St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ABBOTT STENT 2.50MM X 18MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523361
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.50MM X 23MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523362
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

ABBOTT STENT 2.50MM X 23MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523362
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.50MM X 28MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523363
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.50MM X 28MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523363
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

ABBOTT STENT 2.50MM X 33MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523364
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.50MM X 33MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523364
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

ABBOTT STENT 2.50MM X 38MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523365
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.50MM X 38MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523365
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

ABBOTT STENT 2.75MM X 08MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523366
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.75MM X 08MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523366
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

ABBOTT STENT 2.75MM X 12MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523367
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.75MM X 12MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523367
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

ABBOTT STENT 2.75MM X 15MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523368
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.75MM X 15MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523368
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

ABBOTT STENT 2.75MM X 18MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523369
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.75MM X 18MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523369
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

ABBOTT STENT 2.75MM X 23MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523370
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.75MM X 23MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523370
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

ABBOTT STENT 2.75MM X 28MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523371
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

ABBOTT STENT 2.75MM X 28MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523371
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.75MM X 33MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523372
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

ABBOTT STENT 2.75MM X 33MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523372
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.75MM X 38MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523373
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,310.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,210.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Brighton Health Commercial	$1,320.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,265.00
Rate for Payer: EmblemHealth Commercial	$1,100.00
Rate for Payer: Fidelis Medicare Advantage	$2,310.00
Rate for Payer: Group Health Inc Commercial	$1,100.00
Rate for Payer: Group Health Inc Medicare	$770.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,430.00

ABBOTT STENT 2.75MM X 38MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523373
Hospital Revenue Code	278
Min. Negotiated Rate	$1,100.00
Max. Negotiated Rate	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,100.00

Know your out-of-pocket cost for care.

All Charges