St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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

Facility

$1,374.00

Service Code	CPT 74185 TC
Hospital Charge Code	6107418502
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 IV CONTRAST

Facility

$1,374.00

Service Code	CPT 74185 TC
Hospital Charge Code	6107418502
Hospital Revenue Code	610
Min. Negotiated Rate	$687.00
Max. Negotiated Rate	$687.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.00

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

Facility

$1,374.00

Service Code	CPT 71555 TC
Hospital Charge Code	6187155502
Hospital Revenue Code	618
Min. Negotiated Rate	$687.00
Max. Negotiated Rate	$687.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.00

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

Facility

$1,374.00

Service Code	CPT 71555 TC
Hospital Charge Code	6187155502
Hospital Revenue Code	618
Min. Negotiated Rate	$259.35
Max. Negotiated Rate	$1,106.97
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	$1,106.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$931.76
Rate for Payer: EmblemHealth Commercial	$266.68
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	$266.68
Rate for Payer: Healthfirst Essential Plan	$809.71
Rate for Payer: United Healthcare Commercial	$295.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$359.87

HC MR ANGIO CHEST (MRA) - MR CHEST ANGIO W IV CONTRAST

Facility

$1,374.00

Service Code	CPT 71555 TC
Hospital Charge Code	6187155501
Hospital Revenue Code	618
Min. Negotiated Rate	$687.00
Max. Negotiated Rate	$687.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.00

HC MR ANGIO CHEST (MRA) - MR CHEST ANGIO W IV CONTRAST

Facility

$1,374.00

Service Code	CPT 71555 TC
Hospital Charge Code	6187155501
Hospital Revenue Code	618
Min. Negotiated Rate	$259.35
Max. Negotiated Rate	$1,106.97
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	$1,106.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$931.76
Rate for Payer: EmblemHealth Commercial	$266.68
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	$266.68
Rate for Payer: Healthfirst Essential Plan	$809.71
Rate for Payer: United Healthcare Commercial	$295.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$359.87

HC MR ANGIO CHEST (MRA) - MR CHEST ANGIO WO IV CONTRAST

Facility

$1,374.00

Service Code	CPT 71555 TC
Hospital Charge Code	6187155503
Hospital Revenue Code	618
Min. Negotiated Rate	$259.35
Max. Negotiated Rate	$1,106.97
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	$1,106.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$931.76
Rate for Payer: EmblemHealth Commercial	$266.68
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	$266.68
Rate for Payer: Healthfirst Essential Plan	$809.71
Rate for Payer: United Healthcare Commercial	$295.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$359.87

HC MR ANGIO CHEST (MRA) - MR CHEST ANGIO WO IV CONTRAST

Facility

$1,374.00

Service Code	CPT 71555 TC
Hospital Charge Code	6187155503
Hospital Revenue Code	618
Min. Negotiated Rate	$687.00
Max. Negotiated Rate	$687.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.00

HC MR ANGIO, HEAD, COMBO - MR HEAD ANGIO W AND WO IV CONTRAST

Facility

$1,156.00

Service Code	CPT 70546 TC
Hospital Charge Code	6157054601
Hospital Revenue Code	615
Min. Negotiated Rate	$578.00
Max. Negotiated Rate	$578.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.00

HC MR ANGIO, HEAD, COMBO - MR HEAD ANGIO W AND WO IV CONTRAST

Facility

$1,156.00

Service Code	CPT 70546 TC
Hospital Charge Code	6157054601
Hospital Revenue Code	615
Min. Negotiated Rate	$259.35
Max. Negotiated Rate	$1,141.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$635.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$259.35
Rate for Payer: Aetna Government	$259.35
Rate for Payer: Brighton Health Commercial	$867.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,141.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$961.17
Rate for Payer: EmblemHealth Commercial	$278.90
Rate for Payer: Group Health Inc Commercial	$578.00
Rate for Payer: Group Health Inc Medicare	$404.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.00
Rate for Payer: Hamaspik Choice Inc Medicare	$578.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$278.90
Rate for Payer: Healthfirst Essential Plan	$1,114.36
Rate for Payer: United Healthcare Commercial	$426.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$495.27

HC MR ANGIO, HEAD - MR HEAD ANGIO WO IV CONTRAST

Facility

$705.00

Service Code	CPT 70544 TC
Hospital Charge Code	6157054401
Hospital Revenue Code	615
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.50

