St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC MOLECULAR PATHOLOGY PROCEDURE LEVEL 9

Facility

$933.00

Service Code	CPT 81408
Hospital Charge Code	3108140801
Hospital Revenue Code	310
Min. Negotiated Rate	$466.50
Max. Negotiated Rate	$466.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$466.50

HC MONITORING OF INTERSTITIAL FLUID PRESSURE

Facility

$1,847.00

Service Code	CPT 20950
Hospital Charge Code	3612095001
Hospital Revenue Code	361
Min. Negotiated Rate	$923.50
Max. Negotiated Rate	$923.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$923.50

HC MONITORING OF INTERSTITIAL FLUID PRESSURE

Facility

$1,847.00

Service Code	CPT 20950
Hospital Charge Code	3612095001
Hospital Revenue Code	361
Min. Negotiated Rate	$104.20
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$859.66
Rate for Payer: Aetna Government	$859.66
Rate for Payer: Affinity Essential Plan 1&2	$601.76
Rate for Payer: Affinity Essential Plan 3&4	$601.76
Rate for Payer: Affinity Medicaid/CHP/HARP	$601.76
Rate for Payer: Brighton Health Commercial	$1,385.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$859.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,092.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,628.64
Rate for Payer: Elderplan Medicare Advantage	$859.66
Rate for Payer: EmblemHealth Commercial	$859.66
Rate for Payer: Fidelis CHP/HARP/Medicaid	$773.69
Rate for Payer: Fidelis Essential Plan Aliesa	$730.71
Rate for Payer: Fidelis Essential Plan QHP	$765.10
Rate for Payer: Fidelis Medicare Advantage	$859.66
Rate for Payer: Fidelis Qualified Health Plan	$765.10
Rate for Payer: Group Health Inc Commercial	$859.66
Rate for Payer: Group Health Inc Medicare	$859.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$859.66
Rate for Payer: Hamaspik Choice Inc Medicare	$377.60
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$104.20
Rate for Payer: Healthfirst Medicare Advantage	$730.71
Rate for Payer: Healthfirst QHP	$859.66
Rate for Payer: Humana Medicare	$876.85
Rate for Payer: Senior Whole Health Medicare Advantage	$859.66
Rate for Payer: United Healthcare Commercial	$1,188.00
Rate for Payer: United Healthcare Medicare Advantage	$859.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$859.66
Rate for Payer: Wellcare CHP/FHP/Medicaid	$816.68
Rate for Payer: Wellcare Medicare	$816.68

HC MONONUCLEAR CELL ANTIGEN - EACH ANTIGEN

Facility

$66.00

Service Code	CPT 86356
Hospital Charge Code	3028635601
Hospital Revenue Code	302
Min. Negotiated Rate	$18.75
Max. Negotiated Rate	$49.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.78
Rate for Payer: Aetna Government	$26.78
Rate for Payer: Affinity Essential Plan 1&2	$18.75
Rate for Payer: Affinity Essential Plan 3&4	$18.75
Rate for Payer: Affinity Medicaid/CHP/HARP	$18.75
Rate for Payer: Brighton Health Commercial	$49.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$26.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.31
Rate for Payer: Elderplan Medicare Advantage	$26.78
Rate for Payer: EmblemHealth Commercial	$26.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$24.10
Rate for Payer: Fidelis Essential Plan Aliesa	$22.76
Rate for Payer: Fidelis Essential Plan QHP	$23.83
Rate for Payer: Fidelis Medicare Advantage	$26.78
Rate for Payer: Fidelis Qualified Health Plan	$23.83
Rate for Payer: Group Health Inc Commercial	$26.78
Rate for Payer: Group Health Inc Medicare	$26.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.78
Rate for Payer: Hamaspik Choice Inc Medicare	$26.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$26.78
Rate for Payer: Healthfirst Medicare Advantage	$26.78
Rate for Payer: Healthfirst QHP	$26.78
Rate for Payer: Humana Medicare	$27.32
Rate for Payer: Senior Whole Health Medicare Advantage	$26.78
Rate for Payer: United Healthcare Commercial	$33.90
Rate for Payer: United Healthcare Medicare Advantage	$26.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$25.44
Rate for Payer: Wellcare Medicare	$24.10

