St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SP LYMPH NODES. INT.MAM

Facility

$9,175.75

Service Code	HCPCS 38530 TC
Hospital Charge Code	41547648
Hospital Revenue Code	361
Rate for Payer: Cash Price	$4,407.98

SP LYMPH NODES. INT.MAM

Facility

$9,175.75

Service Code	HCPCS 38530 TC
Hospital Charge Code	41547648
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$6,881.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,046.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,587.88
Rate for Payer: Aetna Government	$4,587.88
Rate for Payer: Brighton Health Commercial	$6,881.81
Rate for Payer: Cash Price	$4,407.98
Rate for Payer: Cash Price	$4,407.98
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	$4,587.88
Rate for Payer: Group Health Inc Medicare	$3,211.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,587.88
Rate for Payer: Hamaspik Choice Inc Medicare	$4,587.88

SP LYMPH NODES.SUP. PERCUTANEOUS

Facility

$4,157.25

Service Code	HCPCS 38505 TC
Hospital Charge Code	41547647
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,874.89

SP LYMPH NODES.SUP. PERCUTANEOUS

Facility

$4,157.25

Service Code	HCPCS 38505 TC
Hospital Charge Code	41547647
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 LYSE CHEST FIBRIN INIT DAY

Facility

$1,909.65

Service Code	HCPCS 32561 TC
Hospital Charge Code	41561920
Hospital Revenue Code	361
Rate for Payer: Cash Price	$726.47

SP LYSE CHEST FIBRIN INIT DAY

Facility

$1,909.65

Service Code	HCPCS 32561 TC
Hospital Charge Code	41561920
Hospital Revenue Code	361
Min. Negotiated Rate	$668.38
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,050.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$954.82
Rate for Payer: Aetna Government	$954.82
Rate for Payer: Brighton Health Commercial	$1,432.24
Rate for Payer: Cash Price	$726.47
Rate for Payer: Cash Price	$726.47
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	$954.82
Rate for Payer: Group Health Inc Medicare	$668.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.82
Rate for Payer: Hamaspik Choice Inc Medicare	$954.82

SP LYSE CHEST FIBRIN SUBQ DAY

Facility

$1,909.65

Service Code	HCPCS 32562 TC
Hospital Charge Code	41561921
Hospital Revenue Code	361
Min. Negotiated Rate	$668.38
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,050.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$954.82
Rate for Payer: Aetna Government	$954.82
Rate for Payer: Brighton Health Commercial	$1,432.24
Rate for Payer: Cash Price	$726.47
Rate for Payer: Cash Price	$726.47
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	$954.82
Rate for Payer: Group Health Inc Medicare	$668.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.82
Rate for Payer: Hamaspik Choice Inc Medicare	$954.82

SP LYSE CHEST FIBRIN SUBQ DAY

Facility

$1,909.65

Service Code	HCPCS 32562 TC
Hospital Charge Code	41561921
Hospital Revenue Code	361
Rate for Payer: Cash Price	$726.47

SP MA GUIDED 1ST LOCAL

Facility

$1,847.58

Service Code	HCPCS 19281 TC
Hospital Charge Code	41104035
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	$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	$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

SP MA GUIDED 1ST LOCAL

Facility

$1,847.58

Service Code	HCPCS 19281 TC
Hospital Charge Code	41104035
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,874.89

SP MA GUIDED EACH ADD

Facility

$389.75

Service Code	HCPCS 19282 TC
Hospital Charge Code	41104037
Hospital Revenue Code	361
Min. Negotiated Rate	$136.41
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$194.88
Rate for Payer: Aetna Government	$194.88
Rate for Payer: Brighton Health Commercial	$292.31
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	$194.88
Rate for Payer: Group Health Inc Medicare	$136.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$194.88
Rate for Payer: Hamaspik Choice Inc Medicare	$194.88

SP MCHNCL THRMBCTMY W/BALLN ANGIO

Facility

$30,010.30

Service Code	HCPCS 36905 TC
Hospital Charge Code	41542861
Hospital Revenue Code	361
Rate for Payer: Cash Price	$12,721.98

SP MCHNCL THRMBCTMY W/BALLN ANGIO

Facility

$30,010.30

Service Code	HCPCS 36905 TC
Hospital Charge Code	41542861
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 MCHNCL THRMBCTMY W/STNT PLCMNT

