St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SP ABD/RETRO PERCUTANEOUS

Facility

$4,157.25

Service Code	HCPCS 49180 TC
Hospital Charge Code	41542795
Hospital Revenue Code	361
Min. Negotiated Rate	$1,455.04
Max. Negotiated Rate	$3,117.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,286.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,078.62
Rate for Payer: Aetna Government	$2,078.62
Rate for Payer: Brighton Health Commercial	$3,117.94
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
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	$2,078.62
Rate for Payer: Group Health Inc Medicare	$1,455.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,078.62

SP ABD/RETRO PERCUTANEOUS

Facility

$4,157.25

Service Code	HCPCS 49180 TC
Hospital Charge Code	41542795
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,874.89

SP ABI AT REST/LASER DOPPL

Facility

$330.23

Service Code	HCPCS 93922 TC
Hospital Charge Code	41201164
Hospital Revenue Code	920
Min. Negotiated Rate	$115.58
Max. Negotiated Rate	$264.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$165.12
Rate for Payer: Aetna Government	$165.12
Rate for Payer: Brighton Health Commercial	$247.67
Rate for Payer: Cash Price	$147.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$264.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.56
Rate for Payer: Group Health Inc Commercial	$165.12
Rate for Payer: Group Health Inc Medicare	$115.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.12
Rate for Payer: Hamaspik Choice Inc Medicare	$165.12

SP ABI AT REST/LASER DOPPL

Facility

$330.23

Service Code	HCPCS 93922 TC
Hospital Charge Code	41201164
Hospital Revenue Code	920
Rate for Payer: Cash Price	$147.72

SP ABI WITH EXERCISE

Facility

$419.03

Service Code	HCPCS 93923 TC
Hospital Charge Code	41201165
Hospital Revenue Code	920
Min. Negotiated Rate	$146.66
Max. Negotiated Rate	$335.22
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	$314.27
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$335.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.94
Rate for Payer: Group Health Inc Commercial	$209.52
Rate for Payer: Group Health Inc Medicare	$146.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.52
Rate for Payer: Hamaspik Choice Inc Medicare	$209.52

SP ABI WITH EXERCISE

Facility

$419.03

Service Code	HCPCS 93923 TC
Hospital Charge Code	41201165
Hospital Revenue Code	920
Rate for Payer: Cash Price	$180.64

SP ABSC DRAINAGE,APPENDIX(PERCUT)

Facility

$4,157.25

Service Code	HCPCS 49406 TC
Hospital Charge Code	41547607
Hospital Revenue Code	360
Min. Negotiated Rate	$1,455.04
Max. Negotiated Rate	$3,117.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,286.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,078.62
Rate for Payer: Aetna Government	$2,078.62
Rate for Payer: Brighton Health Commercial	$3,117.94
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
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: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$2,078.62
Rate for Payer: Group Health Inc Medicare	$1,455.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,078.62

SP ABSC DRAINAGE,APPENDIX(PERCUT)

Facility

$4,157.25

Service Code	HCPCS 49406 TC
Hospital Charge Code	41547607
Hospital Revenue Code	360
Rate for Payer: Cash Price	$1,874.89

SP ABSC DRAINAGE PELVIC TRANSRECT

Facility

$3,041.53

Service Code	HCPCS 45000 TC
Hospital Charge Code	41547608
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,364.66

SP ABSC DRAINAGE PELVIC TRANSRECT

Facility

$3,041.53

Service Code	HCPCS 45000 TC
Hospital Charge Code	41547608
Hospital Revenue Code	361
Min. Negotiated Rate	$1,064.54
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,672.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,520.76
Rate for Payer: Aetna Government	$1,520.76
Rate for Payer: Brighton Health Commercial	$2,281.15
Rate for Payer: Cash Price	$1,364.66
Rate for Payer: Cash Price	$1,364.66
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	$1,520.76
Rate for Payer: Group Health Inc Medicare	$1,064.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,520.76
Rate for Payer: Hamaspik Choice Inc Medicare	$1,520.76

SP ABSCESS DRAINAGE LIVER C

Facility

$4,157.25

Service Code	HCPCS 49405 TC
Hospital Charge Code	41542782
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,874.89

SP ABSCESS DRAINAGE LIVER C

Facility

$4,157.25

Service Code	HCPCS 49405 TC
Hospital Charge Code	41542782
Hospital Revenue Code	361
Min. Negotiated Rate	$1,455.04
Max. Negotiated Rate	$3,117.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,286.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,078.62
Rate for Payer: Aetna Government	$2,078.62
Rate for Payer: Brighton Health Commercial	$3,117.94
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
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	$2,078.62
Rate for Payer: Group Health Inc Medicare	$1,455.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,078.62

SP ABSCESS DRAINAGE, PELVIC

Facility

$7,099.93

Service Code	HCPCS 45020
Hospital Charge Code	41547609
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,246.99

