St. Barnabas Hospital

All Charges

Charge

Type

Price

CC BMS MED INTEGRITY 2.25MM X12MM

Facility OP

$1,650.00

Service Code	HCPCS C1887
Hospital Charge Code	66529127
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$1,732.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$907.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$825.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$948.75
Rate for Payer: Fidelis Medicare Advantage	$1,732.50
Rate for Payer: Group Health Inc Commercial	$825.00
Rate for Payer: Group Health Inc Medicare	$577.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,072.50

CC BMS MED INTEGRITY 2.25MM X12MM

Facility IP

$1,650.00

Service Code	HCPCS C1887
Hospital Charge Code	66529127
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

CC BMS MED INTEGRITY 2.25MMX14MM

Facility IP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529128
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

CC BMS MED INTEGRITY 2.25MMX14MM

Facility OP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529128
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,732.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$907.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$825.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$948.75
Rate for Payer: Fidelis Medicare Advantage	$1,732.50
Rate for Payer: Group Health Inc Commercial	$825.00
Rate for Payer: Group Health Inc Medicare	$577.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,072.50

CC BMS MED INTEGRITY 2.25MMX 18MM

Facility OP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529129
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,732.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$907.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$825.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$948.75
Rate for Payer: Fidelis Medicare Advantage	$1,732.50
Rate for Payer: Group Health Inc Commercial	$825.00
Rate for Payer: Group Health Inc Medicare	$577.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,072.50

CC BMS MED INTEGRITY 2.25MMX 18MM

Facility IP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529129
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

CC BMS MED INTEGRITY 2.25MMX 22MM

Facility OP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529130
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,732.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$907.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$825.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$948.75
Rate for Payer: Fidelis Medicare Advantage	$1,732.50
Rate for Payer: Group Health Inc Commercial	$825.00
Rate for Payer: Group Health Inc Medicare	$577.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,072.50

CC BMS MED INTEGRITY 2.25MMX 22MM

Facility IP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529130
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

CC BMS MED INTEGRITY 2.25MMX 26MM

Facility OP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529131
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,732.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$907.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$825.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$948.75
Rate for Payer: Fidelis Medicare Advantage	$1,732.50
Rate for Payer: Group Health Inc Commercial	$825.00
Rate for Payer: Group Health Inc Medicare	$577.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,072.50

CC BMS MED INTEGRITY 2.25MMX 26MM

Facility IP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529131
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

CC BMS MED INTEGRITY 2.25MMX 8MM

Facility IP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529196
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

CC BMS MED INTEGRITY 2.25MMX 8MM

Facility OP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529196
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,732.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$907.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$825.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$948.75
Rate for Payer: Fidelis Medicare Advantage	$1,732.50
Rate for Payer: Group Health Inc Commercial	$825.00
Rate for Payer: Group Health Inc Medicare	$577.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,072.50

CC BMS MED INTEGRITY 2.5MM X 14MM

Facility IP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529199
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

CC BMS MED INTEGRITY 2.5MM X 14MM

Facility OP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529199
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,732.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$907.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$825.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$948.75
Rate for Payer: Fidelis Medicare Advantage	$1,732.50
Rate for Payer: Group Health Inc Commercial	$825.00
Rate for Payer: Group Health Inc Medicare	$577.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,072.50

CC BMS MED INTEGRITY 2.5MM X 18MM

Facility IP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529183
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

CC BMS MED INTEGRITY 2.5MM X 18MM

Facility OP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529183
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,732.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$907.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$825.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$948.75
Rate for Payer: Fidelis Medicare Advantage	$1,732.50
Rate for Payer: Group Health Inc Commercial	$825.00
Rate for Payer: Group Health Inc Medicare	$577.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,072.50

CC BMS MED INTEGRITY 2.5MM X 22MM

Facility OP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529184
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,732.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$907.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$825.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$948.75
Rate for Payer: Fidelis Medicare Advantage	$1,732.50
Rate for Payer: Group Health Inc Commercial	$825.00
Rate for Payer: Group Health Inc Medicare	$577.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,072.50

CC BMS MED INTEGRITY 2.5MM X 22MM

Facility IP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529184
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

CC BMS MED INTEGRITY 2.5MM X 26MM

Facility OP

$77.35

Service Code	HCPCS C1876
Hospital Charge Code	66529186
Hospital Revenue Code	278
Min. Negotiated Rate	$27.07
Max. Negotiated Rate	$398.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$42.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.48
Rate for Payer: Fidelis Medicare Advantage	$81.22
Rate for Payer: Group Health Inc Commercial	$38.68
Rate for Payer: Group Health Inc Medicare	$27.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.68
Rate for Payer: Hamaspik Choice Inc Medicare	$38.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$50.28

CC BMS MED INTEGRITY 2.5MM X 26MM

Facility IP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529185
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

CC BMS MED INTEGRITY 2.5MM X 26MM

Facility IP

$77.35

Service Code	HCPCS C1876
Hospital Charge Code	66529186
Hospital Revenue Code	278
Min. Negotiated Rate	$38.68
Max. Negotiated Rate	$38.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.68
Rate for Payer: Hamaspik Choice Inc Medicare	$38.68

CC BMS MED INTEGRITY 2.5MM X 26MM

Facility OP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529185
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,732.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$907.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$825.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$948.75
Rate for Payer: Fidelis Medicare Advantage	$1,732.50
Rate for Payer: Group Health Inc Commercial	$825.00
Rate for Payer: Group Health Inc Medicare	$577.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,072.50

CC BMS MED INTEGRITY 2.5MMX 8MM

Facility IP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529188
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

CC BMS MED INTEGRITY 2.5MMX 8MM

Facility OP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529188
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,732.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$907.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$825.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$948.75
Rate for Payer: Fidelis Medicare Advantage	$1,732.50
Rate for Payer: Group Health Inc Commercial	$825.00
Rate for Payer: Group Health Inc Medicare	$577.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,072.50

CC BMS MED INTEGRITY 2.75MMX12MM

Facility IP

$1,650.00

Service Code	HCPCS C1876
Hospital Charge Code	66529189
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$825.00
Rate for Payer: Hamaspik Choice Inc Medicare	$825.00

Price Transparency.

All Charges