St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

XR CHEST 4 VIEWS

Facility

$339.45

Service Code	HCPCS 71048 TC
Hospital Charge Code	41109968
Hospital Revenue Code	320
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

XR CHEST DECUBI UNI

Facility

$241.73

Service Code	HCPCS 71045 TC
Hospital Charge Code	41102018
Hospital Revenue Code	324
Rate for Payer: Cash Price	$105.08

XR CHEST DECUBI UNI

Facility

$241.73

Service Code	HCPCS 71045 TC
Hospital Charge Code	41102018
Hospital Revenue Code	324
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

XR CLAVICLE

Facility

$241.73

Service Code	HCPCS 73000 TC
Hospital Charge Code	41102062
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR CLAVICLE

Facility

$241.73

Service Code	HCPCS 73000 TC
Hospital Charge Code	41102062
Hospital Revenue Code	320
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

XR CLAVICLE 1 VIEW

Facility

$241.73

Service Code	HCPCS 73000 TC
Hospital Charge Code	41102852
Hospital Revenue Code	320
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

XR CLAVICLE 1 VIEW

Facility

$53.51

Service Code	HCPCS 76499 TC
Hospital Charge Code	41107506
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR CLAVICLE 1 VIEW

Facility

$241.73

Service Code	HCPCS 73000 TC
Hospital Charge Code	41102852
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR CLAVICLE 1 VIEW

Facility

$53.51

Service Code	HCPCS 76499 TC
Hospital Charge Code	41107506
Hospital Revenue Code	320
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$42.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.76
Rate for Payer: Aetna Government	$26.76
Rate for Payer: Brighton Health Commercial	$40.13
Rate for Payer: Cash Price	$105.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.39
Rate for Payer: Group Health Inc Commercial	$26.76
Rate for Payer: Group Health Inc Medicare	$18.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.76
Rate for Payer: Hamaspik Choice Inc Medicare	$26.76

XR CONSULTATION X-RAY FILMS

Facility

$81.19

Service Code	HCPCS 76140
Hospital Charge Code	41102930
Hospital Revenue Code	320
Min. Negotiated Rate	$28.42
Max. Negotiated Rate	$64.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$59.92
Rate for Payer: Aetna Government	$59.92
Rate for Payer: Brighton Health Commercial	$60.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$64.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$55.21
Rate for Payer: Group Health Inc Commercial	$40.60
Rate for Payer: Group Health Inc Medicare	$28.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.60
Rate for Payer: Hamaspik Choice Inc Medicare	$40.60

XR CONTIN PHYSICS SUPPORT

Facility

$383.40

Service Code	HCPCS 77336
Hospital Charge Code	66542944
Hospital Revenue Code	333
Rate for Payer: Cash Price	$156.91

XR CONTIN PHYSICS SUPPORT

Facility

$383.40

Service Code	HCPCS 77336
Hospital Charge Code	66542944
Hospital Revenue Code	333
Min. Negotiated Rate	$125.53
Max. Negotiated Rate	$306.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$210.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$156.91
Rate for Payer: Aetna Government	$156.91
Rate for Payer: Brighton Health Commercial	$287.55
Rate for Payer: Cash Price	$156.91
Rate for Payer: Cash Price	$156.91
Rate for Payer: Cash Price	$156.91
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$156.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$306.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$260.71
Rate for Payer: Elderplan Medicare Advantage	$156.91
Rate for Payer: EmblemHealth Commercial	$156.91
Rate for Payer: Fidelis CHP/HARP/Medicaid	$279.92
Rate for Payer: Fidelis Essential Plan Aliesa	$279.92
Rate for Payer: Fidelis Essential Plan QHP	$294.00
Rate for Payer: Fidelis Medicare Advantage	$156.91
Rate for Payer: Fidelis Qualified Health Plan	$294.00
Rate for Payer: Group Health Inc Commercial	$156.91
Rate for Payer: Group Health Inc Medicare	$156.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$191.70
Rate for Payer: Hamaspik Choice Inc Medicare	$156.91
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$141.22
Rate for Payer: Healthfirst Medicare Advantage	$156.91
Rate for Payer: Healthfirst QHP	$156.91
Rate for Payer: Senior Whole Health Medicare Advantage	$156.91
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.91
Rate for Payer: Wellcare CHP/FHP/Medicaid	$125.53
Rate for Payer: Wellcare Medicare	$149.06

XR ELBOW 1 VIEW

Facility

$241.73

Service Code	HCPCS 73070 TC
Hospital Charge Code	41102848
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR ELBOW 1 VIEW

Facility

$241.73

Service Code	HCPCS 73070 TC
Hospital Charge Code	41102848
Hospital Revenue Code	320
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

XR ELBOW 2 VIEWS

Facility

$241.73

Service Code	HCPCS 73070 TC
Hospital Charge Code	41102064
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR ELBOW 2 VIEWS

Facility

$241.73

Service Code	HCPCS 73070 TC
Hospital Charge Code	41102064
Hospital Revenue Code	320
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

XR ELBOW COMPLETE

Facility

$241.73

Service Code	HCPCS 73080 TC
Hospital Charge Code	41102460
Hospital Revenue Code	320
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

XR ELBOW COMPLETE

Facility

$241.73

Service Code	HCPCS 73080 TC
Hospital Charge Code	41102460
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR ENTIRE SPINE 2/3 VW

Facility

$339.45

Service Code	HCPCS 72082 TC
Hospital Charge Code	41102434
Hospital Revenue Code	320
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

XR ENTIRE SPINE 2/3 VW

Facility

$339.45

Service Code	HCPCS 72082 TC
Hospital Charge Code	41102434
Hospital Revenue Code	320
Rate for Payer: Cash Price	$127.14

XR ESOPHAGUS DILATION

Facility

$650.40

Service Code	HCPCS 74360 TC
Hospital Charge Code	41107678
Hospital Revenue Code	320
Min. Negotiated Rate	$227.64
Max. Negotiated Rate	$520.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$357.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$325.20
Rate for Payer: Aetna Government	$325.20
Rate for Payer: Brighton Health Commercial	$487.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$520.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$442.27
Rate for Payer: Group Health Inc Commercial	$325.20
Rate for Payer: Group Health Inc Medicare	$227.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$325.20
Rate for Payer: Hamaspik Choice Inc Medicare	$325.20

XR EYE EXAM FOREIGN BODY

Facility

$241.73

Service Code	HCPCS 70030 TC
Hospital Charge Code	41108534
Hospital Revenue Code	320
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

XR EYE EXAM FOREIGN BODY

Facility

$241.73

Service Code	HCPCS 70030 TC
Hospital Charge Code	41108534
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FACIAL BONES COMPLETE

Facility

$327.00

Service Code	HCPCS 70150 TC
Hospital Charge Code	41102164
Hospital Revenue Code	320
Min. Negotiated Rate	$114.45
Max. Negotiated Rate	$261.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$179.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$163.50
Rate for Payer: Aetna Government	$163.50
Rate for Payer: Brighton Health Commercial	$245.25
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$261.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.36
Rate for Payer: Group Health Inc Commercial	$163.50
Rate for Payer: Group Health Inc Medicare	$114.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.50
Rate for Payer: Hamaspik Choice Inc Medicare	$163.50

XR FACIAL BONES COMPLETE

Facility

$327.00

Service Code	HCPCS 70150 TC
Hospital Charge Code	41102164
Hospital Revenue Code	320
Rate for Payer: Cash Price	$127.14

Know your out-of-pocket cost for care.

All Charges