St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

US EMERGENCY BREAST, LTD

Facility

$241.73

Service Code	HCPCS 76642 TC
Hospital Charge Code	41308070
Hospital Revenue Code	402
Rate for Payer: Cash Price	$105.08

US EXAM CHEST W/DOCMNT

Facility

$339.45

Service Code	HCPCS 76604
Hospital Charge Code	30300154
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US EXAM CHEST W/DOCMNT

Facility

$339.45

Service Code	HCPCS 76604
Hospital Charge Code	30300154
Hospital Revenue Code	402
Min. Negotiated Rate	$89.00
Max. Negotiated Rate	$186.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$127.14
Rate for Payer: Aetna Government	$127.14
Rate for Payer: Brighton Health Commercial	$127.14
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cash Price	$127.14
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$124.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$105.41
Rate for Payer: Elderplan Medicare Advantage	$127.14
Rate for Payer: EmblemHealth Commercial	$89.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$108.07
Rate for Payer: Fidelis Essential Plan Aliesa	$108.07
Rate for Payer: Fidelis Essential Plan QHP	$113.15
Rate for Payer: Fidelis Medicare Advantage	$127.14
Rate for Payer: Fidelis Qualified Health Plan	$113.15
Rate for Payer: Group Health Inc Commercial	$114.43
Rate for Payer: Group Health Inc Medicare	$114.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$127.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$114.43
Rate for Payer: Healthfirst Medicare Advantage	$127.14
Rate for Payer: Healthfirst QHP	$127.14
Rate for Payer: Senior Whole Health Medicare Advantage	$127.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.14
Rate for Payer: Wellcare CHP/FHP/Medicaid	$101.71
Rate for Payer: Wellcare Medicare	$120.78

US EXTREM. UPPER ARTERIES BILAT.

Facility

$705.83

Service Code	HCPCS 93930 TC
Hospital Charge Code	41304040
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 EXTREM. UPPER ARTERIES BILAT.

Facility

$705.83

Service Code	HCPCS 93930 TC
Hospital Charge Code	41304040
Hospital Revenue Code	920
Rate for Payer: Cash Price	$283.37

US FETAL BIO PROFILE

Facility

$339.45

Service Code	HCPCS 76818 TC
Hospital Charge Code	41304030
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US FETAL BIO PROFILE

Facility

$339.45

Service Code	HCPCS 76818 TC
Hospital Charge Code	41304030
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 GUIDANCE IJ PUNCTURE

Facility

$1,144.39

Service Code	HCPCS 76942 TC
Hospital Charge Code	41307722
Hospital Revenue Code	402
Min. Negotiated Rate	$400.54
Max. Negotiated Rate	$915.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$629.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$572.20
Rate for Payer: Aetna Government	$572.20
Rate for Payer: Brighton Health Commercial	$858.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$915.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$778.19
Rate for Payer: Group Health Inc Commercial	$572.20
Rate for Payer: Group Health Inc Medicare	$400.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$572.20
Rate for Payer: Hamaspik Choice Inc Medicare	$572.20

US GUIDANCE RFA

Facility

$549.60

Service Code	HCPCS 76940 TC
Hospital Charge Code	41309618
Hospital Revenue Code	402
Min. Negotiated Rate	$192.36
Max. Negotiated Rate	$439.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$302.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$274.80
Rate for Payer: Aetna Government	$274.80
Rate for Payer: Brighton Health Commercial	$412.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$439.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$373.73
Rate for Payer: Group Health Inc Commercial	$274.80
Rate for Payer: Group Health Inc Medicare	$192.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.80
Rate for Payer: Hamaspik Choice Inc Medicare	$274.80

US GUIDANCE - VASCULAR ACC

Facility

$766.58

Service Code	HCPCS 76937 TC
Hospital Charge Code	41309852
Hospital Revenue Code	402
Min. Negotiated Rate	$268.30
Max. Negotiated Rate	$613.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$383.29
Rate for Payer: Aetna Government	$383.29
Rate for Payer: Brighton Health Commercial	$574.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$613.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$521.27
Rate for Payer: Group Health Inc Commercial	$383.29
Rate for Payer: Group Health Inc Medicare	$268.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.29
Rate for Payer: Hamaspik Choice Inc Medicare	$383.29

US GUIDED COMP PSEUDOANEURYSM

Facility

$766.58

Service Code	HCPCS 76936 TC
Hospital Charge Code	41307705
Hospital Revenue Code	402
Min. Negotiated Rate	$268.30
Max. Negotiated Rate	$613.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$383.29
Rate for Payer: Aetna Government	$383.29
Rate for Payer: Brighton Health Commercial	$574.94
Rate for Payer: Cash Price	$362.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$613.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$521.27
Rate for Payer: Group Health Inc Commercial	$383.29
Rate for Payer: Group Health Inc Medicare	$268.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.29
Rate for Payer: Hamaspik Choice Inc Medicare	$383.29

