St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC

Facility

$17,504.42

Service Code	MSDRG 538
Min. Negotiated Rate	$6,080.53
Max. Negotiated Rate	$17,504.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10,455.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17,161.20
Rate for Payer: Aetna Government	$17,161.20
Rate for Payer: Brighton Health Commercial	$10,281.95
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$17,504.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12,245.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$10,105.47
Rate for Payer: Elderplan Medicare Advantage	$16,303.14
Rate for Payer: EmblemHealth Commercial	$6,080.53
Rate for Payer: Fidelis Medicare Advantage	$17,161.20
Rate for Payer: Group Health Inc Commercial	$17,161.20
Rate for Payer: Group Health Inc Medicare	$17,161.20
Rate for Payer: Hamaspik Choice Inc Medicare	$17,161.20
Rate for Payer: Healthfirst Medicare Advantage	$7,979.96
Rate for Payer: Senior Whole Health Medicare Advantage	$17,161.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17,161.20
Rate for Payer: Wellcare Medicare	$16,303.14

SP REM DOUBLEJ-PERC SNARE

Facility

$5,365.58

Service Code	HCPCS 50384 TC
Hospital Charge Code	41548031
Hospital Revenue Code	361
Rate for Payer: Cash Price	$2,355.42

SP REM DOUBLEJ-PERC SNARE

Facility

$5,365.58

Service Code	HCPCS 50384 TC
Hospital Charge Code	41548031
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 REM IMPLANT VEN CATH

Facility

$1,909.65

Service Code	HCPCS 36589 TC
Hospital Charge Code	41542833
Hospital Revenue Code	361
Rate for Payer: Cash Price	$726.47

SP REM IMPLANT VEN CATH

Facility

$1,909.65

Service Code	HCPCS 36589 TC
Hospital Charge Code	41542833
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 REM IMPL INTRAVENOUS INFU PUMP

Facility

$1,909.65

Service Code	HCPCS 36590 TC
Hospital Charge Code	41547712
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,852.05

SP REM IMPL INTRAVENOUS INFU PUMP

Facility

$1,909.65

Service Code	HCPCS 36590 TC
Hospital Charge Code	41547712
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	$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	$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 REM NEPHROSTOMY W/FLUORO

Facility

$1,685.60

Service Code	HCPCS 50389 TC
Hospital Charge Code	41548033
Hospital Revenue Code	361
Rate for Payer: Cash Price	$789.96

SP REM NEPHROSTOMY W/FLUORO

Facility

$1,685.60

Service Code	HCPCS 50389 TC
Hospital Charge Code	41548033
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 REMOVAL G-, J-, G-J, C TUBE ON

Facility

$2,380.35

Service Code	HCPCS 49460 TC
Hospital Charge Code	41561932
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,048.28

SP REMOVAL G-, J-, G-J, C TUBE ON

Facility

$2,380.35

Service Code	HCPCS 49460 TC
Hospital Charge Code	41561932
Hospital Revenue Code	361
Min. Negotiated Rate	$833.12
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,309.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,190.18
Rate for Payer: Aetna Government	$1,190.18
Rate for Payer: Brighton Health Commercial	$1,785.26
Rate for Payer: Cash Price	$1,048.28
Rate for Payer: Cash Price	$1,048.28
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	$1,190.18
Rate for Payer: Group Health Inc Medicare	$833.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,190.18
Rate for Payer: Hamaspik Choice Inc Medicare	$1,190.18

SP REMOVAL OF TUN INTRAPERITONEAL

Facility

$8,393.53

Service Code	HCPCS 49422 TC
Hospital Charge Code	41561816
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP REMOVAL OF TUN INTRAPERITONEAL

Facility

$8,393.53

Service Code	HCPCS 49422 TC
Hospital Charge Code	41561816
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 REMOVE DUCT GLBLDR CALCULI

Facility

$1,562.73

Service Code	HCPCS 47544 TC
Hospital Charge Code	41542714
Hospital Revenue Code	361
Min. Negotiated Rate	$546.96
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$859.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$781.36
Rate for Payer: Aetna Government	$781.36
Rate for Payer: Brighton Health Commercial	$1,172.05
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	$781.36
Rate for Payer: Group Health Inc Medicare	$546.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$781.36
Rate for Payer: Hamaspik Choice Inc Medicare	$781.36

SP REMOVE FOREIGN BODY ABDOMEN

Facility

$9,417.43

Service Code	HCPCS 49402 TC
Hospital Charge Code	41561817
Hospital Revenue Code	361
Rate for Payer: Cash Price	$4,000.83

SP REMOVE FOREIGN BODY ABDOMEN

Facility

$9,417.43

Service Code	HCPCS 49402 TC
Hospital Charge Code	41561817
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 REMOVE LUNG CATHETER

Facility

$1,909.65

Service Code	HCPCS 32552 TC
Hospital Charge Code	41561813
Hospital Revenue Code	361
Rate for Payer: Cash Price	$726.47

SP REMOVE LUNG CATHETER

Facility

$1,909.65

Service Code	HCPCS 32552 TC
Hospital Charge Code	41561813
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 REM&REP DOUBLEJ_PERC

Facility

$5,365.58

Service Code	HCPCS 50382 TC
Hospital Charge Code	41548030
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 REM&REP DOUBLEJ_PERC

Facility

$5,365.58

Service Code	HCPCS 50382 TC
Hospital Charge Code	41548030
Hospital Revenue Code	361
Rate for Payer: Cash Price	$2,355.42

SP RENAL BIOPSY

Facility

$4,157.25

Service Code	HCPCS 50200 TC
Hospital Charge Code	41542302
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,874.89

SP RENAL BIOPSY

Facility

$4,157.25

Service Code	HCPCS 50200 TC
Hospital Charge Code	41542302
Hospital Revenue Code	361
Min. Negotiated Rate	$745.00
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: EmblemHealth Commercial	$745.00
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 RENAL TRANSLUMBAR

Facility

$30,010.30

Service Code	HCPCS 0234T
Hospital Charge Code	41542762
Hospital Revenue Code	361
Rate for Payer: Cash Price	$12,721.98

SP RENAL TRANSLUMBAR

Facility

$30,010.30

Service Code	HCPCS 0234T
Hospital Charge Code	41542762
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 REPAIR ANE,FALS ANE &OCCLDISAB

Facility

$5,313.27

Service Code	HCPCS 35081 TC
Hospital Charge Code	41547704
Hospital Revenue Code	361
Min. Negotiated Rate	$1,859.64
Max. Negotiated Rate	$3,984.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,922.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,656.64
Rate for Payer: Aetna Government	$2,656.64
Rate for Payer: Brighton Health Commercial	$3,984.95
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	$2,656.64
Rate for Payer: Group Health Inc Medicare	$1,859.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,656.64
Rate for Payer: Hamaspik Choice Inc Medicare	$2,656.64

Know your out-of-pocket cost for care.

All Charges