St. Barnabas Hospital

All Charges

Charge

Type

Price

CC CORDIS INFINITI 4 FR IM 100CM

Facility OP

$9.20

Hospital Charge Code	66528332
Hospital Revenue Code	270
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$7.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.60
Rate for Payer: Aetna Government	$4.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.26
Rate for Payer: Group Health Inc Commercial	$4.60
Rate for Payer: Group Health Inc Medicare	$3.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.60
Rate for Payer: Hamaspik Choice Inc Medicare	$4.60

CC CORDIS INFINITI 5FR AL I 100CM

Facility OP

$46.00

Hospital Charge Code	66528245
Hospital Revenue Code	270
Min. Negotiated Rate	$16.10
Max. Negotiated Rate	$36.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.00
Rate for Payer: Aetna Government	$23.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.28
Rate for Payer: Group Health Inc Commercial	$23.00
Rate for Payer: Group Health Inc Medicare	$16.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.00
Rate for Payer: Hamaspik Choice Inc Medicare	$23.00

CC CORDIS INFINITI 5 FR RCB 100CM

Facility OP

$9.20

Hospital Charge Code	66528356
Hospital Revenue Code	270
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$7.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.60
Rate for Payer: Aetna Government	$4.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.26
Rate for Payer: Group Health Inc Commercial	$4.60
Rate for Payer: Group Health Inc Medicare	$3.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.60
Rate for Payer: Hamaspik Choice Inc Medicare	$4.60

CC CORDIS INFINITI 6FR 3DRC 100CM

Facility OP

$46.50

Hospital Charge Code	66528247
Hospital Revenue Code	270
Min. Negotiated Rate	$16.28
Max. Negotiated Rate	$37.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.25
Rate for Payer: Aetna Government	$23.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$37.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.62
Rate for Payer: Group Health Inc Commercial	$23.25
Rate for Payer: Group Health Inc Medicare	$16.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.25
Rate for Payer: Hamaspik Choice Inc Medicare	$23.25

CC CORDIS MULTIPACK ANGIO CATH

Facility OP

$150.00

Service Code	HCPCS C1725
Hospital Charge Code	66520314
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$157.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
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	$75.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$86.25
Rate for Payer: Fidelis Medicare Advantage	$157.50
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$97.50

CC CORDIS MULTIPACK ANGIO CATH

Facility IP

$150.00

Service Code	HCPCS C1725
Hospital Charge Code	66520314
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

CC CORDIS SAVVY 2MM X 2CM

Facility OP

$309.25

Service Code	HCPCS C1876
Hospital Charge Code	66528576
Hospital Revenue Code	278
Min. Negotiated Rate	$108.24
Max. Negotiated Rate	$398.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$170.09
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	$154.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$177.82
Rate for Payer: Fidelis Medicare Advantage	$324.71
Rate for Payer: Group Health Inc Commercial	$154.62
Rate for Payer: Group Health Inc Medicare	$108.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.62
Rate for Payer: Hamaspik Choice Inc Medicare	$154.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$201.01

CC CORDIS SAVVY 2MM X 2CM

Facility IP

$309.25

Service Code	HCPCS C1876
Hospital Charge Code	66528576
Hospital Revenue Code	278
Min. Negotiated Rate	$154.62
Max. Negotiated Rate	$154.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.62
Rate for Payer: Hamaspik Choice Inc Medicare	$154.62

CC CORDIS SMART 10MM X 20MM

Facility IP

$2,316.60

Service Code	HCPCS C1876
Hospital Charge Code	66528565
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.30
Max. Negotiated Rate	$1,158.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,158.30
Rate for Payer: Hamaspik Choice Inc Medicare	$1,158.30

CC CORDIS SMART 10MM X 20MM

Facility OP

$2,316.60

Service Code	HCPCS C1876
Hospital Charge Code	66528565
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,432.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,274.13
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	$1,158.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,332.04
Rate for Payer: Fidelis Medicare Advantage	$2,432.43
Rate for Payer: Group Health Inc Commercial	$1,158.30
Rate for Payer: Group Health Inc Medicare	$810.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,158.30
Rate for Payer: Hamaspik Choice Inc Medicare	$1,158.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,505.79

CC CORDIS SMART 10MM X 40MM

Facility IP

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528564
Hospital Revenue Code	278
Min. Negotiated Rate	$1,283.10
Max. Negotiated Rate	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,283.10

