St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC CATH PUL ART BALLOON REPAIR,PERC,1ST VESL

Facility

$30,010.00

Service Code	CPT 92997
Hospital Charge Code	4819299701
Hospital Revenue Code	481
Min. Negotiated Rate	$15,005.00
Max. Negotiated Rate	$15,005.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,005.00

HC CATH PUL ART BALLOON REPAIR,PERC,1ST VESL

Facility

$30,010.00

Service Code	CPT 92997
Hospital Charge Code	4819299701
Hospital Revenue Code	481
Min. Negotiated Rate	$720.16
Max. Negotiated Rate	$16,505.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16,505.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13,856.14
Rate for Payer: Aetna Government	$13,856.14
Rate for Payer: Affinity Essential Plan 1&2	$9,699.30
Rate for Payer: Affinity Essential Plan 3&4	$9,699.30
Rate for Payer: Affinity Medicaid/CHP/HARP	$9,699.30
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$13,856.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: Elderplan Medicare Advantage	$13,856.14
Rate for Payer: EmblemHealth Commercial	$13,856.14
Rate for Payer: Fidelis CHP/HARP/Medicaid	$12,470.53
Rate for Payer: Fidelis Essential Plan Aliesa	$11,777.72
Rate for Payer: Fidelis Essential Plan QHP	$12,331.96
Rate for Payer: Fidelis Medicare Advantage	$13,856.14
Rate for Payer: Fidelis Qualified Health Plan	$12,331.96
Rate for Payer: Group Health Inc Commercial	$13,856.14
Rate for Payer: Group Health Inc Medicare	$13,856.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$13,856.14
Rate for Payer: Hamaspik Choice Inc Medicare	$13,856.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$720.16
Rate for Payer: Healthfirst Medicare Advantage	$11,777.72
Rate for Payer: Healthfirst QHP	$13,856.14
Rate for Payer: Humana Medicare	$14,133.26
Rate for Payer: Senior Whole Health Medicare Advantage	$13,856.14
Rate for Payer: United Healthcare Commercial	$2,546.00
Rate for Payer: United Healthcare Medicare Advantage	$13,856.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13,856.14
Rate for Payer: Wellcare CHP/FHP/Medicaid	$13,163.33
Rate for Payer: Wellcare Medicare	$13,163.33

HC CATH PUL ART BALLOON REPAIR,PERC,ADDN VES

Facility

$518.00

Service Code	CPT 92998
Hospital Charge Code	4819299801
Hospital Revenue Code	481
Min. Negotiated Rate	$181.30
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$284.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$301.43
Rate for Payer: Aetna Government	$301.43
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: EmblemHealth Commercial	$259.00
Rate for Payer: Group Health Inc Commercial	$259.00
Rate for Payer: Group Health Inc Medicare	$181.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$259.00
Rate for Payer: Hamaspik Choice Inc Medicare	$259.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$365.66
Rate for Payer: United Healthcare Commercial	$2,546.00

HC CATH PUL ART BALLOON REPAIR,PERC,ADDN VES

Facility

$518.00

Service Code	CPT 92998
Hospital Charge Code	4819299801
Hospital Revenue Code	481
Min. Negotiated Rate	$259.00
Max. Negotiated Rate	$259.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$259.00

HC CATH REMOVAL TUNNELED CV CATH W SUBQ PORT OR PUMP

Facility

$1,847.00

Service Code	CPT 36590
Hospital Charge Code	4813659001
Hospital Revenue Code	481
Min. Negotiated Rate	$217.96
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,898.02
Rate for Payer: Aetna Government	$1,898.02
Rate for Payer: Affinity Essential Plan 1&2	$1,328.61
Rate for Payer: Affinity Essential Plan 3&4	$1,328.61
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,328.61
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,898.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: Elderplan Medicare Advantage	$1,898.02
Rate for Payer: EmblemHealth Commercial	$1,898.02
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,708.22
Rate for Payer: Fidelis Essential Plan Aliesa	$1,613.32
Rate for Payer: Fidelis Essential Plan QHP	$1,689.24
Rate for Payer: Fidelis Medicare Advantage	$1,898.02
Rate for Payer: Fidelis Qualified Health Plan	$1,689.24
Rate for Payer: Group Health Inc Commercial	$1,898.02
Rate for Payer: Group Health Inc Medicare	$1,898.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,898.02
Rate for Payer: Hamaspik Choice Inc Medicare	$632.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$217.96
Rate for Payer: Healthfirst Medicare Advantage	$1,613.32
Rate for Payer: Healthfirst QHP	$1,898.02
Rate for Payer: Humana Medicare	$1,935.98
Rate for Payer: Senior Whole Health Medicare Advantage	$1,898.02
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$1,898.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,898.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,803.12
Rate for Payer: Wellcare Medicare	$1,803.12

