St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

TRANEXAMIC ACID 100 MG/10ML INJ

Facility

$140.00

Hospital Charge Code	41656087
Hospital Revenue Code	250
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$112.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.00
Rate for Payer: Aetna Government	$70.00
Rate for Payer: Brighton Health Commercial	$105.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.20
Rate for Payer: Group Health Inc Commercial	$70.00
Rate for Payer: Group Health Inc Medicare	$49.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$91.00

Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography

Facility

$3,615.39

Service Code	CPT 58345
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$3,615.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,615.39
Rate for Payer: Aetna Government	$3,615.39
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$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: Elderplan Medicare Advantage	$3,615.39
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,073.08
Rate for Payer: Fidelis Essential Plan QHP	$3,217.70
Rate for Payer: Fidelis Medicare Advantage	$3,615.39
Rate for Payer: Fidelis Qualified Health Plan	$3,217.70
Rate for Payer: Group Health Inc Commercial	$3,615.39
Rate for Payer: Group Health Inc Medicare	$3,615.39
Rate for Payer: Hamaspik Choice Inc Medicare	$3,615.39
Rate for Payer: Healthfirst Medicare Advantage	$3,073.08
Rate for Payer: Healthfirst QHP	$3,615.39
Rate for Payer: Senior Whole Health Medicare Advantage	$3,615.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,615.39
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,892.31
Rate for Payer: Wellcare Medicare	$3,434.62

TRANSDUCER BELTS E9005BA

Facility

$2.46

Hospital Charge Code	64902368
Hospital Revenue Code	270
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$1.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.23
Rate for Payer: Aetna Government	$1.23
Rate for Payer: Brighton Health Commercial	$1.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.67
Rate for Payer: Group Health Inc Commercial	$1.23
Rate for Payer: Group Health Inc Medicare	$0.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.23
Rate for Payer: Hamaspik Choice Inc Medicare	$1.23

TRANSDUCER DOUBLE LUER LOCK505343

Facility

$0.50

Hospital Charge Code	40209482
Hospital Revenue Code	270
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.34
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25

TRANSDUCER FILTER

Facility

$4.97

Hospital Charge Code	42905080
Hospital Revenue Code	801
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$3.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.48
Rate for Payer: Aetna Government	$2.48
Rate for Payer: Brighton Health Commercial	$3.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.38
Rate for Payer: Group Health Inc Commercial	$2.48
Rate for Payer: Group Health Inc Medicare	$1.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.48
Rate for Payer: Hamaspik Choice Inc Medicare	$2.48

Transection or avulsion of other spinal nerve, extradural

Facility

$2,915.00

Service Code	CPT 64772
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,232.80
Rate for Payer: Aetna Government	$2,232.80
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,232.80
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	$2,232.80
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$1,897.88
Rate for Payer: Fidelis Essential Plan QHP	$1,987.19
Rate for Payer: Fidelis Medicare Advantage	$2,232.80
Rate for Payer: Fidelis Qualified Health Plan	$1,987.19
Rate for Payer: Group Health Inc Commercial	$2,232.80
Rate for Payer: Group Health Inc Medicare	$2,232.80
Rate for Payer: Hamaspik Choice Inc Medicare	$2,232.80
Rate for Payer: Healthfirst Medicare Advantage	$1,897.88
Rate for Payer: Healthfirst QHP	$2,232.80
Rate for Payer: Senior Whole Health Medicare Advantage	$2,232.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,232.80
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,786.24
Rate for Payer: Wellcare Medicare	$2,121.16

TRANSESOPHAGEAL ECHOCARDIOGRAM

Facility

$1,458.58

Service Code	HCPCS 93312 TC
Hospital Charge Code	41118923
Hospital Revenue Code	483
Rate for Payer: Cash Price	$637.97

TRANSESOPHAGEAL ECHOCARDIOGRAM

Facility

$1,458.58

Service Code	HCPCS 93312 TC
Hospital Charge Code	41118923
Hospital Revenue Code	483
Min. Negotiated Rate	$510.50
Max. Negotiated Rate	$1,166.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$802.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$729.29
Rate for Payer: Aetna Government	$729.29
Rate for Payer: Brighton Health Commercial	$1,093.94
Rate for Payer: Cash Price	$637.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$991.83
Rate for Payer: Group Health Inc Commercial	$729.29
Rate for Payer: Group Health Inc Medicare	$510.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$729.29
Rate for Payer: Hamaspik Choice Inc Medicare	$729.29