CC CORDIS SMART 10MM X 40MM

Facility OP

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528564
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,694.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,411.41
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	$1,283.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,475.56
Rate for Payer: Fidelis Medicare Advantage	$2,694.51
Rate for Payer: Group Health Inc Commercial	$1,283.10
Rate for Payer: Group Health Inc Medicare	$898.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,283.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,668.03

CC CORDIS SMART 10MM X 60MM

Facility OP

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528563
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,694.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,411.41
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	$1,283.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,475.56
Rate for Payer: Fidelis Medicare Advantage	$2,694.51
Rate for Payer: Group Health Inc Commercial	$1,283.10
Rate for Payer: Group Health Inc Medicare	$898.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,283.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,668.03

CC CORDIS SMART 10MM X 60MM

Facility IP

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528563
Hospital Revenue Code	278
Min. Negotiated Rate	$1,283.10
Max. Negotiated Rate	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,283.10

CC CORDIS SMART 6MM X 100MM

Facility IP

$3,237.00

Service Code	HCPCS C1876
Hospital Charge Code	66528577
Hospital Revenue Code	278
Min. Negotiated Rate	$1,618.50
Max. Negotiated Rate	$1,618.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,618.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,618.50

CC CORDIS SMART 6MM X 100MM

Facility OP

$3,237.00

Service Code	HCPCS C1876
Hospital Charge Code	66528577
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,398.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,780.35
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	$1,618.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,861.28
Rate for Payer: Fidelis Medicare Advantage	$3,398.85
Rate for Payer: Group Health Inc Commercial	$1,618.50
Rate for Payer: Group Health Inc Medicare	$1,132.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,618.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,618.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,104.05

CC CORDIS SMART 6MM X 20MM

Facility OP

$2,316.60

Service Code	HCPCS C1876
Hospital Charge Code	66528581
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,432.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,274.13
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	$1,158.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,332.04
Rate for Payer: Fidelis Medicare Advantage	$2,432.43
Rate for Payer: Group Health Inc Commercial	$1,158.30
Rate for Payer: Group Health Inc Medicare	$810.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,158.30
Rate for Payer: Hamaspik Choice Inc Medicare	$1,158.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,505.79

CC CORDIS SMART 6MM X 20MM

Facility IP

$2,316.60

Service Code	HCPCS C1876
Hospital Charge Code	66528581
Hospital Revenue Code	278
Min. Negotiated Rate	$1,158.30
Max. Negotiated Rate	$1,158.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,158.30
Rate for Payer: Hamaspik Choice Inc Medicare	$1,158.30

CC CORDIS SMART 6MM X40MM

Facility IP

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528580
Hospital Revenue Code	278
Min. Negotiated Rate	$1,283.10
Max. Negotiated Rate	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,283.10

CC CORDIS SMART 6MM X40MM

Facility OP

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528580
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,694.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,411.41
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	$1,283.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,475.56
Rate for Payer: Fidelis Medicare Advantage	$2,694.51
Rate for Payer: Group Health Inc Commercial	$1,283.10
Rate for Payer: Group Health Inc Medicare	$898.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,283.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,668.03

CC CORDIS SMART 6MM X 60MM

Facility OP

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528579
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,694.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,411.41
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	$1,283.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,475.56
Rate for Payer: Fidelis Medicare Advantage	$2,694.51
Rate for Payer: Group Health Inc Commercial	$1,283.10
Rate for Payer: Group Health Inc Medicare	$898.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,283.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,668.03

CC CORDIS SMART 6MM X 60MM

Facility IP

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528579
Hospital Revenue Code	278
Min. Negotiated Rate	$1,283.10
Max. Negotiated Rate	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,283.10

CC CORDIS SMART 6MM X 80MM

Facility IP

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528578
Hospital Revenue Code	278
Min. Negotiated Rate	$1,283.10
Max. Negotiated Rate	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,283.10

CC CORDIS SMART 6MM X 80MM

Facility OP

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528578
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,694.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,411.41
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	$1,283.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,475.56
Rate for Payer: Fidelis Medicare Advantage	$2,694.51
Rate for Payer: Group Health Inc Commercial	$1,283.10
Rate for Payer: Group Health Inc Medicare	$898.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,283.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,283.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,668.03

CC CORDIS SMART 7MM X 100MM

Facility OP

$3,237.00

Service Code	HCPCS C1876
Hospital Charge Code	66528569
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,398.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,780.35
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	$1,618.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,861.28
Rate for Payer: Fidelis Medicare Advantage	$3,398.85
Rate for Payer: Group Health Inc Commercial	$1,618.50
Rate for Payer: Group Health Inc Medicare	$1,132.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,618.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,618.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,104.05

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