St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CC DES AB X RX 4.0MMX23MM

Facility

$3,900.00

Service Code	HCPCS C1874
Hospital Charge Code	66528977
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$4,095.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,145.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$2,340.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,950.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,242.50
Rate for Payer: EmblemHealth Commercial	$1,950.00
Rate for Payer: Fidelis Medicare Advantage	$4,095.00
Rate for Payer: Group Health Inc Commercial	$1,950.00
Rate for Payer: Group Health Inc Medicare	$1,365.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,950.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,950.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,535.00

CC DES AB X RX 4.0MMX23MM

Facility

$3,900.00

Service Code	HCPCS C1874
Hospital Charge Code	66528977
Hospital Revenue Code	278
Min. Negotiated Rate	$1,950.00
Max. Negotiated Rate	$1,950.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,950.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,950.00

CC DES AB X RX 4.0MMX28MM

Facility

$3,900.00

Service Code	HCPCS C1874
Hospital Charge Code	66528978
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$4,095.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,145.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$2,340.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,950.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,242.50
Rate for Payer: EmblemHealth Commercial	$1,950.00
Rate for Payer: Fidelis Medicare Advantage	$4,095.00
Rate for Payer: Group Health Inc Commercial	$1,950.00
Rate for Payer: Group Health Inc Medicare	$1,365.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,950.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,950.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,535.00

CC DES AB X RX 4.0MMX28MM

Facility

$3,900.00

Service Code	HCPCS C1874
Hospital Charge Code	66528978
Hospital Revenue Code	278
Min. Negotiated Rate	$1,950.00
Max. Negotiated Rate	$1,950.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,950.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,950.00

CC DES AB X RX 4.0MMX8MM

Facility

$3,900.00

Service Code	HCPCS C1874
Hospital Charge Code	66528979
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$4,095.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,145.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$2,340.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,950.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,242.50
Rate for Payer: EmblemHealth Commercial	$1,950.00
Rate for Payer: Fidelis Medicare Advantage	$4,095.00
Rate for Payer: Group Health Inc Commercial	$1,950.00
Rate for Payer: Group Health Inc Medicare	$1,365.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,950.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,950.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,535.00

CC DES AB X RX 4.0MMX8MM

Facility

$3,900.00

Service Code	HCPCS C1874
Hospital Charge Code	66528979
Hospital Revenue Code	278
Min. Negotiated Rate	$1,950.00
Max. Negotiated Rate	$1,950.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,950.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,950.00

CC DES MED END 3.5X9-30MM

Facility

$3,450.00

Service Code	HCPCS C1874
Hospital Charge Code	66528993
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$1,725.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,725.00

CC DES MED END 3.5X9-30MM

Facility

$3,450.00

Service Code	HCPCS C1874
Hospital Charge Code	66528993
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$3,622.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,897.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$2,070.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,725.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,983.75
Rate for Payer: EmblemHealth Commercial	$1,725.00
Rate for Payer: Fidelis Medicare Advantage	$3,622.50
Rate for Payer: Group Health Inc Commercial	$1,725.00
Rate for Payer: Group Health Inc Medicare	$1,207.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,725.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,242.50

CC DES MED ENDEAVOR3.0MMX9-30MM

Facility

$3,450.00

Service Code	HCPCS C1874
Hospital Charge Code	66528989
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$1,725.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,725.00

CC DES MED ENDEAVOR3.0MMX9-30MM

Facility

$3,450.00

Service Code	HCPCS C1874
Hospital Charge Code	66528989
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$3,622.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,897.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$2,070.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,725.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,983.75
Rate for Payer: EmblemHealth Commercial	$1,725.00
Rate for Payer: Fidelis Medicare Advantage	$3,622.50
Rate for Payer: Group Health Inc Commercial	$1,725.00
Rate for Payer: Group Health Inc Medicare	$1,207.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,725.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,242.50

CC DEVICE MAGNET EXCHANGE

Facility

$226.00

Hospital Charge Code	66520125
Hospital Revenue Code	480
Min. Negotiated Rate	$79.10
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$124.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$113.00
Rate for Payer: Aetna Government	$113.00
Rate for Payer: Brighton Health Commercial	$169.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$180.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.68
Rate for Payer: Group Health Inc Commercial	$113.00
Rate for Payer: Group Health Inc Medicare	$79.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$113.00
Rate for Payer: Hamaspik Choice Inc Medicare	$113.00
Rate for Payer: United Healthcare Commercial	$316.00

CC DEVICE VASCULAR CLOSURE MYNX

Facility

$460.00

Hospital Charge Code	66520226
Hospital Revenue Code	481
Min. Negotiated Rate	$161.00
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$253.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$230.00
Rate for Payer: Aetna Government	$230.00
Rate for Payer: Brighton Health Commercial	$6,937.00
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: Group Health Inc Commercial	$230.00
Rate for Payer: Group Health Inc Medicare	$161.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00

CC DEXTRUS IS-1 BI POS FIX 53CM

Facility

$1,350.00

Service Code	HCPCS C1898
Hospital Charge Code	66526872
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$675.00
Rate for Payer: Hamaspik Choice Inc Medicare	$675.00

CC DEXTRUS IS-1 BI POS FIX 53CM

Facility

$1,350.00

Service Code	HCPCS C1898
Hospital Charge Code	66526872
Hospital Revenue Code	278
Min. Negotiated Rate	$98.92
Max. Negotiated Rate	$1,417.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$742.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.92
Rate for Payer: Aetna Government	$98.92
Rate for Payer: Brighton Health Commercial	$810.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$675.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$776.25
Rate for Payer: EmblemHealth Commercial	$675.00
Rate for Payer: Fidelis Medicare Advantage	$1,417.50
Rate for Payer: Group Health Inc Commercial	$675.00
Rate for Payer: Group Health Inc Medicare	$472.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$675.00
Rate for Payer: Hamaspik Choice Inc Medicare	$675.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$877.50

