St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CC CORDIS SMART 8MM X 20MM

Facility

$2,316.60

Service Code	HCPCS C1876
Hospital Charge Code	66528568
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 8MM X 40MM

Facility

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528567
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 8MM X 40MM

Facility

$2,566.20

Service Code	HCPCS C1876
Hospital Charge Code	66528567
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: Brighton Health Commercial	$1,539.72
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: EmblemHealth Commercial	$1,283.10
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 8MM X 60MM

Facility

$3,081.00

Service Code	HCPCS C1876
Hospital Charge Code	66528566
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$3,235.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,694.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,848.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,540.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,771.58
Rate for Payer: EmblemHealth Commercial	$1,540.50
Rate for Payer: Fidelis Medicare Advantage	$3,235.05
Rate for Payer: Group Health Inc Commercial	$1,540.50
Rate for Payer: Group Health Inc Medicare	$1,078.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,540.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,540.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,002.65

CC CORDIS SMART 8MM X 60MM

Facility

$3,081.00

Service Code	HCPCS C1876
Hospital Charge Code	66528566
Hospital Revenue Code	278
Min. Negotiated Rate	$1,540.50
Max. Negotiated Rate	$1,540.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,540.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,540.50

CC CORDIS VBRITE TIP 6F JCL 3.5

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	66528427
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$231.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$121.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
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 CORDIS VBRITE TIP 6F JCL 3.5

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	66528427
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 CORDIS VISTA. 6F JL 3.5

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	66529921
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$231.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$121.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
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 CORDIS VISTA. 6F JL 3.5

Facility

$220.00

Service Code	HCPCS C1887
Hospital Charge Code	66529921
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 COR EM .038 STD JTIP 150CM

Facility

$6.04

Hospital Charge Code	66528368
Hospital Revenue Code	270
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$4.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.02
Rate for Payer: Aetna Government	$3.02
Rate for Payer: Brighton Health Commercial	$4.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.83
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.11
Rate for Payer: Group Health Inc Commercial	$3.02
Rate for Payer: Group Health Inc Medicare	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.02
Rate for Payer: Hamaspik Choice Inc Medicare	$3.02

CC CORONARY ANGIO + IC LYTICS

Facility

$30,010.30

Service Code	HCPCS 92997
Hospital Charge Code	66528253
Hospital Revenue Code	480
Min. Negotiated Rate	$316.00
Max. Negotiated Rate	$24,008.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16,505.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12,721.98
Rate for Payer: Aetna Government	$12,721.98
Rate for Payer: Affinity Essential Plan 1&2	$8,905.39
Rate for Payer: Affinity Essential Plan 3&4	$8,905.39
Rate for Payer: Affinity Medicaid/CHP/HARP	$8,905.39
Rate for Payer: Brighton Health Commercial	$22,507.72
Rate for Payer: Cash Price	$12,721.98
Rate for Payer: Cash Price	$12,721.98
Rate for Payer: Cash Price	$12,721.98
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12,721.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24,008.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$20,407.00
Rate for Payer: Elderplan Medicare Advantage	$12,721.98
Rate for Payer: EmblemHealth Commercial	$12,721.98
Rate for Payer: Fidelis Essential Plan Aliesa	$10,813.68
Rate for Payer: Fidelis Essential Plan QHP	$11,322.56
Rate for Payer: Fidelis Medicare Advantage	$12,721.98
Rate for Payer: Fidelis Qualified Health Plan	$11,322.56
Rate for Payer: Group Health Inc Commercial	$12,721.98
Rate for Payer: Group Health Inc Medicare	$12,721.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,005.15
Rate for Payer: Hamaspik Choice Inc Medicare	$12,721.98
Rate for Payer: Healthfirst Medicare Advantage	$10,813.68
Rate for Payer: Healthfirst QHP	$12,721.98
Rate for Payer: Humana Medicare	$12,976.42
Rate for Payer: Senior Whole Health Medicare Advantage	$12,721.98
Rate for Payer: United Healthcare Commercial	$316.00
Rate for Payer: United Healthcare Medicare Advantage	$12,721.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12,721.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10,177.58
Rate for Payer: Wellcare Medicare	$12,085.88

CC CORONARY ANGIO + IC LYTICS

Facility

$30,010.30

Service Code	HCPCS 92997
Hospital Charge Code	66528253
Hospital Revenue Code	480
Rate for Payer: Cash Price	$12,721.98

CC CORONARY ARTERY ANGIO S&I

Facility

$8,631.78

Service Code	HCPCS 93454 TC
Hospital Charge Code	66528894
Hospital Revenue Code	481
Rate for Payer: Cash Price	$3,768.27