HC MONONUCLEAR CELL ANTIGEN - EACH ANTIGEN

Facility

$66.00

Service Code	CPT 86356
Hospital Charge Code	3028635601
Hospital Revenue Code	302
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.00

HC MOTOR &/SENS 11-12 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$1,470.00

Service Code	CPT 95912 TC
Hospital Charge Code	9229591201
Hospital Revenue Code	922
Min. Negotiated Rate	$90.11
Max. Negotiated Rate	$1,176.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$808.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$90.11
Rate for Payer: Aetna Government	$90.11
Rate for Payer: Brighton Health Commercial	$1,102.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,176.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$999.60
Rate for Payer: EmblemHealth Commercial	$735.00
Rate for Payer: Group Health Inc Commercial	$735.00
Rate for Payer: Group Health Inc Medicare	$514.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$735.00
Rate for Payer: Hamaspik Choice Inc Medicare	$735.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$102.93
Rate for Payer: United Healthcare Commercial	$120.00

HC MOTOR &/SENS 11-12 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$1,470.00

Service Code	CPT 95912 TC
Hospital Charge Code	9229591201
Hospital Revenue Code	922
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$735.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$735.00

HC MOTOR &/SENS 1-2 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$419.00

Service Code	CPT 95907 TC
Hospital Charge Code	9229590701
Hospital Revenue Code	922
Min. Negotiated Rate	$209.50
Max. Negotiated Rate	$209.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.50

HC MOTOR &/SENS 1-2 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$419.00

Service Code	CPT 95907 TC
Hospital Charge Code	9229590701
Hospital Revenue Code	922
Min. Negotiated Rate	$37.67
Max. Negotiated Rate	$335.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.67
Rate for Payer: Aetna Government	$37.67
Rate for Payer: Brighton Health Commercial	$314.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$335.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.92
Rate for Payer: EmblemHealth Commercial	$209.50
Rate for Payer: Group Health Inc Commercial	$209.50
Rate for Payer: Group Health Inc Medicare	$146.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.50
Rate for Payer: Hamaspik Choice Inc Medicare	$209.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$42.93
Rate for Payer: United Healthcare Commercial	$120.00

HC MOTOR &/SENS 13/> NRV CNDJ PRECONF ELTRODE LIMB

Facility

$1,470.00

Service Code	CPT 95913 TC
Hospital Charge Code	9229591301
Hospital Revenue Code	922
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$735.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$735.00

HC MOTOR &/SENS 13/> NRV CNDJ PRECONF ELTRODE LIMB

Facility

$1,470.00

Service Code	CPT 95913 TC
Hospital Charge Code	9229591301
Hospital Revenue Code	922
Min. Negotiated Rate	$97.42
Max. Negotiated Rate	$1,176.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$808.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$97.42
Rate for Payer: Aetna Government	$97.42
Rate for Payer: Brighton Health Commercial	$1,102.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,176.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$999.60
Rate for Payer: EmblemHealth Commercial	$735.00
Rate for Payer: Group Health Inc Commercial	$735.00
Rate for Payer: Group Health Inc Medicare	$514.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$735.00
Rate for Payer: Hamaspik Choice Inc Medicare	$735.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$117.68
Rate for Payer: United Healthcare Commercial	$120.00

HC MOTOR &/SENS 3-4 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$766.00

Service Code	CPT 95908 TC
Hospital Charge Code	9229590801
Hospital Revenue Code	922
Min. Negotiated Rate	$46.25
Max. Negotiated Rate	$612.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$46.25
Rate for Payer: Aetna Government	$46.25
Rate for Payer: Brighton Health Commercial	$574.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$612.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$520.88
Rate for Payer: EmblemHealth Commercial	$383.00
Rate for Payer: Group Health Inc Commercial	$383.00
Rate for Payer: Group Health Inc Medicare	$268.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.00
Rate for Payer: Hamaspik Choice Inc Medicare	$383.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$53.41
Rate for Payer: United Healthcare Commercial	$120.00

