St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SP THROMBOLYTIC ARTERIAL THERAPY

Facility

$13,920.70

Service Code	HCPCS 37211 TC
Hospital Charge Code	41543300
Hospital Revenue Code	329
Rate for Payer: Cash Price	$6,354.94

SP THROMBOLYTIC ARTERIAL THERAPY

Facility

$13,920.70

Service Code	HCPCS 37211 TC
Hospital Charge Code	41543300
Hospital Revenue Code	329
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$10,440.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,656.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,960.35
Rate for Payer: Aetna Government	$6,960.35
Rate for Payer: Brighton Health Commercial	$10,440.52
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cash Price	$6,354.94
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	$6,960.35
Rate for Payer: Group Health Inc Medicare	$4,872.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.35
Rate for Payer: Hamaspik Choice Inc Medicare	$6,960.35

SP THROMBOLYTIC VENOUS THERAPY

Facility

$8,393.53

Service Code	HCPCS 37212 TC
Hospital Charge Code	41543301
Hospital Revenue Code	329
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 THROMBOLYTIC VENOUS THERAPY

Facility

$8,393.53

Service Code	HCPCS 37212 TC
Hospital Charge Code	41543301
Hospital Revenue Code	329
Rate for Payer: Cash Price	$3,686.08

SP THYROID PERCUTANEOUS

Facility

$1,847.58

Service Code	HCPCS 60100 TC
Hospital Charge Code	41542805
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 THYROID PERCUTANEOUS

Facility

$1,847.58

Service Code	HCPCS 60100 TC
Hospital Charge Code	41542805
Hospital Revenue Code	361
Rate for Payer: Cash Price	$813.63

SP TIB/PER REVASC STENT & ATHER

Facility

$48,278.18

Service Code	HCPCS 37231
Hospital Charge Code	41101443
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$36,208.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20,278.00
Rate for Payer: Aetna Government	$20,278.00
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: Cash Price	$20,278.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$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: Elderplan Medicare Advantage	$20,278.00
Rate for Payer: EmblemHealth Commercial	$20,278.00
Rate for Payer: Fidelis Essential Plan Aliesa	$17,236.30
Rate for Payer: Fidelis Essential Plan QHP	$18,047.42
Rate for Payer: Fidelis Medicare Advantage	$20,278.00
Rate for Payer: Fidelis Qualified Health Plan	$18,047.42
Rate for Payer: Group Health Inc Commercial	$20,278.00
Rate for Payer: Group Health Inc Medicare	$20,278.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,139.09
Rate for Payer: Hamaspik Choice Inc Medicare	$20,278.00
Rate for Payer: Healthfirst Medicare Advantage	$17,236.30
Rate for Payer: Healthfirst QHP	$20,278.00
Rate for Payer: Senior Whole Health Medicare Advantage	$20,278.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20,278.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,222.40
Rate for Payer: Wellcare Medicare	$19,264.10

SP TIB/PER REVASC STENT & ATHER

Facility

$48,278.18

Service Code	HCPCS 37231
Hospital Charge Code	41101443
Hospital Revenue Code	361
Rate for Payer: Cash Price	$20,278.00

SP TIB/PER REVASC W/ATHER UNI

Facility

$48,278.18

Service Code	HCPCS 37229
Hospital Charge Code	41546562
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$36,208.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20,278.00
Rate for Payer: Aetna Government	$20,278.00
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: Cash Price	$20,278.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$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: Elderplan Medicare Advantage	$20,278.00
Rate for Payer: EmblemHealth Commercial	$20,278.00
Rate for Payer: Fidelis Essential Plan Aliesa	$17,236.30
Rate for Payer: Fidelis Essential Plan QHP	$18,047.42
Rate for Payer: Fidelis Medicare Advantage	$20,278.00
Rate for Payer: Fidelis Qualified Health Plan	$18,047.42
Rate for Payer: Group Health Inc Commercial	$20,278.00
Rate for Payer: Group Health Inc Medicare	$20,278.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,139.09
Rate for Payer: Hamaspik Choice Inc Medicare	$20,278.00
Rate for Payer: Healthfirst Medicare Advantage	$17,236.30
Rate for Payer: Healthfirst QHP	$20,278.00
Rate for Payer: Senior Whole Health Medicare Advantage	$20,278.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20,278.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,222.40
Rate for Payer: Wellcare Medicare	$19,264.10

SP TIB/PER REVASC W/ATHER UNI

Facility

$48,278.18

Service Code	HCPCS 37229
Hospital Charge Code	41546562
Hospital Revenue Code	361
Rate for Payer: Cash Price	$20,278.00

SP TIB/PER REVASC W/STENT

Facility

$48,278.18

Service Code	HCPCS 37230
Hospital Charge Code	41101442
Hospital Revenue Code	361
Rate for Payer: Cash Price	$20,278.00

SP TIB/PER REVASC W/STENT

Facility

$48,278.18

Service Code	HCPCS 37230
Hospital Charge Code	41101442
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$36,208.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20,278.00
Rate for Payer: Aetna Government	$20,278.00
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: Cash Price	$20,278.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$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: Elderplan Medicare Advantage	$20,278.00
Rate for Payer: EmblemHealth Commercial	$20,278.00
Rate for Payer: Fidelis Essential Plan Aliesa	$17,236.30
Rate for Payer: Fidelis Essential Plan QHP	$18,047.42
Rate for Payer: Fidelis Medicare Advantage	$20,278.00
Rate for Payer: Fidelis Qualified Health Plan	$18,047.42
Rate for Payer: Group Health Inc Commercial	$20,278.00
Rate for Payer: Group Health Inc Medicare	$20,278.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$24,139.09
Rate for Payer: Hamaspik Choice Inc Medicare	$20,278.00
Rate for Payer: Healthfirst Medicare Advantage	$17,236.30
Rate for Payer: Healthfirst QHP	$20,278.00
Rate for Payer: Senior Whole Health Medicare Advantage	$20,278.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20,278.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$16,222.40
Rate for Payer: Wellcare Medicare	$19,264.10

