St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC DRUG SCREENING BARBITURATES - BARBITURATE URINE CONF

Facility

$88.00

Service Code	CPT 80345
Hospital Charge Code	3018034502
Hospital Revenue Code	301
Min. Negotiated Rate	$44.00
Max. Negotiated Rate	$44.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.00

HC DRUG SCREENING BARBITURATES - BARBITURATE URINE QUANT

Facility

$88.00

Service Code	CPT 80345
Hospital Charge Code	3018034501
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$70.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$66.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.84
Rate for Payer: EmblemHealth Commercial	$44.00
Rate for Payer: Group Health Inc Commercial	$44.00
Rate for Payer: Group Health Inc Medicare	$30.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.00
Rate for Payer: Hamaspik Choice Inc Medicare	$44.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$14.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

HC DRUG SCREENING BARBITURATES - BARBITURATE URINE QUANT

Facility

$88.00

Service Code	CPT 80345
Hospital Charge Code	3018034501
Hospital Revenue Code	301
Min. Negotiated Rate	$44.00
Max. Negotiated Rate	$44.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.00

HC DRUG SCREENING BENZODIAZEPINES 1-12 BENZODIAZEPINE - BUNDLED CHARGE

Facility

$33.00

Service Code	CPT 80346
Hospital Charge Code	3018034604
Hospital Revenue Code	301
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50

HC DRUG SCREENING BENZODIAZEPINES 1-12 BENZODIAZEPINE - BUNDLED CHARGE

Facility

$33.00

Service Code	CPT 80346
Hospital Charge Code	3018034604
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$26.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$24.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.44
Rate for Payer: EmblemHealth Commercial	$16.50
Rate for Payer: Group Health Inc Commercial	$16.50
Rate for Payer: Group Health Inc Medicare	$11.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50
Rate for Payer: Hamaspik Choice Inc Medicare	$16.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$24.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

HC DRUG SCREENING BENZODIAZEPINES 1-12 - BENZODIAZEPINE URINE QUANT

Facility

$33.00

Service Code	CPT 80346
Hospital Charge Code	3018034601
Hospital Revenue Code	301
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50

HC DRUG SCREENING BENZODIAZEPINES 1-12 - BENZODIAZEPINE URINE QUANT

Facility

$33.00

Service Code	CPT 80346
Hospital Charge Code	3018034601
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$26.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$24.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.44
Rate for Payer: EmblemHealth Commercial	$16.50
Rate for Payer: Group Health Inc Commercial	$16.50
Rate for Payer: Group Health Inc Medicare	$11.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50
Rate for Payer: Hamaspik Choice Inc Medicare	$16.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$24.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

HC DRUG SCREENING BENZODIAZEPINES 1-12 CLONAZEPAM - BUNDLED CHARGE

Facility

$33.00

Service Code	CPT 80346
Hospital Charge Code	3018034605
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$26.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$24.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.44
Rate for Payer: EmblemHealth Commercial	$16.50
Rate for Payer: Group Health Inc Commercial	$16.50
Rate for Payer: Group Health Inc Medicare	$11.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50
Rate for Payer: Hamaspik Choice Inc Medicare	$16.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$24.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

HC DRUG SCREENING BENZODIAZEPINES 1-12 CLONAZEPAM - BUNDLED CHARGE

Facility

$33.00

Service Code	CPT 80346
Hospital Charge Code	3018034605
Hospital Revenue Code	301
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50

HC DRUG SCREENING BENZODIAZEPINES 1-12 - CLONAZEPAM LEVEL

Facility

$33.00

Service Code	CPT 80346
Hospital Charge Code	3018034602
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$26.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$24.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.44
Rate for Payer: EmblemHealth Commercial	$16.50
Rate for Payer: Group Health Inc Commercial	$16.50
Rate for Payer: Group Health Inc Medicare	$11.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50
Rate for Payer: Hamaspik Choice Inc Medicare	$16.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$24.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

HC DRUG SCREENING BENZODIAZEPINES 1-12 - CLONAZEPAM LEVEL

Facility

$33.00

Service Code	CPT 80346
Hospital Charge Code	3018034602
Hospital Revenue Code	301
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50

HC DRUG SCREENING BENZODIAZEPINES 1-12 FLURAZEPAM - BUNDLED CHARGE

Facility

$33.00

Service Code	CPT 80346
Hospital Charge Code	3018034606
Hospital Revenue Code	301
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50

HC DRUG SCREENING BENZODIAZEPINES 1-12 FLURAZEPAM - BUNDLED CHARGE

Facility

$33.00

Service Code	CPT 80346
Hospital Charge Code	3018034606
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$26.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$24.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.44
Rate for Payer: EmblemHealth Commercial	$16.50
Rate for Payer: Group Health Inc Commercial	$16.50
Rate for Payer: Group Health Inc Medicare	$11.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50
Rate for Payer: Hamaspik Choice Inc Medicare	$16.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$24.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

