St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ABBOTT STENT 3.50MM X 38MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523397
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 3.50MM X 38MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523397
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 4.00MM X 08MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523398
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 4.00MM X 08MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523398
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 4.00MM X 12MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523399
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 4.00MM X 12MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523399
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 4.00MM X 15MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523420
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 4.00MM X 15MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523420
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 4.00MM X 18MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523421
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 4.00MM X 18MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523421
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 4.00MM X 23MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523422
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 4.00MM X 23MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523422
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 4.00MM X 28MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523423
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 4.00MM X 28MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523423
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 4.00MM X 33MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523424
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 4.00MM X 33MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523424
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 4.00MM X 38MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523425
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 4.00MM X 38MM

Facility

$2,200.00

Service Code	HCPCS C1874
Hospital Charge Code	66523425
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 VASCULAR G/WIRE

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66521956
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

ABBOTT VASCULAR G/WIRE

Facility

$200.00

Service Code	HCPCS C1769
Hospital Charge Code	66521956
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

ABCIXIMAB 2 MG/ML INJ

Facility

$1,516.96

Service Code	HCPCS J0130
Hospital Charge Code	41655061
Hospital Revenue Code	636
Min. Negotiated Rate	$530.94
Max. Negotiated Rate	$1,116.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$834.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,116.30
Rate for Payer: Aetna Government	$1,116.30
Rate for Payer: Brighton Health Commercial	$910.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$758.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$872.25
Rate for Payer: Group Health Inc Commercial	$758.48
Rate for Payer: Group Health Inc Medicare	$530.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$758.48
Rate for Payer: Hamaspik Choice Inc Medicare	$758.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$986.02

ABCIXIMAB 2 MG/ML INJ

Facility

$1,516.96

Hospital Charge Code	41645061
Hospital Revenue Code	636
Min. Negotiated Rate	$530.94
Max. Negotiated Rate	$986.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$834.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$758.48
Rate for Payer: Aetna Government	$758.48
Rate for Payer: Brighton Health Commercial	$910.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$758.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$872.25
Rate for Payer: Group Health Inc Commercial	$758.48
Rate for Payer: Group Health Inc Medicare	$530.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$758.48
Rate for Payer: Hamaspik Choice Inc Medicare	$758.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$986.02

ABCIXIMAB 2 MG/ML INJ

Facility

$1,516.96

Hospital Charge Code	41645061
Hospital Revenue Code	636
Min. Negotiated Rate	$758.48
Max. Negotiated Rate	$758.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$758.48
Rate for Payer: Hamaspik Choice Inc Medicare	$758.48

ABCIXIMAB 2 MG/ML INJ

Facility

$1,516.96

Service Code	HCPCS J0130
Hospital Charge Code	41655061
Hospital Revenue Code	636
Min. Negotiated Rate	$758.48
Max. Negotiated Rate	$758.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$758.48
Rate for Payer: Hamaspik Choice Inc Medicare	$758.48

ABDM PERITONEAL LAVAGE

Facility

$2,380.35

Service Code	HCPCS 49082
Hospital Charge Code	40019635
Hospital Revenue Code	360
Min. Negotiated Rate	$733.80
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,048.28
Rate for Payer: Aetna Government	$1,048.28
Rate for Payer: Affinity Essential Plan 1&2	$733.80
Rate for Payer: Affinity Essential Plan 3&4	$733.80
Rate for Payer: Affinity Medicaid/CHP/HARP	$733.80
Rate for Payer: Brighton Health Commercial	$1,785.26
Rate for Payer: Cash Price	$1,048.28
Rate for Payer: Cash Price	$1,048.28
Rate for Payer: Cash Price	$1,048.28
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,048.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$1,048.28
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$891.04
Rate for Payer: Fidelis Essential Plan QHP	$932.97
Rate for Payer: Fidelis Medicare Advantage	$1,048.28
Rate for Payer: Fidelis Qualified Health Plan	$932.97
Rate for Payer: Group Health Inc Commercial	$1,048.28
Rate for Payer: Group Health Inc Medicare	$1,048.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,190.18
Rate for Payer: Hamaspik Choice Inc Medicare	$1,048.28
Rate for Payer: Healthfirst Medicare Advantage	$891.04
Rate for Payer: Healthfirst QHP	$1,048.28
Rate for Payer: Humana Medicare	$1,069.25
Rate for Payer: Senior Whole Health Medicare Advantage	$1,048.28
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$1,048.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,048.28
Rate for Payer: Wellcare CHP/FHP/Medicaid	$838.62
Rate for Payer: Wellcare Medicare	$995.87

Know your out-of-pocket cost for care.

All Charges