St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZZ WALL STENT 8F 14X60

Facility

$2,986.67

Service Code	HCPCS C1876
Hospital Charge Code	41569741
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,136.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,642.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,792.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,493.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,717.34
Rate for Payer: EmblemHealth Commercial	$1,493.34
Rate for Payer: Fidelis Medicare Advantage	$3,136.00
Rate for Payer: Group Health Inc Commercial	$1,493.34
Rate for Payer: Group Health Inc Medicare	$1,045.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,493.34
Rate for Payer: Hamaspik Choice Inc Medicare	$1,493.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,941.34

ZZ WALL STENT 8MM X 40MM

Facility

$3,504.77

Service Code	HCPCS C1876
Hospital Charge Code	41567345
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 8MM X 40MM

Facility

$3,504.77

Service Code	HCPCS C1876
Hospital Charge Code	41567345
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 8X40

Facility

$3,015.74

Service Code	HCPCS C1876
Hospital Charge Code	41567156
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 8X40

Facility

$3,015.74

Service Code	HCPCS C1876
Hospital Charge Code	41567156
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 8X60

Facility

$3,015.74

Service Code	HCPCS C1876
Hospital Charge Code	41567157
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 8X60

Facility

$3,015.74

Service Code	HCPCS C1876
Hospital Charge Code	41567157
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 9X52

Facility

$3,328.74

Service Code	HCPCS C1876
Hospital Charge Code	41569648
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 9X52

Facility

$3,328.74

Service Code	HCPCS C1876
Hospital Charge Code	41569648
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 WILLS OGLES PERC GASTR

Facility

$355.44

Hospital Charge Code	41567193
Hospital Revenue Code	270
Min. Negotiated Rate	$124.40
Max. Negotiated Rate	$284.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$195.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$177.72
Rate for Payer: Aetna Government	$177.72
Rate for Payer: Brighton Health Commercial	$266.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$284.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.70
Rate for Payer: Group Health Inc Commercial	$177.72
Rate for Payer: Group Health Inc Medicare	$124.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.72
Rate for Payer: Hamaspik Choice Inc Medicare	$177.72

ZZ WIRE/AMPLANTZ SS/.038/75CM

Facility

$323.19

Hospital Charge Code	41569220
Hospital Revenue Code	270
Min. Negotiated Rate	$113.12
Max. Negotiated Rate	$258.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$177.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$161.60
Rate for Payer: Aetna Government	$161.60
Rate for Payer: Brighton Health Commercial	$242.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$258.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$219.77
Rate for Payer: Group Health Inc Commercial	$161.60
Rate for Payer: Group Health Inc Medicare	$113.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$161.60
Rate for Payer: Hamaspik Choice Inc Medicare	$161.60

ZZ WIRE/AMPLATZ SS/.035/180CM

Facility

$474.16

Service Code	HCPCS C1769
Hospital Charge Code	41569216
Hospital Revenue Code	278
Min. Negotiated Rate	$237.08
Max. Negotiated Rate	$237.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$237.08
Rate for Payer: Hamaspik Choice Inc Medicare	$237.08

ZZ WIRE/AMPLATZ SS/.035/180CM

Facility

$474.16

Service Code	HCPCS C1769
Hospital Charge Code	41569216
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$497.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$260.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$284.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$237.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$272.64
Rate for Payer: EmblemHealth Commercial	$237.08
Rate for Payer: Fidelis Medicare Advantage	$497.87
Rate for Payer: Group Health Inc Commercial	$237.08
Rate for Payer: Group Health Inc Medicare	$165.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$237.08
Rate for Payer: Hamaspik Choice Inc Medicare	$237.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$308.20

ZZ WIRE/AMPLATZ SS/.035/260CM

Facility

$495.42

Service Code	HCPCS C1769
Hospital Charge Code	41569217
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$520.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$272.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$297.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$247.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.87
Rate for Payer: EmblemHealth Commercial	$247.71
Rate for Payer: Fidelis Medicare Advantage	$520.19
Rate for Payer: Group Health Inc Commercial	$247.71
Rate for Payer: Group Health Inc Medicare	$173.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$247.71
Rate for Payer: Hamaspik Choice Inc Medicare	$247.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$322.02

ZZ WIRE/AMPLATZ SS/.035/260CM

Facility

$495.42

Service Code	HCPCS C1769
Hospital Charge Code	41569217
Hospital Revenue Code	278
Min. Negotiated Rate	$247.71
Max. Negotiated Rate	$247.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$247.71
Rate for Payer: Hamaspik Choice Inc Medicare	$247.71

