St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

XR FACIAL BONES LIMITED

Facility

$241.73

Service Code	HCPCS 70140 TC
Hospital Charge Code	41102170
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 FACIAL BONES LIMITED

Facility

$241.73

Service Code	HCPCS 70140 TC
Hospital Charge Code	41102170
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FEMUR

Facility

$241.73

Service Code	HCPCS 73552 TC
Hospital Charge Code	41102070
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 FEMUR

Facility

$241.73

Service Code	HCPCS 73552 TC
Hospital Charge Code	41102070
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FEMUR 1 VIEW

Facility

$241.73

Service Code	HCPCS 73551 TC
Hospital Charge Code	41102854
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FEMUR 1 VIEW

Facility

$241.73

Service Code	HCPCS 73551 TC
Hospital Charge Code	41102854
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 FINGER 1 VIEW

Facility

$241.73

Service Code	HCPCS 73140 TC
Hospital Charge Code	41102840
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 FINGER 1 VIEW

Facility

$241.73

Service Code	HCPCS 73140 TC
Hospital Charge Code	41102840
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FINGER(S)

Facility

$241.73

Service Code	HCPCS 73140 TC
Hospital Charge Code	41102072
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 FINGER(S)

Facility

$241.73

Service Code	HCPCS 73140 TC
Hospital Charge Code	41102072
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FOOT 1 VIEW

Facility

$241.73

Service Code	HCPCS 73620 TC
Hospital Charge Code	41102862
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 FOOT 1 VIEW

Facility

$241.73

Service Code	HCPCS 73620 TC
Hospital Charge Code	41102862
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FOOT 2 VIEWS

Facility

$241.73

Service Code	HCPCS 73620 TC
Hospital Charge Code	41102492
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FOOT 2 VIEWS

Facility

$241.73

Service Code	HCPCS 73620 TC
Hospital Charge Code	41102492
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 FOOT 3 VIEWS

Facility

$241.73

Service Code	HCPCS 73630 TC
Hospital Charge Code	41102074
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FOOT 3 VIEWS

Facility

$241.73

Service Code	HCPCS 73630 TC
Hospital Charge Code	41102074
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 FOREARM

Facility

$241.73

Service Code	HCPCS 73090 TC
Hospital Charge Code	41102076
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 FOREARM

Facility

$241.73

Service Code	HCPCS 73090 TC
Hospital Charge Code	41102076
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FOREARM 1 VIEW

Facility

$241.73

Service Code	HCPCS 73090 TC
Hospital Charge Code	41102846
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FOREARM 1 VIEW

Facility

$241.73

Service Code	HCPCS 73090 TC
Hospital Charge Code	41102846
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 FOREARM 1 VIEW

Facility

$130.41

Service Code	HCPCS 76499 TC
Hospital Charge Code	41107500
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR FOREARM 1 VIEW

Facility

$130.41

Service Code	HCPCS 76499 TC
Hospital Charge Code	41107500
Hospital Revenue Code	320
Min. Negotiated Rate	$45.64
Max. Negotiated Rate	$104.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$71.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$65.20
Rate for Payer: Aetna Government	$65.20
Rate for Payer: Brighton Health Commercial	$97.81
Rate for Payer: Cash Price	$105.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$104.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$88.68
Rate for Payer: Group Health Inc Commercial	$65.20
Rate for Payer: Group Health Inc Medicare	$45.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.20
Rate for Payer: Hamaspik Choice Inc Medicare	$65.20

XR HAND 1 VIEW

Facility

$235.00

Service Code	HCPCS 76499 TC
Hospital Charge Code	41107496
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

XR HAND 1 VIEW

Facility

$327.00

Service Code	HCPCS 73120 TC
Hospital Charge Code	41102842
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 HAND 1 VIEW

Facility

$327.00

Service Code	HCPCS 73120 TC
Hospital Charge Code	41102842
Hospital Revenue Code	320
Rate for Payer: Cash Price	$127.14

Know your out-of-pocket cost for care.

All Charges