Negotiated Rate	$1,507.87
Max. Negotiated Rate	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,507.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,507.87

ZZ WALL STENT 18X60

Facility

$3,667.79

Service Code	HCPCS C1876
Hospital Charge Code	41567154
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,851.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,017.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,200.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,833.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,108.98
Rate for Payer: EmblemHealth Commercial	$1,833.90
Rate for Payer: Fidelis Medicare Advantage	$3,851.18
Rate for Payer: Group Health Inc Commercial	$1,833.90
Rate for Payer: Group Health Inc Medicare	$1,283.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,833.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,833.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,384.06

ZZ WALL STENT 18X60

Facility

$3,667.79

Service Code	HCPCS C1876
Hospital Charge Code	41567154
Hospital Revenue Code	278
Min. Negotiated Rate	$1,833.90
Max. Negotiated Rate	$1,833.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,833.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,833.90

ZZ WALL STENT 22X45

Facility

$3,667.79

Service Code	HCPCS C1876
Hospital Charge Code	41567155
Hospital Revenue Code	278
Min. Negotiated Rate	$1,833.90
Max. Negotiated Rate	$1,833.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,833.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,833.90

ZZ WALL STENT 22X45

Facility

$3,667.79

Service Code	HCPCS C1876
Hospital Charge Code	41567155
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,851.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,017.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$2,200.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,833.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,108.98
Rate for Payer: EmblemHealth Commercial	$1,833.90
Rate for Payer: Fidelis Medicare Advantage	$3,851.18
Rate for Payer: Group Health Inc Commercial	$1,833.90
Rate for Payer: Group Health Inc Medicare	$1,283.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,833.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,833.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,384.06

ZZ WALL STENT 8F 14X60

Facility

$2,986.67

Service Code	HCPCS C1876
Hospital Charge Code	41569741
Hospital Revenue Code	278
Min. Negotiated Rate	$1,493.34
Max. Negotiated Rate	$1,493.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,493.34
Rate for Payer: Hamaspik Choice Inc Medicare	$1,493.34

Know your out-of-pocket cost for care.

All Charges