St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

US BONE DENSITY MEASURE

Facility

$339.45

Service Code	HCPCS 76977 TC
Hospital Charge Code	41309813
Hospital Revenue Code	402
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$271.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$169.72
Rate for Payer: Aetna Government	$169.72
Rate for Payer: Brighton Health Commercial	$254.59
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.83
Rate for Payer: Group Health Inc Commercial	$169.72
Rate for Payer: Group Health Inc Medicare	$118.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$169.72

US BREAST COMPLETE BILAT

Facility

$678.90

Service Code	HCPCS 76641 TC
Hospital Charge Code	41301632
Hospital Revenue Code	402
Min. Negotiated Rate	$237.62
Max. Negotiated Rate	$543.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$373.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.45
Rate for Payer: Aetna Government	$339.45
Rate for Payer: Brighton Health Commercial	$509.18
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$543.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$461.65
Rate for Payer: Group Health Inc Commercial	$339.45
Rate for Payer: Group Health Inc Medicare	$237.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$339.45
Rate for Payer: Hamaspik Choice Inc Medicare	$339.45

US BREAST COMPLETE BILAT

Facility

$678.90

Service Code	HCPCS 76641 TC
Hospital Charge Code	41301632
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US BREAST COMPLETE UNI

Facility

$339.45

Service Code	HCPCS 76641 TC
Hospital Charge Code	41304006
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US BREAST COMPLETE UNI

Facility

$339.45

Service Code	HCPCS 76641 TC
Hospital Charge Code	41304006
Hospital Revenue Code	402
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$271.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$169.72
Rate for Payer: Aetna Government	$169.72
Rate for Payer: Brighton Health Commercial	$254.59
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.83
Rate for Payer: Group Health Inc Commercial	$169.72
Rate for Payer: Group Health Inc Medicare	$118.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$169.72

US BREAST LIMITED UNI

Facility

$241.73

Service Code	HCPCS 76642 TC
Hospital Charge Code	41309978
Hospital Revenue Code	402
Rate for Payer: Cash Price	$105.08

US BREAST LIMITED UNI

Facility

$241.73

Service Code	HCPCS 76642 TC
Hospital Charge Code	41309978
Hospital Revenue Code	402
Min. Negotiated Rate	$84.61
Max. Negotiated Rate	$193.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$120.86
Rate for Payer: Aetna Government	$120.86
Rate for Payer: Brighton Health Commercial	$181.30
Rate for Payer: Cash Price	$105.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$193.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$164.38
Rate for Payer: Group Health Inc Commercial	$120.86
Rate for Payer: Group Health Inc Medicare	$84.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.86
Rate for Payer: Hamaspik Choice Inc Medicare	$120.86

US CENTRAL VAS/CAROTID

Facility

$705.83

Service Code	HCPCS 93880 TC
Hospital Charge Code	41304046
Hospital Revenue Code	920
Rate for Payer: Cash Price	$283.37

US CENTRAL VAS/CAROTID

Facility

$705.83

Service Code	HCPCS 93880 TC
Hospital Charge Code	41304046
Hospital Revenue Code	920
Min. Negotiated Rate	$247.04
Max. Negotiated Rate	$564.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$388.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$352.92
Rate for Payer: Aetna Government	$352.92
Rate for Payer: Brighton Health Commercial	$529.37
Rate for Payer: Cash Price	$283.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$564.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$479.96
Rate for Payer: Group Health Inc Commercial	$352.92
Rate for Payer: Group Health Inc Medicare	$247.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.92
Rate for Payer: Hamaspik Choice Inc Medicare	$352.92

US CENTRAL VASC/CAROTID UNI

Facility

$339.45

Service Code	HCPCS 93882 TC
Hospital Charge Code	41307393
Hospital Revenue Code	920
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$271.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$169.72
Rate for Payer: Aetna Government	$169.72
Rate for Payer: Brighton Health Commercial	$254.59
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.83
Rate for Payer: Group Health Inc Commercial	$169.72
Rate for Payer: Group Health Inc Medicare	$118.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$169.72

US CENTRAL VASC/CAROTID UNI

Facility

$339.45

Service Code	HCPCS 93882 TC
Hospital Charge Code	41307393
Hospital Revenue Code	920
Rate for Payer: Cash Price	$127.14

US CHEST

Facility

$339.45

Service Code	HCPCS 76604 TC
Hospital Charge Code	41304022
Hospital Revenue Code	402
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$271.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$169.72
Rate for Payer: Aetna Government	$169.72
Rate for Payer: Brighton Health Commercial	$254.59
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.83
Rate for Payer: Group Health Inc Commercial	$169.72
Rate for Payer: Group Health Inc Medicare	$118.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$169.72

US CHEST

Facility

$339.45

Service Code	HCPCS 76604 TC
Hospital Charge Code	41304022
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

