St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SP AORTA CATHETER

Facility

$1,965.63

Service Code	HCPCS 36200 TC
Hospital Charge Code	41542689
Hospital Revenue Code	361
Min. Negotiated Rate	$687.97
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,081.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$982.82
Rate for Payer: Aetna Government	$982.82
Rate for Payer: Brighton Health Commercial	$1,474.22
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	$982.82
Rate for Payer: Group Health Inc Medicare	$687.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$982.82
Rate for Payer: Hamaspik Choice Inc Medicare	$982.82

SP AORTA/IVC/ILIA COMP

Facility

$705.83

Service Code	HCPCS 93978 TC
Hospital Charge Code	41201174
Hospital Revenue Code	920
Rate for Payer: Cash Price	$283.37

SP AORTA/IVC/ILIA COMP

Facility

$705.83

Service Code	HCPCS 93978 TC
Hospital Charge Code	41201174
Hospital Revenue Code	920
Min. Negotiated Rate	$247.04
Max. Negotiated Rate	$564.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$388.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$352.92
Rate for Payer: Aetna Government	$352.92
Rate for Payer: Brighton Health Commercial	$529.37
Rate for Payer: Cash Price	$283.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$564.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$479.96
Rate for Payer: Group Health Inc Commercial	$352.92
Rate for Payer: Group Health Inc Medicare	$247.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.92
Rate for Payer: Hamaspik Choice Inc Medicare	$352.92

SP AORTA/IVC/ILIA LTD

Facility

$339.45

Service Code	HCPCS 93979 TC
Hospital Charge Code	41201175
Hospital Revenue Code	920
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$271.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$169.72
Rate for Payer: Aetna Government	$169.72
Rate for Payer: Brighton Health Commercial	$254.59
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.83
Rate for Payer: Group Health Inc Commercial	$169.72
Rate for Payer: Group Health Inc Medicare	$118.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$169.72

SP AORTA/IVC/ILIA LTD

Facility

$339.45

Service Code	HCPCS 93979 TC
Hospital Charge Code	41201175
Hospital Revenue Code	920
Rate for Payer: Cash Price	$127.14

SP AORTA TRANSLUMBAR

Facility

$30,010.30

Service Code	HCPCS 0236T
Hospital Charge Code	41542766
Hospital Revenue Code	361
Rate for Payer: Cash Price	$12,721.98

SP AORTA TRANSLUMBAR

Facility

$30,010.30

Service Code	HCPCS 0236T
Hospital Charge Code	41542766
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$22,507.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12,721.98
Rate for Payer: Aetna Government	$12,721.98
Rate for Payer: Brighton Health Commercial	$22,507.72
Rate for Payer: Cash Price	$12,721.98
Rate for Payer: Cash Price	$12,721.98
Rate for Payer: Cash Price	$12,721.98
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12,721.98
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	$12,721.98
Rate for Payer: EmblemHealth Commercial	$12,721.98
Rate for Payer: Fidelis Essential Plan Aliesa	$10,813.68
Rate for Payer: Fidelis Essential Plan QHP	$11,322.56
Rate for Payer: Fidelis Medicare Advantage	$12,721.98
Rate for Payer: Fidelis Qualified Health Plan	$11,322.56
Rate for Payer: Group Health Inc Commercial	$12,721.98
Rate for Payer: Group Health Inc Medicare	$12,721.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,005.15
Rate for Payer: Hamaspik Choice Inc Medicare	$12,721.98
Rate for Payer: Healthfirst Medicare Advantage	$10,813.68
Rate for Payer: Healthfirst QHP	$12,721.98
Rate for Payer: Senior Whole Health Medicare Advantage	$12,721.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12,721.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10,177.58
Rate for Payer: Wellcare Medicare	$12,085.88

SP ARTER. ABOVE DIAPH. 1S

Facility

$3,471.23

Service Code	HCPCS 36215 TC
Hospital Charge Code	41542678
Hospital Revenue Code	361
Min. Negotiated Rate	$1,214.93
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,909.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,735.62
Rate for Payer: Aetna Government	$1,735.62
Rate for Payer: Brighton Health Commercial	$2,603.42
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	$1,735.62
Rate for Payer: Group Health Inc Medicare	$1,214.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,735.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,735.62

