St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SP INJ CHOLANGIO EXT CATH

Facility

$9,417.43

Service Code	HCPCS 47531 TC
Hospital Charge Code	41548038
Hospital Revenue Code	361
Rate for Payer: Cash Price	$4,000.83

SP INJ CON OR AIR INTO PERIT CAVI

Facility

$505.78

Service Code	HCPCS 49400 TC
Hospital Charge Code	41547617
Hospital Revenue Code	361
Min. Negotiated Rate	$177.02
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$278.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$252.89
Rate for Payer: Aetna Government	$252.89
Rate for Payer: Brighton Health Commercial	$379.34
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	$252.89
Rate for Payer: Group Health Inc Medicare	$177.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$252.89
Rate for Payer: Hamaspik Choice Inc Medicare	$252.89

SP INJ PROC EVAL PERTIO VEN SHUNT

Facility

$2,425.06

Service Code	HCPCS 49427 TC
Hospital Charge Code	41547620
Hospital Revenue Code	361
Min. Negotiated Rate	$848.77
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,333.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,212.53
Rate for Payer: Aetna Government	$1,212.53
Rate for Payer: Brighton Health Commercial	$1,818.80
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	$1,212.53
Rate for Payer: Group Health Inc Medicare	$848.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,212.53
Rate for Payer: Hamaspik Choice Inc Medicare	$1,212.53

SPINL TRAY SPINL TAP LUMBR PU

Facility

$45.36

Hospital Charge Code	40205730
Hospital Revenue Code	270
Min. Negotiated Rate	$15.88
Max. Negotiated Rate	$36.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.68
Rate for Payer: Aetna Government	$22.68
Rate for Payer: Brighton Health Commercial	$34.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.84
Rate for Payer: Group Health Inc Commercial	$22.68
Rate for Payer: Group Health Inc Medicare	$15.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.68
Rate for Payer: Hamaspik Choice Inc Medicare	$22.68

SP INS CENT LN NONTUN < 5

Facility

$4,940.28

Service Code	HCPCS 36555 TC
Hospital Charge Code	41549853
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP INS CENT LN NONTUN < 5

Facility

$4,940.28

Service Code	HCPCS 36555 TC
Hospital Charge Code	41549853
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 INS CENT LN NONTUN > 5

Facility

$4,940.28

Service Code	HCPCS 36556 TC
Hospital Charge Code	41549854
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 INS CENT LN NONTUN > 5

Facility

$4,940.28

Service Code	HCPCS 36556 TC
Hospital Charge Code	41549854
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP INSERTION MIDLINE CATHETER

Facility

$4,940.28

Service Code	HCPCS 36569
Hospital Charge Code	41542902
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,852.05

SP INSERTION MIDLINE CATHETER

Facility

$4,940.28

Service Code	HCPCS 36569
Hospital Charge Code	41542902
Hospital Revenue Code	361
Min. Negotiated Rate	$1,412.00
Max. Negotiated Rate	$3,705.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,852.05
Rate for Payer: Aetna Government	$1,852.05
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: Cash Price	$1,852.05
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$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: Elderplan Medicare Advantage	$1,852.05
Rate for Payer: EmblemHealth Commercial	$1,852.05
Rate for Payer: Fidelis Essential Plan Aliesa	$1,574.24
Rate for Payer: Fidelis Essential Plan QHP	$1,648.32
Rate for Payer: Fidelis Medicare Advantage	$1,852.05
Rate for Payer: Fidelis Qualified Health Plan	$1,648.32
Rate for Payer: Group Health Inc Commercial	$1,852.05
Rate for Payer: Group Health Inc Medicare	$1,852.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,470.14
Rate for Payer: Hamaspik Choice Inc Medicare	$1,852.05
Rate for Payer: Healthfirst Medicare Advantage	$1,574.24
Rate for Payer: Healthfirst QHP	$1,852.05
Rate for Payer: Senior Whole Health Medicare Advantage	$1,852.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,852.05
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,481.64
Rate for Payer: Wellcare Medicare	$1,759.45

SP INSERT OF TUN CATH DIALYSIS

Facility

$9,417.43

Service Code	HCPCS 49421 TC
Hospital Charge Code	41561815
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$7,063.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,179.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,708.72
Rate for Payer: Aetna Government	$4,708.72
Rate for Payer: Brighton Health Commercial	$7,063.07
Rate for Payer: Cash Price	$4,000.83
Rate for Payer: Cash Price	$4,000.83
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	$4,708.72
Rate for Payer: Group Health Inc Medicare	$3,296.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,708.72
Rate for Payer: Hamaspik Choice Inc Medicare	$4,708.72

SP INSERT OF TUN CATH DIALYSIS

Facility

$9,417.43

Service Code	HCPCS 49421 TC
Hospital Charge Code	41561815
Hospital Revenue Code	361
Rate for Payer: Cash Price	$4,000.83