HC MOTOR &/SENS 3-4 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$766.00

Service Code	CPT 95908 TC
Hospital Charge Code	9229590801
Hospital Revenue Code	922
Min. Negotiated Rate	$383.00
Max. Negotiated Rate	$383.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.00

HC MOTOR &/SENS 5-6 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$766.00

Service Code	CPT 95909 TC
Hospital Charge Code	9229590901
Hospital Revenue Code	922
Min. Negotiated Rate	$383.00
Max. Negotiated Rate	$383.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.00

HC MOTOR &/SENS 5-6 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$766.00

Service Code	CPT 95909 TC
Hospital Charge Code	9229590901
Hospital Revenue Code	922
Min. Negotiated Rate	$57.37
Max. Negotiated Rate	$612.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.37
Rate for Payer: Aetna Government	$57.37
Rate for Payer: Brighton Health Commercial	$574.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$612.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$520.88
Rate for Payer: EmblemHealth Commercial	$383.00
Rate for Payer: Group Health Inc Commercial	$383.00
Rate for Payer: Group Health Inc Medicare	$268.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.00
Rate for Payer: Hamaspik Choice Inc Medicare	$383.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$64.28
Rate for Payer: United Healthcare Commercial	$120.00

HC MOTOR &/SENS 7-8 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$766.00

Service Code	CPT 95910 TC
Hospital Charge Code	9229591001
Hospital Revenue Code	922
Min. Negotiated Rate	$383.00
Max. Negotiated Rate	$383.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.00

HC MOTOR &/SENS 7-8 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$766.00

Service Code	CPT 95910 TC
Hospital Charge Code	9229591001
Hospital Revenue Code	922
Min. Negotiated Rate	$76.12
Max. Negotiated Rate	$612.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$76.12
Rate for Payer: Aetna Government	$76.12
Rate for Payer: Brighton Health Commercial	$574.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$612.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$520.88
Rate for Payer: EmblemHealth Commercial	$383.00
Rate for Payer: Group Health Inc Commercial	$383.00
Rate for Payer: Group Health Inc Medicare	$268.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.00
Rate for Payer: Hamaspik Choice Inc Medicare	$383.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$81.74
Rate for Payer: United Healthcare Commercial	$120.00

HC MOTOR &/SENS 9-10 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$1,470.00

Service Code	CPT 95911 TC
Hospital Charge Code	9229591101
Hospital Revenue Code	922
Min. Negotiated Rate	$87.88
Max. Negotiated Rate	$1,176.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$808.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$87.88
Rate for Payer: Aetna Government	$87.88
Rate for Payer: Brighton Health Commercial	$1,102.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,176.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$999.60
Rate for Payer: EmblemHealth Commercial	$735.00
Rate for Payer: Group Health Inc Commercial	$735.00
Rate for Payer: Group Health Inc Medicare	$514.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$735.00
Rate for Payer: Hamaspik Choice Inc Medicare	$735.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$92.22
Rate for Payer: United Healthcare Commercial	$120.00

HC MOTOR &/SENS 9-10 NRV CNDJ PRECONF ELTRODE LIMB

Facility

$1,470.00

Service Code	CPT 95911 TC
Hospital Charge Code	9229591101
Hospital Revenue Code	922
Min. Negotiated Rate	$735.00
Max. Negotiated Rate	$735.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$735.00

HC MOTOR/SENSORY NERVE CONDUCTION, STUDY, INCL F-WAVE

Facility

$330.00

Service Code	CPT 95905 TC
Hospital Charge Code	9229590501
Hospital Revenue Code	922
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.00

