St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SP EMBOLI BLEED

Facility

$30,010.30

Service Code	HCPCS 37244 TC
Hospital Charge Code	41104009
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$22,507.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16,505.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15,005.15
Rate for Payer: Aetna Government	$15,005.15
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: 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	$15,005.15
Rate for Payer: Group Health Inc Medicare	$10,503.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,005.15
Rate for Payer: Hamaspik Choice Inc Medicare	$15,005.15

SP EMBOLI BLEED

Facility

$30,010.30

Service Code	HCPCS 37244 TC
Hospital Charge Code	41104009
Hospital Revenue Code	361
Rate for Payer: Cash Price	$12,721.98

SP EMBOLI ORGAN

Facility

$30,948.00

Service Code	HCPCS 37243 TC
Hospital Charge Code	41104007
Hospital Revenue Code	361
Rate for Payer: Cash Price	$12,721.98

SP EMBOLI ORGAN

Facility

$30,948.00

Service Code	HCPCS 37243 TC
Hospital Charge Code	41104007
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$23,211.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17,021.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15,474.00
Rate for Payer: Aetna Government	$15,474.00
Rate for Payer: Brighton Health Commercial	$23,211.00
Rate for Payer: Cash Price	$12,721.98
Rate for Payer: Cash Price	$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: Group Health Inc Commercial	$15,474.00
Rate for Payer: Group Health Inc Medicare	$10,831.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,474.00
Rate for Payer: Hamaspik Choice Inc Medicare	$15,474.00

SP EMBOLIZATION (NEURO)

Facility

$3,193.63

Service Code	HCPCS 61624 TC
Hospital Charge Code	41542743
Hospital Revenue Code	361
Min. Negotiated Rate	$1,117.77
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,756.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,596.82
Rate for Payer: Aetna Government	$1,596.82
Rate for Payer: Brighton Health Commercial	$2,395.22
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	$1,596.82
Rate for Payer: Group Health Inc Medicare	$1,117.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,596.82
Rate for Payer: Hamaspik Choice Inc Medicare	$1,596.82

SP EMBOLIZ. EXTRACRAN. HEAD &NECK

Facility

$30,010.30

Service Code	HCPCS 61626 TC
Hospital Charge Code	41549742
Hospital Revenue Code	361
Rate for Payer: Cash Price	$12,721.98

SP EMBOLIZ. EXTRACRAN. HEAD &NECK

Facility

$30,010.30

Service Code	HCPCS 61626 TC
Hospital Charge Code	41549742
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$22,507.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16,505.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15,005.15
Rate for Payer: Aetna Government	$15,005.15
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: 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	$15,005.15
Rate for Payer: Group Health Inc Medicare	$10,503.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,005.15
Rate for Payer: Hamaspik Choice Inc Medicare	$15,005.15

SP EMB/THROMB-AXILL,BRACH-ARMINCI

Facility

$13,920.70

Service Code	HCPCS 34101 TC
Hospital Charge Code	41547715
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$10,440.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,656.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,960.35
Rate for Payer: Aetna Government	$6,960.35
Rate for Payer: Brighton Health Commercial	$10,440.52
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cash Price	$6,354.94
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	$6,960.35
Rate for Payer: Group Health Inc Medicare	$4,872.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.35
Rate for Payer: Hamaspik Choice Inc Medicare	$6,960.35

SP EMB/THROMB-AXILL,BRACH-ARMINCI

Facility

$13,920.70

Service Code	HCPCS 34101 TC
Hospital Charge Code	41547715
Hospital Revenue Code	361
Rate for Payer: Cash Price	$6,354.94

SP EMB/THROM,FEMOR,AORT-IL ART,LE

Facility

$13,920.70

Service Code	HCPCS 34201 TC
Hospital Charge Code	41547717
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$10,440.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,656.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,960.35
Rate for Payer: Aetna Government	$6,960.35
Rate for Payer: Brighton Health Commercial	$10,440.52
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cash Price	$6,354.94
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	$6,960.35
Rate for Payer: Group Health Inc Medicare	$4,872.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.35
Rate for Payer: Hamaspik Choice Inc Medicare	$6,960.35

SP EMB/THROM,FEMOR,AORT-IL ART,LE

Facility

$13,920.70

Service Code	HCPCS 34201 TC
Hospital Charge Code	41547717
Hospital Revenue Code	361
Rate for Payer: Cash Price	$6,354.94

SP EMB/THROM-REN,CEL,AORILL,ABD I

Facility

$2,061.05

Service Code	HCPCS 34151 TC
Hospital Charge Code	41547716
Hospital Revenue Code	361
Min. Negotiated Rate	$721.37
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,133.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,030.52
Rate for Payer: Aetna Government	$1,030.52
Rate for Payer: Brighton Health Commercial	$1,545.79
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	$1,030.52
Rate for Payer: Group Health Inc Medicare	$721.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,030.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1,030.52

SP ENDOLUMINAL BX URTR RNL PLVS

Facility

$2,804.37

Service Code	HCPCS 50606
Hospital Charge Code	41542909
Hospital Revenue Code	361
Min. Negotiated Rate	$192.44
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$192.44
Rate for Payer: Aetna Government	$192.44
Rate for Payer: Brighton Health Commercial	$2,103.28
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	$1,402.18
Rate for Payer: Group Health Inc Medicare	$981.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,402.18
Rate for Payer: Hamaspik Choice Inc Medicare	$1,402.18

SP ENDOVENOUS ABLAT THERAPY

Facility

$8,393.53

Service Code	HCPCS 36478
Hospital Charge Code	41200615
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP ENDOVENOUS ABLAT THERAPY