SP ARTER. ABOVE DIAPH. 2N

Facility

$3,790.55

Service Code	HCPCS 36216 TC
Hospital Charge Code	41542679
Hospital Revenue Code	361
Min. Negotiated Rate	$1,326.69
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,084.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,895.28
Rate for Payer: Aetna Government	$1,895.28
Rate for Payer: Brighton Health Commercial	$2,842.91
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	$1,895.28
Rate for Payer: Group Health Inc Medicare	$1,326.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,895.28
Rate for Payer: Hamaspik Choice Inc Medicare	$1,895.28

SP ARTER. ABOVE DIAPH. 3R

Facility

$6,223.85

Service Code	HCPCS 36217 TC
Hospital Charge Code	41542680
Hospital Revenue Code	361
Min. Negotiated Rate	$2,178.35
Max. Negotiated Rate	$4,667.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,423.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,111.92
Rate for Payer: Aetna Government	$3,111.92
Rate for Payer: Brighton Health Commercial	$4,667.89
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	$3,111.92
Rate for Payer: Group Health Inc Medicare	$2,178.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,111.92
Rate for Payer: Hamaspik Choice Inc Medicare	$3,111.92

SP ARTER. ABOVE DIAPH. >3RD

Facility

$577.70

Service Code	HCPCS 36218 TC
Hospital Charge Code	41542681
Hospital Revenue Code	361
Min. Negotiated Rate	$202.20
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$317.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$288.85
Rate for Payer: Aetna Government	$288.85
Rate for Payer: Brighton Health Commercial	$433.28
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: Group Health Inc Commercial	$288.85
Rate for Payer: Group Health Inc Medicare	$202.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$288.85
Rate for Payer: Hamaspik Choice Inc Medicare	$288.85

SP ARTER. BELOW DIAPH. 1ST

Facility

$3,839.45

Service Code	HCPCS 36245 TC
Hospital Charge Code	41542026
Hospital Revenue Code	361
Min. Negotiated Rate	$1,343.81
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,111.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,919.72
Rate for Payer: Aetna Government	$1,919.72
Rate for Payer: Brighton Health Commercial	$2,879.59
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	$1,919.72
Rate for Payer: Group Health Inc Medicare	$1,343.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,919.72
Rate for Payer: Hamaspik Choice Inc Medicare	$1,919.72

SP ARTER. BELOW DIAPH. 2N

Facility

$3,759.98

Service Code	HCPCS 36246 TC
Hospital Charge Code	41542052
Hospital Revenue Code	361
Min. Negotiated Rate	$1,315.99
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,067.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,879.99
Rate for Payer: Aetna Government	$1,879.99
Rate for Payer: Brighton Health Commercial	$2,819.98
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	$1,879.99
Rate for Payer: Group Health Inc Medicare	$1,315.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,879.99
Rate for Payer: Hamaspik Choice Inc Medicare	$1,879.99

SP ARTER. BELOW DIAPH. >3

Facility

$494.03

Service Code	HCPCS 36248 TC
Hospital Charge Code	41542683
Hospital Revenue Code	361
Min. Negotiated Rate	$172.91
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$271.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$247.02
Rate for Payer: Aetna Government	$247.02
Rate for Payer: Brighton Health Commercial	$370.52
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	$247.02
Rate for Payer: Group Health Inc Medicare	$172.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$247.02
Rate for Payer: Hamaspik Choice Inc Medicare	$247.02

SP ARTER. BELOW DIAPH. 3R

Facility

$5,942.45

Service Code	HCPCS 36247 TC
Hospital Charge Code	41542682
Hospital Revenue Code	361
Min. Negotiated Rate	$2,079.86
Max. Negotiated Rate	$4,456.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,268.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,971.22
Rate for Payer: Aetna Government	$2,971.22
Rate for Payer: Brighton Health Commercial	$4,456.84
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	$2,971.22
Rate for Payer: Group Health Inc Medicare	$2,079.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,971.22
Rate for Payer: Hamaspik Choice Inc Medicare	$2,971.22

