St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SP REP DISL G-J TUBE COMPLEX

Facility

$711.45

Service Code	HCPCS 43761 TC
Hospital Charge Code	41547665
Hospital Revenue Code	361
Rate for Payer: Cash Price	$285.81

SP REP DISL G-J TUBE COMPLEX

Facility

$711.45

Service Code	HCPCS 43761 TC
Hospital Charge Code	41547665
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 REP DISL G-J TUBE COMPLEX

Facility

$4,716.98

Service Code	HCPCS 44373 TC
Hospital Charge Code	41547667
Hospital Revenue Code	361
Rate for Payer: Cash Price	$2,200.46

SP REP DISL G-J TUBE COMPLEX

Facility

$4,716.98

Service Code	HCPCS 44373 TC
Hospital Charge Code	41547667
Hospital Revenue Code	361
Min. Negotiated Rate	$745.00
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: EmblemHealth Commercial	$745.00
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

SP REPLACE AREM-CHEST PORT

Facility

$8,393.53

Service Code	HCPCS 36578 TC
Hospital Charge Code	41561831
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP REPLACE AREM-CHEST PORT

Facility

$8,393.53

Service Code	HCPCS 36578 TC
Hospital Charge Code	41561831
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 REPLACE ARM PORT ENTIRE

Facility

$8,393.53

Service Code	HCPCS 36585 TC
Hospital Charge Code	41561833
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP REPLACE ARM PORT ENTIRE

Facility

$8,393.53

Service Code	HCPCS 36585 TC
Hospital Charge Code	41561833
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 REPLACE CHEST PORT ENTIRE

Facility

$8,393.53

Service Code	HCPCS 36582 TC
Hospital Charge Code	41561834
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 REPLACE CHEST PORT ENTIRE

Facility

$8,393.53

Service Code	HCPCS 36582 TC
Hospital Charge Code	41561834
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP REPLACE DUOD/JEJ TUBE PERC

Facility

$2,316.08

Service Code	HCPCS 49451 TC
Hospital Charge Code	41561821
Hospital Revenue Code	361
Min. Negotiated Rate	$810.63
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,273.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,158.04
Rate for Payer: Aetna Government	$1,158.04
Rate for Payer: Brighton Health Commercial	$1,737.06
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	$1,158.04
Rate for Payer: Group Health Inc Medicare	$810.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,158.04
Rate for Payer: Hamaspik Choice Inc Medicare	$1,158.04

SP REPLACE DUOD/JEJ TUBE PERC

Facility

$2,316.08

Service Code	HCPCS 49451 TC
Hospital Charge Code	41561821
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,048.28

SPREPLACE G/C TUBE PERC

Facility

$2,380.35

Service Code	HCPCS 49450 TC
Hospital Charge Code	41561823
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

SPREPLACE G/C TUBE PERC

Facility

$2,380.35

Service Code	HCPCS 49450 TC
Hospital Charge Code	41561823
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,048.28

SP REPLACE G-J TUBE PERC

Facility

$2,380.35

Service Code	HCPCS 49452 TC
Hospital Charge Code	41561822
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,048.28

SP REPLACE G-J TUBE PERC

Facility

$2,380.35

Service Code	HCPCS 49452 TC
Hospital Charge Code	41561822
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 REPL DISLODG G-J TUBE SIMPLE

Facility

$711.45

Service Code	HCPCS 43763 TC
Hospital Charge Code	41547661
Hospital Revenue Code	361
Rate for Payer: Cash Price	$285.81

SP REPL DISLODG G-J TUBE SIMPLE

Facility

$711.45

Service Code	HCPCS 43763 TC
Hospital Charge Code	41547661
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 REPN CENTVENCAT

Facility

$4,940.28

Service Code	HCPCS 36597 TC
Hospital Charge Code	41549850
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 REPN CENTVENCAT

Facility

$4,940.28

Service Code	HCPCS 36597 TC
Hospital Charge Code	41549850
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,852.05

SP REPO. CENTRAL VEN. CATH

Facility

$4,940.28

Service Code	HCPCS 36597 TC
Hospital Charge Code	41542836
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,852.05

SP REPO. CENTRAL VEN. CATH

Facility

$4,940.28

Service Code	HCPCS 36597 TC
Hospital Charge Code	41542836
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 REPOSI DISLODG G-J TUBE SIMPLE

Facility

$711.45

Service Code	HCPCS 43761 TC
Hospital Charge Code	41547663
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 REPOSI DISLODG G-J TUBE SIMPLE

Facility

$711.45

Service Code	HCPCS 43761 TC
Hospital Charge Code	41547663
Hospital Revenue Code	361
Rate for Payer: Cash Price	$285.81

SP REPOSITION GI FEED TBE

Facility

$711.45

Service Code	HCPCS 43761 TC
Hospital Charge Code	41542710
Hospital Revenue Code	361
Rate for Payer: Cash Price	$285.81

Know your out-of-pocket cost for care.

All Charges