St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CC CORDIS 4FR 3DRC CATHETER

Facility

$50.00

Service Code	HCPCS C1725
Hospital Charge Code	66520313
Hospital Revenue Code	278
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$52.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$30.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.75
Rate for Payer: EmblemHealth Commercial	$25.00
Rate for Payer: Fidelis Medicare Advantage	$52.50
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$32.50

CC CORDIS 4 FR AV+STD L S 11CM

Facility

$7.20

Service Code	HCPCS C1725
Hospital Charge Code	66528358
Hospital Revenue Code	278
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60

CC CORDIS 4 FR AV+STD L S 11CM

Facility

$7.20

Service Code	HCPCS C1725
Hospital Charge Code	66528358
Hospital Revenue Code	278
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$4.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.14
Rate for Payer: EmblemHealth Commercial	$3.60
Rate for Payer: Fidelis Medicare Advantage	$7.56
Rate for Payer: Group Health Inc Commercial	$3.60
Rate for Payer: Group Health Inc Medicare	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.68

CC CORDIS 5 FR AV+STD L S 11CM

Facility

$7.20

Service Code	HCPCS C1725
Hospital Charge Code	66528359
Hospital Revenue Code	278
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60

CC CORDIS 5 FR AV+STD L S 11CM

Facility

$7.20

Service Code	HCPCS C1725
Hospital Charge Code	66528359
Hospital Revenue Code	278
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$4.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.14
Rate for Payer: EmblemHealth Commercial	$3.60
Rate for Payer: Fidelis Medicare Advantage	$7.56
Rate for Payer: Group Health Inc Commercial	$3.60
Rate for Payer: Group Health Inc Medicare	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.68

CC CORDIS AVIATOR 4.0MM X 15MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528562
Hospital Revenue Code	278
Min. Negotiated Rate	$177.10
Max. Negotiated Rate	$177.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10

CC CORDIS AVIATOR 4.0MM X 15MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528562
Hospital Revenue Code	278
Min. Negotiated Rate	$123.97
Max. Negotiated Rate	$398.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$212.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$177.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$203.66
Rate for Payer: EmblemHealth Commercial	$177.10
Rate for Payer: Fidelis Medicare Advantage	$371.91
Rate for Payer: Group Health Inc Commercial	$177.10
Rate for Payer: Group Health Inc Medicare	$123.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$230.23

CC CORDIS AVIATOR 4.0MM X 20MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528561
Hospital Revenue Code	278
Min. Negotiated Rate	$177.10
Max. Negotiated Rate	$177.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10

CC CORDIS AVIATOR 4.0MM X 20MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528561
Hospital Revenue Code	278
Min. Negotiated Rate	$123.97
Max. Negotiated Rate	$398.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$212.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$177.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$203.66
Rate for Payer: EmblemHealth Commercial	$177.10
Rate for Payer: Fidelis Medicare Advantage	$371.91
Rate for Payer: Group Health Inc Commercial	$177.10
Rate for Payer: Group Health Inc Medicare	$123.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$230.23

CC CORDIS AVIATOR 5.0MM X 15MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528560
Hospital Revenue Code	278
Min. Negotiated Rate	$177.10
Max. Negotiated Rate	$177.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10

CC CORDIS AVIATOR 5.0MM X 15MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528560
Hospital Revenue Code	278
Min. Negotiated Rate	$123.97
Max. Negotiated Rate	$398.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$212.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$177.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$203.66
Rate for Payer: EmblemHealth Commercial	$177.10
Rate for Payer: Fidelis Medicare Advantage	$371.91
Rate for Payer: Group Health Inc Commercial	$177.10
Rate for Payer: Group Health Inc Medicare	$123.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$230.23

CC CORDIS AVIATOR 5.0MM X 20MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528559
Hospital Revenue Code	278
Min. Negotiated Rate	$123.97
Max. Negotiated Rate	$398.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$212.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$177.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$203.66
Rate for Payer: EmblemHealth Commercial	$177.10
Rate for Payer: Fidelis Medicare Advantage	$371.91
Rate for Payer: Group Health Inc Commercial	$177.10
Rate for Payer: Group Health Inc Medicare	$123.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$230.23

CC CORDIS AVIATOR 5.0MM X 20MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528559
Hospital Revenue Code	278
Min. Negotiated Rate	$177.10
Max. Negotiated Rate	$177.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10

CC CORDIS AVIATOR 6.0MM X 15MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528558
Hospital Revenue Code	278
Min. Negotiated Rate	$123.97
Max. Negotiated Rate	$398.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$212.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$177.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$203.66
Rate for Payer: EmblemHealth Commercial	$177.10
Rate for Payer: Fidelis Medicare Advantage	$371.91
Rate for Payer: Group Health Inc Commercial	$177.10
Rate for Payer: Group Health Inc Medicare	$123.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$230.23