HC CATH REMOVAL TUNNELED CV CATH W SUBQ PORT OR PUMP

Facility

$1,847.00

Service Code	CPT 36590
Hospital Charge Code	4813659001
Hospital Revenue Code	481
Min. Negotiated Rate	$923.50
Max. Negotiated Rate	$923.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$923.50

HC CATH REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH

Facility

$44,573.00

Service Code	CPT 33369
Hospital Charge Code	4813336901
Hospital Revenue Code	481
Min. Negotiated Rate	$1,111.58
Max. Negotiated Rate	$24,515.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24,515.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,111.58
Rate for Payer: Aetna Government	$1,111.58
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: EmblemHealth Commercial	$22,286.50
Rate for Payer: Group Health Inc Commercial	$22,286.50
Rate for Payer: Group Health Inc Medicare	$15,600.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,286.50
Rate for Payer: Hamaspik Choice Inc Medicare	$22,286.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,125.27
Rate for Payer: United Healthcare Commercial	$1,496.00

HC CATH REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH

Facility

$44,573.00

Service Code	CPT 33369
Hospital Charge Code	4813336901
Hospital Revenue Code	481
Min. Negotiated Rate	$22,286.50
Max. Negotiated Rate	$22,286.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,286.50

HC CATH REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH

Facility

$44,573.00

Service Code	CPT 33368
Hospital Charge Code	4813336801
Hospital Revenue Code	481
Min. Negotiated Rate	$840.87
Max. Negotiated Rate	$24,515.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24,515.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$840.87
Rate for Payer: Aetna Government	$840.87
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: EmblemHealth Commercial	$22,286.50
Rate for Payer: Group Health Inc Commercial	$22,286.50
Rate for Payer: Group Health Inc Medicare	$15,600.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,286.50
Rate for Payer: Hamaspik Choice Inc Medicare	$22,286.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$852.41
Rate for Payer: United Healthcare Commercial	$1,496.00

HC CATH REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH

Facility

$44,573.00

Service Code	CPT 33368
Hospital Charge Code	4813336801
Hospital Revenue Code	481
Min. Negotiated Rate	$22,286.50
Max. Negotiated Rate	$22,286.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,286.50

HC CATH REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH

Facility

$44,573.00

Service Code	CPT 33367
Hospital Charge Code	4813336701
Hospital Revenue Code	481
Min. Negotiated Rate	$22,286.50
Max. Negotiated Rate	$22,286.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,286.50

HC CATH REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH

Facility

$44,573.00

Service Code	CPT 33367
Hospital Charge Code	4813336701
Hospital Revenue Code	481
Min. Negotiated Rate	$699.94
Max. Negotiated Rate	$24,515.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24,515.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$699.94
Rate for Payer: Aetna Government	$699.94
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: EmblemHealth Commercial	$22,286.50
Rate for Payer: Group Health Inc Commercial	$22,286.50
Rate for Payer: Group Health Inc Medicare	$15,600.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,286.50
Rate for Payer: Hamaspik Choice Inc Medicare	$22,286.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$704.55
Rate for Payer: United Healthcare Commercial	$1,496.00

