St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SP TRANSCERVICAL - FALLOPIAN

Facility

$7,566.13

Service Code	HCPCS 58345 TC
Hospital Charge Code	41547462
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$5,674.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,161.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,783.06
Rate for Payer: Aetna Government	$3,783.06
Rate for Payer: Brighton Health Commercial	$5,674.60
Rate for Payer: Cash Price	$3,615.39
Rate for Payer: Cash Price	$3,615.39
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	$3,783.06
Rate for Payer: Group Health Inc Medicare	$2,648.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,783.06
Rate for Payer: Hamaspik Choice Inc Medicare	$3,783.06

SP TRANSCERVICAL - FALLOPIAN

Facility

$7,566.13

Service Code	HCPCS 58345 TC
Hospital Charge Code	41547462
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,615.39

SP TRANSHEPA PORTOGRAPHY W/O HEMO

Facility

$1,249.78

Service Code	HCPCS 36481 TC
Hospital Charge Code	41547687
Hospital Revenue Code	361
Min. Negotiated Rate	$437.42
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$687.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$624.89
Rate for Payer: Aetna Government	$624.89
Rate for Payer: Brighton Health Commercial	$937.34
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	$624.89
Rate for Payer: Group Health Inc Medicare	$437.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$624.89
Rate for Payer: Hamaspik Choice Inc Medicare	$624.89

SP TRANSJUGULAR LIVER BIOPSY

Facility

$13,920.70

Service Code	HCPCS 37200 TC
Hospital Charge Code	41547653
Hospital Revenue Code	361
Rate for Payer: Cash Price	$6,354.94

SP TRANSJUGULAR LIVER BIOPSY

Facility

$13,920.70

Service Code	HCPCS 37200 TC
Hospital Charge Code	41547653
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 TREAT SPINAL CANAL LESION

Facility

$2,459.50

Service Code	HCPCS 62282
Hospital Charge Code	41561541
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,054.06

SP TREAT SPINAL CANAL LESION

Facility

$2,459.50

Service Code	HCPCS 62282
Hospital Charge Code	41561541
Hospital Revenue Code	361
Min. Negotiated Rate	$843.25
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,054.06
Rate for Payer: Aetna Government	$1,054.06
Rate for Payer: Brighton Health Commercial	$1,844.62
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,054.06
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	$1,054.06
Rate for Payer: EmblemHealth Commercial	$1,054.06
Rate for Payer: Fidelis Essential Plan Aliesa	$895.95
Rate for Payer: Fidelis Essential Plan QHP	$938.11
Rate for Payer: Fidelis Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Qualified Health Plan	$938.11
Rate for Payer: Group Health Inc Commercial	$1,054.06
Rate for Payer: Group Health Inc Medicare	$1,054.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,229.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,054.06
Rate for Payer: Healthfirst Medicare Advantage	$895.95
Rate for Payer: Healthfirst QHP	$1,054.06
Rate for Payer: Senior Whole Health Medicare Advantage	$1,054.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,054.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$843.25
Rate for Payer: Wellcare Medicare	$1,001.36

SP TREAT SPINAL CORD LESION

Facility

$2,459.50

Service Code	HCPCS 62281
Hospital Charge Code	41561540
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,054.06

SP TREAT SPINAL CORD LESION

Facility

$2,459.50

Service Code	HCPCS 62281
Hospital Charge Code	41561540
Hospital Revenue Code	361
Min. Negotiated Rate	$843.25
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,054.06
Rate for Payer: Aetna Government	$1,054.06
Rate for Payer: Brighton Health Commercial	$1,844.62
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,054.06
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	$1,054.06
Rate for Payer: EmblemHealth Commercial	$1,054.06
Rate for Payer: Fidelis Essential Plan Aliesa	$895.95
Rate for Payer: Fidelis Essential Plan QHP	$938.11
Rate for Payer: Fidelis Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Qualified Health Plan	$938.11
Rate for Payer: Group Health Inc Commercial	$1,054.06
Rate for Payer: Group Health Inc Medicare	$1,054.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,229.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,054.06
Rate for Payer: Healthfirst Medicare Advantage	$895.95
Rate for Payer: Healthfirst QHP	$1,054.06
Rate for Payer: Senior Whole Health Medicare Advantage	$1,054.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,054.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$843.25
Rate for Payer: Wellcare Medicare	$1,001.36

SP TUN CATHETER EXCH PERM

Facility

$8,393.53

Service Code	HCPCS 36581 TC
Hospital Charge Code	41549845
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 TUN CATHETER EXCH PERM

Facility

$8,393.53

Service Code	HCPCS 36581 TC
Hospital Charge Code	41549845
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP TUN CATHETER INS PERM

