St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CC BOST. SCIEN. 5 FR MP B-1 100CM

Facility

$18.50

Hospital Charge Code	66528239
Hospital Revenue Code	480
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$316.00
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
Rate for Payer: United Healthcare Commercial	$316.00

CC BOST. SCIEN. 6 FR FL 3.5 100CM

Facility

$18.50

Hospital Charge Code	66528240
Hospital Revenue Code	480
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$316.00
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
Rate for Payer: United Healthcare Commercial	$316.00

CC BOST. SCIEN. 6 FR FL 4 100CM

Facility

$18.50

Hospital Charge Code	66528241
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 BOST. SCIEN. 6 FR FR 4 100CM

Facility

$18.50

Hospital Charge Code	66528242
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 BOST. SCIEN. 6 FR IM 100CM

Facility

$18.50

Hospital Charge Code	66528243
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 BOST. SCIEN. 6FR PINNACLE 10CM

Facility

$19.00

Hospital Charge Code	66528257
Hospital Revenue Code	270
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$15.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.50
Rate for Payer: Aetna Government	$9.50
Rate for Payer: Brighton Health Commercial	$14.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.92
Rate for Payer: Group Health Inc Commercial	$9.50
Rate for Payer: Group Health Inc Medicare	$6.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.50
Rate for Payer: Hamaspik Choice Inc Medicare	$9.50

CC BOST. SCIEN. 7FR PINNACLE 10CM

Facility

$19.00

Hospital Charge Code	66528258
Hospital Revenue Code	270
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$15.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.50
Rate for Payer: Aetna Government	$9.50
Rate for Payer: Brighton Health Commercial	$14.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.92
Rate for Payer: Group Health Inc Commercial	$9.50
Rate for Payer: Group Health Inc Medicare	$6.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.50
Rate for Payer: Hamaspik Choice Inc Medicare	$9.50

CC BRNCHSC W/THER ASPIR 1ST

Facility

$4,535.55

Service Code	HCPCS 31645
Hospital Charge Code	66581567
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,962.76

CC BRNCHSC W/THER ASPIR 1ST

Facility

$4,535.55

Service Code	HCPCS 31645
Hospital Charge Code	66581567
Hospital Revenue Code	361
Min. Negotiated Rate	$745.00
Max. Negotiated Rate	$3,401.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,962.76
Rate for Payer: Aetna Government	$1,962.76
Rate for Payer: Affinity Essential Plan 1&2	$1,373.93
Rate for Payer: Affinity Essential Plan 3&4	$1,373.93
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,373.93
Rate for Payer: Brighton Health Commercial	$3,401.66
Rate for Payer: Cash Price	$1,962.76
Rate for Payer: Cash Price	$1,962.76
Rate for Payer: Cash Price	$1,962.76
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,962.76
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	$1,962.76
Rate for Payer: EmblemHealth Commercial	$745.00
Rate for Payer: Fidelis Essential Plan Aliesa	$1,668.35
Rate for Payer: Fidelis Essential Plan QHP	$1,746.86
Rate for Payer: Fidelis Medicare Advantage	$1,962.76
Rate for Payer: Fidelis Qualified Health Plan	$1,746.86
Rate for Payer: Group Health Inc Commercial	$1,962.76
Rate for Payer: Group Health Inc Medicare	$1,962.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,267.78
Rate for Payer: Hamaspik Choice Inc Medicare	$1,962.76
Rate for Payer: Healthfirst Medicare Advantage	$1,668.35
Rate for Payer: Healthfirst QHP	$1,962.76
Rate for Payer: Humana Medicare	$2,002.02
Rate for Payer: Senior Whole Health Medicare Advantage	$1,962.76
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$1,962.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,962.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,570.21
Rate for Payer: Wellcare Medicare	$1,864.62

CC BRONCH EBUS IVNTJ PERPH LES

Facility

$3,872.52

Service Code	HCPCS 31654
Hospital Charge Code	66581564
Hospital Revenue Code	361
Min. Negotiated Rate	$69.87
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,880.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.87
Rate for Payer: Aetna Government	$69.87
Rate for Payer: Brighton Health Commercial	$2,904.39
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: EmblemHealth Commercial	$745.00
Rate for Payer: Group Health Inc Commercial	$1,936.26
Rate for Payer: Group Health Inc Medicare	$1,355.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,936.26
Rate for Payer: Hamaspik Choice Inc Medicare	$1,936.26
Rate for Payer: United Healthcare Commercial	$1,113.00

CC B.S. 035 TER STR STIFF 150CM

Facility

$97.15

Service Code	HCPCS C1769
Hospital Charge Code	66528324
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$102.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$58.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$55.86
Rate for Payer: EmblemHealth Commercial	$48.58
Rate for Payer: Fidelis Medicare Advantage	$102.01
Rate for Payer: Group Health Inc Commercial	$48.58
Rate for Payer: Group Health Inc Medicare	$34.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.58
Rate for Payer: Hamaspik Choice Inc Medicare	$48.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$63.15

CC B.S. 035 TER STR STIFF 150CM

Facility

$97.15

Service Code	HCPCS C1769
Hospital Charge Code	66528324
Hospital Revenue Code	278
Min. Negotiated Rate	$48.58
Max. Negotiated Rate	$48.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.58
Rate for Payer: Hamaspik Choice Inc Medicare	$48.58

