St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ

Professional

Both

$405.62

Service Code	HCPCS 93318 26
Min. Negotiated Rate	$304.22
Max. Negotiated Rate	$304.22
Rate for Payer: Cash Price	$109.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$304.22
Rate for Payer: SOMOS Essential	$304.22

PR ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ

Professional

Both

$409.54

Service Code	HCPCS 93318 TC
Min. Negotiated Rate	$307.16
Max. Negotiated Rate	$307.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$307.16
Rate for Payer: SOMOS Essential	$307.16

PR ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY

Professional

Both

$603.47

Service Code	HCPCS 93314 TC
Min. Negotiated Rate	$452.60
Max. Negotiated Rate	$452.60
Rate for Payer: Cash Price	$164.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$452.60
Rate for Payer: SOMOS Essential	$452.60

PR ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY

Professional

Both

$367.22

Service Code	HCPCS 93314 26
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$275.42
Rate for Payer: Cash Price	$97.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$275.42
Rate for Payer: SOMOS Essential	$275.42

PR ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY

Professional

Both

$970.69

Service Code	HCPCS 93314
Min. Negotiated Rate	$728.02
Max. Negotiated Rate	$728.02
Rate for Payer: Cash Price	$262.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$728.02
Rate for Payer: SOMOS Essential	$728.02

PR ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R

Professional

Both

$568.96

Service Code	HCPCS 93312 TC
Min. Negotiated Rate	$426.72
Max. Negotiated Rate	$426.72
Rate for Payer: Cash Price	$155.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$426.72
Rate for Payer: SOMOS Essential	$426.72

PR ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R

Professional

Both

$416.33

Service Code	HCPCS 93312 26
Min. Negotiated Rate	$312.25
Max. Negotiated Rate	$312.25
Rate for Payer: Cash Price	$113.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$312.25
Rate for Payer: SOMOS Essential	$312.25

PR ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R

Professional

Both

$985.32

Service Code	HCPCS 93312
Min. Negotiated Rate	$738.99
Max. Negotiated Rate	$738.99
Rate for Payer: Cash Price	$269.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$738.99
Rate for Payer: SOMOS Essential	$738.99

PR ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP

Professional

Both

$406.53

Service Code	HCPCS 93307 TC
Min. Negotiated Rate	$304.90
Max. Negotiated Rate	$304.90
Rate for Payer: Cash Price	$111.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$304.90
Rate for Payer: SOMOS Essential	$304.90

PR ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP

Professional

Both

$172.17

Service Code	HCPCS 93307 26
Min. Negotiated Rate	$129.13
Max. Negotiated Rate	$129.13
Rate for Payer: Cash Price	$46.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$129.13
Rate for Payer: SOMOS Essential	$129.13

PR ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP

Professional

Both

$578.69

Service Code	HCPCS 93307
Min. Negotiated Rate	$434.02
Max. Negotiated Rate	$434.02
Rate for Payer: Cash Price	$157.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$434.02
Rate for Payer: SOMOS Essential	$434.02

PR ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD

Professional

Both

$418.01

Service Code	HCPCS 93308
Min. Negotiated Rate	$313.51
Max. Negotiated Rate	$313.51
Rate for Payer: Cash Price	$114.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$313.51
Rate for Payer: SOMOS Essential	$313.51

PR ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD

Professional

Both

$97.72

Service Code	HCPCS 93308 26
Min. Negotiated Rate	$73.29
Max. Negotiated Rate	$73.29
Rate for Payer: Cash Price	$26.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$73.29
Rate for Payer: SOMOS Essential	$73.29

PR ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD

Professional

Both

$320.29

Service Code	HCPCS 93308 TC
Min. Negotiated Rate	$240.22
Max. Negotiated Rate	$240.22
Rate for Payer: Cash Price	$88.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$240.22
Rate for Payer: SOMOS Essential	$240.22

PR ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST

Professional

Both

$267.12

Service Code	HCPCS 93350 26
Min. Negotiated Rate	$200.34
Max. Negotiated Rate	$200.34
Rate for Payer: Cash Price	$74.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$200.34
Rate for Payer: SOMOS Essential	$200.34

PR ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST

Professional

Both

$777.14

Service Code	HCPCS 93350
Min. Negotiated Rate	$582.86
Max. Negotiated Rate	$582.86
Rate for Payer: Cash Price	$213.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$582.86
Rate for Payer: SOMOS Essential	$582.86

PR ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST

Professional

Both

$510.02

Service Code	HCPCS 93350 TC
Min. Negotiated Rate	$382.52
Max. Negotiated Rate	$382.52
Rate for Payer: Cash Price	$139.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$382.52
Rate for Payer: SOMOS Essential	$382.52

PR ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D

Professional

Both

$267.12

Service Code	HCPCS 93306 26
Min. Negotiated Rate	$200.34
Max. Negotiated Rate	$200.34
Rate for Payer: Cash Price	$74.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$200.34
Rate for Payer: SOMOS Essential	$200.34

PR ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D

Professional

Both

$825.76

Service Code	HCPCS 93306
Min. Negotiated Rate	$619.32
Max. Negotiated Rate	$619.32
Rate for Payer: Cash Price	$226.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$619.32
Rate for Payer: SOMOS Essential	$619.32

PR ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D

Professional

Both

$558.64

Service Code	HCPCS 93306 TC
Min. Negotiated Rate	$418.98
Max. Negotiated Rate	$418.98
Rate for Payer: Cash Price	$152.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$418.98
Rate for Payer: SOMOS Essential	$418.98

PR ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG

Professional

Both

$323.30

Service Code	HCPCS 93351 26
Min. Negotiated Rate	$242.48
Max. Negotiated Rate	$242.48
Rate for Payer: Cash Price	$88.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$242.48
Rate for Payer: SOMOS Essential	$242.48

PR ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG

Professional

Both

$976.78

Service Code	HCPCS 93351
Min. Negotiated Rate	$732.58
Max. Negotiated Rate	$732.58
Rate for Payer: Cash Price	$268.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$732.58
Rate for Payer: SOMOS Essential	$732.58

PR ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG

Professional

Both

$653.52

Service Code	HCPCS 93351 TC
Min. Negotiated Rate	$490.14
Max. Negotiated Rate	$490.14
Rate for Payer: Cash Price	$179.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$490.14
Rate for Payer: SOMOS Essential	$490.14

PRECISION ATTACHMENT

Facility

$685.00

Service Code	HCPCS D6950
Hospital Charge Code	42301595
Hospital Revenue Code	361
Min. Negotiated Rate	$168.60
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$376.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$168.60
Rate for Payer: Aetna Government	$168.60
Rate for Payer: Brighton Health Commercial	$513.75
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: Group Health Inc Commercial	$342.50
Rate for Payer: Group Health Inc Medicare	$239.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$342.50
Rate for Payer: Hamaspik Choice Inc Medicare	$342.50

PRECISION ATTACHMENT, BY REPORT

Facility

$2,233.00

Service Code	HCPCS D5862
Hospital Charge Code	42301205
Hospital Revenue Code	361
Min. Negotiated Rate	$201.13
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,228.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$201.13
Rate for Payer: Aetna Government	$201.13
Rate for Payer: Brighton Health Commercial	$1,674.75
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: Group Health Inc Commercial	$1,116.50
Rate for Payer: Group Health Inc Medicare	$781.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,116.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,116.50

Know your out-of-pocket cost for care.

All Charges