St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SLP STUDY, UNATTENDED

Facility

$419.03

Service Code	HCPCS 95800 TC
Hospital Charge Code	30504505
Hospital Revenue Code	510
Rate for Payer: Cash Price	$180.64

SLP STUDY, UNATTENDED

Facility

$419.03

Service Code	HCPCS 95800 TC
Hospital Charge Code	30304505
Hospital Revenue Code	510
Min. Negotiated Rate	$173.89
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$209.52
Rate for Payer: Aetna Government	$209.52
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.52
Rate for Payer: Hamaspik Choice Inc Medicare	$209.52

SLP STUDY, UNATTENDED

Facility

$419.03

Service Code	HCPCS 95800 TC
Hospital Charge Code	30504505
Hospital Revenue Code	510
Min. Negotiated Rate	$173.89
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$209.52
Rate for Payer: Aetna Government	$209.52
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.52
Rate for Payer: Hamaspik Choice Inc Medicare	$209.52

SM 32-34 A-C MAS KIT WH

Facility

$74.88

Hospital Charge Code	64905841
Hospital Revenue Code	270
Min. Negotiated Rate	$26.21
Max. Negotiated Rate	$59.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.44
Rate for Payer: Aetna Government	$37.44
Rate for Payer: Brighton Health Commercial	$56.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$59.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$50.92
Rate for Payer: Group Health Inc Commercial	$37.44
Rate for Payer: Group Health Inc Medicare	$26.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.44
Rate for Payer: Hamaspik Choice Inc Medicare	$37.44

SMALL BONE RECIP BLADE

Facility

$58.30

Hospital Charge Code	64905703
Hospital Revenue Code	270
Min. Negotiated Rate	$20.40
Max. Negotiated Rate	$46.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.15
Rate for Payer: Aetna Government	$29.15
Rate for Payer: Brighton Health Commercial	$43.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.64
Rate for Payer: Group Health Inc Commercial	$29.15
Rate for Payer: Group Health Inc Medicare	$20.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.15
Rate for Payer: Hamaspik Choice Inc Medicare	$29.15

SMALL BOWEL ENDOSCOPY

Facility

$4,716.98

Service Code	HCPCS 44372
Hospital Charge Code	40014134
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$3,537.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,200.46
Rate for Payer: Aetna Government	$2,200.46
Rate for Payer: Brighton Health Commercial	$3,537.74
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,200.46
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	$2,200.46
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$1,870.39
Rate for Payer: Fidelis Essential Plan QHP	$1,958.41
Rate for Payer: Fidelis Medicare Advantage	$2,200.46
Rate for Payer: Fidelis Qualified Health Plan	$1,958.41
Rate for Payer: Group Health Inc Commercial	$2,200.46
Rate for Payer: Group Health Inc Medicare	$2,200.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,358.49
Rate for Payer: Hamaspik Choice Inc Medicare	$2,200.46
Rate for Payer: Healthfirst Medicare Advantage	$1,870.39
Rate for Payer: Healthfirst QHP	$2,200.46
Rate for Payer: Senior Whole Health Medicare Advantage	$2,200.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,200.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,760.37
Rate for Payer: Wellcare Medicare	$2,090.44

SMALL BOWEL ENDOSCOPY

Facility

$4,716.98

Service Code	HCPCS 44372
Hospital Charge Code	40014134
Hospital Revenue Code	360
Rate for Payer: Cash Price	$2,200.46

SMALL BOWEL ENDOSCOPY/BIOPSY

Facility

$4,716.98

Service Code	HCPCS 44377
Hospital Charge Code	40019837
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$3,537.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,200.46
Rate for Payer: Aetna Government	$2,200.46
Rate for Payer: Brighton Health Commercial	$3,537.74
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,200.46
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	$2,200.46
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$1,870.39
Rate for Payer: Fidelis Essential Plan QHP	$1,958.41
Rate for Payer: Fidelis Medicare Advantage	$2,200.46
Rate for Payer: Fidelis Qualified Health Plan	$1,958.41
Rate for Payer: Group Health Inc Commercial	$2,200.46
Rate for Payer: Group Health Inc Medicare	$2,200.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,358.49
Rate for Payer: Hamaspik Choice Inc Medicare	$2,200.46
Rate for Payer: Healthfirst Medicare Advantage	$1,870.39
Rate for Payer: Healthfirst QHP	$2,200.46
Rate for Payer: Senior Whole Health Medicare Advantage	$2,200.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,200.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,760.37
Rate for Payer: Wellcare Medicare	$2,090.44

SMALL BOWEL ENDOSCOPY/BIOPSY

Facility

$4,716.98

Service Code	HCPCS 44377
Hospital Charge Code	40019837
Hospital Revenue Code	360
Rate for Payer: Cash Price	$2,200.46

SMALL JOINT

Facility

$792.83

Service Code	HCPCS 20600
Hospital Charge Code	30301304
Hospital Revenue Code	510
Rate for Payer: Cash Price	$342.51

SMALL JOINT

Facility

$792.83

Service Code	HCPCS 20600
Hospital Charge Code	30301304
Hospital Revenue Code	510
Min. Negotiated Rate	$233.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$342.51
Rate for Payer: Aetna Government	$342.51
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$342.51
Rate for Payer: Cash Price	$342.51
Rate for Payer: Cash Price	$342.51
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$342.51
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	$342.51
Rate for Payer: Fidelis Essential Plan Aliesa	$291.13
Rate for Payer: Fidelis Essential Plan QHP	$304.83
Rate for Payer: Fidelis Medicare Advantage	$342.51
Rate for Payer: Fidelis Qualified Health Plan	$304.83
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$396.42
Rate for Payer: Hamaspik Choice Inc Medicare	$342.51
Rate for Payer: Healthfirst Medicare Advantage	$291.13
Rate for Payer: Healthfirst QHP	$342.51
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$342.51
Rate for Payer: Senior Whole Health Medicare Advantage	$342.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$342.51
Rate for Payer: Wellcare CHP/FHP/Medicaid	$274.01
Rate for Payer: Wellcare Medicare	$325.38