SP ABSCESS DRAINAGE, PELVIC

Facility

$7,099.93

Service Code	HCPCS 45020
Hospital Charge Code	41547609
Hospital Revenue Code	361
Min. Negotiated Rate	$1,888.00
Max. Negotiated Rate	$5,324.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,246.99
Rate for Payer: Aetna Government	$3,246.99
Rate for Payer: Brighton Health Commercial	$5,324.95
Rate for Payer: Cash Price	$3,246.99
Rate for Payer: Cash Price	$3,246.99
Rate for Payer: Cash Price	$3,246.99
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,246.99
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	$3,246.99
Rate for Payer: EmblemHealth Commercial	$3,246.99
Rate for Payer: Fidelis Essential Plan Aliesa	$2,759.94
Rate for Payer: Fidelis Essential Plan QHP	$2,889.82
Rate for Payer: Fidelis Medicare Advantage	$3,246.99
Rate for Payer: Fidelis Qualified Health Plan	$2,889.82
Rate for Payer: Group Health Inc Commercial	$3,246.99
Rate for Payer: Group Health Inc Medicare	$3,246.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,549.96
Rate for Payer: Hamaspik Choice Inc Medicare	$3,246.99
Rate for Payer: Healthfirst Medicare Advantage	$2,759.94
Rate for Payer: Healthfirst QHP	$3,246.99
Rate for Payer: Senior Whole Health Medicare Advantage	$3,246.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,246.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,597.59
Rate for Payer: Wellcare Medicare	$3,084.64

SP ABSCESS DRAINAGE PERIVESICAL

Facility

$5,365.58

Service Code	HCPCS 51060 TC
Hospital Charge Code	41547610
Hospital Revenue Code	361
Rate for Payer: Cash Price	$2,355.42

SP ABSCESS DRAINAGE PERIVESICAL

Facility

$5,365.58

Service Code	HCPCS 51060 TC
Hospital Charge Code	41547610
Hospital Revenue Code	361
Min. Negotiated Rate	$1,877.95
Max. Negotiated Rate	$4,024.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,951.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,682.79
Rate for Payer: Aetna Government	$2,682.79
Rate for Payer: Brighton Health Commercial	$4,024.18
Rate for Payer: Cash Price	$2,355.42
Rate for Payer: Cash Price	$2,355.42
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	$2,682.79
Rate for Payer: Group Health Inc Medicare	$1,877.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,682.79
Rate for Payer: Hamaspik Choice Inc Medicare	$2,682.79

SP ABSCESS DRAINAGE, SUBUTANEOUS

Facility

$967.73

Service Code	HCPCS 10160 TC
Hospital Charge Code	41546555
Hospital Revenue Code	361
Rate for Payer: Cash Price	$461.12

SP ABSCESS DRAINAGE, SUBUTANEOUS

Facility

$967.73

Service Code	HCPCS 10160 TC
Hospital Charge Code	41546555
Hospital Revenue Code	361
Min. Negotiated Rate	$338.71
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$532.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$483.86
Rate for Payer: Aetna Government	$483.86
Rate for Payer: Brighton Health Commercial	$725.80
Rate for Payer: Cash Price	$461.12
Rate for Payer: Cash Price	$461.12
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	$483.86
Rate for Payer: Group Health Inc Medicare	$338.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$483.86
Rate for Payer: Hamaspik Choice Inc Medicare	$483.86

SP ABSCESS DRAIN EMP/HEM

Facility

$4,940.28

Service Code	HCPCS 32551 TC
Hospital Charge Code	41542783
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,852.05

SP ABSCESS DRAIN EMP/HEM

Facility

$4,940.28

Service Code	HCPCS 32551 TC
Hospital Charge Code	41542783
Hospital Revenue Code	361
Min. Negotiated Rate	$1,729.10
Max. Negotiated Rate	$3,705.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,717.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,470.14
Rate for Payer: Aetna Government	$2,470.14
Rate for Payer: Brighton Health Commercial	$3,705.21
Rate for Payer: Cash Price	$1,852.05
Rate for Payer: Cash Price	$1,852.05
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	$2,470.14
Rate for Payer: Group Health Inc Medicare	$1,729.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,470.14
Rate for Payer: Hamaspik Choice Inc Medicare	$2,470.14

SP ABSCESS DRAIN PERITON

Facility

$4,157.25

Service Code	HCPCS 49405 TC
Hospital Charge Code	41542784
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,874.89

SP ABSCESS DRAIN PERITON

Facility

$4,157.25

Service Code	HCPCS 49405 TC
Hospital Charge Code	41542784
Hospital Revenue Code	361
Min. Negotiated Rate	$1,455.04
Max. Negotiated Rate	$3,117.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,286.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,078.62
Rate for Payer: Aetna Government	$2,078.62
Rate for Payer: Brighton Health Commercial	$3,117.94
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
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	$2,078.62
Rate for Payer: Group Health Inc Medicare	$1,455.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,078.62

SP ABSCESS DRAIN RENAL

Facility

$4,157.25

Service Code	HCPCS 49406 TC
Hospital Charge Code	41542787
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,874.89

SP ABSCESS DRAIN RENAL

Facility

$4,157.25

Service Code	HCPCS 49406 TC
Hospital Charge Code	41542787
Hospital Revenue Code	361
Min. Negotiated Rate	$1,455.04
Max. Negotiated Rate	$3,117.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,286.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,078.62
Rate for Payer: Aetna Government	$2,078.62
Rate for Payer: Brighton Health Commercial	$3,117.94
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
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	$2,078.62
Rate for Payer: Group Health Inc Medicare	$1,455.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,078.62

SP ABSCESS DRAIN RETROPERI

Facility

$4,157.25

Service Code	HCPCS 49406 TC
Hospital Charge Code	41542785
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,874.89

Know your out-of-pocket cost for care.

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