St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SP BYPASS GRFT/SUBCLAVIAN/AXILLAR

Facility

$3,187.33

Service Code	HCPCS 35616 TC
Hospital Charge Code	41547698
Hospital Revenue Code	361
Min. Negotiated Rate	$1,115.57
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,753.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,593.66
Rate for Payer: Aetna Government	$1,593.66
Rate for Payer: Brighton Health Commercial	$2,390.50
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	$1,593.66
Rate for Payer: Group Health Inc Medicare	$1,115.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,593.66
Rate for Payer: Hamaspik Choice Inc Medicare	$1,593.66

SP CAROTID COMPLETE

Facility

$705.83

Service Code	HCPCS 93880 TC
Hospital Charge Code	41201160
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 CAROTID COMPLETE

Facility

$705.83

Service Code	HCPCS 93880 TC
Hospital Charge Code	41201160
Hospital Revenue Code	920
Rate for Payer: Cash Price	$283.37

SP CAROTID, EXTERNAL BI

Facility

$1,872.25

Service Code	HCPCS 36227 TC
Hospital Charge Code	41102552
Hospital Revenue Code	361
Min. Negotiated Rate	$655.29
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,029.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$936.12
Rate for Payer: Aetna Government	$936.12
Rate for Payer: Brighton Health Commercial	$1,404.19
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	$936.12
Rate for Payer: Group Health Inc Medicare	$655.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$936.12
Rate for Payer: Hamaspik Choice Inc Medicare	$936.12

SP CAROTID, EXTERNAL UNI

Facility

$1,872.25

Service Code	HCPCS 36227 TC
Hospital Charge Code	41102550
Hospital Revenue Code	361
Min. Negotiated Rate	$655.29
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,029.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$936.12
Rate for Payer: Aetna Government	$936.12
Rate for Payer: Brighton Health Commercial	$1,404.19
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	$936.12
Rate for Payer: Group Health Inc Medicare	$655.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$936.12
Rate for Payer: Hamaspik Choice Inc Medicare	$936.12

SP CAROTID, INTERNAL BI

Facility

$1,147.78

Service Code	HCPCS 36228 TC
Hospital Charge Code	41103344
Hospital Revenue Code	361
Min. Negotiated Rate	$401.72
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$631.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$573.89
Rate for Payer: Aetna Government	$573.89
Rate for Payer: Brighton Health Commercial	$860.84
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	$573.89
Rate for Payer: Group Health Inc Medicare	$401.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$573.89
Rate for Payer: Hamaspik Choice Inc Medicare	$573.89

SP CAROTID, INTERNAL UNI

Facility

$1,147.78

Service Code	HCPCS 36228 TC
Hospital Charge Code	41103343
Hospital Revenue Code	361
Min. Negotiated Rate	$401.72
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$631.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$573.89
Rate for Payer: Aetna Government	$573.89
Rate for Payer: Brighton Health Commercial	$860.84
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	$573.89
Rate for Payer: Group Health Inc Medicare	$401.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$573.89
Rate for Payer: Hamaspik Choice Inc Medicare	$573.89

SP CAROTID LIMITED

Facility

$339.45

Service Code	HCPCS 93882 TC
Hospital Charge Code	41201161
Hospital Revenue Code	920
Rate for Payer: Cash Price	$127.14

SP CAROTID LIMITED

Facility

$339.45

Service Code	HCPCS 93882 TC
Hospital Charge Code	41201161
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 CATHETERIZATION HEPATIC VEIN

Facility

$2,814.83

Service Code	HCPCS 36011 TC
Hospital Charge Code	41547723
Hospital Revenue Code	361
Min. Negotiated Rate	$985.19
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,548.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,407.42
Rate for Payer: Aetna Government	$1,407.42
Rate for Payer: Brighton Health Commercial	$2,111.12
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	$1,407.42
Rate for Payer: Group Health Inc Medicare	$985.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,407.42
Rate for Payer: Hamaspik Choice Inc Medicare	$1,407.42

SP CATH PLAC/PICC/SHIL

Facility

$4,940.28

Service Code	HCPCS 36555 TC
Hospital Charge Code	41542835
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP CATH PLAC/PICC/SHIL

Facility

$4,940.28

Service Code	HCPCS 36555 TC
Hospital Charge Code	41542835
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	$3,686.08
Rate for Payer: Cash Price	$3,686.08
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 CAVERNOSOGRAM

