St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CC 1200 PSI TUBING 30 IN. MERIT

Facility

$6.60

Hospital Charge Code	66528227
Hospital Revenue Code	270
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$5.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.30
Rate for Payer: Aetna Government	$3.30
Rate for Payer: Brighton Health Commercial	$4.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.49
Rate for Payer: Group Health Inc Commercial	$3.30
Rate for Payer: Group Health Inc Medicare	$2.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.30
Rate for Payer: Hamaspik Choice Inc Medicare	$3.30

CC 4F JR 100CM

Facility

$427.75

Hospital Charge Code	66528767
Hospital Revenue Code	480
Min. Negotiated Rate	$149.71
Max. Negotiated Rate	$342.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$213.88
Rate for Payer: Aetna Government	$213.88
Rate for Payer: Brighton Health Commercial	$320.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$342.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$290.87
Rate for Payer: Group Health Inc Commercial	$213.88
Rate for Payer: Group Health Inc Medicare	$149.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$213.88
Rate for Payer: Hamaspik Choice Inc Medicare	$213.88
Rate for Payer: United Healthcare Commercial	$316.00

CC 4FR CORDIS JL 100 CM

Facility

$50.00

Hospital Charge Code	66528766
Hospital Revenue Code	279
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$40.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.00
Rate for Payer: Aetna Government	$25.00
Rate for Payer: Brighton Health Commercial	$37.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.00
Rate for Payer: Group Health Inc Commercial	$25.00
Rate for Payer: Group Health Inc Medicare	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.00
Rate for Payer: Hamaspik Choice Inc Medicare	$25.00

CC 4FR PIG STR 110CM

Facility

$46.00

Hospital Charge Code	66520304
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: Brighton Health Commercial	$34.50
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 5F EBU4.0 .058

Facility

$260.00

Hospital Charge Code	66528772
Hospital Revenue Code	480
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.00
Rate for Payer: Aetna Government	$130.00
Rate for Payer: Brighton Health Commercial	$195.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.80
Rate for Payer: Group Health Inc Commercial	$130.00
Rate for Payer: Group Health Inc Medicare	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 5F ECR4

Facility

$260.00

Hospital Charge Code	66528770
Hospital Revenue Code	480
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.00
Rate for Payer: Aetna Government	$130.00
Rate for Payer: Brighton Health Commercial	$195.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.80
Rate for Payer: Group Health Inc Commercial	$130.00
Rate for Payer: Group Health Inc Medicare	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 5F JCL 3.5

Facility

$260.00

Hospital Charge Code	66528773
Hospital Revenue Code	480
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.00
Rate for Payer: Aetna Government	$130.00
Rate for Payer: Brighton Health Commercial	$195.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.80
Rate for Payer: Group Health Inc Commercial	$130.00
Rate for Payer: Group Health Inc Medicare	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 5F JCL 3.5 SH

Facility

$260.00

Hospital Charge Code	66528777
Hospital Revenue Code	480
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.00
Rate for Payer: Aetna Government	$130.00
Rate for Payer: Brighton Health Commercial	$195.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.80
Rate for Payer: Group Health Inc Commercial	$130.00
Rate for Payer: Group Health Inc Medicare	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 5F JL 4.0

Facility

$260.00

Hospital Charge Code	66528774
Hospital Revenue Code	480
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.00
Rate for Payer: Aetna Government	$130.00
Rate for Payer: Brighton Health Commercial	$195.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.80
Rate for Payer: Group Health Inc Commercial	$130.00
Rate for Payer: Group Health Inc Medicare	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 5F JR3.5

Facility

$160.00

Hospital Charge Code	66528775
Hospital Revenue Code	480
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$80.00
Rate for Payer: Aetna Government	$80.00
Rate for Payer: Brighton Health Commercial	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$128.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$108.80
Rate for Payer: Group Health Inc Commercial	$80.00
Rate for Payer: Group Health Inc Medicare	$56.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 5F JR4.0 .058

Facility

$260.00

Hospital Charge Code	66528776
Hospital Revenue Code	480
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.00
Rate for Payer: Aetna Government	$130.00
Rate for Payer: Brighton Health Commercial	$195.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.80
Rate for Payer: Group Health Inc Commercial	$130.00
Rate for Payer: Group Health Inc Medicare	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 5F MBI .058

Facility

$260.00

Hospital Charge Code	66528771
Hospital Revenue Code	480
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$130.00
Rate for Payer: Aetna Government	$130.00
Rate for Payer: Brighton Health Commercial	$195.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$176.80
Rate for Payer: Group Health Inc Commercial	$130.00
Rate for Payer: Group Health Inc Medicare	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 5F PACEL FLOW DIR PACING CATH

Facility

$220.00

Service Code	HCPCS C1756
Hospital Charge Code	66526870
Hospital Revenue Code	278
Min. Negotiated Rate	$77.00
Max. Negotiated Rate	$231.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$121.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$172.46
Rate for Payer: Aetna Government	$172.46
Rate for Payer: Brighton Health Commercial	$132.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$110.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$126.50
Rate for Payer: EmblemHealth Commercial	$110.00
Rate for Payer: Fidelis Medicare Advantage	$231.00
Rate for Payer: Group Health Inc Commercial	$110.00
Rate for Payer: Group Health Inc Medicare	$77.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$110.00
Rate for Payer: Hamaspik Choice Inc Medicare	$110.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$143.00

CC 5F PACEL FLOW DIR PACING CATH

Facility

$220.00

Service Code	HCPCS C1756
Hospital Charge Code	66526870
Hospital Revenue Code	278
Min. Negotiated Rate	$110.00
Max. Negotiated Rate	$110.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$110.00
Rate for Payer: Hamaspik Choice Inc Medicare	$110.00

