St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC NASAL/SINUS ENDOSCOPY,BX/RMV POLYP/DEBRID

Facility

$4,332.00

Service Code	CPT 31237
Hospital Charge Code	3613123701
Hospital Revenue Code	361
Min. Negotiated Rate	$2,166.00
Max. Negotiated Rate	$2,166.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,166.00

HC NASAL/SINUS ENDOSCOPY,W/CONTROL NASAL HEM

Facility

$4,332.00

Service Code	CPT 31238
Hospital Charge Code	3613123801
Hospital Revenue Code	361
Min. Negotiated Rate	$2,166.00
Max. Negotiated Rate	$2,166.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,166.00

HC NASAL/SINUS ENDOSCOPY,W/CONTROL NASAL HEM

Facility

$4,332.00

Service Code	CPT 31238
Hospital Charge Code	3613123801
Hospital Revenue Code	361
Min. Negotiated Rate	$192.25
Max. Negotiated Rate	$3,249.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,106.99
Rate for Payer: Aetna Government	$2,106.99
Rate for Payer: Affinity Essential Plan 1&2	$1,474.89
Rate for Payer: Affinity Essential Plan 3&4	$1,474.89
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,474.89
Rate for Payer: Brighton Health Commercial	$3,249.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,106.99
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	$2,106.99
Rate for Payer: EmblemHealth Commercial	$2,106.99
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,896.29
Rate for Payer: Fidelis Essential Plan Aliesa	$1,790.94
Rate for Payer: Fidelis Essential Plan QHP	$1,875.22
Rate for Payer: Fidelis Medicare Advantage	$2,106.99
Rate for Payer: Fidelis Qualified Health Plan	$1,875.22
Rate for Payer: Group Health Inc Commercial	$2,106.99
Rate for Payer: Group Health Inc Medicare	$2,106.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,106.99
Rate for Payer: Hamaspik Choice Inc Medicare	$792.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$192.25
Rate for Payer: Healthfirst Medicare Advantage	$1,790.94
Rate for Payer: Healthfirst QHP	$2,106.99
Rate for Payer: Humana Medicare	$2,149.13
Rate for Payer: Senior Whole Health Medicare Advantage	$2,106.99
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$2,106.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,106.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,001.64
Rate for Payer: Wellcare Medicare	$2,001.64

HC NASAL/SINUS ENDOSCOPY W/SPHENOID SINUSOSCOPY

Facility

$4,794.00

Service Code	CPT 31235
Hospital Charge Code	3613123501
Hospital Revenue Code	361
Min. Negotiated Rate	$184.92
Max. Negotiated Rate	$3,595.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,106.99
Rate for Payer: Aetna Government	$2,106.99
Rate for Payer: Affinity Essential Plan 1&2	$1,474.89
Rate for Payer: Affinity Essential Plan 3&4	$1,474.89
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,474.89
Rate for Payer: Brighton Health Commercial	$3,595.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,106.99
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	$2,106.99
Rate for Payer: EmblemHealth Commercial	$2,106.99
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,896.29
Rate for Payer: Fidelis Essential Plan Aliesa	$1,790.94
Rate for Payer: Fidelis Essential Plan QHP	$1,875.22
Rate for Payer: Fidelis Medicare Advantage	$2,106.99
Rate for Payer: Fidelis Qualified Health Plan	$1,875.22
Rate for Payer: Group Health Inc Commercial	$2,106.99
Rate for Payer: Group Health Inc Medicare	$2,106.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,106.99
Rate for Payer: Hamaspik Choice Inc Medicare	$792.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$184.92
Rate for Payer: Healthfirst Medicare Advantage	$1,790.94
Rate for Payer: Healthfirst QHP	$2,106.99
Rate for Payer: Humana Medicare	$2,149.13
Rate for Payer: Senior Whole Health Medicare Advantage	$2,106.99
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$2,106.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,106.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,001.64
Rate for Payer: Wellcare Medicare	$2,001.64

