St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC PERC SKELETAL FIX, DISTAL RADIUS FRAC

Facility

$8,291.00

Service Code	CPT 25606
Hospital Charge Code	3612560601
Hospital Revenue Code	361
Min. Negotiated Rate	$4,145.50
Max. Negotiated Rate	$4,145.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,145.50

HC PERC SKEL FIX THUMB FRAC/DISLOC, W/MANIP

Facility

$8,291.00

Service Code	CPT 26650
Hospital Charge Code	3612665001
Hospital Revenue Code	361
Min. Negotiated Rate	$4,145.50
Max. Negotiated Rate	$4,145.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,145.50

HC PERC SKEL FIX THUMB FRAC/DISLOC, W/MANIP

Facility

$8,291.00

Service Code	CPT 26650
Hospital Charge Code	3612665001
Hospital Revenue Code	361
Min. Negotiated Rate	$582.72
Max. Negotiated Rate	$6,218.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,964.33
Rate for Payer: Aetna Government	$3,964.33
Rate for Payer: Affinity Essential Plan 1&2	$2,775.03
Rate for Payer: Affinity Essential Plan 3&4	$2,775.03
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,775.03
Rate for Payer: Brighton Health Commercial	$6,218.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,964.33
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	$3,964.33
Rate for Payer: EmblemHealth Commercial	$3,964.33
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3,567.90
Rate for Payer: Fidelis Essential Plan Aliesa	$3,369.68
Rate for Payer: Fidelis Essential Plan QHP	$3,528.25
Rate for Payer: Fidelis Medicare Advantage	$3,964.33
Rate for Payer: Fidelis Qualified Health Plan	$3,528.25
Rate for Payer: Group Health Inc Commercial	$3,964.33
Rate for Payer: Group Health Inc Medicare	$3,964.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,964.33
Rate for Payer: Hamaspik Choice Inc Medicare	$1,579.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$582.72
Rate for Payer: Healthfirst Medicare Advantage	$3,369.68
Rate for Payer: Healthfirst QHP	$3,964.33
Rate for Payer: Humana Medicare	$4,043.62
Rate for Payer: Senior Whole Health Medicare Advantage	$3,964.33
Rate for Payer: United Healthcare Commercial	$1,468.00
Rate for Payer: United Healthcare Medicare Advantage	$3,964.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,964.33
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,766.11
Rate for Payer: Wellcare Medicare	$3,766.11

HC PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS

Facility

$2,802.00

Service Code	CPT 95004
Hospital Charge Code	5109500401
Hospital Revenue Code	510
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$1,541.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,541.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,243.07
Rate for Payer: Aetna Government	$1,243.07
Rate for Payer: Affinity Essential Plan 1&2	$870.15
Rate for Payer: Affinity Essential Plan 3&4	$870.15
Rate for Payer: Affinity Medicaid/CHP/HARP	$870.15
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,243.07
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	$1,243.07
Rate for Payer: EmblemHealth Commercial	$250.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,118.76
Rate for Payer: Fidelis Essential Plan Aliesa	$1,056.61
Rate for Payer: Fidelis Essential Plan QHP	$1,106.33
Rate for Payer: Fidelis Medicare Advantage	$1,243.07
Rate for Payer: Fidelis Qualified Health Plan	$1,106.33
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	$1,243.07
Rate for Payer: Hamaspik Choice Inc Medicare	$1,243.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.46
Rate for Payer: Healthfirst Medicare Advantage	$1,056.61
Rate for Payer: Healthfirst QHP	$1,243.07
Rate for Payer: Humana Medicare	$1,267.93
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$1,305.22
Rate for Payer: Senior Whole Health Medicare Advantage	$1,243.07
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$1,243.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,243.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,180.92
Rate for Payer: Wellcare Medicare	$1,180.92

HC PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS

Facility

$2,802.00

Service Code	CPT 95004
Hospital Charge Code	5109500401
Hospital Revenue Code	510
Min. Negotiated Rate	$1,401.00
Max. Negotiated Rate	$1,401.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,401.00

HC PERCUT BIOPSY, ABDOMINAL MASS

Facility

$4,157.00

Service Code	CPT 49180 TC
Hospital Charge Code	3614918001
Hospital Revenue Code	361
Min. Negotiated Rate	$184.79
Max. Negotiated Rate	$3,117.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$184.79
Rate for Payer: Aetna Government	$184.79
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 PERCUT BIOPSY, ABDOMINAL MASS

