St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

US KIDNEYS

Facility

$339.45

Service Code	HCPCS 76770 TC
Hospital Charge Code	41301508
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 LOW EXTREM ARTERIES BI

Facility

$705.83

Service Code	HCPCS 93925 TC
Hospital Charge Code	41307390
Hospital Revenue Code	920
Rate for Payer: Cash Price	$283.37

US LOW EXTREM ARTERIES BI

Facility

$705.83

Service Code	HCPCS 93925 TC
Hospital Charge Code	41307390
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 LOW EXTREM ARTERIES UNI

Facility

$339.45

Service Code	HCPCS 93926 TC
Hospital Charge Code	41307391
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 LOW EXTREM ARTERIES UNI

Facility

$339.45

Service Code	HCPCS 93926 TC
Hospital Charge Code	41307391
Hospital Revenue Code	920
Rate for Payer: Cash Price	$127.14

US LWR XTR VASC STDY BILAT

Facility

$801.55

Service Code	HCPCS 93924
Hospital Charge Code	41302365
Hospital Revenue Code	921
Min. Negotiated Rate	$144.51
Max. Negotiated Rate	$641.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$440.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.64
Rate for Payer: Aetna Government	$180.64
Rate for Payer: Brighton Health Commercial	$601.16
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cash Price	$180.64
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$180.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$641.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$545.05
Rate for Payer: Elderplan Medicare Advantage	$180.64
Rate for Payer: EmblemHealth Commercial	$180.64
Rate for Payer: Fidelis Essential Plan Aliesa	$153.54
Rate for Payer: Fidelis Essential Plan QHP	$160.77
Rate for Payer: Fidelis Medicare Advantage	$180.64
Rate for Payer: Fidelis Qualified Health Plan	$160.77
Rate for Payer: Group Health Inc Commercial	$180.64
Rate for Payer: Group Health Inc Medicare	$180.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$400.78
Rate for Payer: Hamaspik Choice Inc Medicare	$180.64
Rate for Payer: Healthfirst Medicare Advantage	$153.54
Rate for Payer: Healthfirst QHP	$180.64
Rate for Payer: Senior Whole Health Medicare Advantage	$180.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$180.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$144.51
Rate for Payer: Wellcare Medicare	$171.61

US LWR XTR VASC STDY BILAT

Facility

$801.55

Service Code	HCPCS 93924
Hospital Charge Code	41302365
Hospital Revenue Code	921
Rate for Payer: Cash Price	$180.64

US OBGYN AMNIOCENTESIS DIAGNOSTIC

Facility

$1,933.73

Service Code	HCPCS 59000
Hospital Charge Code	41301503
Hospital Revenue Code	409
Rate for Payer: Cash Price	$929.66

US OBGYN AMNIOCENTESIS DIAGNOSTIC

Facility

$1,933.73

Service Code	HCPCS 59000
Hospital Charge Code	41301503
Hospital Revenue Code	409
Min. Negotiated Rate	$650.76
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$929.66
Rate for Payer: Aetna Government	$929.66
Rate for Payer: Brighton Health Commercial	$929.66
Rate for Payer: Cash Price	$929.66
Rate for Payer: Cash Price	$929.66
Rate for Payer: Cash Price	$929.66
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$929.66
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	$929.66
Rate for Payer: EmblemHealth Commercial	$650.76
Rate for Payer: Fidelis CHP/HARP/Medicaid	$790.21
Rate for Payer: Fidelis Essential Plan Aliesa	$790.21
Rate for Payer: Fidelis Essential Plan QHP	$827.40
Rate for Payer: Fidelis Medicare Advantage	$929.66
Rate for Payer: Fidelis Qualified Health Plan	$827.40
Rate for Payer: Group Health Inc Commercial	$836.69
Rate for Payer: Group Health Inc Medicare	$836.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$966.86
Rate for Payer: Hamaspik Choice Inc Medicare	$929.66
Rate for Payer: Healthfirst Medicare Advantage	$790.21
Rate for Payer: Healthfirst QHP	$929.66
Rate for Payer: Senior Whole Health Medicare Advantage	$929.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$929.66
Rate for Payer: Wellcare CHP/FHP/Medicaid	$743.73
Rate for Payer: Wellcare Medicare	$883.18

US OBGYN BIO PHYSICAL PROFILE

Facility

$339.45

Service Code	HCPCS 76819 TC
Hospital Charge Code	41108875
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US OBGYN BIO PHYSICAL PROFILE