CC CORONARY ARTERY ANGIO S&I

Facility

$8,631.78

Service Code	HCPCS 93454 TC
Hospital Charge Code	66528894
Hospital Revenue Code	481
Min. Negotiated Rate	$2,637.79
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,768.27
Rate for Payer: Aetna Government	$3,768.27
Rate for Payer: Affinity Essential Plan 1&2	$2,637.79
Rate for Payer: Affinity Essential Plan 3&4	$2,637.79
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,637.79
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cash Price	$3,768.27
Rate for Payer: Cash Price	$3,768.27
Rate for Payer: Cash Price	$3,768.27
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,768.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,959.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,215.78
Rate for Payer: Elderplan Medicare Advantage	$3,768.27
Rate for Payer: EmblemHealth Commercial	$3,768.27
Rate for Payer: Fidelis Essential Plan Aliesa	$3,203.03
Rate for Payer: Fidelis Essential Plan QHP	$3,353.76
Rate for Payer: Fidelis Medicare Advantage	$3,768.27
Rate for Payer: Fidelis Qualified Health Plan	$3,353.76
Rate for Payer: Group Health Inc Commercial	$3,768.27
Rate for Payer: Group Health Inc Medicare	$3,768.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,315.89
Rate for Payer: Hamaspik Choice Inc Medicare	$3,768.27
Rate for Payer: Healthfirst Medicare Advantage	$3,203.03
Rate for Payer: Healthfirst QHP	$3,768.27
Rate for Payer: Humana Medicare	$3,843.64
Rate for Payer: Senior Whole Health Medicare Advantage	$3,768.27
Rate for Payer: United Healthcare Commercial	$3,955.00
Rate for Payer: United Healthcare Medicare Advantage	$3,768.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,768.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,014.62
Rate for Payer: Wellcare Medicare	$3,579.86

CC CORONARY ART/GRFT ANGIO S&I

Facility

$8,631.78

Service Code	HCPCS 93455 TC
Hospital Charge Code	66528895
Hospital Revenue Code	481
Rate for Payer: Cash Price	$3,768.27

CC CORONARY ART/GRFT ANGIO S&I

Facility

$8,631.78

Service Code	HCPCS 93455 TC
Hospital Charge Code	66528895
Hospital Revenue Code	481
Min. Negotiated Rate	$2,637.79
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,768.27
Rate for Payer: Aetna Government	$3,768.27
Rate for Payer: Affinity Essential Plan 1&2	$2,637.79
Rate for Payer: Affinity Essential Plan 3&4	$2,637.79
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,637.79
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cash Price	$3,768.27
Rate for Payer: Cash Price	$3,768.27
Rate for Payer: Cash Price	$3,768.27
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,768.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,959.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,215.78
Rate for Payer: Elderplan Medicare Advantage	$3,768.27
Rate for Payer: EmblemHealth Commercial	$3,768.27
Rate for Payer: Fidelis Essential Plan Aliesa	$3,203.03
Rate for Payer: Fidelis Essential Plan QHP	$3,353.76
Rate for Payer: Fidelis Medicare Advantage	$3,768.27
Rate for Payer: Fidelis Qualified Health Plan	$3,353.76
Rate for Payer: Group Health Inc Commercial	$3,768.27
Rate for Payer: Group Health Inc Medicare	$3,768.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,315.89
Rate for Payer: Hamaspik Choice Inc Medicare	$3,768.27
Rate for Payer: Healthfirst Medicare Advantage	$3,203.03
Rate for Payer: Healthfirst QHP	$3,768.27
Rate for Payer: Humana Medicare	$3,843.64
Rate for Payer: Senior Whole Health Medicare Advantage	$3,768.27
Rate for Payer: United Healthcare Commercial	$3,955.00
Rate for Payer: United Healthcare Medicare Advantage	$3,768.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,768.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,014.62
Rate for Payer: Wellcare Medicare	$3,579.86

CC CRT-ICD 40Q

Facility

$37,500.00

Service Code	HCPCS C1882
Hospital Charge Code	66571448
Hospital Revenue Code	278
Min. Negotiated Rate	$4,752.01
Max. Negotiated Rate	$39,375.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20,625.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,752.01
Rate for Payer: Aetna Government	$4,752.01
Rate for Payer: Brighton Health Commercial	$22,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18,750.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$21,562.50
Rate for Payer: EmblemHealth Commercial	$18,750.00
Rate for Payer: Fidelis Medicare Advantage	$39,375.00
Rate for Payer: Group Health Inc Commercial	$18,750.00
Rate for Payer: Group Health Inc Medicare	$13,125.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$18,750.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$24,375.00

CC CRT-ICD 40Q

Facility

$37,500.00

Service Code	HCPCS C1882
Hospital Charge Code	66571448
Hospital Revenue Code	278
Min. Negotiated Rate	$18,750.00
Max. Negotiated Rate	$18,750.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$18,750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$18,750.00

CC C/WIRE AB A G/S .014(300CM)

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66529120
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$210.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.00
Rate for Payer: EmblemHealth Commercial	$100.00
Rate for Payer: Fidelis Medicare Advantage	$210.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$130.00

CC C/WIRE AB A G/S .014(300CM)

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66529120
Hospital Revenue Code	278
Min. Negotiated Rate	$100.00
Max. Negotiated Rate	$100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

CC C/WIRE AB ASAHI .014X180CM

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66528984
Hospital Revenue Code	278
Min. Negotiated Rate	$100.00
Max. Negotiated Rate	$100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

CC C/WIRE AB ASAHI .014X180CM

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66528984
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$210.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.00
Rate for Payer: EmblemHealth Commercial	$100.00
Rate for Payer: Fidelis Medicare Advantage	$210.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$130.00

CC C/WIRE ABBOTT .014 190-300CM

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66522115
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$210.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.00
Rate for Payer: EmblemHealth Commercial	$100.00
Rate for Payer: Fidelis Medicare Advantage	$210.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$130.00

CC C/WIRE ABBOTT .014 190-300CM

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66522115
Hospital Revenue Code	278
Min. Negotiated Rate	$100.00
Max. Negotiated Rate	$100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

CC C/WIRE ABBOTT BAL HT .014

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66522105
Hospital Revenue Code	278
Min. Negotiated Rate	$100.00
Max. Negotiated Rate	$100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

Know your out-of-pocket cost for care.

All Charges