HC NASAL/SINUS ENDOSCOPY W/SPHENOID SINUSOSCOPY

Facility

$4,794.00

Service Code	CPT 31235
Hospital Charge Code	3613123501
Hospital Revenue Code	361
Min. Negotiated Rate	$2,397.00
Max. Negotiated Rate	$2,397.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,397.00

HC NASOPHARYNGOSCOPY

Facility

$474.00

Service Code	CPT 92511
Hospital Charge Code	5109251101
Hospital Revenue Code	510
Min. Negotiated Rate	$42.51
Max. Negotiated Rate	$260.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$260.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$237.20
Rate for Payer: Aetna Government	$237.20
Rate for Payer: Affinity Essential Plan 1&2	$166.04
Rate for Payer: Affinity Essential Plan 3&4	$166.04
Rate for Payer: Affinity Medicaid/CHP/HARP	$166.04
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$237.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$217.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.48
Rate for Payer: Elderplan Medicare Advantage	$237.20
Rate for Payer: EmblemHealth Commercial	$250.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$213.48
Rate for Payer: Fidelis Essential Plan Aliesa	$201.62
Rate for Payer: Fidelis Essential Plan QHP	$211.11
Rate for Payer: Fidelis Medicare Advantage	$237.20
Rate for Payer: Fidelis Qualified Health Plan	$211.11
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$237.20
Rate for Payer: Hamaspik Choice Inc Medicare	$237.20
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$42.51
Rate for Payer: Healthfirst Medicare Advantage	$201.62
Rate for Payer: Healthfirst QHP	$237.20
Rate for Payer: Humana Medicare	$241.94
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$249.06
Rate for Payer: Senior Whole Health Medicare Advantage	$237.20
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$237.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$237.20
Rate for Payer: Wellcare CHP/FHP/Medicaid	$225.34
Rate for Payer: Wellcare Medicare	$225.34

HC NASOPHARYNGOSCOPY

Facility

$474.00

Service Code	CPT 92511
Hospital Charge Code	5109251101
Hospital Revenue Code	510
Min. Negotiated Rate	$237.00
Max. Negotiated Rate	$237.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$237.00

HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP)

Facility

$98.00

Service Code	CPT 83880
Hospital Charge Code	3018388001
Hospital Revenue Code	301
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$49.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.00

HC NATRIURETIC PEPTIDE - B-TYPE NATRIURETIC PEPTIDE (BNP)

Facility

$98.00

Service Code	CPT 83880
Hospital Charge Code	3018388001
Hospital Revenue Code	301
Min. Negotiated Rate	$27.48
Max. Negotiated Rate	$77.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$39.26
Rate for Payer: Aetna Government	$39.26
Rate for Payer: Affinity Essential Plan 1&2	$27.48
Rate for Payer: Affinity Essential Plan 3&4	$27.48
Rate for Payer: Affinity Medicaid/CHP/HARP	$27.48
Rate for Payer: Brighton Health Commercial	$73.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$39.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$57.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.57
Rate for Payer: Elderplan Medicare Advantage	$39.26
Rate for Payer: EmblemHealth Commercial	$39.26
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35.33
Rate for Payer: Fidelis Essential Plan Aliesa	$33.37
Rate for Payer: Fidelis Essential Plan QHP	$34.94
Rate for Payer: Fidelis Medicare Advantage	$39.26
Rate for Payer: Fidelis Qualified Health Plan	$34.94
Rate for Payer: Group Health Inc Commercial	$39.26
Rate for Payer: Group Health Inc Medicare	$39.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$39.26
Rate for Payer: Hamaspik Choice Inc Medicare	$39.26
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$34.41
Rate for Payer: Healthfirst Essential Plan	$77.42
Rate for Payer: Healthfirst Medicare Advantage	$39.26
Rate for Payer: Healthfirst QHP	$39.26
Rate for Payer: Humana Medicare	$40.05
Rate for Payer: Senior Whole Health Medicare Advantage	$39.26
Rate for Payer: United Healthcare Commercial	$42.99
Rate for Payer: United Healthcare Medicare Advantage	$39.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$39.26
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34.41
Rate for Payer: Wellcare Medicare	$35.33