US GUIDED COMP PSEUDOANEURYSM

Facility

$766.58

Service Code	HCPCS 76936 TC
Hospital Charge Code	41307705
Hospital Revenue Code	402
Rate for Payer: Cash Price	$362.98

US GUID FOR CYST ASP

Facility

$1,144.39

Service Code	HCPCS 76942 TC
Hospital Charge Code	41104066
Hospital Revenue Code	402
Min. Negotiated Rate	$400.54
Max. Negotiated Rate	$915.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$629.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$572.20
Rate for Payer: Aetna Government	$572.20
Rate for Payer: Brighton Health Commercial	$858.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$915.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$778.19
Rate for Payer: Group Health Inc Commercial	$572.20
Rate for Payer: Group Health Inc Medicare	$400.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$572.20
Rate for Payer: Hamaspik Choice Inc Medicare	$572.20

US GUID FOR CYST ASP

Facility

$1,144.39

Service Code	HCPCS 76942 TC
Hospital Charge Code	41304066
Hospital Revenue Code	402
Min. Negotiated Rate	$400.54
Max. Negotiated Rate	$915.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$629.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$572.20
Rate for Payer: Aetna Government	$572.20
Rate for Payer: Brighton Health Commercial	$858.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$915.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$778.19
Rate for Payer: Group Health Inc Commercial	$572.20
Rate for Payer: Group Health Inc Medicare	$400.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$572.20
Rate for Payer: Hamaspik Choice Inc Medicare	$572.20

US GUID RENAL PELVIS ASP

Facility

$1,144.39

Service Code	HCPCS 76942 TC
Hospital Charge Code	41304068
Hospital Revenue Code	402
Min. Negotiated Rate	$400.54
Max. Negotiated Rate	$915.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$629.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$572.20
Rate for Payer: Aetna Government	$572.20
Rate for Payer: Brighton Health Commercial	$858.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$915.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$778.19
Rate for Payer: Group Health Inc Commercial	$572.20
Rate for Payer: Group Health Inc Medicare	$400.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$572.20
Rate for Payer: Hamaspik Choice Inc Medicare	$572.20

US HEAD/NECK/THRYOID

Facility

$339.45

Service Code	HCPCS 76536 TC
Hospital Charge Code	41304020
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US HEAD/NECK/THRYOID

Facility

$339.45

Service Code	HCPCS 76536 TC
Hospital Charge Code	41304020
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 HEMO-DIALYSIS EVAL

Facility

$339.45

Service Code	HCPCS 93990 TC
Hospital Charge Code	41201183
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 HEMO-DIALYSIS EVAL

Facility

$339.45

Service Code	HCPCS 93990 TC
Hospital Charge Code	41201183
Hospital Revenue Code	921
Rate for Payer: Cash Price	$127.14

US HYSTEROSONOGRAPHY

Facility

$705.83

Service Code	HCPCS 76831 TC
Hospital Charge Code	41309621
Hospital Revenue Code	402
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 HYSTEROSONOGRAPHY

Facility

$705.83

Service Code	HCPCS 76831 TC
Hospital Charge Code	41309621
Hospital Revenue Code	402
Rate for Payer: Cash Price	$283.37

US INFANT HIPS

Facility

$241.73

Service Code	HCPCS 76885 TC
Hospital Charge Code	41307750
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 INFANT HIPS

Facility

$241.73

Service Code	HCPCS 76885 TC
Hospital Charge Code	41307750
Hospital Revenue Code	402
Rate for Payer: Cash Price	$105.08

US IN O/R (TRANSCATHETER THERAPY)

Facility

$348.15

Service Code	HCPCS 76998 TC
Hospital Charge Code	41307706
Hospital Revenue Code	402
Min. Negotiated Rate	$121.85
Max. Negotiated Rate	$278.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$174.08
Rate for Payer: Aetna Government	$174.08
Rate for Payer: Brighton Health Commercial	$261.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$278.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$236.74
Rate for Payer: Group Health Inc Commercial	$174.08
Rate for Payer: Group Health Inc Medicare	$121.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.08
Rate for Payer: Hamaspik Choice Inc Medicare	$174.08

US KIDNEYS

Facility

$339.45

Service Code	HCPCS 76770 TC
Hospital Charge Code	41301508
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

Know your out-of-pocket cost for care.

All Charges