Facility

$8,393.53

Service Code	HCPCS 36558 TC
Hospital Charge Code	41549843
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP TUN CATHETER INS PERM

Facility

$8,393.53

Service Code	HCPCS 36558 TC
Hospital Charge Code	41549843
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 TUN CATHETER RMVL PERM

Facility

$1,909.65

Service Code	HCPCS 36589 TC
Hospital Charge Code	41549847
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 TUN CATHETER RMVL PERM

Facility

$1,909.65

Service Code	HCPCS 36589 TC
Hospital Charge Code	41549847
Hospital Revenue Code	361
Rate for Payer: Cash Price	$726.47

SP URETERAL EMBOLIZATION/OCCL

Facility

$2,804.37

Service Code	HCPCS 50705
Hospital Charge Code	41542912
Hospital Revenue Code	361
Min. Negotiated Rate	$247.02
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$247.02
Rate for Payer: Aetna Government	$247.02
Rate for Payer: Brighton Health Commercial	$2,103.28
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	$1,402.18
Rate for Payer: Group Health Inc Medicare	$981.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,402.18
Rate for Payer: Hamaspik Choice Inc Medicare	$1,402.18

SP URETERAL PTA

Facility

$12,816.53

Service Code	HCPCS 50553 TC
Hospital Charge Code	41547737
Hospital Revenue Code	361
Rate for Payer: Cash Price	$5,983.74

SP URETERAL PTA

Facility

$12,816.53

Service Code	HCPCS 50553 TC
Hospital Charge Code	41547737
Hospital Revenue Code	361
Min. Negotiated Rate	$745.00
Max. Negotiated Rate	$9,612.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,049.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,408.26
Rate for Payer: Aetna Government	$6,408.26
Rate for Payer: Brighton Health Commercial	$9,612.40
Rate for Payer: Cash Price	$5,983.74
Rate for Payer: Cash Price	$5,983.74
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	$6,408.26
Rate for Payer: Group Health Inc Medicare	$4,485.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,408.26
Rate for Payer: Hamaspik Choice Inc Medicare	$6,408.26

SP URETERAL STENT

Facility

$9,142.40

Service Code	HCPCS 50694 TC
Hospital Charge Code	41546559
Hospital Revenue Code	361
Rate for Payer: Cash Price	$4,031.47

SP URETERAL STENT

Facility

$9,142.40

Service Code	HCPCS 50694 TC
Hospital Charge Code	41546559
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$6,856.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,028.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,571.20
Rate for Payer: Aetna Government	$4,571.20
Rate for Payer: Brighton Health Commercial	$6,856.80
Rate for Payer: Cash Price	$4,031.47
Rate for Payer: Cash Price	$4,031.47
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	$4,571.20
Rate for Payer: Group Health Inc Medicare	$3,199.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,571.20
Rate for Payer: Hamaspik Choice Inc Medicare	$4,571.20

SP URETHROCYSTOGRAM, RETRO

Facility

$855.81

Service Code	HCPCS 51610 TC
Hospital Charge Code	41542828
Hospital Revenue Code	361
Min. Negotiated Rate	$299.53
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$470.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$427.90
Rate for Payer: Aetna Government	$427.90
Rate for Payer: Brighton Health Commercial	$641.86
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	$427.90
Rate for Payer: Group Health Inc Medicare	$299.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$427.90
Rate for Payer: Hamaspik Choice Inc Medicare	$427.90

SP URETHROCYSTOGRAM VOID

Facility

$605.55

Service Code	HCPCS 51600 TC
Hospital Charge Code	41542526
Hospital Revenue Code	361
Min. Negotiated Rate	$211.94
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$333.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$302.78
Rate for Payer: Aetna Government	$302.78
Rate for Payer: Brighton Health Commercial	$454.16
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	$302.78
Rate for Payer: Group Health Inc Medicare	$211.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$302.78
Rate for Payer: Hamaspik Choice Inc Medicare	$302.78

SP US GUIDED 1ST LOCAL

Facility

$1,847.58

Service Code	HCPCS 19285 TC
Hospital Charge Code	41104043
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 US GUIDED 1ST LOCAL

Facility

$1,847.58

Service Code	HCPCS 19285 TC
Hospital Charge Code	41104043
Hospital Revenue Code	361
Rate for Payer: Cash Price	$813.63

SP US GUIDED BREAST ADD

Facility

$1,042.00

Service Code	HCPCS 19084
Hospital Charge Code	41104021
Hospital Revenue Code	402
Min. Negotiated Rate	$68.16
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$68.16
Rate for Payer: Aetna Government	$68.16
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

Know your out-of-pocket cost for care.

All Charges