SP TIB/PERUCT REVASC W/TLA UNI

Facility

$30,010.30

Service Code	HCPCS 37228
Hospital Charge Code	41546561
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 TIB/PERUCT REVASC W/TLA UNI

Facility

$30,010.30

Service Code	HCPCS 37228
Hospital Charge Code	41546561
Hospital Revenue Code	361
Rate for Payer: Cash Price	$12,721.98

SP TIPS EXCLUDING EMBOLIZATION

Facility

$6,574.83

Service Code	HCPCS 37182 TC
Hospital Charge Code	41561846
Hospital Revenue Code	361
Min. Negotiated Rate	$2,301.19
Max. Negotiated Rate	$4,931.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,616.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,287.42
Rate for Payer: Aetna Government	$3,287.42
Rate for Payer: Brighton Health Commercial	$4,931.12
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	$3,287.42
Rate for Payer: Group Health Inc Medicare	$2,301.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,287.42
Rate for Payer: Hamaspik Choice Inc Medicare	$3,287.42

SP TIPS REVISION

Facility

$15,004.15

Service Code	HCPCS 37183 TC
Hospital Charge Code	41561839
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 TIPS REVISION

Facility

$15,004.15

Service Code	HCPCS 37183 TC
Hospital Charge Code	41561839
Hospital Revenue Code	361
Rate for Payer: Cash Price	$6,609.72

SP TIPSS - ANASTO. PORTOCAVAL

Facility

$4,320.82

Service Code	HCPCS 37140 TC
Hospital Charge Code	41546003
Hospital Revenue Code	361
Min. Negotiated Rate	$1,512.29
Max. Negotiated Rate	$3,240.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,376.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,160.41
Rate for Payer: Aetna Government	$2,160.41
Rate for Payer: Brighton Health Commercial	$3,240.62
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	$2,160.41
Rate for Payer: Group Health Inc Medicare	$1,512.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,160.41
Rate for Payer: Hamaspik Choice Inc Medicare	$2,160.41

SP TMJ ARTHOGRAM

Facility

$122.03

Service Code	HCPCS 21116 TC
Hospital Charge Code	41561913
Hospital Revenue Code	361
Min. Negotiated Rate	$42.71
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$67.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$61.02
Rate for Payer: Aetna Government	$61.02
Rate for Payer: Brighton Health Commercial	$91.52
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	$61.02
Rate for Payer: Group Health Inc Medicare	$42.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.02
Rate for Payer: Hamaspik Choice Inc Medicare	$61.02

SP TRANSCATHETER BILIARY BIOPSY

Facility

$9,417.43

Service Code	HCPCS 47553 TC
Hospital Charge Code	41547649
Hospital Revenue Code	361
Rate for Payer: Cash Price	$8,748.99

SP TRANSCATHETER BILIARY BIOPSY

Facility

$9,417.43

Service Code	HCPCS 47553 TC
Hospital Charge Code	41547649
Hospital Revenue Code	361
Min. Negotiated Rate	$745.00
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	$8,748.99
Rate for Payer: Cash Price	$8,748.99
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	$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 TRANSCATHETER BIOPSY

Facility

$13,920.70

Service Code	HCPCS 37200 TC
Hospital Charge Code	41547693
Hospital Revenue Code	361
Rate for Payer: Cash Price	$6,354.94

SP TRANSCATHETER BIOPSY

Facility

$13,920.70

Service Code	HCPCS 37200 TC
Hospital Charge Code	41547693
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$10,440.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,656.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,960.35
Rate for Payer: Aetna Government	$6,960.35
Rate for Payer: Brighton Health Commercial	$10,440.52
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cash Price	$6,354.94
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	$6,960.35
Rate for Payer: Group Health Inc Medicare	$4,872.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.35
Rate for Payer: Hamaspik Choice Inc Medicare	$6,960.35

SP TRANSCATH STENT CCA W/EPS

Facility

$8,432.56

Service Code	HCPCS 37215 TC
Hospital Charge Code	41562369
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$6,324.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,637.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,216.28
Rate for Payer: Aetna Government	$4,216.28
Rate for Payer: Brighton Health Commercial	$6,324.42
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	$4,216.28
Rate for Payer: Group Health Inc Medicare	$2,951.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,216.28
Rate for Payer: Hamaspik Choice Inc Medicare	$4,216.28

SP TRANSCATH STENT CCA W/O EPS

Facility

$8,432.56

Service Code	HCPCS 37216 TC
Hospital Charge Code	41562371
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$6,324.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,637.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,216.28
Rate for Payer: Aetna Government	$4,216.28
Rate for Payer: Brighton Health Commercial	$6,324.42
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	$4,216.28
Rate for Payer: Group Health Inc Medicare	$2,951.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,216.28
Rate for Payer: Hamaspik Choice Inc Medicare	$4,216.28

Know your out-of-pocket cost for care.

All Charges