HC MR ANGIO, HEAD - MR HEAD ANGIO WO IV CONTRAST

Facility

$705.00

Service Code	CPT 70544 TC
Hospital Charge Code	6157054401
Hospital Revenue Code	615
Min. Negotiated Rate	$171.10
Max. Negotiated Rate	$733.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$387.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$259.35
Rate for Payer: Aetna Government	$259.35
Rate for Payer: Brighton Health Commercial	$528.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$733.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$617.72
Rate for Payer: EmblemHealth Commercial	$171.10
Rate for Payer: Group Health Inc Commercial	$352.50
Rate for Payer: Group Health Inc Medicare	$246.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.50
Rate for Payer: Hamaspik Choice Inc Medicare	$352.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$171.10
Rate for Payer: Healthfirst Essential Plan	$729.92
Rate for Payer: United Healthcare Commercial	$274.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$324.41

HC MR ANGIO, HEAD W/CONTRAST - MR HEAD ANGIO W IV CONTRAST

Facility

$1,156.00

Service Code	CPT 70545 TC
Hospital Charge Code	6157054501
Hospital Revenue Code	615
Min. Negotiated Rate	$184.02
Max. Negotiated Rate	$935.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$635.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$259.35
Rate for Payer: Aetna Government	$259.35
Rate for Payer: Brighton Health Commercial	$867.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$935.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$787.13
Rate for Payer: EmblemHealth Commercial	$184.02
Rate for Payer: Group Health Inc Commercial	$578.00
Rate for Payer: Group Health Inc Medicare	$404.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.00
Rate for Payer: Hamaspik Choice Inc Medicare	$578.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$184.02
Rate for Payer: Healthfirst Essential Plan	$827.44
Rate for Payer: United Healthcare Commercial	$349.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$367.75

HC MR ANGIO, HEAD W/CONTRAST - MR HEAD ANGIO W IV CONTRAST

Facility

$1,156.00

Service Code	CPT 70545 TC
Hospital Charge Code	6157054501
Hospital Revenue Code	615
Min. Negotiated Rate	$578.00
Max. Negotiated Rate	$578.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.00

HC MR ANGIO LOWER EXTREM (MRA) - MR LOWER EXT ANGIO W AND WO IV CONT

Facility

$1,376.00

Service Code	CPT 73725 TC
Hospital Charge Code	6167372506
Hospital Revenue Code	616
Min. Negotiated Rate	$259.35
Max. Negotiated Rate	$1,104.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$756.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$259.35
Rate for Payer: Aetna Government	$259.35
Rate for Payer: Brighton Health Commercial	$1,032.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,104.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$929.73
Rate for Payer: EmblemHealth Commercial	$270.17
Rate for Payer: Group Health Inc Commercial	$688.00
Rate for Payer: Group Health Inc Medicare	$481.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.00
Rate for Payer: Hamaspik Choice Inc Medicare	$688.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$270.17
Rate for Payer: Healthfirst Essential Plan	$808.18
Rate for Payer: United Healthcare Commercial	$296.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$359.19

HC MR ANGIO LOWER EXTREM (MRA) - MR LOWER EXT ANGIO W AND WO IV CONT

Facility

$1,376.00

Service Code	CPT 73725 TC
Hospital Charge Code	6167372506
Hospital Revenue Code	616
Min. Negotiated Rate	$688.00
Max. Negotiated Rate	$688.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.00

HC MR ANGIO LOWER EXTREM (MRA) - MR LOWER EXT ANGIO W IV CONT

Facility

$1,376.00

Service Code	CPT 73725 TC
Hospital Charge Code	6167372505
Hospital Revenue Code	616
Min. Negotiated Rate	$688.00
Max. Negotiated Rate	$688.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.00

HC MR ANGIO LOWER EXTREM (MRA) - MR LOWER EXT ANGIO W IV CONT

Facility

$1,376.00

Service Code	CPT 73725 TC
Hospital Charge Code	6167372505
Hospital Revenue Code	616
Min. Negotiated Rate	$259.35
Max. Negotiated Rate	$1,104.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$756.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$259.35
Rate for Payer: Aetna Government	$259.35
Rate for Payer: Brighton Health Commercial	$1,032.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,104.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$929.73
Rate for Payer: EmblemHealth Commercial	$270.17
Rate for Payer: Group Health Inc Commercial	$688.00
Rate for Payer: Group Health Inc Medicare	$481.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.00
Rate for Payer: Hamaspik Choice Inc Medicare	$688.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$270.17
Rate for Payer: Healthfirst Essential Plan	$808.18
Rate for Payer: United Healthcare Commercial	$296.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$359.19