Facility

$295.08

Service Code	HCPCS 54230 TC
Hospital Charge Code	41547454
Hospital Revenue Code	361
Min. Negotiated Rate	$103.28
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$162.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$147.54
Rate for Payer: Aetna Government	$147.54
Rate for Payer: Brighton Health Commercial	$221.31
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	$147.54
Rate for Payer: Group Health Inc Medicare	$103.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$147.54
Rate for Payer: Hamaspik Choice Inc Medicare	$147.54

SP CELIAC PLEXUS BLOCK

Facility

$2,459.50

Service Code	HCPCS 64530 TC
Hospital Charge Code	41561842
Hospital Revenue Code	361
Min. Negotiated Rate	$860.82
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,352.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,229.75
Rate for Payer: Aetna Government	$1,229.75
Rate for Payer: Brighton Health Commercial	$1,844.62
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
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	$1,229.75
Rate for Payer: Group Health Inc Medicare	$860.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,229.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,229.75

SP CELIAC PLEXUS BLOCK

Facility

$2,459.50

Service Code	HCPCS 64530 TC
Hospital Charge Code	41561842
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,054.06

SP CEN LINE EXCH

Facility

$4,940.28

Service Code	HCPCS 36580 TC
Hospital Charge Code	41549844
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,852.05

SP CEN LINE EXCH

Facility

$4,940.28

Service Code	HCPCS 36580 TC
Hospital Charge Code	41549844
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 CESSATION AT/VEN THROMB THER

Facility

$4,940.28

Service Code	HCPCS 37214 TC
Hospital Charge Code	41543303
Hospital Revenue Code	329
Rate for Payer: Cash Price	$3,686.08

SP CESSATION AT/VEN THROMB THER

Facility

$4,940.28

Service Code	HCPCS 37214 TC
Hospital Charge Code	41543303
Hospital Revenue Code	329
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	$3,686.08
Rate for Payer: Cash Price	$3,686.08
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 CHANGE CYSTOSTOMY TUBE

Facility

$711.45

Service Code	HCPCS 51705 TC
Hospital Charge Code	41547645
Hospital Revenue Code	361
Min. Negotiated Rate	$249.01
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$391.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$355.72
Rate for Payer: Aetna Government	$355.72
Rate for Payer: Brighton Health Commercial	$533.59
Rate for Payer: Cash Price	$285.81
Rate for Payer: Cash Price	$285.81
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	$355.72
Rate for Payer: Group Health Inc Medicare	$249.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$355.72
Rate for Payer: Hamaspik Choice Inc Medicare	$355.72

SP CHANGE CYSTOSTOMY TUBE

Facility

$711.45

Service Code	HCPCS 51705 TC
Hospital Charge Code	41547645
Hospital Revenue Code	361
Rate for Payer: Cash Price	$285.81

SP CHANGE CYSTOSTOMY TUBE COMPLIC

Facility

$1,685.60

Service Code	HCPCS 51710 TC
Hospital Charge Code	41549906
Hospital Revenue Code	361
Rate for Payer: Cash Price	$789.96

SP CHANGE CYSTOSTOMY TUBE COMPLIC

Facility

$1,685.60

Service Code	HCPCS 51710 TC
Hospital Charge Code	41549906
Hospital Revenue Code	361
Min. Negotiated Rate	$589.96
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$927.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$842.80
Rate for Payer: Aetna Government	$842.80
Rate for Payer: Brighton Health Commercial	$1,264.20
Rate for Payer: Cash Price	$789.96
Rate for Payer: Cash Price	$789.96
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	$842.80
Rate for Payer: Group Health Inc Medicare	$589.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$842.80
Rate for Payer: Hamaspik Choice Inc Medicare	$842.80

SP CHANGE GASTRO TUBE

Facility

$711.45

Service Code	HCPCS 43763 TC
Hospital Charge Code	41542707
Hospital Revenue Code	361
Min. Negotiated Rate	$249.01
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$391.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$355.72
Rate for Payer: Aetna Government	$355.72
Rate for Payer: Brighton Health Commercial	$533.59
Rate for Payer: Cash Price	$285.81
Rate for Payer: Cash Price	$285.81
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	$355.72
Rate for Payer: Group Health Inc Medicare	$249.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$355.72
Rate for Payer: Hamaspik Choice Inc Medicare	$355.72

SP CHANGE GASTRO TUBE

Facility

$711.45

Service Code	HCPCS 43763 TC
Hospital Charge Code	41542707
Hospital Revenue Code	361
Rate for Payer: Cash Price	$285.81

Know your out-of-pocket cost for care.

All Charges