SMALL JOINT 2.5MM FULL RAD

Facility

$500.00

Hospital Charge Code	64905882
Hospital Revenue Code	270
Min. Negotiated Rate	$175.00
Max. Negotiated Rate	$400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$250.00
Rate for Payer: Aetna Government	$250.00
Rate for Payer: Brighton Health Commercial	$375.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$340.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00

SMALL MEDEBRA WOMEN WHTE

Facility

$63.13

Hospital Charge Code	64905833
Hospital Revenue Code	270
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$50.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.56
Rate for Payer: Aetna Government	$31.56
Rate for Payer: Brighton Health Commercial	$47.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$42.93
Rate for Payer: Group Health Inc Commercial	$31.56
Rate for Payer: Group Health Inc Medicare	$22.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.56
Rate for Payer: Hamaspik Choice Inc Medicare	$31.56

SMALLPOX & MONKEYPOX VAC, LIVE 0.5 ML SC SUSP [186334]

Facility

$648.00

Service Code	NDC 50632000103
Hospital Charge Code	50632000103
Hospital Revenue Code	250
Min. Negotiated Rate	$226.80
Max. Negotiated Rate	$518.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$356.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$324.00
Rate for Payer: Aetna Government	$324.00
Rate for Payer: Brighton Health Commercial	$486.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$518.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$440.64
Rate for Payer: Group Health Inc Commercial	$324.00
Rate for Payer: Group Health Inc Medicare	$226.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$324.00
Rate for Payer: Hamaspik Choice Inc Medicare	$324.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$421.20

SMALLPOX & MONKEYPOX VAC, LIVE 0.5 ML SC SUSP [186334]

Facility

$648.00

Service Code	NDC 50632000101
Hospital Charge Code	50632000101
Hospital Revenue Code	250
Min. Negotiated Rate	$226.80
Max. Negotiated Rate	$518.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$356.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$324.00
Rate for Payer: Aetna Government	$324.00
Rate for Payer: Brighton Health Commercial	$486.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$518.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$440.64
Rate for Payer: Group Health Inc Commercial	$324.00
Rate for Payer: Group Health Inc Medicare	$226.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$324.00
Rate for Payer: Hamaspik Choice Inc Medicare	$324.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$421.20

SMALL STAPLE

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	40200802
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$450.00

SMALL STAPLE

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	40200802
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$945.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$495.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$540.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$450.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$517.50
Rate for Payer: EmblemHealth Commercial	$450.00
Rate for Payer: Fidelis Medicare Advantage	$945.00
Rate for Payer: Group Health Inc Commercial	$450.00
Rate for Payer: Group Health Inc Medicare	$315.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$450.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$585.00

SMALL STAPLE 13 X 10 MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	40200803
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$450.00

SMALL STAPLE 13 X 10 MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	40200803
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$945.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$495.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$540.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$450.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$517.50
Rate for Payer: EmblemHealth Commercial	$450.00
Rate for Payer: Fidelis Medicare Advantage	$945.00
Rate for Payer: Group Health Inc Commercial	$450.00
Rate for Payer: Group Health Inc Medicare	$315.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$450.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$585.00

SMALL STAPLE 2

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	40205163
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,181.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$618.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$675.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$562.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$646.88
Rate for Payer: EmblemHealth Commercial	$562.50
Rate for Payer: Fidelis Medicare Advantage	$1,181.25
Rate for Payer: Group Health Inc Commercial	$562.50
Rate for Payer: Group Health Inc Medicare	$393.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$562.50
Rate for Payer: Hamaspik Choice Inc Medicare	$562.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$731.25

SMALL STAPLE 2

Facility

$1,125.00

Service Code	HCPCS C1713
Hospital Charge Code	40205163
Hospital Revenue Code	278
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$562.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$562.50
Rate for Payer: Hamaspik Choice Inc Medicare	$562.50

SMALL STAPLE 7 X 5MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	40200804
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$450.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$450.00

SMALL STAPLE 7 X 5MM

Facility

$900.00

Service Code	HCPCS C1713
Hospital Charge Code	40200804
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$945.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$495.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$540.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$450.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$517.50
Rate for Payer: EmblemHealth Commercial	$450.00
Rate for Payer: Fidelis Medicare Advantage	$945.00
Rate for Payer: Group Health Inc Commercial	$450.00
Rate for Payer: Group Health Inc Medicare	$315.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$450.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$585.00

SMALL STAPLE 9 X 7 MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	40200808
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$577.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$302.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$330.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$275.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$316.25
Rate for Payer: EmblemHealth Commercial	$275.00
Rate for Payer: Fidelis Medicare Advantage	$577.50
Rate for Payer: Group Health Inc Commercial	$275.00
Rate for Payer: Group Health Inc Medicare	$192.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$275.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$357.50

SMALL STAPLE 9 X 7 MM

Facility

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	40200808
Hospital Revenue Code	278
Min. Negotiated Rate	$275.00
Max. Negotiated Rate	$275.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$275.00

Know your out-of-pocket cost for care.

All Charges