HC CATH RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT

Facility

$8,631.00

Service Code	CPT 93451
Hospital Charge Code	4819345101
Hospital Revenue Code	481
Min. Negotiated Rate	$951.24
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,929.87
Rate for Payer: Aetna Government	$3,929.87
Rate for Payer: Affinity Essential Plan 1&2	$2,750.91
Rate for Payer: Affinity Essential Plan 3&4	$2,750.91
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,750.91
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,929.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: Elderplan Medicare Advantage	$3,929.87
Rate for Payer: EmblemHealth Commercial	$3,929.87
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3,536.88
Rate for Payer: Fidelis Essential Plan Aliesa	$3,340.39
Rate for Payer: Fidelis Essential Plan QHP	$3,497.58
Rate for Payer: Fidelis Medicare Advantage	$3,929.87
Rate for Payer: Fidelis Qualified Health Plan	$3,497.58
Rate for Payer: Group Health Inc Commercial	$3,929.87
Rate for Payer: Group Health Inc Medicare	$3,929.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,929.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,655.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$951.24
Rate for Payer: Healthfirst Medicare Advantage	$3,340.39
Rate for Payer: Healthfirst QHP	$3,929.87
Rate for Payer: Humana Medicare	$4,008.47
Rate for Payer: Senior Whole Health Medicare Advantage	$3,929.87
Rate for Payer: United Healthcare Commercial	$3,955.00
Rate for Payer: United Healthcare Medicare Advantage	$3,929.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,929.87
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,733.38
Rate for Payer: Wellcare Medicare	$3,733.38

HC CATH RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT

Facility

$8,631.00

Service Code	CPT 93451
Hospital Charge Code	4819345101
Hospital Revenue Code	481
Min. Negotiated Rate	$4,315.50
Max. Negotiated Rate	$4,315.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,315.50

HC CATH RIGHT & LEFT HEART CATH INJECT VETRICULOGRAPHY, IMAGE SUPERVISE/INTERP

Facility

$8,631.00

Service Code	CPT 93453
Hospital Charge Code	4819345301
Hospital Revenue Code	481
Min. Negotiated Rate	$1,271.97
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,929.87
Rate for Payer: Aetna Government	$3,929.87
Rate for Payer: Affinity Essential Plan 1&2	$2,750.91
Rate for Payer: Affinity Essential Plan 3&4	$2,750.91
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,750.91
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,929.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: Elderplan Medicare Advantage	$3,929.87
Rate for Payer: EmblemHealth Commercial	$3,929.87
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3,536.88
Rate for Payer: Fidelis Essential Plan Aliesa	$3,340.39
Rate for Payer: Fidelis Essential Plan QHP	$3,497.58
Rate for Payer: Fidelis Medicare Advantage	$3,929.87
Rate for Payer: Fidelis Qualified Health Plan	$3,497.58
Rate for Payer: Group Health Inc Commercial	$3,929.87
Rate for Payer: Group Health Inc Medicare	$3,929.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,929.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,655.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,271.97
Rate for Payer: Healthfirst Medicare Advantage	$3,340.39
Rate for Payer: Healthfirst QHP	$3,929.87
Rate for Payer: Humana Medicare	$4,008.47
Rate for Payer: Senior Whole Health Medicare Advantage	$3,929.87
Rate for Payer: United Healthcare Commercial	$3,955.00
Rate for Payer: United Healthcare Medicare Advantage	$3,929.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,929.87
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,733.38
Rate for Payer: Wellcare Medicare	$3,733.38

HC CATH RIGHT & LEFT HEART CATH INJECT VETRICULOGRAPHY, IMAGE SUPERVISE/INTERP

Facility

$8,631.00

Service Code	CPT 93453
Hospital Charge Code	4819345301
Hospital Revenue Code	481
Min. Negotiated Rate	$4,315.50
Max. Negotiated Rate	$4,315.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,315.50

HC CATH RMV AORTIC BALLOON DEVICE

Facility

$1,847.00

Service Code	CPT 33968
Hospital Charge Code	4813396801
Hospital Revenue Code	481
Min. Negotiated Rate	$37.40
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,015.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.40
Rate for Payer: Aetna Government	$37.40
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: EmblemHealth Commercial	$923.50
Rate for Payer: Group Health Inc Commercial	$923.50
Rate for Payer: Group Health Inc Medicare	$646.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$923.50
Rate for Payer: Hamaspik Choice Inc Medicare	$923.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$39.47
Rate for Payer: United Healthcare Commercial	$4,446.00

HC CATH RMV AORTIC BALLOON DEVICE

Facility

$1,847.00

Service Code	CPT 33968
Hospital Charge Code	4813396801
Hospital Revenue Code	481
Min. Negotiated Rate	$923.50
Max. Negotiated Rate	$923.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$923.50