HC MOTOR/SENSORY NERVE CONDUCTION, STUDY, INCL F-WAVE

Facility

$330.00

Service Code	CPT 95905 TC
Hospital Charge Code	9229590501
Hospital Revenue Code	922
Min. Negotiated Rate	$35.16
Max. Negotiated Rate	$264.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$60.55
Rate for Payer: Aetna Government	$60.55
Rate for Payer: Brighton Health Commercial	$247.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$264.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.40
Rate for Payer: EmblemHealth Commercial	$165.00
Rate for Payer: Group Health Inc Commercial	$165.00
Rate for Payer: Group Health Inc Medicare	$115.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.00
Rate for Payer: Hamaspik Choice Inc Medicare	$165.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35.16
Rate for Payer: United Healthcare Commercial	$120.00

HC M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB - HER-2 / NEU, FISH

Facility

$406.00

Service Code	CPT 88377
Hospital Charge Code	3128837701
Hospital Revenue Code	312
Min. Negotiated Rate	$146.56
Max. Negotiated Rate	$446.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$223.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$209.37
Rate for Payer: Aetna Government	$209.37
Rate for Payer: Affinity Essential Plan 1&2	$146.56
Rate for Payer: Affinity Essential Plan 3&4	$146.56
Rate for Payer: Affinity Medicaid/CHP/HARP	$146.56
Rate for Payer: Brighton Health Commercial	$209.37
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$209.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$324.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$276.08
Rate for Payer: Elderplan Medicare Advantage	$209.37
Rate for Payer: EmblemHealth Commercial	$446.23
Rate for Payer: Fidelis CHP/HARP/Medicaid	$188.43
Rate for Payer: Fidelis Essential Plan Aliesa	$177.96
Rate for Payer: Fidelis Essential Plan QHP	$186.34
Rate for Payer: Fidelis Medicare Advantage	$209.37
Rate for Payer: Fidelis Qualified Health Plan	$186.34
Rate for Payer: Group Health Inc Commercial	$209.37
Rate for Payer: Group Health Inc Medicare	$209.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.37
Rate for Payer: Hamaspik Choice Inc Medicare	$209.37
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$179.38
Rate for Payer: Healthfirst Essential Plan	$403.61
Rate for Payer: Healthfirst Medicare Advantage	$209.37
Rate for Payer: Healthfirst QHP	$209.37
Rate for Payer: Humana Medicare	$213.56
Rate for Payer: Senior Whole Health Medicare Advantage	$209.37
Rate for Payer: United Healthcare Medicare Advantage	$209.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$209.37
Rate for Payer: Wellcare CHP/FHP/Medicaid	$179.38
Rate for Payer: Wellcare Medicare	$188.43

HC M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB - HER-2 / NEU, FISH

Facility

$406.00

Service Code	CPT 88377
Hospital Charge Code	3128837701
Hospital Revenue Code	312
Min. Negotiated Rate	$203.00
Max. Negotiated Rate	$203.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.00

HC MR ANGIO ABDOMEN (MRA) - MR ABDOMEN ANGIO W AND WO IV CONTRAST

Facility

$1,374.00

Service Code	CPT 74185 TC
Hospital Charge Code	6107418501
Hospital Revenue Code	610
Min. Negotiated Rate	$259.35
Max. Negotiated Rate	$1,101.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$755.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$259.35
Rate for Payer: Aetna Government	$259.35
Rate for Payer: Brighton Health Commercial	$1,030.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,101.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$927.01
Rate for Payer: EmblemHealth Commercial	$270.87
Rate for Payer: Group Health Inc Commercial	$687.00
Rate for Payer: Group Health Inc Medicare	$480.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.00
Rate for Payer: Hamaspik Choice Inc Medicare	$687.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$270.87
Rate for Payer: Healthfirst Essential Plan	$804.76
Rate for Payer: United Healthcare Commercial	$295.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$357.67

HC MR ANGIO ABDOMEN (MRA) - MR ABDOMEN ANGIO W AND WO IV CONTRAST

Facility

$1,374.00

Service Code	CPT 74185 TC
Hospital Charge Code	6107418501
Hospital Revenue Code	610
Min. Negotiated Rate	$687.00
Max. Negotiated Rate	$687.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.00

Know your out-of-pocket cost for care.

All Charges