CC DEXTRUS IS-1 BI POS FIX 60CM

Facility

$1,350.00

Service Code	HCPCS C1898
Hospital Charge Code	66526873
Hospital Revenue Code	278
Min. Negotiated Rate	$98.92
Max. Negotiated Rate	$1,417.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$742.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.92
Rate for Payer: Aetna Government	$98.92
Rate for Payer: Brighton Health Commercial	$810.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$675.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$776.25
Rate for Payer: EmblemHealth Commercial	$675.00
Rate for Payer: Fidelis Medicare Advantage	$1,417.50
Rate for Payer: Group Health Inc Commercial	$675.00
Rate for Payer: Group Health Inc Medicare	$472.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$675.00
Rate for Payer: Hamaspik Choice Inc Medicare	$675.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$877.50

CC DEXTRUS IS-1 BI POS FIX 60CM

Facility

$1,350.00

Service Code	HCPCS C1898
Hospital Charge Code	66526873
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$675.00
Rate for Payer: Hamaspik Choice Inc Medicare	$675.00

CC DEXTRUS IS-1 BI POS FIX RA/RV

Facility

$1,350.00

Service Code	HCPCS C1898
Hospital Charge Code	66526901
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$675.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$675.00
Rate for Payer: Hamaspik Choice Inc Medicare	$675.00

CC DEXTRUS IS-1 BI POS FIX RA/RV

Facility

$1,350.00

Service Code	HCPCS C1898
Hospital Charge Code	66526901
Hospital Revenue Code	278
Min. Negotiated Rate	$98.92
Max. Negotiated Rate	$1,417.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$742.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.92
Rate for Payer: Aetna Government	$98.92
Rate for Payer: Brighton Health Commercial	$810.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$675.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$776.25
Rate for Payer: EmblemHealth Commercial	$675.00
Rate for Payer: Fidelis Medicare Advantage	$1,417.50
Rate for Payer: Group Health Inc Commercial	$675.00
Rate for Payer: Group Health Inc Medicare	$472.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$675.00
Rate for Payer: Hamaspik Choice Inc Medicare	$675.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$877.50

CC D/G/WIRE CORDIS EMERALD .025

Facility

$52.00

Service Code	HCPCS C1725
Hospital Charge Code	66520106
Hospital Revenue Code	278
Min. Negotiated Rate	$18.20
Max. Negotiated Rate	$54.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$31.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$29.90
Rate for Payer: EmblemHealth Commercial	$26.00
Rate for Payer: Fidelis Medicare Advantage	$54.60
Rate for Payer: Group Health Inc Commercial	$26.00
Rate for Payer: Group Health Inc Medicare	$18.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.00
Rate for Payer: Hamaspik Choice Inc Medicare	$26.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.80

CC D/G/WIRE CORDIS EMERALD .025

Facility

$52.00

Service Code	HCPCS C1725
Hospital Charge Code	66520106
Hospital Revenue Code	278
Min. Negotiated Rate	$26.00
Max. Negotiated Rate	$26.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.00
Rate for Payer: Hamaspik Choice Inc Medicare	$26.00

CC D IS-1 BI POS/FIX RA/RV 53CM

Facility

$1,200.00

Service Code	HCPCS C1896
Hospital Charge Code	66528869
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$3,139.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$660.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,139.11
Rate for Payer: Aetna Government	$3,139.11
Rate for Payer: Brighton Health Commercial	$720.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$690.00
Rate for Payer: EmblemHealth Commercial	$600.00
Rate for Payer: Fidelis Medicare Advantage	$1,260.00
Rate for Payer: Group Health Inc Commercial	$600.00
Rate for Payer: Group Health Inc Medicare	$420.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$780.00

CC D IS-1 BI POS/FIX RA/RV 53CM

Facility

$1,200.00

Service Code	HCPCS C1896
Hospital Charge Code	66528869
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00

CC D IS-1BI POS/FIX RA/RV 53CM

Facility

$1,200.00

Hospital Charge Code	40208869
Hospital Revenue Code	480
Min. Negotiated Rate	$316.00
Max. Negotiated Rate	$960.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$660.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$600.00
Rate for Payer: Aetna Government	$600.00
Rate for Payer: Brighton Health Commercial	$900.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$960.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$816.00
Rate for Payer: Group Health Inc Commercial	$600.00
Rate for Payer: Group Health Inc Medicare	$420.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00
Rate for Payer: United Healthcare Commercial	$316.00

CC DISPOSABLE HAND CONTROLLER

Facility

$24.48

Hospital Charge Code	66520247
Hospital Revenue Code	270
Min. Negotiated Rate	$8.57
Max. Negotiated Rate	$19.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.24
Rate for Payer: Aetna Government	$12.24
Rate for Payer: Brighton Health Commercial	$18.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.65
Rate for Payer: Group Health Inc Commercial	$12.24
Rate for Payer: Group Health Inc Medicare	$8.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.24
Rate for Payer: Hamaspik Choice Inc Medicare	$12.24

CC DISPOSABLE SINGL SET LONG

Facility

$65.16

Hospital Charge Code	66521929
Hospital Revenue Code	270
Min. Negotiated Rate	$22.81
Max. Negotiated Rate	$52.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.58
Rate for Payer: Aetna Government	$32.58
Rate for Payer: Brighton Health Commercial	$48.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.31
Rate for Payer: Group Health Inc Commercial	$32.58
Rate for Payer: Group Health Inc Medicare	$22.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.58
Rate for Payer: Hamaspik Choice Inc Medicare	$32.58

Know your out-of-pocket cost for care.

All Charges