HC NEEDLE BIOPSY LIVER

Facility

$4,157.00

Service Code	CPT 47000 TC
Hospital Charge Code	3614700001
Hospital Revenue Code	361
Min. Negotiated Rate	$2,078.50
Max. Negotiated Rate	$2,078.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.50

HC NEEDLE BIOPSY LIVER

Facility

$4,157.00

Service Code	CPT 47000 TC
Hospital Charge Code	3614700001
Hospital Revenue Code	361
Min. Negotiated Rate	$414.04
Max. Negotiated Rate	$3,117.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$414.04
Rate for Payer: Aetna Government	$414.04
Rate for Payer: Brighton Health Commercial	$3,117.75
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: EmblemHealth Commercial	$2,078.50
Rate for Payer: Group Health Inc Commercial	$2,078.50
Rate for Payer: Group Health Inc Medicare	$1,454.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.50
Rate for Payer: Hamaspik Choice Inc Medicare	$708.28
Rate for Payer: United Healthcare Commercial	$1,409.00

HC NEEDLE BIOPSY LIVER PERC W/ OTHER PROCED

Facility

$286.00

Service Code	CPT 47001 TC
Hospital Charge Code	3614700101
Hospital Revenue Code	361
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00

HC NEEDLE BIOPSY LIVER PERC W/ OTHER PROCED

Facility

$286.00

Service Code	CPT 47001 TC
Hospital Charge Code	3614700101
Hospital Revenue Code	361
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$123.91
Rate for Payer: Aetna Government	$123.91
Rate for Payer: Brighton Health Commercial	$214.50
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: EmblemHealth Commercial	$143.00
Rate for Payer: Group Health Inc Commercial	$143.00
Rate for Payer: Group Health Inc Medicare	$100.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00
Rate for Payer: United Healthcare Commercial	$1,113.00

HC NEEDLE BIOPSY, LYMPH NODE(S)

Facility

$4,157.00

Service Code	CPT 38505 TC
Hospital Charge Code	3613850501
Hospital Revenue Code	361
Min. Negotiated Rate	$2,078.50
Max. Negotiated Rate	$2,078.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.50

HC NEEDLE BIOPSY, LYMPH NODE(S)

Facility

$4,157.00

Service Code	CPT 38505 TC
Hospital Charge Code	3613850501
Hospital Revenue Code	361
Min. Negotiated Rate	$127.99
Max. Negotiated Rate	$3,117.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$127.99
Rate for Payer: Aetna Government	$127.99
Rate for Payer: Brighton Health Commercial	$3,117.75
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: EmblemHealth Commercial	$2,078.50
Rate for Payer: Group Health Inc Commercial	$2,078.50
Rate for Payer: Group Health Inc Medicare	$1,454.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.50
Rate for Payer: Hamaspik Choice Inc Medicare	$708.28
Rate for Payer: United Healthcare Commercial	$1,409.00

HC NEEDLE BIOPSY,MUSCLE

Facility

$4,157.00

Service Code	CPT 20206 TC
Hospital Charge Code	3612020601
Hospital Revenue Code	361
Min. Negotiated Rate	$2,078.50
Max. Negotiated Rate	$2,078.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.50

HC NEEDLE BIOPSY,MUSCLE

Facility

$4,157.00

Service Code	CPT 20206 TC
Hospital Charge Code	3612020601
Hospital Revenue Code	361
Min. Negotiated Rate	$238.87
Max. Negotiated Rate	$3,117.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$238.87
Rate for Payer: Aetna Government	$238.87
Rate for Payer: Brighton Health Commercial	$3,117.75
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: EmblemHealth Commercial	$2,078.50
Rate for Payer: Group Health Inc Commercial	$2,078.50
Rate for Payer: Group Health Inc Medicare	$1,454.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.50
Rate for Payer: Hamaspik Choice Inc Medicare	$708.28
Rate for Payer: United Healthcare Commercial	$1,409.00

