St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CC GUIDE CATH AL 6F .75-3.0

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66522007
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 GUIDE CATH AL 6F .75-3.0

Facility

$102.00

Service Code	HCPCS C1887
Hospital Charge Code	66522007
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 GUIDEWIRE .035X180 AMPLATZ SUP

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	66520207
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$441.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$252.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$210.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.50
Rate for Payer: EmblemHealth Commercial	$210.00
Rate for Payer: Fidelis Medicare Advantage	$441.00
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$273.00

CC GUIDEWIRE .035X180 AMPLATZ SUP

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	66520207
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

CC GUIDEWIRE 40CM STRAIGHT TIP

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	66520235
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

CC GUIDEWIRE 40CM STRAIGHT TIP

Facility

$420.00

Service Code	HCPCS C1769
Hospital Charge Code	66520235
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$441.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$252.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$210.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.50
Rate for Payer: EmblemHealth Commercial	$210.00
Rate for Payer: Fidelis Medicare Advantage	$441.00
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$273.00

CC GUIDEWIRE MAILMAN 182CM STR

Facility

$1,340.00

Service Code	HCPCS C1769
Hospital Charge Code	66520123
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$1,407.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$737.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$804.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$670.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$770.50
Rate for Payer: EmblemHealth Commercial	$670.00
Rate for Payer: Fidelis Medicare Advantage	$1,407.00
Rate for Payer: Group Health Inc Commercial	$670.00
Rate for Payer: Group Health Inc Medicare	$469.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$670.00
Rate for Payer: Hamaspik Choice Inc Medicare	$670.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$871.00

CC GUIDEWIRE MAILMAN 182CM STR

Facility

$1,340.00

Service Code	HCPCS C1769
Hospital Charge Code	66520123
Hospital Revenue Code	278
Min. Negotiated Rate	$670.00
Max. Negotiated Rate	$670.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$670.00
Rate for Payer: Hamaspik Choice Inc Medicare	$670.00

CC GUIDEWIRE MAILMAN 300CM STR

Facility

$1,638.00

Service Code	HCPCS C1769
Hospital Charge Code	66520124
Hospital Revenue Code	278
Min. Negotiated Rate	$819.00
Max. Negotiated Rate	$819.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$819.00
Rate for Payer: Hamaspik Choice Inc Medicare	$819.00

CC GUIDEWIRE MAILMAN 300CM STR

Facility

$1,638.00

Service Code	HCPCS C1769
Hospital Charge Code	66520124
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$1,719.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$900.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$982.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$819.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$941.85
Rate for Payer: EmblemHealth Commercial	$819.00
Rate for Payer: Fidelis Medicare Advantage	$1,719.90
Rate for Payer: Group Health Inc Commercial	$819.00
Rate for Payer: Group Health Inc Medicare	$573.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$819.00
Rate for Payer: Hamaspik Choice Inc Medicare	$819.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,064.70

CC GUIDEWIRE MOD SUP LUGE 182C ST

Facility

$1,340.00

Service Code	HCPCS C1769
Hospital Charge Code	66520122
Hospital Revenue Code	278
Min. Negotiated Rate	$670.00
Max. Negotiated Rate	$670.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$670.00
Rate for Payer: Hamaspik Choice Inc Medicare	$670.00

CC GUIDEWIRE MOD SUP LUGE 182C ST

Facility

$1,340.00

Service Code	HCPCS C1769
Hospital Charge Code	66520122
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$1,407.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$737.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$804.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$670.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$770.50
Rate for Payer: EmblemHealth Commercial	$670.00
Rate for Payer: Fidelis Medicare Advantage	$1,407.00
Rate for Payer: Group Health Inc Commercial	$670.00
Rate for Payer: Group Health Inc Medicare	$469.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$670.00
Rate for Payer: Hamaspik Choice Inc Medicare	$670.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$871.00

CC HAND CONTROLLER SHEATH

Facility

$326.50

Hospital Charge Code	66520248
Hospital Revenue Code	270
Min. Negotiated Rate	$114.28
Max. Negotiated Rate	$261.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$179.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$163.25
Rate for Payer: Aetna Government	$163.25
Rate for Payer: Brighton Health Commercial	$244.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$261.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.02
Rate for Payer: Group Health Inc Commercial	$163.25
Rate for Payer: Group Health Inc Medicare	$114.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.25
Rate for Payer: Hamaspik Choice Inc Medicare	$163.25