CC B.S. .035 TER STR STIFF 260CM

Facility

$106.66

Service Code	HCPCS C1769
Hospital Charge Code	66528325
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$111.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$64.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.33
Rate for Payer: EmblemHealth Commercial	$53.33
Rate for Payer: Fidelis Medicare Advantage	$111.99
Rate for Payer: Group Health Inc Commercial	$53.33
Rate for Payer: Group Health Inc Medicare	$37.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.33
Rate for Payer: Hamaspik Choice Inc Medicare	$53.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$69.33

CC B.S. .035 TER STR STIFF 260CM

Facility

$106.66

Service Code	HCPCS C1769
Hospital Charge Code	66528325
Hospital Revenue Code	278
Min. Negotiated Rate	$53.33
Max. Negotiated Rate	$53.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.33
Rate for Payer: Hamaspik Choice Inc Medicare	$53.33

CC B.S. .038 TER STR STIFF 150CM

Facility

$97.16

Service Code	HCPCS C1769
Hospital Charge Code	66528429
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$102.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$58.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$55.87
Rate for Payer: EmblemHealth Commercial	$48.58
Rate for Payer: Fidelis Medicare Advantage	$102.02
Rate for Payer: Group Health Inc Commercial	$48.58
Rate for Payer: Group Health Inc Medicare	$34.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.58
Rate for Payer: Hamaspik Choice Inc Medicare	$48.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$63.15

CC B.S. .038 TER STR STIFF 150CM

Facility

$97.16

Service Code	HCPCS C1769
Hospital Charge Code	66528429
Hospital Revenue Code	278
Min. Negotiated Rate	$48.58
Max. Negotiated Rate	$48.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.58
Rate for Payer: Hamaspik Choice Inc Medicare	$48.58

CC B.S. .038 TERUMO ANG 150CM

Facility

$63.36

Service Code	HCPCS C1769
Hospital Charge Code	66528326
Hospital Revenue Code	278
Min. Negotiated Rate	$31.68
Max. Negotiated Rate	$31.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.68
Rate for Payer: Hamaspik Choice Inc Medicare	$31.68

CC B.S. .038 TERUMO ANG 150CM

Facility

$63.36

Service Code	HCPCS C1769
Hospital Charge Code	66528326
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$66.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$38.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$31.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.43
Rate for Payer: EmblemHealth Commercial	$31.68
Rate for Payer: Fidelis Medicare Advantage	$66.53
Rate for Payer: Group Health Inc Commercial	$31.68
Rate for Payer: Group Health Inc Medicare	$22.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.68
Rate for Payer: Hamaspik Choice Inc Medicare	$31.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$41.18

CC B.S. .038 TERUMO ANG STIFF 180

Facility

$101.03

Hospital Charge Code	66528327
Hospital Revenue Code	480
Min. Negotiated Rate	$35.36
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.52
Rate for Payer: Aetna Government	$50.52
Rate for Payer: Brighton Health Commercial	$75.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.70
Rate for Payer: Group Health Inc Commercial	$50.52
Rate for Payer: Group Health Inc Medicare	$35.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.52
Rate for Payer: Hamaspik Choice Inc Medicare	$50.52
Rate for Payer: United Healthcare Commercial	$316.00

CC B.S. .038 TERUMO STR 150CM

Facility

$86.94

Service Code	HCPCS C1769
Hospital Charge Code	66528328
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$91.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$52.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$43.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$49.99
Rate for Payer: EmblemHealth Commercial	$43.47
Rate for Payer: Fidelis Medicare Advantage	$91.29
Rate for Payer: Group Health Inc Commercial	$43.47
Rate for Payer: Group Health Inc Medicare	$30.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.47
Rate for Payer: Hamaspik Choice Inc Medicare	$43.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$56.51

CC B.S. .038 TERUMO STR 150CM

Facility

$86.94

Service Code	HCPCS C1769
Hospital Charge Code	66528328
Hospital Revenue Code	278
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$43.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.47
Rate for Payer: Hamaspik Choice Inc Medicare	$43.47

CC B.S. .038 TERUMO STR 180CM

Facility

$85.89

Service Code	HCPCS C1769
Hospital Charge Code	66528329
Hospital Revenue Code	278
Min. Negotiated Rate	$42.94
Max. Negotiated Rate	$42.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.94
Rate for Payer: Hamaspik Choice Inc Medicare	$42.94

CC B.S. .038 TERUMO STR 180CM

Facility

$85.89

Service Code	HCPCS C1769
Hospital Charge Code	66528329
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$90.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$51.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$49.39
Rate for Payer: EmblemHealth Commercial	$42.94
Rate for Payer: Fidelis Medicare Advantage	$90.18
Rate for Payer: Group Health Inc Commercial	$42.94
Rate for Payer: Group Health Inc Medicare	$30.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.94
Rate for Payer: Hamaspik Choice Inc Medicare	$42.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$55.83

CC B.S. 038 X 260CM AMP SUPER STF

Facility

$86.94

Service Code	HCPCS C1769
Hospital Charge Code	66528330
Hospital Revenue Code	278
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$43.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.47
Rate for Payer: Hamaspik Choice Inc Medicare	$43.47

CC B.S. 038 X 260CM AMP SUPER STF

Facility

$86.94

Service Code	HCPCS C1769
Hospital Charge Code	66528330
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$91.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$47.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$52.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$43.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$49.99
Rate for Payer: EmblemHealth Commercial	$43.47
Rate for Payer: Fidelis Medicare Advantage	$91.29
Rate for Payer: Group Health Inc Commercial	$43.47
Rate for Payer: Group Health Inc Medicare	$30.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.47
Rate for Payer: Hamaspik Choice Inc Medicare	$43.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$56.51

Know your out-of-pocket cost for care.

All Charges