HC CATH TCAT PLMT IV STENT CTR DIALYSIS SEG W/IMG S&I

Facility

$345.00

Service Code	CPT 36908
Hospital Charge Code	4813690801
Hospital Revenue Code	481
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,903.39
Rate for Payer: Aetna Government	$2,903.39
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: EmblemHealth Commercial	$172.50
Rate for Payer: Group Health Inc Commercial	$172.50
Rate for Payer: Group Health Inc Medicare	$120.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.50
Rate for Payer: Hamaspik Choice Inc Medicare	$172.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$233.38
Rate for Payer: United Healthcare Commercial	$1,113.00

HC CATH TCAT PLMT IV STENT CTR DIALYSIS SEG W/IMG S&I

Facility

$345.00

Service Code	CPT 36908
Hospital Charge Code	4813690801
Hospital Revenue Code	481
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.50

HC CATH TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH

Facility

$44,573.00

Service Code	CPT 33477
Hospital Charge Code	4813347701
Hospital Revenue Code	481
Min. Negotiated Rate	$1,408.28
Max. Negotiated Rate	$24,515.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24,515.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,408.28
Rate for Payer: Aetna Government	$1,408.28
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: EmblemHealth Commercial	$22,286.50
Rate for Payer: Group Health Inc Commercial	$22,286.50
Rate for Payer: Group Health Inc Medicare	$15,600.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,286.50
Rate for Payer: Hamaspik Choice Inc Medicare	$22,286.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,464.26
Rate for Payer: United Healthcare Commercial	$1,496.00

HC CATH TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH

Facility

$44,573.00

Service Code	CPT 33477
Hospital Charge Code	4813347701
Hospital Revenue Code	481
Min. Negotiated Rate	$22,286.50
Max. Negotiated Rate	$22,286.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$22,286.50

HC CATH THROMBOLYSIS,CORONARY,IA INFUSN

Facility

$1,396.00

Service Code	CPT 92975
Hospital Charge Code	4819297501
Hospital Revenue Code	481
Min. Negotiated Rate	$698.00
Max. Negotiated Rate	$698.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$698.00

HC CATH THROMBOLYSIS,CORONARY,IA INFUSN

Facility

$1,396.00

Service Code	CPT 92975
Hospital Charge Code	4819297501
Hospital Revenue Code	481
Min. Negotiated Rate	$364.64
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$767.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$364.64
Rate for Payer: Aetna Government	$364.64
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: EmblemHealth Commercial	$698.00
Rate for Payer: Group Health Inc Commercial	$698.00
Rate for Payer: Group Health Inc Medicare	$488.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$698.00
Rate for Payer: Hamaspik Choice Inc Medicare	$698.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$433.25
Rate for Payer: United Healthcare Commercial	$1,496.00

HC CATH THROMBOLYSIS,CORONARY,IV INFUSN

Facility

$1,396.00

Service Code	CPT 92977
Hospital Charge Code	4819297701
Hospital Revenue Code	481
Min. Negotiated Rate	$68.66
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$767.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$405.27
Rate for Payer: Aetna Government	$405.27
Rate for Payer: Affinity Essential Plan 1&2	$283.69
Rate for Payer: Affinity Essential Plan 3&4	$283.69
Rate for Payer: Affinity Medicaid/CHP/HARP	$283.69
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$405.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,261.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,472.52
Rate for Payer: Elderplan Medicare Advantage	$405.27
Rate for Payer: EmblemHealth Commercial	$405.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$364.74
Rate for Payer: Fidelis Essential Plan Aliesa	$344.48
Rate for Payer: Fidelis Essential Plan QHP	$360.69
Rate for Payer: Fidelis Medicare Advantage	$405.27
Rate for Payer: Fidelis Qualified Health Plan	$360.69
Rate for Payer: Group Health Inc Commercial	$405.27
Rate for Payer: Group Health Inc Medicare	$405.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$405.27
Rate for Payer: Hamaspik Choice Inc Medicare	$405.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$68.66
Rate for Payer: Healthfirst Medicare Advantage	$344.48
Rate for Payer: Healthfirst QHP	$405.27
Rate for Payer: Humana Medicare	$413.38
Rate for Payer: Senior Whole Health Medicare Advantage	$405.27
Rate for Payer: United Healthcare Commercial	$1,113.00
Rate for Payer: United Healthcare Medicare Advantage	$405.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$405.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$385.01
Rate for Payer: Wellcare Medicare	$385.01

Know your out-of-pocket cost for care.

All Charges