St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CC 6 FR JL 4 (100CM)

Facility

$310.00

Hospital Charge Code	66528814
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

CC 6FR JL 5.0 071

Facility

$220.00

Hospital Charge Code	66520302
Hospital Revenue Code	279
Min. Negotiated Rate	$77.00
Max. Negotiated Rate	$176.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$121.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$110.00
Rate for Payer: Aetna Government	$110.00
Rate for Payer: Brighton Health Commercial	$165.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$176.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$149.60
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

CC 6 FR JR 6.0 (100CM)

Facility

$46.50

Hospital Charge Code	66528845
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 MPA 1-(100CM)

Facility

$17.44

Hospital Charge Code	66528847
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 6FR MP A-2 (100CM)

Facility

$17.44

Hospital Charge Code	66528848
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 MP B-2 (100CM)

Facility

$46.50

Hospital Charge Code	66528849
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 PIG 145 ANG 110CM 6SH

Facility

$18.50

Hospital Charge Code	66528244
Hospital Revenue Code	270
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$14.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.25
Rate for Payer: Aetna Government	$9.25
Rate for Payer: Brighton Health Commercial	$13.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.58
Rate for Payer: Group Health Inc Commercial	$9.25
Rate for Payer: Group Health Inc Medicare	$6.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.25
Rate for Payer: Hamaspik Choice Inc Medicare	$9.25

CC 6FR PINNACLE (25CM)

Facility

$37.90

Hospital Charge Code	66528842
Hospital Revenue Code	480
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.95
Rate for Payer: Aetna Government	$18.95
Rate for Payer: Brighton Health Commercial	$28.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.77
Rate for Payer: Group Health Inc Commercial	$18.95
Rate for Payer: Group Health Inc Medicare	$13.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.95
Rate for Payer: Hamaspik Choice Inc Medicare	$18.95
Rate for Payer: United Healthcare Commercial	$316.00

CC 6 FR SUPER ARROW FLEX 11CM

Facility

$42.00

Hospital Charge Code	66528279
Hospital Revenue Code	480
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.00
Rate for Payer: Aetna Government	$21.00
Rate for Payer: Brighton Health Commercial	$31.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.56
Rate for Payer: Group Health Inc Commercial	$21.00
Rate for Payer: Group Health Inc Medicare	$14.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.00
Rate for Payer: Hamaspik Choice Inc Medicare	$21.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 6FR SUPER ARROW FLEX 24CM

Facility

$90.00

Hospital Charge Code	66528256
Hospital Revenue Code	480
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.00
Rate for Payer: Aetna Government	$45.00
Rate for Payer: Brighton Health Commercial	$67.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.20
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00
Rate for Payer: United Healthcare Commercial	$316.00

CC 6 FR SUPER ARROW FLEX 35CM

Facility

$109.60

Hospital Charge Code	66528268
Hospital Revenue Code	480
Min. Negotiated Rate	$38.36
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$60.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$54.80
Rate for Payer: Aetna Government	$54.80
Rate for Payer: Brighton Health Commercial	$82.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$87.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$74.53
Rate for Payer: Group Health Inc Commercial	$54.80
Rate for Payer: Group Health Inc Medicare	$38.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.80
Rate for Payer: Hamaspik Choice Inc Medicare	$54.80
Rate for Payer: United Healthcare Commercial	$316.00

CC 6 FR SWAN GANZ CATH 110 CM

Facility

$71.40

Hospital Charge Code	66528236
Hospital Revenue Code	270
Min. Negotiated Rate	$24.99
Max. Negotiated Rate	$57.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.70
Rate for Payer: Aetna Government	$35.70
Rate for Payer: Brighton Health Commercial	$53.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$57.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.55
Rate for Payer: Group Health Inc Commercial	$35.70
Rate for Payer: Group Health Inc Medicare	$24.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.70
Rate for Payer: Hamaspik Choice Inc Medicare	$35.70

CC 7FR BERM ANGIO BALL CATH 110CM

Facility

$85.68

Hospital Charge Code	66528237
Hospital Revenue Code	270
Min. Negotiated Rate	$29.99
Max. Negotiated Rate	$68.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$42.84
Rate for Payer: Aetna Government	$42.84
Rate for Payer: Brighton Health Commercial	$64.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$68.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.26
Rate for Payer: Group Health Inc Commercial	$42.84
Rate for Payer: Group Health Inc Medicare	$29.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.84
Rate for Payer: Hamaspik Choice Inc Medicare	$42.84

CC 7FR CLASSIC SHEATH HEMO INTRO

Facility

$50.00

Hospital Charge Code	66526874
Hospital Revenue Code	270
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 7 FR SWAN GANZ CATH 110 CM

Facility

$75.48

Hospital Charge Code	66528238
Hospital Revenue Code	270
Min. Negotiated Rate	$26.42
Max. Negotiated Rate	$60.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.74
Rate for Payer: Aetna Government	$37.74
Rate for Payer: Brighton Health Commercial	$56.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.33
Rate for Payer: Group Health Inc Commercial	$37.74
Rate for Payer: Group Health Inc Medicare	$26.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.74
Rate for Payer: Hamaspik Choice Inc Medicare	$37.74

CC AAI PACER INSERTION

Facility

$31,050.58

Service Code	HCPCS 33206
Hospital Charge Code	66528627
Hospital Revenue Code	360
Rate for Payer: Cash Price	$12,348.58