Facility

$339.45

Service Code	HCPCS 76819 TC
Hospital Charge Code	41108875
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 OBGYN DETAILED ADDL FETUS

Facility

$595.93

Service Code	HCPCS 76812 TC
Hospital Charge Code	41301501
Hospital Revenue Code	402
Min. Negotiated Rate	$208.58
Max. Negotiated Rate	$476.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$327.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$297.96
Rate for Payer: Aetna Government	$297.96
Rate for Payer: Brighton Health Commercial	$446.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$476.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$405.23
Rate for Payer: Group Health Inc Commercial	$297.96
Rate for Payer: Group Health Inc Medicare	$208.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$297.96
Rate for Payer: Hamaspik Choice Inc Medicare	$297.96

US OBGYN DETAILED SNGL FETUS

Facility

$705.83

Service Code	HCPCS 76811 TC
Hospital Charge Code	41301500
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 OBGYN DETAILED SNGL FETUS

Facility

$705.83

Service Code	HCPCS 76811 TC
Hospital Charge Code	41301500
Hospital Revenue Code	402
Rate for Payer: Cash Price	$283.37

US OBGYN ECHO GUI FOR AMNIO

Facility

$453.64

Service Code	HCPCS 76946 TC
Hospital Charge Code	41309826
Hospital Revenue Code	402
Min. Negotiated Rate	$158.77
Max. Negotiated Rate	$362.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$249.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$226.82
Rate for Payer: Aetna Government	$226.82
Rate for Payer: Brighton Health Commercial	$340.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$362.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$308.48
Rate for Payer: Group Health Inc Commercial	$226.82
Rate for Payer: Group Health Inc Medicare	$158.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.82
Rate for Payer: Hamaspik Choice Inc Medicare	$226.82

US OBGYN MIDDLE CEREB ARTERY ECHO

Facility

$339.45

Service Code	HCPCS 76821 TC
Hospital Charge Code	41301507
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 OBGYN MIDDLE CEREB ARTERY ECHO

Facility

$339.45

Service Code	HCPCS 76821 TC
Hospital Charge Code	41301507
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US OBGYN PREG <14 WKS ADDL FETUS

Facility

$169.73

Service Code	HCPCS 76802 TC
Hospital Charge Code	41301505
Hospital Revenue Code	402
Min. Negotiated Rate	$59.41
Max. Negotiated Rate	$135.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$84.86
Rate for Payer: Aetna Government	$84.86
Rate for Payer: Brighton Health Commercial	$127.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$135.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.42
Rate for Payer: Group Health Inc Commercial	$84.86
Rate for Payer: Group Health Inc Medicare	$59.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$84.86
Rate for Payer: Hamaspik Choice Inc Medicare	$84.86

US OBGYN PREG >/=14WKS ADDL FETUS

Facility

$169.73

Service Code	HCPCS 76810 TC
Hospital Charge Code	41301506
Hospital Revenue Code	402
Min. Negotiated Rate	$59.41
Max. Negotiated Rate	$135.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$84.86
Rate for Payer: Aetna Government	$84.86
Rate for Payer: Brighton Health Commercial	$127.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$135.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.42
Rate for Payer: Group Health Inc Commercial	$84.86
Rate for Payer: Group Health Inc Medicare	$59.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$84.86
Rate for Payer: Hamaspik Choice Inc Medicare	$84.86

US OBGYN PREG 1ST TRI (<14WKS)

Facility

$339.45

Service Code	HCPCS 76801 TC
Hospital Charge Code	41301504
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 OBGYN PREG 1ST TRI (<14WKS)

Facility

$339.45

Service Code	HCPCS 76801 TC
Hospital Charge Code	41301504
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US OBGYN PREG 2ND & 3RD TRI >14WK

Facility

$339.45

Service Code	HCPCS 76805 TC
Hospital Charge Code	41309827
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 OBGYN PREG 2ND & 3RD TRI >14WK

Facility

$339.45

Service Code	HCPCS 76805 TC
Hospital Charge Code	41309827
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US OBGYN PREGNANCY FOLLOW UP

Facility

$339.45

Service Code	HCPCS 76816 TC
Hospital Charge Code	41309828
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 OBGYN PREGNANCY FOLLOW UP

Facility

$339.45

Service Code	HCPCS 76816 TC
Hospital Charge Code	41309828
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

Know your out-of-pocket cost for care.

All Charges