St. Barnabas Hospital

All Charges

Charge

Type

Price

CATH SWAN GANZ TD VIP 831F75

Facility OP

$104.74

Hospital Charge Code	64901681
Hospital Revenue Code	279
Min. Negotiated Rate	$36.66
Max. Negotiated Rate	$83.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$52.37
Rate for Payer: Aetna Government	$52.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$83.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.22
Rate for Payer: Group Health Inc Commercial	$52.37
Rate for Payer: Group Health Inc Medicare	$36.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.37
Rate for Payer: Hamaspik Choice Inc Medicare	$52.37

CATH TAL PALINDROME 14.5FRX23CM

Facility IP

$835.42

Service Code	HCPCS C1725
Hospital Charge Code	40202005
Hospital Revenue Code	278
Min. Negotiated Rate	$417.71
Max. Negotiated Rate	$417.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$417.71
Rate for Payer: Hamaspik Choice Inc Medicare	$417.71

CATH TAL PALINDROME 14.5FRX23CM

Facility OP

$835.42

Service Code	HCPCS C1725
Hospital Charge Code	40202005
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$877.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$459.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$417.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$480.37
Rate for Payer: Fidelis Medicare Advantage	$877.19
Rate for Payer: Group Health Inc Commercial	$417.71
Rate for Payer: Group Health Inc Medicare	$292.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$417.71
Rate for Payer: Hamaspik Choice Inc Medicare	$417.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$543.02

CATH TEMP PACING W INTRO KIT

Facility OP

$621.67

Hospital Charge Code	64901656
Hospital Revenue Code	279
Min. Negotiated Rate	$217.58
Max. Negotiated Rate	$497.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$341.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$310.84
Rate for Payer: Aetna Government	$310.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$497.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$422.74
Rate for Payer: Group Health Inc Commercial	$310.84
Rate for Payer: Group Health Inc Medicare	$217.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$310.84
Rate for Payer: Hamaspik Choice Inc Medicare	$310.84

CATH TEXAS EXT MALE LTX W/STRAP

Facility OP

$1.06

Service Code	HCPCS C1758
Hospital Charge Code	64902093
Hospital Revenue Code	279
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$2.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.97
Rate for Payer: Aetna Government	$2.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.72
Rate for Payer: Group Health Inc Commercial	$0.53
Rate for Payer: Group Health Inc Medicare	$0.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.53
Rate for Payer: Hamaspik Choice Inc Medicare	$0.53

CATH THORACIC 28FR RT ANGLE

Facility OP

$18.92

Hospital Charge Code	64904201
Hospital Revenue Code	279
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$15.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.46
Rate for Payer: Aetna Government	$9.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.87
Rate for Payer: Group Health Inc Commercial	$9.46
Rate for Payer: Group Health Inc Medicare	$6.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.46
Rate for Payer: Hamaspik Choice Inc Medicare	$9.46

CATH THORACIC 40FR

Facility OP

$18.92

Hospital Charge Code	64901508
Hospital Revenue Code	279
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$15.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.46
Rate for Payer: Aetna Government	$9.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.87
Rate for Payer: Group Health Inc Commercial	$9.46
Rate for Payer: Group Health Inc Medicare	$6.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.46
Rate for Payer: Hamaspik Choice Inc Medicare	$9.46

CATH THORACIC RT ANG 36FR X 12MM

Facility OP

$20.64

Hospital Charge Code	64904851
Hospital Revenue Code	279
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$16.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.32
Rate for Payer: Aetna Government	$10.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.04
Rate for Payer: Group Health Inc Commercial	$10.32
Rate for Payer: Group Health Inc Medicare	$7.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.32
Rate for Payer: Hamaspik Choice Inc Medicare	$10.32

CATH THORACIC RT ANGLE 32FR

Facility OP

$18.92

Hospital Charge Code	64904169
Hospital Revenue Code	279
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$15.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.46
Rate for Payer: Aetna Government	$9.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.87
Rate for Payer: Group Health Inc Commercial	$9.46
Rate for Payer: Group Health Inc Medicare	$6.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.46
Rate for Payer: Hamaspik Choice Inc Medicare	$9.46

CATH,THORACIC,ST,A,28FR

Facility OP

$13.11

Hospital Charge Code	64902089
Hospital Revenue Code	279
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$10.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.56
Rate for Payer: Aetna Government	$6.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.91
Rate for Payer: Group Health Inc Commercial	$6.56
Rate for Payer: Group Health Inc Medicare	$4.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.56
Rate for Payer: Hamaspik Choice Inc Medicare	$6.56

CATH THORACIC STRAIGHT 36FR

Facility OP

$13.11

Hospital Charge Code	64902535
Hospital Revenue Code	279
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$10.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.56
Rate for Payer: Aetna Government	$6.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.91
Rate for Payer: Group Health Inc Commercial	$6.56
Rate for Payer: Group Health Inc Medicare	$4.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.56
Rate for Payer: Hamaspik Choice Inc Medicare	$6.56

CATH, THROBECTOMY/EMBOL SEPARAT

Facility IP

$2,390.00

Service Code	HCPCS C1757
Hospital Charge Code	41103922
Hospital Revenue Code	278
Min. Negotiated Rate	$1,195.00
Max. Negotiated Rate	$1,195.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,195.00