TRANSESOPHAGEAL ECHOCARDIOGRAM

Facility

$1,458.58

Service Code	HCPCS 93312 TC
Hospital Charge Code	40802500
Hospital Revenue Code	483
Min. Negotiated Rate	$510.50
Max. Negotiated Rate	$1,166.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$802.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$729.29
Rate for Payer: Aetna Government	$729.29
Rate for Payer: Brighton Health Commercial	$1,093.94
Rate for Payer: Cash Price	$637.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$991.83
Rate for Payer: Group Health Inc Commercial	$729.29
Rate for Payer: Group Health Inc Medicare	$510.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$729.29
Rate for Payer: Hamaspik Choice Inc Medicare	$729.29

TRANSESOPHAGEAL ECHOCARDIOGRAM

Facility

$1,458.58

Service Code	HCPCS 93312 TC
Hospital Charge Code	40802500
Hospital Revenue Code	483
Rate for Payer: Cash Price	$637.97

TRANSESOPHAGEAL ECHOCARDIOGRAPHY

Facility

$1,458.58

Service Code	HCPCS 93312 TC
Hospital Charge Code	41508705
Hospital Revenue Code	483
Min. Negotiated Rate	$510.50
Max. Negotiated Rate	$1,166.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$802.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$729.29
Rate for Payer: Aetna Government	$729.29
Rate for Payer: Brighton Health Commercial	$1,093.94
Rate for Payer: Cash Price	$637.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$991.83
Rate for Payer: Group Health Inc Commercial	$729.29
Rate for Payer: Group Health Inc Medicare	$510.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$729.29
Rate for Payer: Hamaspik Choice Inc Medicare	$729.29

TRANSESOPHAGEAL ECHOCARDIOGRAPHY

Facility

$1,458.58

Service Code	HCPCS 93312 TC
Hospital Charge Code	41508705
Hospital Revenue Code	483
Rate for Payer: Cash Price	$637.97

TRANSESOPHAGEAL ECHO W/BUB SETTIN

Facility

$1,458.58

Service Code	HCPCS 93312 TC
Hospital Charge Code	41506554
Hospital Revenue Code	483
Min. Negotiated Rate	$510.50
Max. Negotiated Rate	$1,166.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$802.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$729.29
Rate for Payer: Aetna Government	$729.29
Rate for Payer: Brighton Health Commercial	$1,093.94
Rate for Payer: Cash Price	$637.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$991.83
Rate for Payer: Group Health Inc Commercial	$729.29
Rate for Payer: Group Health Inc Medicare	$510.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$729.29
Rate for Payer: Hamaspik Choice Inc Medicare	$729.29

TRANSESOPHAGEAL ECHO W/BUB SETTIN

Facility

$1,458.58

Service Code	HCPCS 93312 TC
Hospital Charge Code	41506554
Hospital Revenue Code	483
Rate for Payer: Cash Price	$637.97

TRANSESOPHAGEAL ECHO W/BUB SETTIN

Facility

$1,458.58

Service Code	HCPCS 93312 TC
Hospital Charge Code	40804116
Hospital Revenue Code	483
Rate for Payer: Cash Price	$637.97

TRANSESOPHAGEAL ECHO W/BUB SETTIN

Facility

$1,458.58

Service Code	HCPCS 93312 TC
Hospital Charge Code	40804116
Hospital Revenue Code	483
Min. Negotiated Rate	$510.50
Max. Negotiated Rate	$1,166.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$802.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$729.29
Rate for Payer: Aetna Government	$729.29
Rate for Payer: Brighton Health Commercial	$1,093.94
Rate for Payer: Cash Price	$637.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$991.83
Rate for Payer: Group Health Inc Commercial	$729.29
Rate for Payer: Group Health Inc Medicare	$510.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$729.29
Rate for Payer: Hamaspik Choice Inc Medicare	$729.29

TRANSFERRIN_

Facility

$31.90

Service Code	HCPCS 84466
Hospital Charge Code	40609125
Hospital Revenue Code	300
Min. Negotiated Rate	$10.21
Max. Negotiated Rate	$23.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.76
Rate for Payer: Aetna Government	$12.76
Rate for Payer: Brighton Health Commercial	$23.92
Rate for Payer: Cash Price	$12.76
Rate for Payer: Cash Price	$12.76
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.18
Rate for Payer: Elderplan Medicare Advantage	$12.76
Rate for Payer: EmblemHealth Commercial	$12.76
Rate for Payer: Fidelis Essential Plan Aliesa	$10.85
Rate for Payer: Fidelis Essential Plan QHP	$11.36
Rate for Payer: Fidelis Medicare Advantage	$12.76
Rate for Payer: Fidelis Qualified Health Plan	$11.36
Rate for Payer: Group Health Inc Commercial	$12.76
Rate for Payer: Group Health Inc Medicare	$12.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.95
Rate for Payer: Hamaspik Choice Inc Medicare	$12.76
Rate for Payer: Healthfirst Medicare Advantage	$12.76
Rate for Payer: Healthfirst QHP	$12.76
Rate for Payer: Senior Whole Health Medicare Advantage	$12.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.76
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.21
Rate for Payer: Wellcare Medicare	$11.48