USCI

Facility

$53.87

Hospital Charge Code	40207020
Hospital Revenue Code	270
Min. Negotiated Rate	$18.85
Max. Negotiated Rate	$43.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.94
Rate for Payer: Aetna Government	$26.94
Rate for Payer: Brighton Health Commercial	$40.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$43.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.63
Rate for Payer: Group Health Inc Commercial	$26.94
Rate for Payer: Group Health Inc Medicare	$18.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.94
Rate for Payer: Hamaspik Choice Inc Medicare	$26.94

US DUP ABD/PEL/SCO/ RETRO ART CO

Facility

$705.83

Service Code	HCPCS 93975 TC
Hospital Charge Code	41301510
Hospital Revenue Code	921
Min. Negotiated Rate	$247.04
Max. Negotiated Rate	$564.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$388.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$352.92
Rate for Payer: Aetna Government	$352.92
Rate for Payer: Brighton Health Commercial	$529.37
Rate for Payer: Cash Price	$283.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$564.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$479.96
Rate for Payer: Group Health Inc Commercial	$352.92
Rate for Payer: Group Health Inc Medicare	$247.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.92
Rate for Payer: Hamaspik Choice Inc Medicare	$352.92

US DUP ABD/PEL/SCO/ RETRO ART CO

Facility

$705.83

Service Code	HCPCS 93975 TC
Hospital Charge Code	41301510
Hospital Revenue Code	921
Rate for Payer: Cash Price	$283.37

US DUP ABD/PEL/SCO/RETRO ART LIM

Facility

$339.45

Service Code	HCPCS 93976 TC
Hospital Charge Code	41301511
Hospital Revenue Code	921
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$271.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$169.72
Rate for Payer: Aetna Government	$169.72
Rate for Payer: Brighton Health Commercial	$254.59
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.83
Rate for Payer: Group Health Inc Commercial	$169.72
Rate for Payer: Group Health Inc Medicare	$118.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$169.72

US DUP ABD/PEL/SCO/RETRO ART LIM

Facility

$339.45

Service Code	HCPCS 93976 TC
Hospital Charge Code	41301511
Hospital Revenue Code	921
Rate for Payer: Cash Price	$127.14

US DUP HEMO ACCESS ART/VEIN

Facility

$339.45

Service Code	HCPCS 93990 TC
Hospital Charge Code	41301512
Hospital Revenue Code	921
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$271.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$169.72
Rate for Payer: Aetna Government	$169.72
Rate for Payer: Brighton Health Commercial	$254.59
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.83
Rate for Payer: Group Health Inc Commercial	$169.72
Rate for Payer: Group Health Inc Medicare	$118.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$169.72

US DUP HEMO ACCESS ART/VEIN

Facility

$339.45

Service Code	HCPCS 93990 TC
Hospital Charge Code	41301512
Hospital Revenue Code	921
Rate for Payer: Cash Price	$127.14

US ECHOENCEPHALOGRAPHY

Facility

$339.45

Service Code	HCPCS 76506 TC
Hospital Charge Code	41308751
Hospital Revenue Code	402
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$271.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$169.72
Rate for Payer: Aetna Government	$169.72
Rate for Payer: Brighton Health Commercial	$254.59
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.83
Rate for Payer: Group Health Inc Commercial	$169.72
Rate for Payer: Group Health Inc Medicare	$118.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$169.72

US ECHOENCEPHALOGRAPHY

Facility

$339.45

Service Code	HCPCS 76506 TC
Hospital Charge Code	41308751
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US ECHO EXAM OF EYE

Facility

$339.45

Service Code	HCPCS 76519 TC
Hospital Charge Code	41309734
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US ECHO EXAM OF EYE

Facility

$339.45

Service Code	HCPCS 76519 TC
Hospital Charge Code	41309734
Hospital Revenue Code	402
Min. Negotiated Rate	$118.81
Max. Negotiated Rate	$271.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$169.72
Rate for Payer: Aetna Government	$169.72
Rate for Payer: Brighton Health Commercial	$254.59
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.83
Rate for Payer: Group Health Inc Commercial	$169.72
Rate for Payer: Group Health Inc Medicare	$118.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$169.72

US EMERGENCY BREAST, LTD

Facility

$241.73

Service Code	HCPCS 76642 TC
Hospital Charge Code	41308070
Hospital Revenue Code	402
Min. Negotiated Rate	$84.61
Max. Negotiated Rate	$193.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$120.86
Rate for Payer: Aetna Government	$120.86
Rate for Payer: Brighton Health Commercial	$181.30
Rate for Payer: Cash Price	$105.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$193.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$164.38
Rate for Payer: Group Health Inc Commercial	$120.86
Rate for Payer: Group Health Inc Medicare	$84.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.86
Rate for Payer: Hamaspik Choice Inc Medicare	$120.86

Know your out-of-pocket cost for care.

All Charges