SP ARTHROCENTESIS LARGE JOINT

Facility

$786.00

Service Code	HCPCS 20610 TC
Hospital Charge Code	41548512
Hospital Revenue Code	361
Rate for Payer: Cash Price	$342.51

SP ARTHROCENTESIS LARGE JOINT

Facility

$786.00

Service Code	HCPCS 20610
Hospital Charge Code	30302002
Hospital Revenue Code	510
Rate for Payer: Cash Price	$342.51

SP ARTHROCENTESIS LARGE JOINT

Facility

$786.00

Service Code	HCPCS 20610
Hospital Charge Code	30302002
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	$393.00
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

SP ARTHROCENTESIS LARGE JOINT

Facility

$1,229.75

Service Code	HCPCS 20610
Hospital Charge Code	30102473
Hospital Revenue Code	450
Min. Negotiated Rate	$165.00
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	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$342.51
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$342.51
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: EmblemHealth Commercial	$525.00
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	$525.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$614.88
Rate for Payer: Hamaspik Choice Inc Medicare	$342.51
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
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

SP ARTHROCENTESIS LARGE JOINT

Facility

$786.00

Service Code	HCPCS 20610 TC
Hospital Charge Code	41548512
Hospital Revenue Code	361
Min. Negotiated Rate	$275.10
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$432.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$393.00
Rate for Payer: Aetna Government	$393.00
Rate for Payer: Brighton Health Commercial	$589.50
Rate for Payer: Cash Price	$342.51
Rate for Payer: Cash Price	$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: Group Health Inc Commercial	$393.00
Rate for Payer: Group Health Inc Medicare	$275.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$393.00
Rate for Payer: Hamaspik Choice Inc Medicare	$393.00

SP ARTHROCENTESIS LARGE JOINT

Facility

$1,229.75

Service Code	HCPCS 20610
Hospital Charge Code	30102473
Hospital Revenue Code	450
Rate for Payer: Cash Price	$342.51

SP ARTHROCENTESIS MEDIUM JOINT

Facility

$786.00

Service Code	HCPCS 20605 TC
Hospital Charge Code	41548511
Hospital Revenue Code	361
Min. Negotiated Rate	$275.10
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$432.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$393.00
Rate for Payer: Aetna Government	$393.00
Rate for Payer: Brighton Health Commercial	$589.50
Rate for Payer: Cash Price	$342.51
Rate for Payer: Cash Price	$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: Group Health Inc Commercial	$393.00
Rate for Payer: Group Health Inc Medicare	$275.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$393.00
Rate for Payer: Hamaspik Choice Inc Medicare	$393.00

SP ARTHROCENTESIS MEDIUM JOINT

Facility

$786.00

Service Code	HCPCS 20605 TC
Hospital Charge Code	41548511
Hospital Revenue Code	361
Rate for Payer: Cash Price	$342.51

SP ART OCCLUSIVE DEVICE PLCMT

Facility

$776.34

Service Code	HCPCS G0269 TC
Hospital Charge Code	41561953
Hospital Revenue Code	320
Min. Negotiated Rate	$271.72
Max. Negotiated Rate	$621.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$426.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$388.17
Rate for Payer: Aetna Government	$388.17
Rate for Payer: Brighton Health Commercial	$582.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$621.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$527.91
Rate for Payer: Group Health Inc Commercial	$388.17
Rate for Payer: Group Health Inc Medicare	$271.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$388.17
Rate for Payer: Hamaspik Choice Inc Medicare	$388.17

SP ASPIRATION BREAST CYST

Facility

$1,847.58

Service Code	HCPCS 19000 TC
Hospital Charge Code	41549614
Hospital Revenue Code	361
Min. Negotiated Rate	$646.65
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,016.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$923.79
Rate for Payer: Aetna Government	$923.79
Rate for Payer: Brighton Health Commercial	$1,385.68
Rate for Payer: Cash Price	$813.63
Rate for Payer: Cash Price	$813.63
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	$923.79
Rate for Payer: Group Health Inc Medicare	$646.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$923.79
Rate for Payer: Hamaspik Choice Inc Medicare	$923.79

Know your out-of-pocket cost for care.

All Charges