St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDANCE FOR NEEDLE PLACEMENT

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701243
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED ASPIR ABSCESS,HEMATOMA,CYST

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701202
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED ASPIR ABSCESS,HEMATOMA,CYST

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701202
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED CYST ASPIRATION

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701238
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED CYST ASPIRATION

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701238
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED FIDUCIAL MARKER ABDOMEN

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701203
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED FIDUCIAL MARKER ABDOMEN

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701203
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED FIDUCIAL MARKER ABDOMEN CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701204
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED FIDUCIAL MARKER ABDOMEN CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701204
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED FINE NEEDLE ASPIRATION CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701206
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED FINE NEEDLE ASPIRATION CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701206
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY BONE

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701207
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY BONE

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701207
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY BONE CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701208
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY BONE CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701208
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY BONE DEEP

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701209
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY BONE DEEP

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701209
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY BONE DEEP CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701210
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY BONE DEEP CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701210
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY LUNG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701231
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY LUNG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701231
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY MEDIASTINUM

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701227
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED NEEDLE BIOPSY MEDIASTINUM

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701227
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED PERC BIOPSY MUSCLE CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701211
Hospital Revenue Code	350
Min. Negotiated Rate	$60.29
Max. Negotiated Rate	$1,582.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,087.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.16
Rate for Payer: Aetna Government	$70.16
Rate for Payer: Brighton Health Commercial	$1,483.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,582.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,345.04
Rate for Payer: EmblemHealth Commercial	$60.29
Rate for Payer: Group Health Inc Commercial	$989.00
Rate for Payer: Group Health Inc Medicare	$692.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00
Rate for Payer: Hamaspik Choice Inc Medicare	$989.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$60.29
Rate for Payer: Healthfirst Essential Plan	$236.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$105.00

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED PERC BIOPSY MUSCLE CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701211
Hospital Revenue Code	350
Min. Negotiated Rate	$989.00
Max. Negotiated Rate	$989.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$989.00

Know your out-of-pocket cost for care.

All Charges