HC NEEDLE BIOPSY OF PANCREAS

Facility

$4,157.00

Service Code	CPT 48102 TC
Hospital Charge Code	3614810201
Hospital Revenue Code	361
Min. Negotiated Rate	$2,078.50
Max. Negotiated Rate	$2,078.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.50

HC NEEDLE BIOPSY OF PANCREAS

Facility

$4,157.00

Service Code	CPT 48102 TC
Hospital Charge Code	3614810201
Hospital Revenue Code	361
Min. Negotiated Rate	$605.90
Max. Negotiated Rate	$3,117.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$605.90
Rate for Payer: Aetna Government	$605.90
Rate for Payer: Brighton Health Commercial	$3,117.75
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: EmblemHealth Commercial	$2,078.50
Rate for Payer: Group Health Inc Commercial	$2,078.50
Rate for Payer: Group Health Inc Medicare	$1,454.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.50
Rate for Payer: Hamaspik Choice Inc Medicare	$708.28
Rate for Payer: United Healthcare Commercial	$1,409.00

HC NEEDLE BIOPSY PLEURA

Facility

$4,157.00

Service Code	CPT 32400 TC
Hospital Charge Code	3613240001
Hospital Revenue Code	361
Min. Negotiated Rate	$157.32
Max. Negotiated Rate	$3,117.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$157.32
Rate for Payer: Aetna Government	$157.32
Rate for Payer: Brighton Health Commercial	$3,117.75
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: EmblemHealth Commercial	$2,078.50
Rate for Payer: Group Health Inc Commercial	$2,078.50
Rate for Payer: Group Health Inc Medicare	$1,454.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.50
Rate for Payer: Hamaspik Choice Inc Medicare	$708.28
Rate for Payer: United Healthcare Commercial	$1,409.00

HC NEEDLE BIOPSY PLEURA

Facility

$4,157.00

Service Code	CPT 32400 TC
Hospital Charge Code	3613240001
Hospital Revenue Code	361
Min. Negotiated Rate	$2,078.50
Max. Negotiated Rate	$2,078.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.50

HC NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE

Facility

$149.00

Service Code	CPT 95886 TC
Hospital Charge Code	9229588601
Hospital Revenue Code	922
Min. Negotiated Rate	$74.50
Max. Negotiated Rate	$74.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.50

HC NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE

Facility

$149.00

Service Code	CPT 95886 TC
Hospital Charge Code	9229588601
Hospital Revenue Code	922
Min. Negotiated Rate	$40.05
Max. Negotiated Rate	$120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$40.05
Rate for Payer: Aetna Government	$40.05
Rate for Payer: Brighton Health Commercial	$111.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$119.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$101.32
Rate for Payer: EmblemHealth Commercial	$74.50
Rate for Payer: Group Health Inc Commercial	$74.50
Rate for Payer: Group Health Inc Medicare	$52.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.50
Rate for Payer: Hamaspik Choice Inc Medicare	$74.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$57.06
Rate for Payer: United Healthcare Commercial	$120.00

HC NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION

Facility

$210.00

Service Code	CPT 95887 TC
Hospital Charge Code	9229588701
Hospital Revenue Code	922
Min. Negotiated Rate	$38.46
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$115.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$38.46
Rate for Payer: Aetna Government	$38.46
Rate for Payer: Brighton Health Commercial	$157.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$168.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.80
Rate for Payer: EmblemHealth Commercial	$105.00
Rate for Payer: Group Health Inc Commercial	$105.00
Rate for Payer: Group Health Inc Medicare	$73.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$52.40
Rate for Payer: United Healthcare Commercial	$120.00

HC NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION

Facility

$210.00

Service Code	CPT 95887 TC
Hospital Charge Code	9229588701
Hospital Revenue Code	922
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00

Know your out-of-pocket cost for care.

All Charges