TRANSFERRIN_

Facility

$31.90

Service Code	HCPCS 84466
Hospital Charge Code	40609125
Hospital Revenue Code	300
Rate for Payer: Cash Price	$12.76

TRANSFIXING PINS

Facility

$214.00

Service Code	HCPCS C1713
Hospital Charge Code	40209863
Hospital Revenue Code	278
Min. Negotiated Rate	$107.00
Max. Negotiated Rate	$107.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$107.00
Rate for Payer: Hamaspik Choice Inc Medicare	$107.00

TRANSFIXING PINS

Facility

$214.00

Service Code	HCPCS C1713
Hospital Charge Code	40209863
Hospital Revenue Code	278
Min. Negotiated Rate	$74.90
Max. Negotiated Rate	$224.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$117.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$128.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$107.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$123.05
Rate for Payer: EmblemHealth Commercial	$107.00
Rate for Payer: Fidelis Medicare Advantage	$224.70
Rate for Payer: Group Health Inc Commercial	$107.00
Rate for Payer: Group Health Inc Medicare	$74.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$107.00
Rate for Payer: Hamaspik Choice Inc Medicare	$107.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$139.10

TRANSFUSION REACTION

Facility

$434.63

Service Code	HCPCS 86078
Hospital Charge Code	40711160
Hospital Revenue Code	300
Rate for Payer: Cash Price	$197.52

TRANSFUSION REACTION

Facility

$434.63

Service Code	HCPCS 86078
Hospital Charge Code	40711160
Hospital Revenue Code	300
Min. Negotiated Rate	$46.11
Max. Negotiated Rate	$325.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$239.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$197.52
Rate for Payer: Aetna Government	$197.52
Rate for Payer: Brighton Health Commercial	$325.97
Rate for Payer: Cash Price	$197.52
Rate for Payer: Cash Price	$197.52
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$197.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$54.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.11
Rate for Payer: Elderplan Medicare Advantage	$197.52
Rate for Payer: EmblemHealth Commercial	$197.52
Rate for Payer: Fidelis Essential Plan Aliesa	$167.89
Rate for Payer: Fidelis Essential Plan QHP	$175.79
Rate for Payer: Fidelis Medicare Advantage	$197.52
Rate for Payer: Fidelis Qualified Health Plan	$175.79
Rate for Payer: Group Health Inc Commercial	$197.52
Rate for Payer: Group Health Inc Medicare	$197.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$217.32
Rate for Payer: Hamaspik Choice Inc Medicare	$197.52
Rate for Payer: Healthfirst Medicare Advantage	$197.52
Rate for Payer: Healthfirst QHP	$197.52
Rate for Payer: Senior Whole Health Medicare Advantage	$197.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$197.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$158.02
Rate for Payer: Wellcare Medicare	$177.77

TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC

Facility

$18,771.80

Service Code	MSDRG 069
Min. Negotiated Rate	$6,848.85
Max. Negotiated Rate	$18,771.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11,776.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18,403.73
Rate for Payer: Aetna Government	$18,403.73
Rate for Payer: Brighton Health Commercial	$11,581.15
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$18,771.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13,792.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$11,382.37
Rate for Payer: Elderplan Medicare Advantage	$17,483.54
Rate for Payer: EmblemHealth Commercial	$6,848.85
Rate for Payer: Fidelis Medicare Advantage	$18,403.73
Rate for Payer: Group Health Inc Commercial	$18,403.73
Rate for Payer: Group Health Inc Medicare	$18,403.73
Rate for Payer: Hamaspik Choice Inc Medicare	$18,403.73
Rate for Payer: Healthfirst Medicare Advantage	$8,557.73
Rate for Payer: Senior Whole Health Medicare Advantage	$18,403.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18,403.73
Rate for Payer: Wellcare Medicare	$17,483.54

TRANSLUMIAL ARTHRECTOMY ILIAC

Facility

$48,278.18

Service Code	HCPCS 0238T
Hospital Charge Code	40039877
Hospital Revenue Code	360
Rate for Payer: Cash Price	$20,278.00

TRANSLUMIAL ARTHRECTOMY ILIAC

Facility

$48,278.18

Service Code	HCPCS 0238T
Hospital Charge Code	40039877
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
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	$1,505.00
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

Know your out-of-pocket cost for care.

All Charges