ZZ WIRE/AMPLATZ SS/.038/145CM

Facility

$323.19

Service Code	HCPCS C1769
Hospital Charge Code	41569218
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$339.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$177.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$193.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$161.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$185.83
Rate for Payer: EmblemHealth Commercial	$161.60
Rate for Payer: Fidelis Medicare Advantage	$339.35
Rate for Payer: Group Health Inc Commercial	$161.60
Rate for Payer: Group Health Inc Medicare	$113.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$161.60
Rate for Payer: Hamaspik Choice Inc Medicare	$161.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$210.07

ZZ WIRE/AMPLATZ SS/.038/145CM

Facility

$323.19

Service Code	HCPCS C1769
Hospital Charge Code	41569218
Hospital Revenue Code	278
Min. Negotiated Rate	$161.60
Max. Negotiated Rate	$161.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$161.60
Rate for Payer: Hamaspik Choice Inc Medicare	$161.60

ZZ WIRE/AMPLATZ SS/.038/260CM

Facility

$495.42

Service Code	HCPCS C1769
Hospital Charge Code	41569219
Hospital Revenue Code	278
Min. Negotiated Rate	$247.71
Max. Negotiated Rate	$247.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$247.71
Rate for Payer: Hamaspik Choice Inc Medicare	$247.71

ZZ WIRE/AMPLATZ SS/.038/260CM

Facility

$495.42

Service Code	HCPCS C1769
Hospital Charge Code	41569219
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$520.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$272.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$297.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$247.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.87
Rate for Payer: EmblemHealth Commercial	$247.71
Rate for Payer: Fidelis Medicare Advantage	$520.19
Rate for Payer: Group Health Inc Commercial	$247.71
Rate for Payer: Group Health Inc Medicare	$173.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$247.71
Rate for Payer: Hamaspik Choice Inc Medicare	$247.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$322.02

ZZ WIRE/AMPLATZ STIFF/.038/180CM

Facility

$44.35

Service Code	HCPCS C1769
Hospital Charge Code	41569221
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$46.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$26.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.50
Rate for Payer: EmblemHealth Commercial	$22.18
Rate for Payer: Fidelis Medicare Advantage	$46.57
Rate for Payer: Group Health Inc Commercial	$22.18
Rate for Payer: Group Health Inc Medicare	$15.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.18
Rate for Payer: Hamaspik Choice Inc Medicare	$22.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.83

ZZ WIRE/AMPLATZ STIFF/.038/180CM

Facility

$44.35

Service Code	HCPCS C1769
Hospital Charge Code	41569221
Hospital Revenue Code	278
Min. Negotiated Rate	$22.18
Max. Negotiated Rate	$22.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.18
Rate for Payer: Hamaspik Choice Inc Medicare	$22.18

ZZ WIRE/BENTSON/.032/145CM

Facility

$39.33

Hospital Charge Code	41569145
Hospital Revenue Code	270
Min. Negotiated Rate	$13.77
Max. Negotiated Rate	$31.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.66
Rate for Payer: Aetna Government	$19.66
Rate for Payer: Brighton Health Commercial	$29.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$31.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.74
Rate for Payer: Group Health Inc Commercial	$19.66
Rate for Payer: Group Health Inc Medicare	$13.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.66
Rate for Payer: Hamaspik Choice Inc Medicare	$19.66

ZZ WIRE/BENTSON/.035/145CM

Facility

$30.43

Hospital Charge Code	41569146
Hospital Revenue Code	270
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$24.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.22
Rate for Payer: Aetna Government	$15.22
Rate for Payer: Brighton Health Commercial	$22.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.69
Rate for Payer: Group Health Inc Commercial	$15.22
Rate for Payer: Group Health Inc Medicare	$10.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.22
Rate for Payer: Hamaspik Choice Inc Medicare	$15.22

ZZ WIRE/BENTSON/.038/145CM

Facility

$30.43

Hospital Charge Code	41569147
Hospital Revenue Code	270
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$24.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.22
Rate for Payer: Aetna Government	$15.22
Rate for Payer: Brighton Health Commercial	$22.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.69
Rate for Payer: Group Health Inc Commercial	$15.22
Rate for Payer: Group Health Inc Medicare	$10.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.22
Rate for Payer: Hamaspik Choice Inc Medicare	$15.22

ZZ WIRE/COONS/.035/145CM

Facility

$40.74

Hospital Charge Code	41569148
Hospital Revenue Code	270
Min. Negotiated Rate	$14.26
Max. Negotiated Rate	$32.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.37
Rate for Payer: Aetna Government	$20.37
Rate for Payer: Brighton Health Commercial	$30.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.70
Rate for Payer: Group Health Inc Commercial	$20.37
Rate for Payer: Group Health Inc Medicare	$14.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.37
Rate for Payer: Hamaspik Choice Inc Medicare	$20.37

Know your out-of-pocket cost for care.

All Charges