CC 5 FR AL II (100CM)

Facility

$217.50

Hospital Charge Code	66528820
Hospital Revenue Code	480
Min. Negotiated Rate	$76.12
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$119.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$108.75
Rate for Payer: Aetna Government	$108.75
Rate for Payer: Brighton Health Commercial	$163.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$147.90
Rate for Payer: Group Health Inc Commercial	$108.75
Rate for Payer: Group Health Inc Medicare	$76.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.75
Rate for Payer: Hamaspik Choice Inc Medicare	$108.75
Rate for Payer: United Healthcare Commercial	$316.00

CC 5 FR AR II (100CM)

Facility

$217.50

Hospital Charge Code	66528843
Hospital Revenue Code	480
Min. Negotiated Rate	$76.12
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$119.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$108.75
Rate for Payer: Aetna Government	$108.75
Rate for Payer: Brighton Health Commercial	$163.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$147.90
Rate for Payer: Group Health Inc Commercial	$108.75
Rate for Payer: Group Health Inc Medicare	$76.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.75
Rate for Payer: Hamaspik Choice Inc Medicare	$108.75
Rate for Payer: United Healthcare Commercial	$316.00

CC 5 FR AR MOD (100CM)

Facility

$160.00

Hospital Charge Code	66528769
Hospital Revenue Code	480
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$80.00
Rate for Payer: Aetna Government	$80.00
Rate for Payer: Brighton Health Commercial	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$128.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$108.80
Rate for Payer: Group Health Inc Commercial	$80.00
Rate for Payer: Group Health Inc Medicare	$56.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 5 FR FL 3.5 (100CM)

Facility

$217.50

Hospital Charge Code	66528819
Hospital Revenue Code	480
Min. Negotiated Rate	$76.12
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$119.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$108.75
Rate for Payer: Aetna Government	$108.75
Rate for Payer: Brighton Health Commercial	$163.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$147.90
Rate for Payer: Group Health Inc Commercial	$108.75
Rate for Payer: Group Health Inc Medicare	$76.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.75
Rate for Payer: Hamaspik Choice Inc Medicare	$108.75
Rate for Payer: United Healthcare Commercial	$316.00

CC 5 FR LCB (100CM)

Facility

$217.50

Hospital Charge Code	66528822
Hospital Revenue Code	480
Min. Negotiated Rate	$76.12
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$119.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$108.75
Rate for Payer: Aetna Government	$108.75
Rate for Payer: Brighton Health Commercial	$163.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$147.90
Rate for Payer: Group Health Inc Commercial	$108.75
Rate for Payer: Group Health Inc Medicare	$76.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.75
Rate for Payer: Hamaspik Choice Inc Medicare	$108.75
Rate for Payer: United Healthcare Commercial	$316.00

CC 5 FR MPA 1-(100CM)

Facility

$43.50

Hospital Charge Code	66528817
Hospital Revenue Code	480
Min. Negotiated Rate	$15.22
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.75
Rate for Payer: Aetna Government	$21.75
Rate for Payer: Brighton Health Commercial	$32.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$29.58
Rate for Payer: Group Health Inc Commercial	$21.75
Rate for Payer: Group Health Inc Medicare	$15.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.75
Rate for Payer: Hamaspik Choice Inc Medicare	$21.75
Rate for Payer: United Healthcare Commercial	$316.00

CC 5FR PIG 145 ANG 100CM 6SH

Facility

$46.00

Hospital Charge Code	66528246
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: Brighton Health Commercial	$34.50
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 5 FR SUPER ARROW FLEX 24CM

Facility

$96.00

Hospital Charge Code	66528278
Hospital Revenue Code	480
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$52.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$48.00
Rate for Payer: Aetna Government	$48.00
Rate for Payer: Brighton Health Commercial	$72.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$76.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$65.28
Rate for Payer: Group Health Inc Commercial	$48.00
Rate for Payer: Group Health Inc Medicare	$33.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.00
Rate for Payer: Hamaspik Choice Inc Medicare	$48.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 6 FR AR II MOD (100CM)

Facility

$46.50

Hospital Charge Code	66528850
Hospital Revenue Code	480
Min. Negotiated Rate	$16.28
Max. Negotiated Rate	$316.00
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: Brighton Health Commercial	$34.88
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
Rate for Payer: United Healthcare Commercial	$316.00

CC 6 FR AR I MOD (100CM)

Facility

$17.44

Hospital Charge Code	66528851
Hospital Revenue Code	480
Min. Negotiated Rate	$6.10
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.72
Rate for Payer: Aetna Government	$8.72
Rate for Payer: Brighton Health Commercial	$13.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.86
Rate for Payer: Group Health Inc Commercial	$8.72
Rate for Payer: Group Health Inc Medicare	$6.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.72
Rate for Payer: Hamaspik Choice Inc Medicare	$8.72
Rate for Payer: United Healthcare Commercial	$316.00

CC 6 FR JL 3.5 (100CM)

Facility

$310.00

Hospital Charge Code	66528815
Hospital Revenue Code	480
Min. Negotiated Rate	$108.50
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$170.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$155.00
Rate for Payer: Aetna Government	$155.00
Rate for Payer: Brighton Health Commercial	$232.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$248.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$210.80
Rate for Payer: Group Health Inc Commercial	$155.00
Rate for Payer: Group Health Inc Medicare	$108.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$155.00
Rate for Payer: Hamaspik Choice Inc Medicare	$155.00
Rate for Payer: United Healthcare Commercial	$316.00

Know your out-of-pocket cost for care.

All Charges