St. Barnabas Hospital

All Charges

Charge

Type

Price

CC B.S. APEX FLEX 1.5MM-8-12-15M

Facility IP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66521087
Hospital Revenue Code	278
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00

CC B.S. APEX PUSH 1.5MMX12MM BALL

Facility OP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66521079
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$493.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$258.50
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	$235.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$270.25
Rate for Payer: Fidelis Medicare Advantage	$493.50
Rate for Payer: Group Health Inc Commercial	$235.00
Rate for Payer: Group Health Inc Medicare	$164.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$305.50

CC B.S. APEX PUSH 1.5MMX12MM BALL

Facility IP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66521079
Hospital Revenue Code	278
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00

CC B.S. APEX PUSH 1.5MMX8-12-15MM

Facility IP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66521089
Hospital Revenue Code	278
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00

CC B.S. APEX PUSH 1.5MMX8-12-15MM

Facility OP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66521089
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$493.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$258.50
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	$235.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$270.25
Rate for Payer: Fidelis Medicare Advantage	$493.50
Rate for Payer: Group Health Inc Commercial	$235.00
Rate for Payer: Group Health Inc Medicare	$164.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$305.50

CC BS APEX PUSH 1.5MMX 8MM BALL

Facility IP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66521083
Hospital Revenue Code	278
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00

CC BS APEX PUSH 1.5MMX 8MM BALL

Facility OP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66521083
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$493.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$258.50
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	$235.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$270.25
Rate for Payer: Fidelis Medicare Advantage	$493.50
Rate for Payer: Group Health Inc Commercial	$235.00
Rate for Payer: Group Health Inc Medicare	$164.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$305.50

CC BS APEX PUSH 1.5X15MM BALL

Facility OP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66521081
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$493.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$258.50
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	$235.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$270.25
Rate for Payer: Fidelis Medicare Advantage	$493.50
Rate for Payer: Group Health Inc Commercial	$235.00
Rate for Payer: Group Health Inc Medicare	$164.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$305.50

CC BS APEX PUSH 1.5X15MM BALL

Facility IP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66521081
Hospital Revenue Code	278
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00

CC B SCI 2MM BIOSPY FORCEPS

Facility IP

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	66571555
Hospital Revenue Code	278
Min. Negotiated Rate	$475.00
Max. Negotiated Rate	$475.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$475.00
Rate for Payer: Hamaspik Choice Inc Medicare	$475.00

CC B SCI 2MM BIOSPY FORCEPS

Facility OP

$950.00

Service Code	HCPCS C1713
Hospital Charge Code	66571555
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$997.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$522.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$475.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$546.25
Rate for Payer: Fidelis Medicare Advantage	$997.50
Rate for Payer: Group Health Inc Commercial	$475.00
Rate for Payer: Group Health Inc Medicare	$332.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$475.00
Rate for Payer: Hamaspik Choice Inc Medicare	$475.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$617.50

CC B SCI COMPLIANCE ENDOKIT

Facility OP

$390.00

Hospital Charge Code	66571556
Hospital Revenue Code	270
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$312.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$195.00
Rate for Payer: Aetna Government	$195.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$265.20
Rate for Payer: Group Health Inc Commercial	$195.00
Rate for Payer: Group Health Inc Medicare	$136.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00

CC B.S. C/WIRE .014

Facility IP

$190.00

Service Code	HCPCS C1769
Hospital Charge Code	66522111
Hospital Revenue Code	278
Min. Negotiated Rate	$95.00
Max. Negotiated Rate	$95.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$95.00
Rate for Payer: Hamaspik Choice Inc Medicare	$95.00

CC B.S. C/WIRE .014

Facility OP

$190.00

Service Code	HCPCS C1769
Hospital Charge Code	66522111
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$199.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$95.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$109.25
Rate for Payer: Fidelis Medicare Advantage	$199.50
Rate for Payer: Group Health Inc Commercial	$95.00
Rate for Payer: Group Health Inc Medicare	$66.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$95.00
Rate for Payer: Hamaspik Choice Inc Medicare	$95.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$123.50

CC B.S. C/WIRE AMPLATZ SUPERSTIFF

Facility IP

$88.00

Service Code	HCPCS C1769
Hospital Charge Code	66522117
Hospital Revenue Code	278
Min. Negotiated Rate	$44.00
Max. Negotiated Rate	$44.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.00
Rate for Payer: Hamaspik Choice Inc Medicare	$44.00

CC B.S. C/WIRE AMPLATZ SUPERSTIFF

Facility OP

$88.00

Service Code	HCPCS C1769
Hospital Charge Code	66522117
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$92.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$50.60
Rate for Payer: Fidelis Medicare Advantage	$92.40
Rate for Payer: Group Health Inc Commercial	$44.00
Rate for Payer: Group Health Inc Medicare	$30.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.00
Rate for Payer: Hamaspik Choice Inc Medicare	$44.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$57.20

CC BS MAV2 2.0MM X 9MM

Facility IP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66522005
Hospital Revenue Code	278
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00

CC BS MAV2 2.0MM X 9MM

Facility OP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66522005
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$493.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$258.50
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	$235.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$270.25
Rate for Payer: Fidelis Medicare Advantage	$493.50
Rate for Payer: Group Health Inc Commercial	$235.00
Rate for Payer: Group Health Inc Medicare	$164.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$305.50

CC BS MAV2 3.0MM X 12MM BALL

Facility IP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66522021
Hospital Revenue Code	278
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00

CC BS MAV2 3.0MM X 12MM BALL

Facility OP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66522021
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$493.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$258.50
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	$235.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$270.25
Rate for Payer: Fidelis Medicare Advantage	$493.50
Rate for Payer: Group Health Inc Commercial	$235.00
Rate for Payer: Group Health Inc Medicare	$164.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$305.50

CC BS MAV2 3.0MM X 15MM BALL

Facility OP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66522025
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$493.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$258.50
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	$235.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$270.25
Rate for Payer: Fidelis Medicare Advantage	$493.50
Rate for Payer: Group Health Inc Commercial	$235.00
Rate for Payer: Group Health Inc Medicare	$164.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$305.50

CC BS MAV2 3.0MM X 15MM BALL

Facility IP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66522025
Hospital Revenue Code	278
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00

CC BS MAV2 3.25MM X 12MM BALL

Facility IP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66522027
Hospital Revenue Code	278
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00

CC BS MAV2 3.25MM X 12MM BALL

Facility OP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66522027
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$493.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$258.50
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	$235.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$270.25
Rate for Payer: Fidelis Medicare Advantage	$493.50
Rate for Payer: Group Health Inc Commercial	$235.00
Rate for Payer: Group Health Inc Medicare	$164.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$305.50

CC BS MAV2 3.25MM X 15MM

Facility IP

$470.00

Service Code	HCPCS C1725
Hospital Charge Code	66522029
Hospital Revenue Code	278
Min. Negotiated Rate	$235.00
Max. Negotiated Rate	$235.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.00
Rate for Payer: Hamaspik Choice Inc Medicare	$235.00

Price Transparency.

All Charges