Facility

$48,278.18

Service Code	HCPCS 36906 TC
Hospital Charge Code	41542863
Hospital Revenue Code	361
Rate for Payer: Cash Price	$20,278.00

SP MCHNCL THRMBCTMY W/STNT PLCMNT

Facility

$48,278.18

Service Code	HCPCS 36906 TC
Hospital Charge Code	41542863
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$36,208.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26,553.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24,139.09
Rate for Payer: Aetna Government	$24,139.09
Rate for Payer: Brighton Health Commercial	$36,208.64
Rate for Payer: Cash Price	$20,278.00
Rate for Payer: Cash Price	$20,278.00
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	$24,139.09
Rate for Payer: Group Health Inc Medicare	$16,897.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,139.09
Rate for Payer: Hamaspik Choice Inc Medicare	$24,139.09

SP MCHNICL THRMBCTMY

Facility

$15,004.15

Service Code	HCPCS 36904 TC
Hospital Charge Code	41542859
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$11,253.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8,252.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7,502.08
Rate for Payer: Aetna Government	$7,502.08
Rate for Payer: Brighton Health Commercial	$11,253.11
Rate for Payer: Cash Price	$6,609.72
Rate for Payer: Cash Price	$6,609.72
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	$7,502.08
Rate for Payer: Group Health Inc Medicare	$5,251.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,502.08
Rate for Payer: Hamaspik Choice Inc Medicare	$7,502.08

SP MCHNICL THRMBCTMY

Facility

$15,004.15

Service Code	HCPCS 36904 TC
Hospital Charge Code	41542859
Hospital Revenue Code	361
Rate for Payer: Cash Price	$6,609.72

SP MCHNICL THRMBCTMY ART/BYPASS

Facility

$30,010.30

Service Code	HCPCS 37184 TC
Hospital Charge Code	41548024
Hospital Revenue Code	361
Rate for Payer: Cash Price	$20,278.00

SP MCHNICL THRMBCTMY ART/BYPASS

Facility

$30,010.30

Service Code	HCPCS 37184 TC
Hospital Charge Code	41548024
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	$20,278.00
Rate for Payer: Cash Price	$20,278.00
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 MCHNICL THRMBCTMY ART/COMFIX

Facility

$6,253.68

Service Code	HCPCS 37186 TC
Hospital Charge Code	41548026
Hospital Revenue Code	361
Min. Negotiated Rate	$2,188.79
Max. Negotiated Rate	$4,690.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,439.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,126.84
Rate for Payer: Aetna Government	$3,126.84
Rate for Payer: Brighton Health Commercial	$4,690.26
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	$3,126.84
Rate for Payer: Group Health Inc Medicare	$2,188.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,126.84
Rate for Payer: Hamaspik Choice Inc Medicare	$3,126.84

SP MCHNICL THRMBCTMY ART/SUB VES

Facility

$2,552.23

Service Code	HCPCS 37185 TC
Hospital Charge Code	41548025
Hospital Revenue Code	361
Min. Negotiated Rate	$893.28
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,403.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,276.12
Rate for Payer: Aetna Government	$1,276.12
Rate for Payer: Brighton Health Commercial	$1,914.17
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	$1,276.12
Rate for Payer: Group Health Inc Medicare	$893.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,276.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,276.12

SP MCHNICL THRMBCTMY VEIN/1ST

Facility

$15,004.15

Service Code	HCPCS 37187 TC
Hospital Charge Code	41548027
Hospital Revenue Code	361
Rate for Payer: Cash Price	$12,721.98

SP MCHNICL THRMBCTMY VEIN/1ST

Facility

$15,004.15

Service Code	HCPCS 37187 TC
Hospital Charge Code	41548027
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$11,253.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8,252.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7,502.08
Rate for Payer: Aetna Government	$7,502.08
Rate for Payer: Brighton Health Commercial	$11,253.11
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	$7,502.08
Rate for Payer: Group Health Inc Medicare	$5,251.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,502.08
Rate for Payer: Hamaspik Choice Inc Medicare	$7,502.08

SP MCHNICL THRMBCTMY VEIN F/U

Facility

$8,393.53

Service Code	HCPCS 37188 TC
Hospital Charge Code	41548028
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 MCHNICL THRMBCTMY VEIN F/U

Facility

$8,393.53

Service Code	HCPCS 37188 TC
Hospital Charge Code	41548028
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

Know your out-of-pocket cost for care.

All Charges