St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CC G/CATH JL 3.5 6F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521037
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JL 3.5 6F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521037
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JL 3.5 7F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521039
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JL 3.5 7F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521039
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JL 4.0 6F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521041
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JL 4.0 6F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521041
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JL 4.5 7FMED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521043
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JL 4.5 7FMED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521043
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JL 5.0 6F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521047
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JL 5.0 6F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521047
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JL 5.0 7F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521045
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JL 5.0 7F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521045
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JL SH 3.5 6F MED L

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521049
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JL SH 3.5 6F MED L

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521049
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JL SH 4.0 6F MED LAUNCH

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521051
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JL SH 4.0 6F MED LAUNCH

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521051
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JR 3.0 6F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521053
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JR 3.0 6F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521053
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JR 3.0 7F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521055
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JR 3.0 7F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521055
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JR 3.5 6F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521059
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JR 3.5 6F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521059
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JR 3.5 7F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521057
Hospital Revenue Code	278
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$107.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.21
Rate for Payer: Aetna Government	$3.21
Rate for Payer: Brighton Health Commercial	$61.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.65
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Fidelis Medicare Advantage	$107.10
Rate for Payer: Group Health Inc Commercial	$51.00
Rate for Payer: Group Health Inc Medicare	$35.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$66.30

CC G/CATH JR 3.5 7F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521057
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

CC G/CATH JR 4.0 6F MED LAUNCHER

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66521063
Hospital Revenue Code	278
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.00
Rate for Payer: Hamaspik Choice Inc Medicare	$51.00

Know your out-of-pocket cost for care.

All Charges