St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SP US GUIDED BREAST BX

Facility

$4,157.25

Service Code	HCPCS 19083
Hospital Charge Code	41104019
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 US GUIDED BREAST BX

Facility

$4,157.25

Service Code	HCPCS 19083
Hospital Charge Code	41104019
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,874.89

SP US GUIDED EACH ADD

Facility

$1,042.00

Service Code	HCPCS 19286 TC
Hospital Charge Code	41104025
Hospital Revenue Code	361
Min. Negotiated Rate	$364.70
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$573.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$521.00
Rate for Payer: Aetna Government	$521.00
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

SPUTUM COLLECTION/INDUCTION

Facility

$557.18

Service Code	HCPCS 94640
Hospital Charge Code	40306700
Hospital Revenue Code	410
Min. Negotiated Rate	$132.45
Max. Negotiated Rate	$417.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$306.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$246.65
Rate for Payer: Aetna Government	$246.65
Rate for Payer: Brighton Health Commercial	$417.88
Rate for Payer: Cash Price	$246.65
Rate for Payer: Cash Price	$246.65
Rate for Payer: Cash Price	$246.65
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$246.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.45
Rate for Payer: Elderplan Medicare Advantage	$246.65
Rate for Payer: EmblemHealth Commercial	$246.65
Rate for Payer: Fidelis Essential Plan Aliesa	$209.65
Rate for Payer: Fidelis Essential Plan QHP	$219.52
Rate for Payer: Fidelis Medicare Advantage	$246.65
Rate for Payer: Fidelis Qualified Health Plan	$219.52
Rate for Payer: Group Health Inc Commercial	$246.65
Rate for Payer: Group Health Inc Medicare	$246.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$278.59
Rate for Payer: Hamaspik Choice Inc Medicare	$246.65
Rate for Payer: Healthfirst Medicare Advantage	$209.65
Rate for Payer: Healthfirst QHP	$246.65
Rate for Payer: Senior Whole Health Medicare Advantage	$246.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$246.65
Rate for Payer: Wellcare CHP/FHP/Medicaid	$197.32
Rate for Payer: Wellcare Medicare	$234.32

SPUTUM COLLECTION/INDUCTION

Facility

$557.18

Service Code	HCPCS 94640
Hospital Charge Code	40306700
Hospital Revenue Code	410
Rate for Payer: Cash Price	$246.65

SP VASC ABLAT 1ST VEIN

Facility

$8,393.53

Service Code	HCPCS 36478 TC
Hospital Charge Code	41563283
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 VASC ABLAT 1ST VEIN

Facility

$8,393.53

Service Code	HCPCS 36478 TC
Hospital Charge Code	41563283
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP VASC ABLAT EACH ADD'L VEIN

Facility

$2,077.28

Service Code	HCPCS 36476 TC
Hospital Charge Code	41563284
Hospital Revenue Code	361
Min. Negotiated Rate	$727.05
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,142.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,038.64
Rate for Payer: Aetna Government	$1,038.64
Rate for Payer: Brighton Health Commercial	$1,557.96
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	$1,038.64
Rate for Payer: Group Health Inc Medicare	$727.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,038.64
Rate for Payer: Hamaspik Choice Inc Medicare	$1,038.64

SP VASCU EMBO ARTERY

Facility

$30,010.30

Service Code	HCPCS 37242 TC
Hospital Charge Code	41104005
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	$20,278.00
Rate for Payer: Cash Price	$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: 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 VASCU EMBO ARTERY

Facility

$30,010.30

Service Code	HCPCS 37242 TC
Hospital Charge Code	41104005
Hospital Revenue Code	361
Rate for Payer: Cash Price	$20,278.00

SP VASCU EMBO VENOUS

Facility

$30,010.30

Service Code	HCPCS 37241 TC
Hospital Charge Code	41104013
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 VASCU EMBO VENOUS

Facility

$30,010.30

Service Code	HCPCS 37241 TC
Hospital Charge Code	41104013
Hospital Revenue Code	361
Rate for Payer: Cash Price	$12,721.98

SP VEIN X-RAY NECK

Facility

$8,393.53

Service Code	HCPCS 75860 TC
Hospital Charge Code	41543352
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 VEIN X-RAY NECK

Facility

$8,393.53

Service Code	HCPCS 75860 TC
Hospital Charge Code	41543352
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP VEIN X-RAY SKULL

Facility

$4,940.28

Service Code	HCPCS 75870 TC
Hospital Charge Code	41543353
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP VEIN X-RAY SKULL

Facility

$4,940.28

Service Code	HCPCS 75870 TC
Hospital Charge Code	41543353
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	$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	$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 VEN ACCE-CENT PERC >2YR(LOC CU

Facility

$330.23

Service Code	HCPCS 36556
Hospital Charge Code	30102469
Hospital Revenue Code	450
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$3,686.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,686.08
Rate for Payer: Aetna Government	$3,686.08
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$3,686.08
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$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: Elderplan Medicare Advantage	$3,686.08
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,133.17
Rate for Payer: Fidelis Essential Plan QHP	$3,280.61
Rate for Payer: Fidelis Medicare Advantage	$3,686.08
Rate for Payer: Fidelis Qualified Health Plan	$3,280.61
Rate for Payer: Group Health Inc Commercial	$525.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.12
Rate for Payer: Hamaspik Choice Inc Medicare	$3,686.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$3,686.08
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$3,686.08
Rate for Payer: Senior Whole Health Medicare Advantage	$3,686.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,686.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,948.86
Rate for Payer: Wellcare Medicare	$3,501.78

SP VEN ACCE-CENT PERC >2YR(LOC CU

Facility

$4,940.28

Service Code	HCPCS 36556 TC
Hospital Charge Code	41547709
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP VEN ACCE-CENT PERC >2YR(LOC CU

Facility

$330.23

Service Code	HCPCS 36556
Hospital Charge Code	30102469
Hospital Revenue Code	450
Rate for Payer: Cash Price	$3,686.08

SP VEN ACCE-CENT PERC >2YR(LOC CU

Facility

$4,940.28

Service Code	HCPCS 36556 TC
Hospital Charge Code	41547709
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	$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	$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 VEN ACCE-CENTRAL PERC<2YR (LOC

Facility

$4,940.28

Service Code	HCPCS 36555 TC
Hospital Charge Code	41547710
Hospital Revenue Code	361
Rate for Payer: Cash Price	$3,686.08

SP VEN ACCE-CENTRAL PERC<2YR (LOC

Facility

$4,940.28

Service Code	HCPCS 36555 TC
Hospital Charge Code	41547710
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	$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	$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 VEN ACCE-REV IMP VEN ACCE PORT

Facility

$1,909.65

Service Code	HCPCS 36575 TC
Hospital Charge Code	41547711
Hospital Revenue Code	361
Rate for Payer: Cash Price	$726.47

SP VEN ACCE-REV IMP VEN ACCE PORT

Facility

$1,909.65

Service Code	HCPCS 36575 TC
Hospital Charge Code	41547711
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 VENOUS BLOOD SAMPLING

Facility

$600.79

Service Code	HCPCS 36500 TC
Hospital Charge Code	41542602
Hospital Revenue Code	361
Min. Negotiated Rate	$210.28
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$330.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$300.40
Rate for Payer: Aetna Government	$300.40
Rate for Payer: Brighton Health Commercial	$450.59
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	$300.40
Rate for Payer: Group Health Inc Medicare	$210.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.40
Rate for Payer: Hamaspik Choice Inc Medicare	$300.40

Know your out-of-pocket cost for care.

All Charges