St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

US OBGYN PREGNANCY LIMITED

Facility

$339.45

Service Code	HCPCS 76815 TC
Hospital Charge Code	41309829
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US OBGYN PREGNANCY LIMITED

Facility

$339.45

Service Code	HCPCS 76815 TC
Hospital Charge Code	41309829
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 OB/GYN TRANSVAGINAL

Facility

$339.45

Service Code	HCPCS 76817 TC
Hospital Charge Code	41309830
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US OB/GYN TRANSVAGINAL

Facility

$339.45

Service Code	HCPCS 76817 TC
Hospital Charge Code	41309830
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 UMBILICAL ARTERY ECHO

Facility

$339.45

Service Code	HCPCS 76820 TC
Hospital Charge Code	41301502
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US OBGYN UMBILICAL ARTERY ECHO

Facility

$339.45

Service Code	HCPCS 76820 TC
Hospital Charge Code	41301502
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 OB/GYN US GUIDANCE FOR AMNIOCE

Facility

$197.40

Service Code	HCPCS 76946 TC
Hospital Charge Code	41309831
Hospital Revenue Code	402
Min. Negotiated Rate	$69.09
Max. Negotiated Rate	$157.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$108.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.70
Rate for Payer: Aetna Government	$98.70
Rate for Payer: Brighton Health Commercial	$148.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$157.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$134.23
Rate for Payer: Group Health Inc Commercial	$98.70
Rate for Payer: Group Health Inc Medicare	$69.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.70
Rate for Payer: Hamaspik Choice Inc Medicare	$98.70

US OPH US DX B-SCAN&QUAN A-SCAN

Facility

$330.23

Service Code	HCPCS 76510 TC
Hospital Charge Code	41309967
Hospital Revenue Code	402
Min. Negotiated Rate	$115.58
Max. Negotiated Rate	$264.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$165.12
Rate for Payer: Aetna Government	$165.12
Rate for Payer: Brighton Health Commercial	$247.67
Rate for Payer: Cash Price	$147.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$264.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.56
Rate for Payer: Group Health Inc Commercial	$165.12
Rate for Payer: Group Health Inc Medicare	$115.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.12
Rate for Payer: Hamaspik Choice Inc Medicare	$165.12

US OPH US DX B-SCAN&QUAN A-SCAN

Facility

$330.23

Service Code	HCPCS 76510 TC
Hospital Charge Code	41309967
Hospital Revenue Code	402
Rate for Payer: Cash Price	$147.72

US OPH US DX QUAN A-SCAN ONLY

Facility

$339.45

Service Code	HCPCS 76511 TC
Hospital Charge Code	41309910
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 OPH US DX QUAN A-SCAN ONLY

Facility

$339.45

Service Code	HCPCS 76511 TC
Hospital Charge Code	41309910
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US PELVIC COMPLETE

Facility

$339.45

Service Code	HCPCS 76856 TC
Hospital Charge Code	41304018
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 PELVIC COMPLETE

Facility

$339.45

Service Code	HCPCS 76856 TC
Hospital Charge Code	41304018
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US PELVIC LIMITED

Facility

$339.45

Service Code	HCPCS 76857 TC
Hospital Charge Code	41304032
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 PELVIC LIMITED

Facility

$339.45

Service Code	HCPCS 76857 TC
Hospital Charge Code	41304032
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US PERC. DRAIN. W/WO CATH.

Facility

$453.64

Service Code	HCPCS 75989 TC
Hospital Charge Code	41304062
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 PERI VASC UP/LOW EXT. BI

Facility

$705.83

Service Code	HCPCS 93970 TC
Hospital Charge Code	41307394
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 PERI VASC UP/LOW EXT. BI

Facility

$705.83

Service Code	HCPCS 93970 TC
Hospital Charge Code	41307394
Hospital Revenue Code	920
Rate for Payer: Cash Price	$283.37

US PERI VASC UP/LOW EXT.UNI

Facility

$339.45

Service Code	HCPCS 93971 TC
Hospital Charge Code	41304014
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 PERI VASC UP/LOW EXT.UNI

Facility

$339.45

Service Code	HCPCS 93971 TC
Hospital Charge Code	41304014
Hospital Revenue Code	920
Rate for Payer: Cash Price	$127.14

US PREGNANCY COMPLETE

Facility

$339.45

Service Code	HCPCS 76805 TC
Hospital Charge Code	41304028
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US PREGNANCY COMPLETE

Facility

$339.45

Service Code	HCPCS 76805 TC
Hospital Charge Code	41304028
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 PREGNANCY FOLLOW-UP

Facility

$339.45

Service Code	HCPCS 76816 TC
Hospital Charge Code	41304010
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

US PREGNANCY FOLLOW-UP

Facility

$339.45

Service Code	HCPCS 76816 TC
Hospital Charge Code	41304010
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 PREGNANCY LIMITED

Facility

$339.45

Service Code	HCPCS 76815 TC
Hospital Charge Code	41304008
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

Know your out-of-pocket cost for care.

All Charges