CC HIGH PRESSURE SYRINGE

Facility

$74.84

Hospital Charge Code	66520249
Hospital Revenue Code	480
Min. Negotiated Rate	$26.19
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.42
Rate for Payer: Aetna Government	$37.42
Rate for Payer: Brighton Health Commercial	$56.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$59.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$50.89
Rate for Payer: Group Health Inc Commercial	$37.42
Rate for Payer: Group Health Inc Medicare	$26.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.42
Rate for Payer: Hamaspik Choice Inc Medicare	$37.42
Rate for Payer: United Healthcare Commercial	$316.00

CC HOSPIRA 7FR THERMO. CATH 110CM

Facility

$57.88

Hospital Charge Code	66529925
Hospital Revenue Code	480
Min. Negotiated Rate	$20.26
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.94
Rate for Payer: Aetna Government	$28.94
Rate for Payer: Brighton Health Commercial	$43.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.36
Rate for Payer: Group Health Inc Commercial	$28.94
Rate for Payer: Group Health Inc Medicare	$20.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.94
Rate for Payer: Hamaspik Choice Inc Medicare	$28.94
Rate for Payer: United Healthcare Commercial	$316.00

CC HRT ART/GRFT ANGIO

Facility

$8,631.78

Service Code	HCPCS 93459 TC
Hospital Charge Code	66528889
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 HRT ART/GRFT ANGIO

Facility

$8,631.78

Service Code	HCPCS 93459 TC
Hospital Charge Code	66528889
Hospital Revenue Code	481
Rate for Payer: Cash Price	$3,768.27

CC HYDROCOAT HT J W MS .014190CM

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66529125
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 HYDROCOAT HT J W MS .014190CM

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66529125
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 HYDROCOAT HT J W MS .014300CM

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66529126
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 HYDROCOAT HT J W MS .014300CM

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66529126
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 IAB BALLOON 25CC

Facility

$1,880.00

Hospital Charge Code	66528370
Hospital Revenue Code	480
Min. Negotiated Rate	$316.00
Max. Negotiated Rate	$1,504.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,034.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$940.00
Rate for Payer: Aetna Government	$940.00
Rate for Payer: Brighton Health Commercial	$1,410.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,504.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,278.40
Rate for Payer: Group Health Inc Commercial	$940.00
Rate for Payer: Group Health Inc Medicare	$658.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$940.00
Rate for Payer: Hamaspik Choice Inc Medicare	$940.00
Rate for Payer: United Healthcare Commercial	$316.00

CC IAB BALLOON 40CC 8F

Facility

$1,880.00

Hospital Charge Code	66528372
Hospital Revenue Code	480
Min. Negotiated Rate	$316.00
Max. Negotiated Rate	$1,504.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,034.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$940.00
Rate for Payer: Aetna Government	$940.00
Rate for Payer: Brighton Health Commercial	$1,410.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,504.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,278.40
Rate for Payer: Group Health Inc Commercial	$940.00
Rate for Payer: Group Health Inc Medicare	$658.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$940.00
Rate for Payer: Hamaspik Choice Inc Medicare	$940.00
Rate for Payer: United Healthcare Commercial	$316.00

CC IAB CATH MAQUET LINEAR 7.5FR

Facility

$2,238.00

Service Code	HCPCS C1725
Hospital Charge Code	66522011
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$2,349.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,230.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$1,342.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,119.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,286.85
Rate for Payer: EmblemHealth Commercial	$1,119.00
Rate for Payer: Fidelis Medicare Advantage	$2,349.90
Rate for Payer: Group Health Inc Commercial	$1,119.00
Rate for Payer: Group Health Inc Medicare	$783.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,119.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,119.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,454.70

CC IAB CATH MAQUET LINEAR 7.5FR

Facility

$2,238.00

Service Code	HCPCS C1725
Hospital Charge Code	66522011
Hospital Revenue Code	278
Min. Negotiated Rate	$1,119.00
Max. Negotiated Rate	$1,119.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,119.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,119.00

Know your out-of-pocket cost for care.

All Charges