CATH, THROBECTOMY/EMBOL SEPARAT

Facility OP

$2,390.00

Service Code	HCPCS C1757
Hospital Charge Code	41103922
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$2,509.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,314.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.33
Rate for Payer: Aetna Government	$16.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,195.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,374.25
Rate for Payer: Fidelis Medicare Advantage	$2,509.50
Rate for Payer: Group Health Inc Commercial	$1,195.00
Rate for Payer: Group Health Inc Medicare	$836.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,195.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,553.50

CATH THROMBECTOMY 4FRX40CM

Facility OP

$309.96

Hospital Charge Code	40202179
Hospital Revenue Code	270
Min. Negotiated Rate	$108.49
Max. Negotiated Rate	$247.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$170.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$154.98
Rate for Payer: Aetna Government	$154.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$247.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$210.77
Rate for Payer: Group Health Inc Commercial	$154.98
Rate for Payer: Group Health Inc Medicare	$108.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.98
Rate for Payer: Hamaspik Choice Inc Medicare	$154.98

CATH THROMBECTOMY/EMBOL SEPARAT 8

Facility OP

$3,990.00

Service Code	HCPCS C1757
Hospital Charge Code	41103926
Hospital Revenue Code	278
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$4,189.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,194.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.33
Rate for Payer: Aetna Government	$16.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,995.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,294.25
Rate for Payer: Fidelis Medicare Advantage	$4,189.50
Rate for Payer: Group Health Inc Commercial	$1,995.00
Rate for Payer: Group Health Inc Medicare	$1,396.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,995.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,995.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,593.50

CATH THROMBECTOMY/EMBOL SEPARAT 8

Facility IP

$3,990.00

Service Code	HCPCS C1757
Hospital Charge Code	41103926
Hospital Revenue Code	278
Min. Negotiated Rate	$1,995.00
Max. Negotiated Rate	$1,995.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,995.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,995.00

CATH TORQUEABLE BERN SN 5FR

Facility OP

$47.85

Hospital Charge Code	64905386
Hospital Revenue Code	279
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$38.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.92
Rate for Payer: Aetna Government	$23.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.54
Rate for Payer: Group Health Inc Commercial	$23.92
Rate for Payer: Group Health Inc Medicare	$16.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.92
Rate for Payer: Hamaspik Choice Inc Medicare	$23.92

CATH TRAY QUINTON 19.5CM STR

Facility OP

$1,193.63

Hospital Charge Code	64903078
Hospital Revenue Code	279
Min. Negotiated Rate	$417.77
Max. Negotiated Rate	$954.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$656.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$596.82
Rate for Payer: Aetna Government	$596.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$954.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$811.67
Rate for Payer: Group Health Inc Commercial	$596.82
Rate for Payer: Group Health Inc Medicare	$417.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$596.82
Rate for Payer: Hamaspik Choice Inc Medicare	$596.82

CATH,TREK 2.25 MM X 12 MM

Facility OP

$362.50

Hospital Charge Code	64902641
Hospital Revenue Code	279
Min. Negotiated Rate	$126.88
Max. Negotiated Rate	$290.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$199.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$181.25
Rate for Payer: Aetna Government	$181.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$290.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.50
Rate for Payer: Group Health Inc Commercial	$181.25
Rate for Payer: Group Health Inc Medicare	$126.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$181.25
Rate for Payer: Hamaspik Choice Inc Medicare	$181.25

CATH,TREK 2.75 MM X 25 MM

Facility OP

$375.00

Hospital Charge Code	64902642
Hospital Revenue Code	279
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$300.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$187.50
Rate for Payer: Aetna Government	$187.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$255.00
Rate for Payer: Group Health Inc Commercial	$187.50
Rate for Payer: Group Health Inc Medicare	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.50
Rate for Payer: Hamaspik Choice Inc Medicare	$187.50

CATH TROCAR 10FR

Facility OP

$37.15

Hospital Charge Code	64902379
Hospital Revenue Code	279
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$29.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.58
Rate for Payer: Aetna Government	$18.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.26
Rate for Payer: Group Health Inc Commercial	$18.58
Rate for Payer: Group Health Inc Medicare	$13.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.58
Rate for Payer: Hamaspik Choice Inc Medicare	$18.58

CATH TROCAR 32FR

Facility OP

$36.35

Hospital Charge Code	64902046
Hospital Revenue Code	279
Min. Negotiated Rate	$12.72
Max. Negotiated Rate	$29.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.18
Rate for Payer: Aetna Government	$18.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.72
Rate for Payer: Group Health Inc Commercial	$18.18
Rate for Payer: Group Health Inc Medicare	$12.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.18
Rate for Payer: Hamaspik Choice Inc Medicare	$18.18

CATH ULTRA .018 5MM/220MMX75CM

Facility IP

$500.00

Service Code	HCPCS C1725
Hospital Charge Code	40004775
Hospital Revenue Code	278
Min. Negotiated Rate	$250.00
Max. Negotiated Rate	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00

CATH ULTRA .018 5MM/220MMX75CM

Facility OP

$500.00

Service Code	HCPCS C1725
Hospital Charge Code	40004775
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$525.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$287.50
Rate for Payer: Fidelis Medicare Advantage	$525.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$325.00

CATH ULTRA .018 5MMX100MMX75CM

Facility OP

$500.00

Service Code	HCPCS C1725
Hospital Charge Code	40004774
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$525.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$287.50
Rate for Payer: Fidelis Medicare Advantage	$525.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$325.00

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