Facility

$8,393.53

Service Code	HCPCS 36478
Hospital Charge Code	41200615
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$6,295.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,686.08
Rate for Payer: Aetna Government	$3,686.08
Rate for Payer: Brighton Health Commercial	$6,295.15
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$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: Elderplan Medicare Advantage	$3,686.08
Rate for Payer: EmblemHealth Commercial	$3,686.08
Rate for Payer: Fidelis Essential Plan Aliesa	$3,133.17
Rate for Payer: Fidelis Essential Plan QHP	$3,280.61
Rate for Payer: Fidelis Medicare Advantage	$3,686.08
Rate for Payer: Fidelis Qualified Health Plan	$3,280.61
Rate for Payer: Group Health Inc Commercial	$3,686.08
Rate for Payer: Group Health Inc Medicare	$3,686.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.76
Rate for Payer: Hamaspik Choice Inc Medicare	$3,686.08
Rate for Payer: Healthfirst Medicare Advantage	$3,133.17
Rate for Payer: Healthfirst QHP	$3,686.08
Rate for Payer: Senior Whole Health Medicare Advantage	$3,686.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,686.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,948.86
Rate for Payer: Wellcare Medicare	$3,501.78

SP ENDOVENOUS LASER ABLATION, 1ST

Facility

$8,393.53

Service Code	HCPCS 36478 TC
Hospital Charge Code	41561844
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP ENDOVENOUS LASER ABLATION, 1ST

Facility

$8,393.53

Service Code	HCPCS 36478 TC
Hospital Charge Code	41561844
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$6,295.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,616.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,196.76
Rate for Payer: Aetna Government	$4,196.76
Rate for Payer: Brighton Health Commercial	$6,295.15
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	$4,196.76
Rate for Payer: Group Health Inc Medicare	$2,937.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.76
Rate for Payer: Hamaspik Choice Inc Medicare	$4,196.76

SP ENDOVENOUS LASER ABLATION ADD

Facility

$6,231.85

Service Code	HCPCS 36479 TC
Hospital Charge Code	41561845
Hospital Revenue Code	361
Min. Negotiated Rate	$2,181.15
Max. Negotiated Rate	$4,673.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,427.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,115.92
Rate for Payer: Aetna Government	$3,115.92
Rate for Payer: Brighton Health Commercial	$4,673.89
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	$3,115.92
Rate for Payer: Group Health Inc Medicare	$2,181.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,115.92
Rate for Payer: Hamaspik Choice Inc Medicare	$3,115.92

SP ENDOVENOUS MCHNCHEM 1ST VEIN

Facility

$8,393.53

Service Code	HCPCS 36473 TC
Hospital Charge Code	41563235
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP ENDOVENOUS MCHNCHEM 1ST VEIN

Facility

$8,393.53

Service Code	HCPCS 36473 TC
Hospital Charge Code	41563235
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$6,295.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,616.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,196.76
Rate for Payer: Aetna Government	$4,196.76
Rate for Payer: Brighton Health Commercial	$6,295.15
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	$4,196.76
Rate for Payer: Group Health Inc Medicare	$2,937.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.76
Rate for Payer: Hamaspik Choice Inc Medicare	$4,196.76

SP ENDOVENOUS MCHNCHEM ADDL

Facility

$2,077.28

Service Code	HCPCS 36474 TC
Hospital Charge Code	41563236
Hospital Revenue Code	361
Min. Negotiated Rate	$727.05
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,142.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,038.64
Rate for Payer: Aetna Government	$1,038.64
Rate for Payer: Brighton Health Commercial	$1,557.96
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	$1,038.64
Rate for Payer: Group Health Inc Medicare	$727.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,038.64
Rate for Payer: Hamaspik Choice Inc Medicare	$1,038.64

SP ENTEROCLYSIS

Facility

$494.71

Service Code	HCPCS 44015 TC
Hospital Charge Code	41542709
Hospital Revenue Code	361
Min. Negotiated Rate	$173.15
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$272.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$247.36
Rate for Payer: Aetna Government	$247.36
Rate for Payer: Brighton Health Commercial	$371.03
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	$247.36
Rate for Payer: Group Health Inc Medicare	$173.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$247.36
Rate for Payer: Hamaspik Choice Inc Medicare	$247.36

SP E.R.C.P. W/STENT

Facility

$14,479.95

Service Code	HCPCS 43274 TC
Hospital Charge Code	41546008
Hospital Revenue Code	361
Rate for Payer: Cash Price	$6,590.73

SP E.R.C.P. W/STENT

Facility

$14,479.95

Service Code	HCPCS 43274 TC
Hospital Charge Code	41546008
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$10,859.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,963.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7,239.98
Rate for Payer: Aetna Government	$7,239.98
Rate for Payer: Brighton Health Commercial	$10,859.96
Rate for Payer: Cash Price	$6,590.73
Rate for Payer: Cash Price	$6,590.73
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	$7,239.98
Rate for Payer: Group Health Inc Medicare	$5,067.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,239.98
Rate for Payer: Hamaspik Choice Inc Medicare	$7,239.98

SP ESOPHAGUS DILATION

Facility

$4,716.98

Service Code	HCPCS 43453 TC
Hospital Charge Code	41547677
Hospital Revenue Code	361
Min. Negotiated Rate	$1,650.94
Max. Negotiated Rate	$3,537.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,594.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,358.49
Rate for Payer: Aetna Government	$2,358.49
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: 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	$2,358.49
Rate for Payer: Group Health Inc Medicare	$1,650.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,358.49
Rate for Payer: Hamaspik Choice Inc Medicare	$2,358.49

Know your out-of-pocket cost for care.

All Charges