SP INSERT PERITONEAL VENOUS SHUNT

Facility

$2,425.06

Service Code	HCPCS 49425 TC
Hospital Charge Code	41561819
Hospital Revenue Code	361
Min. Negotiated Rate	$848.77
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,333.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,212.53
Rate for Payer: Aetna Government	$1,212.53
Rate for Payer: Brighton Health Commercial	$1,818.80
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	$1,212.53
Rate for Payer: Group Health Inc Medicare	$848.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,212.53
Rate for Payer: Hamaspik Choice Inc Medicare	$1,212.53

SP INSERT PLEURAL CATH

Facility

$9,417.43

Service Code	HCPCS 32550 TC
Hospital Charge Code	41561818
Hospital Revenue Code	361
Rate for Payer: Cash Price	$4,000.83

SP INSERT PLEURAL CATH

Facility

$9,417.43

Service Code	HCPCS 32550 TC
Hospital Charge Code	41561818
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$7,063.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,179.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,708.72
Rate for Payer: Aetna Government	$4,708.72
Rate for Payer: Brighton Health Commercial	$7,063.07
Rate for Payer: Cash Price	$4,000.83
Rate for Payer: Cash Price	$4,000.83
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	$4,708.72
Rate for Payer: Group Health Inc Medicare	$3,296.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,708.72
Rate for Payer: Hamaspik Choice Inc Medicare	$4,708.72

SP INSERT SUPRAPUBIC CATHETER

Facility

$5,365.58

Service Code	HCPCS 51102 TC
Hospital Charge Code	41547644
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 INSERT SUPRAPUBIC CATHETER

Facility

$5,365.58

Service Code	HCPCS 51102 TC
Hospital Charge Code	41547644
Hospital Revenue Code	361
Rate for Payer: Cash Price	$2,355.42

SP INSERT TUN IP CATH PERCU

Facility

$9,417.43

Service Code	HCPCS 49418 TC
Hospital Charge Code	41561908
Hospital Revenue Code	320
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$7,063.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,179.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,708.72
Rate for Payer: Aetna Government	$4,708.72
Rate for Payer: Brighton Health Commercial	$7,063.07
Rate for Payer: Cash Price	$4,000.83
Rate for Payer: Cash Price	$4,000.83
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	$4,708.72
Rate for Payer: Group Health Inc Medicare	$3,296.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,708.72
Rate for Payer: Hamaspik Choice Inc Medicare	$4,708.72

SP INSERT TUN IP CATH PERCU

Facility

$9,417.43

Service Code	HCPCS 49418 TC
Hospital Charge Code	41561908
Hospital Revenue Code	320
Rate for Payer: Cash Price	$4,000.83

SP INS GRAFT,AORTA OR GRT VESW/OS

Facility

$4,544.47

Service Code	HCPCS 33330 TC
Hospital Charge Code	41547695
Hospital Revenue Code	361
Min. Negotiated Rate	$1,590.56
Max. Negotiated Rate	$3,408.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,499.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,272.24
Rate for Payer: Aetna Government	$2,272.24
Rate for Payer: Brighton Health Commercial	$3,408.35
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	$2,272.24
Rate for Payer: Group Health Inc Medicare	$1,590.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,272.24
Rate for Payer: Hamaspik Choice Inc Medicare	$2,272.24

SP INTERCOSTAL BLOCK

Facility

$2,459.50

Service Code	HCPCS 64421 TC
Hospital Charge Code	41561841
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 INTERCOSTAL BLOCK

Facility

$2,459.50

Service Code	HCPCS 64421 TC
Hospital Charge Code	41561841
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,054.06

SP INTERNAL MAMMARY ANGIO

Facility

$8,393.53

Service Code	HCPCS 75756 TC
Hospital Charge Code	41561889
Hospital Revenue Code	320
Min. Negotiated Rate	$2,937.74
Max. Negotiated Rate	$6,714.82
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: Cigna HMO/Network Benefit Plan/Open Access	$6,714.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,707.60
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 INTERNAL MAMMARY ANGIO

Facility

$8,393.53

Service Code	HCPCS 75756 TC
Hospital Charge Code	41561889
Hospital Revenue Code	320
Rate for Payer: Cash Price	$3,686.08

SP INTRA ARTERIAL CHEMO,INFUSION

Facility

$556.18

Service Code	HCPCS 96422 TC
Hospital Charge Code	41561852
Hospital Revenue Code	335
Min. Negotiated Rate	$194.66
Max. Negotiated Rate	$644.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$305.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$278.09
Rate for Payer: Aetna Government	$278.09
Rate for Payer: Brighton Health Commercial	$417.14
Rate for Payer: Cash Price	$391.64
Rate for Payer: Cash Price	$391.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$644.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$547.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$279.92
Rate for Payer: Fidelis Essential Plan Aliesa	$279.92
Rate for Payer: Fidelis Essential Plan QHP	$294.00
Rate for Payer: Fidelis Qualified Health Plan	$294.00
Rate for Payer: Group Health Inc Commercial	$278.09
Rate for Payer: Group Health Inc Medicare	$194.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$278.09
Rate for Payer: Hamaspik Choice Inc Medicare	$278.09

Know your out-of-pocket cost for care.

All Charges