HC MR ANGIO LOWER EXTREM (MRA) - MR LOWER EXT ANGIO WO IV CONT

Facility

$1,376.00

Service Code	CPT 73725 TC
Hospital Charge Code	6167372501
Hospital Revenue Code	616
Min. Negotiated Rate	$688.00
Max. Negotiated Rate	$688.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.00

HC MR ANGIO LOWER EXTREM (MRA) - MR LOWER EXT ANGIO WO IV CONT

Facility

$1,376.00

Service Code	CPT 73725 TC
Hospital Charge Code	6167372501
Hospital Revenue Code	616
Min. Negotiated Rate	$259.35
Max. Negotiated Rate	$1,104.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$756.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$259.35
Rate for Payer: Aetna Government	$259.35
Rate for Payer: Brighton Health Commercial	$1,032.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,104.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$929.73
Rate for Payer: EmblemHealth Commercial	$270.17
Rate for Payer: Group Health Inc Commercial	$688.00
Rate for Payer: Group Health Inc Medicare	$481.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.00
Rate for Payer: Hamaspik Choice Inc Medicare	$688.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$270.17
Rate for Payer: Healthfirst Essential Plan	$808.18
Rate for Payer: United Healthcare Commercial	$296.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$359.19

HC MR ANGIO, NECK, COMBO - MR NECK ANGIO W AND WO IV CONTRAST

Facility

$1,156.00

Service Code	CPT 70549 TC
Hospital Charge Code	6157054901
Hospital Revenue Code	615
Min. Negotiated Rate	$259.35
Max. Negotiated Rate	$1,141.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$635.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$259.35
Rate for Payer: Aetna Government	$259.35
Rate for Payer: Brighton Health Commercial	$867.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,141.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$961.17
Rate for Payer: EmblemHealth Commercial	$279.95
Rate for Payer: Group Health Inc Commercial	$578.00
Rate for Payer: Group Health Inc Medicare	$404.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.00
Rate for Payer: Hamaspik Choice Inc Medicare	$578.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$279.95
Rate for Payer: Healthfirst Essential Plan	$1,114.36
Rate for Payer: United Healthcare Commercial	$426.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$495.27

HC MR ANGIO, NECK, COMBO - MR NECK ANGIO W AND WO IV CONTRAST

Facility

$1,156.00

Service Code	CPT 70549 TC
Hospital Charge Code	6157054901
Hospital Revenue Code	615
Min. Negotiated Rate	$578.00
Max. Negotiated Rate	$578.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.00

HC MR ANGIO, NECK - MR NECK ANGIO WO IV CONTRAST

Facility

$705.00

Service Code	CPT 70547 TC
Hospital Charge Code	6157054701
Hospital Revenue Code	615
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.50

HC MR ANGIO, NECK - MR NECK ANGIO WO IV CONTRAST

Facility

$705.00

Service Code	CPT 70547 TC
Hospital Charge Code	6157054701
Hospital Revenue Code	615
Min. Negotiated Rate	$171.45
Max. Negotiated Rate	$733.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$387.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$259.35
Rate for Payer: Aetna Government	$259.35
Rate for Payer: Brighton Health Commercial	$528.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$733.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$617.72
Rate for Payer: EmblemHealth Commercial	$171.45
Rate for Payer: Group Health Inc Commercial	$352.50
Rate for Payer: Group Health Inc Medicare	$246.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.50
Rate for Payer: Hamaspik Choice Inc Medicare	$352.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$171.45
Rate for Payer: Healthfirst Essential Plan	$729.23
Rate for Payer: United Healthcare Commercial	$274.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$324.10

HC MR ANGIO, NECK W/CONTRAST - MR NECK ANGIO W IV CONTRAST

Facility

$1,156.00

Service Code	CPT 70548 TC
Hospital Charge Code	6157054801
Hospital Revenue Code	615
Min. Negotiated Rate	$188.92
Max. Negotiated Rate	$935.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$635.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$259.35
Rate for Payer: Aetna Government	$259.35
Rate for Payer: Brighton Health Commercial	$867.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$935.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$787.13
Rate for Payer: EmblemHealth Commercial	$188.92
Rate for Payer: Group Health Inc Commercial	$578.00
Rate for Payer: Group Health Inc Medicare	$404.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.00
Rate for Payer: Hamaspik Choice Inc Medicare	$578.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$188.92
Rate for Payer: Healthfirst Essential Plan	$828.18
Rate for Payer: United Healthcare Commercial	$349.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$368.08

Know your out-of-pocket cost for care.

All Charges