St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SP SIALOGRAM/DUCT DILAT

Facility

$1,337.85

Service Code	HCPCS 42660 TC
Hospital Charge Code	41542819
Hospital Revenue Code	361
Rate for Payer: Cash Price	$636.27

SP SIALOGRAM/DUCT DILAT

Facility

$1,337.85

Service Code	HCPCS 42660 TC
Hospital Charge Code	41542819
Hospital Revenue Code	361
Min. Negotiated Rate	$468.25
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$735.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$668.92
Rate for Payer: Aetna Government	$668.92
Rate for Payer: Brighton Health Commercial	$1,003.39
Rate for Payer: Cash Price	$636.27
Rate for Payer: Cash Price	$636.27
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	$668.92
Rate for Payer: Group Health Inc Medicare	$468.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$668.92
Rate for Payer: Hamaspik Choice Inc Medicare	$668.92

SP SPINAL INJ CERV/THOR

Facility

$1,893.13

Service Code	HCPCS 62321 TC
Hospital Charge Code	41563281
Hospital Revenue Code	361
Min. Negotiated Rate	$662.60
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,041.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$946.56
Rate for Payer: Aetna Government	$946.56
Rate for Payer: Brighton Health Commercial	$1,419.85
Rate for Payer: Cash Price	$799.72
Rate for Payer: Cash Price	$799.72
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	$946.56
Rate for Payer: Group Health Inc Medicare	$662.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$946.56
Rate for Payer: Hamaspik Choice Inc Medicare	$946.56

SP SPINAL INJ CERV/THOR

Facility

$1,893.13

Service Code	HCPCS 62321 TC
Hospital Charge Code	41563281
Hospital Revenue Code	361
Rate for Payer: Cash Price	$799.72

SP SPINAL INJ LUM/SAC

Facility

$1,893.13

Service Code	HCPCS 62323 TC
Hospital Charge Code	41563282
Hospital Revenue Code	361
Rate for Payer: Cash Price	$799.72

SP SPINAL INJ LUM/SAC

Facility

$1,893.13

Service Code	HCPCS 62323 TC
Hospital Charge Code	41563282
Hospital Revenue Code	361
Min. Negotiated Rate	$662.60
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,041.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$946.56
Rate for Payer: Aetna Government	$946.56
Rate for Payer: Brighton Health Commercial	$1,419.85
Rate for Payer: Cash Price	$799.72
Rate for Payer: Cash Price	$799.72
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	$946.56
Rate for Payer: Group Health Inc Medicare	$662.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$946.56
Rate for Payer: Hamaspik Choice Inc Medicare	$946.56

SP SPLENOPORTOGRAPHY

Facility

$379.68

Service Code	HCPCS 38200 TC
Hospital Charge Code	41547685
Hospital Revenue Code	361
Min. Negotiated Rate	$132.89
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$208.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$189.84
Rate for Payer: Aetna Government	$189.84
Rate for Payer: Brighton Health Commercial	$284.76
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	$189.84
Rate for Payer: Group Health Inc Medicare	$132.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$189.84
Rate for Payer: Hamaspik Choice Inc Medicare	$189.84

SP STAB PHLEB VEINS XTR 10-20

Facility

$8,393.53

Service Code	HCPCS 37765 TC
Hospital Charge Code	41563237
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP STAB PHLEB VEINS XTR 10-20

Facility

$8,393.53

Service Code	HCPCS 37765 TC
Hospital Charge Code	41563237
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 STAB PHLEB VEINS XTR >20

Facility

$8,393.53

Service Code	HCPCS 37766 TC
Hospital Charge Code	41563238
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 STAB PHLEB VEINS XTR >20

Facility

$8,393.53

Service Code	HCPCS 37766 TC
Hospital Charge Code	41563238
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP STENT PLACEMENT

Facility

$30,948.00

Service Code	HCPCS 37236 TC
Hospital Charge Code	41547728
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 STENT PLACEMENT

Facility

$30,948.00

Service Code	HCPCS 37236 TC
Hospital Charge Code	41547728
Hospital Revenue Code	361
Rate for Payer: Cash Price	$12,721.98

SP STENT PLACEMENT

Facility

$30,010.30

Service Code	HCPCS 37238 TC
Hospital Charge Code	41104049
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 STENT PLACEMENT

Facility

$30,010.30

Service Code	HCPCS 37238 TC
Hospital Charge Code	41104049
Hospital Revenue Code	361
Rate for Payer: Cash Price	$12,721.98

SP STENT PLACEMENT ADD

Facility

$13,095.00

Service Code	HCPCS 37239 TC
Hospital Charge Code	41104011
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$9,821.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,202.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,547.50
Rate for Payer: Aetna Government	$6,547.50
Rate for Payer: Brighton Health Commercial	$9,821.25
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	$6,547.50
Rate for Payer: Group Health Inc Medicare	$4,583.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,547.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,547.50