HC DRUG SCREENING BENZODIAZEPINES 13+ BENZODIAZEPINE - BUNDLED CHARGE

Facility

$37.00

Service Code	CPT 80347
Hospital Charge Code	3018034701
Hospital Revenue Code	301
Min. Negotiated Rate	$18.50
Max. Negotiated Rate	$18.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.50

HC DRUG SCREENING BENZODIAZEPINES 13+ BENZODIAZEPINE - BUNDLED CHARGE

Facility

$37.00

Service Code	CPT 80347
Hospital Charge Code	3018034701
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$29.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$27.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.16
Rate for Payer: EmblemHealth Commercial	$18.50
Rate for Payer: Group Health Inc Commercial	$18.50
Rate for Payer: Group Health Inc Medicare	$12.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.50
Rate for Payer: Hamaspik Choice Inc Medicare	$18.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$24.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

HC DRUG SCREENING BENZODIAZEPINES 13+ CLONAZEPAM - BUNDLED CHARGE

Facility

$67.00

Service Code	CPT 80347
Hospital Charge Code	3018034702
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$53.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$50.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$45.56
Rate for Payer: EmblemHealth Commercial	$33.50
Rate for Payer: Group Health Inc Commercial	$33.50
Rate for Payer: Group Health Inc Medicare	$23.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.50
Rate for Payer: Hamaspik Choice Inc Medicare	$33.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$24.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

HC DRUG SCREENING BENZODIAZEPINES 13+ CLONAZEPAM - BUNDLED CHARGE

Facility

$67.00

Service Code	CPT 80347
Hospital Charge Code	3018034702
Hospital Revenue Code	301
Min. Negotiated Rate	$33.50
Max. Negotiated Rate	$33.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.50

HC DRUG SCREENING BENZODIAZEPINES 13+ FLURAZEPAM - BUNDLED CHARGE

Facility

$67.00

Service Code	CPT 80347
Hospital Charge Code	3018034703
Hospital Revenue Code	301
Min. Negotiated Rate	$33.50
Max. Negotiated Rate	$33.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.50

HC DRUG SCREENING BENZODIAZEPINES 13+ FLURAZEPAM - BUNDLED CHARGE

Facility

$67.00

Service Code	CPT 80347
Hospital Charge Code	3018034703
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$53.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$50.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$45.56
Rate for Payer: EmblemHealth Commercial	$33.50
Rate for Payer: Group Health Inc Commercial	$33.50
Rate for Payer: Group Health Inc Medicare	$23.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.50
Rate for Payer: Hamaspik Choice Inc Medicare	$33.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$24.25
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

HC DRUG SCREENING BUPRENORPHINE, URINE

Facility

$45.00

Service Code	CPT 80348
Hospital Charge Code	3018034801
Hospital Revenue Code	301
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.50

HC DRUG SCREENING BUPRENORPHINE, URINE

Facility

$45.00

Service Code	CPT 80348
Hospital Charge Code	3018034801
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$36.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$33.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.60
Rate for Payer: EmblemHealth Commercial	$22.50
Rate for Payer: Group Health Inc Commercial	$22.50
Rate for Payer: Group Health Inc Medicare	$15.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.50
Rate for Payer: Hamaspik Choice Inc Medicare	$22.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$14.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

HC DRUG SCREENING CANNABINOIDS NATURAL - CANNABINOID CONFIRMATION UR

Facility

$70.00

Service Code	CPT 80349
Hospital Charge Code	3018034901
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$56.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$52.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.60
Rate for Payer: EmblemHealth Commercial	$35.00
Rate for Payer: Group Health Inc Commercial	$35.00
Rate for Payer: Group Health Inc Medicare	$24.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.00
Rate for Payer: Hamaspik Choice Inc Medicare	$35.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$21.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

HC DRUG SCREENING CANNABINOIDS NATURAL - CANNABINOID CONFIRMATION UR

Facility

$70.00

Service Code	CPT 80349
Hospital Charge Code	3018034901
Hospital Revenue Code	301
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$35.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.00

HC DRUG SCREENING COCAINE - COCAINE URINE CONF

Facility

$49.00

Service Code	CPT 80353
Hospital Charge Code	3018035301
Hospital Revenue Code	301
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$24.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.50

HC DRUG SCREENING COCAINE - COCAINE URINE CONF

Facility

$49.00

Service Code	CPT 80353
Hospital Charge Code	3018035301
Hospital Revenue Code	301
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$39.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$36.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$39.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.32
Rate for Payer: EmblemHealth Commercial	$24.50
Rate for Payer: Group Health Inc Commercial	$24.50
Rate for Payer: Group Health Inc Medicare	$17.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.50
Rate for Payer: Hamaspik Choice Inc Medicare	$24.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.05
Rate for Payer: Healthfirst Essential Plan	$11.36
Rate for Payer: United Healthcare Commercial	$18.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.05

Know your out-of-pocket cost for care.

All Charges