CC CORDIS AVIATOR 6.0MM X 15MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528558
Hospital Revenue Code	278
Min. Negotiated Rate	$177.10
Max. Negotiated Rate	$177.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10

CC CORDIS AVIATOR 6.0MM X 20MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528557
Hospital Revenue Code	278
Min. Negotiated Rate	$123.97
Max. Negotiated Rate	$398.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$212.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$177.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$203.66
Rate for Payer: EmblemHealth Commercial	$177.10
Rate for Payer: Fidelis Medicare Advantage	$371.91
Rate for Payer: Group Health Inc Commercial	$177.10
Rate for Payer: Group Health Inc Medicare	$123.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$230.23

CC CORDIS AVIATOR 6.0MM X 20MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528557
Hospital Revenue Code	278
Min. Negotiated Rate	$177.10
Max. Negotiated Rate	$177.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10

CC CORDIS AVIATOR 7.0MM X 15MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528556
Hospital Revenue Code	278
Min. Negotiated Rate	$177.10
Max. Negotiated Rate	$177.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10

CC CORDIS AVIATOR 7.0MM X 15MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528556
Hospital Revenue Code	278
Min. Negotiated Rate	$123.97
Max. Negotiated Rate	$398.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$212.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$177.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$203.66
Rate for Payer: EmblemHealth Commercial	$177.10
Rate for Payer: Fidelis Medicare Advantage	$371.91
Rate for Payer: Group Health Inc Commercial	$177.10
Rate for Payer: Group Health Inc Medicare	$123.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$230.23

CC CORDIS AVIATOR 7.0MM X 20MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528555
Hospital Revenue Code	278
Min. Negotiated Rate	$177.10
Max. Negotiated Rate	$177.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10

CC CORDIS AVIATOR 7.0MM X 20MM

Facility

$354.20

Service Code	HCPCS C1876
Hospital Charge Code	66528555
Hospital Revenue Code	278
Min. Negotiated Rate	$123.97
Max. Negotiated Rate	$398.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$212.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$177.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$203.66
Rate for Payer: EmblemHealth Commercial	$177.10
Rate for Payer: Fidelis Medicare Advantage	$371.91
Rate for Payer: Group Health Inc Commercial	$177.10
Rate for Payer: Group Health Inc Medicare	$123.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.10
Rate for Payer: Hamaspik Choice Inc Medicare	$177.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$230.23

CC CORDIS EM 035 FIXED CORE PTFE

Facility

$44.20

Hospital Charge Code	66528409
Hospital Revenue Code	480
Min. Negotiated Rate	$15.47
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.10
Rate for Payer: Aetna Government	$22.10
Rate for Payer: Brighton Health Commercial	$33.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.06
Rate for Payer: Group Health Inc Commercial	$22.10
Rate for Payer: Group Health Inc Medicare	$15.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.10
Rate for Payer: Hamaspik Choice Inc Medicare	$22.10
Rate for Payer: United Healthcare Commercial	$316.00

CC CORDIS EM. 035 STD JTIP 260CM

Facility

$44.20

Hospital Charge Code	66529930
Hospital Revenue Code	270
Min. Negotiated Rate	$15.47
Max. Negotiated Rate	$35.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.10
Rate for Payer: Aetna Government	$22.10
Rate for Payer: Brighton Health Commercial	$33.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.06
Rate for Payer: Group Health Inc Commercial	$22.10
Rate for Payer: Group Health Inc Medicare	$15.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.10
Rate for Payer: Hamaspik Choice Inc Medicare	$22.10

CC CORDIS EMERAL .035 JTIP 150CM

Facility

$20.60

Hospital Charge Code	66528259
Hospital Revenue Code	270
Min. Negotiated Rate	$7.21
Max. Negotiated Rate	$16.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.30
Rate for Payer: Aetna Government	$10.30
Rate for Payer: Brighton Health Commercial	$15.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.01
Rate for Payer: Group Health Inc Commercial	$10.30
Rate for Payer: Group Health Inc Medicare	$7.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.30
Rate for Payer: Hamaspik Choice Inc Medicare	$10.30

CC CORDIS EMERALD .035X260CM

Facility

$42.00

Service Code	HCPCS C1769
Hospital Charge Code	66528502
Hospital Revenue Code	278
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.00
Rate for Payer: Hamaspik Choice Inc Medicare	$21.00

Know your out-of-pocket cost for care.

All Charges