SP STENT PLACEMT ANTE CAROTID

Facility

$6,859.25

Service Code	HCPCS 37218 TC
Hospital Charge Code	41562375
Hospital Revenue Code	361
Min. Negotiated Rate	$2,400.74
Max. Negotiated Rate	$5,144.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,772.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,429.62
Rate for Payer: Aetna Government	$3,429.62
Rate for Payer: Brighton Health Commercial	$5,144.44
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	$3,429.62
Rate for Payer: Group Health Inc Medicare	$2,400.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,429.62
Rate for Payer: Hamaspik Choice Inc Medicare	$3,429.62

SP STENT PLACEMT RETRO CAROTID

Facility

$9,114.44

Service Code	HCPCS 37217 TC
Hospital Charge Code	41562373
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$6,835.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,012.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,557.22
Rate for Payer: Aetna Government	$4,557.22
Rate for Payer: Brighton Health Commercial	$6,835.83
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	$4,557.22
Rate for Payer: Group Health Inc Medicare	$3,190.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,557.22
Rate for Payer: Hamaspik Choice Inc Medicare	$4,557.22

SP STEREO EACH ADD

Facility

$146.00

Service Code	HCPCS 19284 TC
Hospital Charge Code	41104041
Hospital Revenue Code	361
Min. Negotiated Rate	$51.10
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.00
Rate for Payer: Aetna Government	$73.00
Rate for Payer: Brighton Health Commercial	$109.50
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	$73.00
Rate for Payer: Group Health Inc Medicare	$51.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.00
Rate for Payer: Hamaspik Choice Inc Medicare	$73.00

SP STEREO GUIDED 1ST LOCAL

Facility

$1,847.58

Service Code	HCPCS 19283 TC
Hospital Charge Code	41104039
Hospital Revenue Code	361
Rate for Payer: Cash Price	$813.63

SP STEREO GUIDED 1ST LOCAL

Facility

$1,847.58

Service Code	HCPCS 19283 TC
Hospital Charge Code	41104039
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	$813.63
Rate for Payer: Cash Price	$813.63
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 STEROTACTIC TX ADD

Facility

$1,042.00

Service Code	HCPCS 19082
Hospital Charge Code	41104017
Hospital Revenue Code	361
Min. Negotiated Rate	$72.75
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$72.75
Rate for Payer: Aetna Government	$72.75
Rate for Payer: Brighton Health Commercial	$781.50
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	$521.00
Rate for Payer: Group Health Inc Medicare	$364.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$521.00
Rate for Payer: Hamaspik Choice Inc Medicare	$521.00

SP STROTACTIC BX

Facility

$4,157.25

Service Code	HCPCS 19081
Hospital Charge Code	41104015
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,874.89

SP STROTACTIC BX

Facility

$4,157.25

Service Code	HCPCS 19081
Hospital Charge Code	41104015
Hospital Revenue Code	361
Min. Negotiated Rate	$1,499.91
Max. Negotiated Rate	$3,117.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,874.89
Rate for Payer: Aetna Government	$1,874.89
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: Cash Price	$1,874.89
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$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: Elderplan Medicare Advantage	$1,874.89
Rate for Payer: EmblemHealth Commercial	$1,874.89
Rate for Payer: Fidelis Essential Plan Aliesa	$1,593.66
Rate for Payer: Fidelis Essential Plan QHP	$1,668.65
Rate for Payer: Fidelis Medicare Advantage	$1,874.89
Rate for Payer: Fidelis Qualified Health Plan	$1,668.65
Rate for Payer: Group Health Inc Commercial	$1,874.89
Rate for Payer: Group Health Inc Medicare	$1,874.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,874.89
Rate for Payer: Healthfirst Medicare Advantage	$1,593.66
Rate for Payer: Healthfirst QHP	$1,874.89
Rate for Payer: Senior Whole Health Medicare Advantage	$1,874.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,874.89
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,499.91
Rate for Payer: Wellcare Medicare	$1,781.15

SP SUP/INF VENA CAVA

Facility

$1,769.28

Service Code	HCPCS 36010 TC
Hospital Charge Code	41542034
Hospital Revenue Code	361
Min. Negotiated Rate	$619.25
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$973.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$884.64
Rate for Payer: Aetna Government	$884.64
Rate for Payer: Brighton Health Commercial	$1,326.96
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	$884.64
Rate for Payer: Group Health Inc Medicare	$619.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$884.64
Rate for Payer: Hamaspik Choice Inc Medicare	$884.64

Know your out-of-pocket cost for care.

All Charges