St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC CT GUIDANCE NEEDLE PLACEMENT - CT GUIDED PERC BIOPSY RENAL

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701212
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 PERC BIOPSY RENAL

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701212
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 RENAL CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701213
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 RENAL CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701213
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 PERC BIOPSY RENAL RIGHT

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701214
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 RENAL RIGHT

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701214
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 PERC BIOPSY RENAL RIGHT CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701215
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 PERC BIOPSY RENAL RIGHT CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701215
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 NEEDLE BIOPSY MUSCLE

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701216
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 PERC NEEDLE BIOPSY MUSCLE

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701216
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 PLEURA NEEDLE BIOPSY

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701217
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 PLEURA NEEDLE BIOPSY

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701217
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 PLEURA NEEDLE BIOPSY CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701218
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 PLEURA NEEDLE BIOPSY CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701218
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 PSEUDOANEURYSM THROMBIN INJ

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701220
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 PSEUDOANEURYSM THROMBIN INJ

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701220
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 PSEUDOAN THROMBIN INJ CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701219
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 PSEUDOAN THROMBIN INJ CHG

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701219
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 RENAL CYST ASPIRATION

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701228
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 RENAL CYST ASPIRATION

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701228
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 RENAL CYST ASPIRATION BILAT

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701224
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 RENAL CYST ASPIRATION BILAT

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701224
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 RENAL CYST ASPIRATION LEFT

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701225
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 RENAL CYST ASPIRATION LEFT

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701225
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 RENAL CYST ASPIRATION RIGHT

Facility

$1,978.00

Service Code	CPT 77012 TC
Hospital Charge Code	3507701226
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.

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