CC AAI PACER INSERTION

Facility

$31,050.58

Service Code	HCPCS 33206
Hospital Charge Code	66528627
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$23,287.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16,751.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12,348.58
Rate for Payer: Aetna Government	$12,348.58
Rate for Payer: Affinity Essential Plan 1&2	$8,644.01
Rate for Payer: Affinity Essential Plan 3&4	$8,644.01
Rate for Payer: Affinity Medicaid/CHP/HARP	$8,644.01
Rate for Payer: Brighton Health Commercial	$23,287.94
Rate for Payer: Cash Price	$12,348.58
Rate for Payer: Cash Price	$12,348.58
Rate for Payer: Cash Price	$12,348.58
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12,348.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$12,348.58
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$10,496.29
Rate for Payer: Fidelis Essential Plan QHP	$10,990.24
Rate for Payer: Fidelis Medicare Advantage	$12,348.58
Rate for Payer: Fidelis Qualified Health Plan	$10,990.24
Rate for Payer: Group Health Inc Commercial	$12,348.58
Rate for Payer: Group Health Inc Medicare	$12,348.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,525.29
Rate for Payer: Hamaspik Choice Inc Medicare	$12,348.58
Rate for Payer: Healthfirst Medicare Advantage	$10,496.29
Rate for Payer: Healthfirst QHP	$12,348.58
Rate for Payer: Humana Medicare	$12,595.55
Rate for Payer: Senior Whole Health Medicare Advantage	$12,348.58
Rate for Payer: United Healthcare Commercial	$3,190.00
Rate for Payer: United Healthcare Medicare Advantage	$12,348.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12,348.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$9,878.86
Rate for Payer: Wellcare Medicare	$11,731.15

CC AB A/C .014(300CM)

Facility

$370.00

Service Code	HCPCS C1769
Hospital Charge Code	66528983
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$388.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$203.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$222.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$185.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$212.75
Rate for Payer: EmblemHealth Commercial	$185.00
Rate for Payer: Fidelis Medicare Advantage	$388.50
Rate for Payer: Group Health Inc Commercial	$185.00
Rate for Payer: Group Health Inc Medicare	$129.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$185.00
Rate for Payer: Hamaspik Choice Inc Medicare	$185.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$240.50

CC AB A/C .014(300CM)

Facility

$370.00

Service Code	HCPCS C1769
Hospital Charge Code	66528983
Hospital Revenue Code	278
Min. Negotiated Rate	$185.00
Max. Negotiated Rate	$185.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$185.00
Rate for Payer: Hamaspik Choice Inc Medicare	$185.00

CC ABBOTT 7FR SWAN GANZ CATH 110C

Facility

$75.48

Hospital Charge Code	66528405
Hospital Revenue Code	270
Min. Negotiated Rate	$26.42
Max. Negotiated Rate	$60.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.74
Rate for Payer: Aetna Government	$37.74
Rate for Payer: Brighton Health Commercial	$56.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.33
Rate for Payer: Group Health Inc Commercial	$37.74
Rate for Payer: Group Health Inc Medicare	$26.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.74
Rate for Payer: Hamaspik Choice Inc Medicare	$37.74

CC ABBOTT COPILOT BLEEDBK C VALVE

Facility

$98.00

Hospital Charge Code	66522015
Hospital Revenue Code	270
Min. Negotiated Rate	$34.30
Max. Negotiated Rate	$78.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$49.00
Rate for Payer: Aetna Government	$49.00
Rate for Payer: Brighton Health Commercial	$73.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$78.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.64
Rate for Payer: Group Health Inc Commercial	$49.00
Rate for Payer: Group Health Inc Medicare	$34.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.00
Rate for Payer: Hamaspik Choice Inc Medicare	$49.00

CC ABBOTT DOC .014(145CM)

Facility

$550.00

Service Code	HCPCS C1769
Hospital Charge Code	66522113
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$577.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$302.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$330.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$275.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$316.25
Rate for Payer: EmblemHealth Commercial	$275.00
Rate for Payer: Fidelis Medicare Advantage	$577.50
Rate for Payer: Group Health Inc Commercial	$275.00
Rate for Payer: Group Health Inc Medicare	$192.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$275.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$357.50

CC ABBOTT DOC .014(145CM)

Facility

$550.00

Service Code	HCPCS C1769
Hospital Charge Code	66522113
Hospital Revenue Code	278
Min. Negotiated Rate	$275.00
Max. Negotiated Rate	$275.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$275.00

CC ABBOTT THERM CATH 100CM

Facility

$57.88

Hospital Charge Code	66528401
Hospital Revenue Code	480
Min. Negotiated Rate	$20.26
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.94
Rate for Payer: Aetna Government	$28.94
Rate for Payer: Brighton Health Commercial	$43.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.36
Rate for Payer: Group Health Inc Commercial	$28.94
Rate for Payer: Group Health Inc Medicare	$20.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.94
Rate for Payer: Hamaspik Choice Inc Medicare	$28.94
Rate for Payer: United Healthcare Commercial	$316.00

CC AB MINI VISION 2.25MMX15MM

Facility

$1,950.00

Service Code	HCPCS C1876
Hospital Charge Code	66528915
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,047.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,072.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,170.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$975.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,121.25
Rate for Payer: EmblemHealth Commercial	$975.00
Rate for Payer: Fidelis Medicare Advantage	$2,047.50
Rate for Payer: Group Health Inc Commercial	$975.00
Rate for Payer: Group Health Inc Medicare	$682.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$975.00
Rate for Payer: Hamaspik Choice Inc Medicare	$975.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,267.50

Know your out-of-pocket cost for care.

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