Facility

$4,157.00

Service Code	CPT 49180 TC
Hospital Charge Code	3614918001
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 PERCUT BX, LUNG/MEDIASTINUM

Facility

$4,157.00

Service Code	CPT 32405
Hospital Charge Code	3613240501
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 PERCUT BX, LUNG/MEDIASTINUM

Facility

$4,157.00

Service Code	CPT 32405
Hospital Charge Code	3613240501
Hospital Revenue Code	361
Min. Negotiated Rate	$1,454.95
Max. Negotiated Rate	$3,117.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,286.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,078.50
Rate for Payer: Aetna Government	$2,078.50
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	$2,078.50

HC PERCUT DRAIN/INJECT RENAL CYST

Facility

$1,847.00

Service Code	CPT 50390 TC
Hospital Charge Code	3615039001
Hospital Revenue Code	361
Min. Negotiated Rate	$923.50
Max. Negotiated Rate	$923.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$923.50

HC PERCUT DRAIN/INJECT RENAL CYST

Facility

$1,847.00

Service Code	CPT 50390 TC
Hospital Charge Code	3615039001
Hospital Revenue Code	361
Min. Negotiated Rate	$117.08
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$117.08
Rate for Payer: Aetna Government	$117.08
Rate for Payer: Brighton Health Commercial	$1,385.25
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	$923.50
Rate for Payer: Group Health Inc Commercial	$923.50
Rate for Payer: Group Health Inc Medicare	$646.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$923.50
Rate for Payer: Hamaspik Choice Inc Medicare	$377.60
Rate for Payer: United Healthcare Commercial	$1,188.00

HC PERCUT PORTAL VEIN CATH

Facility

$1,249.00

Service Code	CPT 36481 TC
Hospital Charge Code	3613648101
Hospital Revenue Code	361
Min. Negotiated Rate	$437.15
Max. Negotiated Rate	$4,065.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,195.76
Rate for Payer: Aetna Government	$2,195.76
Rate for Payer: Brighton Health Commercial	$936.75
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	$624.50
Rate for Payer: Group Health Inc Commercial	$624.50
Rate for Payer: Group Health Inc Medicare	$437.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$624.50
Rate for Payer: Hamaspik Choice Inc Medicare	$624.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PERCUT PORTAL VEIN CATH

Facility

$1,249.00

Service Code	CPT 36481 TC
Hospital Charge Code	3613648101
Hospital Revenue Code	361
Min. Negotiated Rate	$624.50
Max. Negotiated Rate	$624.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$624.50

HC PERICARDIOCENTESIS W/IMAGING

Facility

$4,940.00

Service Code	CPT 33016 TC
Hospital Charge Code	3613301601
Hospital Revenue Code	361
Min. Negotiated Rate	$2,470.00
Max. Negotiated Rate	$2,470.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,470.00

HC PERICARDIOCENTESIS W/IMAGING

Facility

$4,940.00

Service Code	CPT 33016 TC
Hospital Charge Code	3613301601
Hospital Revenue Code	361
Min. Negotiated Rate	$267.24
Max. Negotiated Rate	$3,705.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$267.24
Rate for Payer: Aetna Government	$267.24
Rate for Payer: Brighton Health Commercial	$3,705.00
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	$2,470.00
Rate for Payer: Group Health Inc Commercial	$2,470.00
Rate for Payer: Group Health Inc Medicare	$1,729.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,470.00
Rate for Payer: Hamaspik Choice Inc Medicare	$632.40
Rate for Payer: United Healthcare Commercial	$1,188.00

HC PERIC DRAINAGE W/ CONGENITAL CARD ANOM, <5YR

Facility

$819.00

Service Code	CPT 33018 TC
Hospital Charge Code	3613301801
Hospital Revenue Code	361
Min. Negotiated Rate	$409.50
Max. Negotiated Rate	$409.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$409.50

HC PERIC DRAINAGE W/ CONGENITAL CARD ANOM, <5YR

Facility

$819.00

Service Code	CPT 33018 TC
Hospital Charge Code	3613301801
Hospital Revenue Code	361
Min. Negotiated Rate	$286.65
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$450.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$311.25
Rate for Payer: Aetna Government	$311.25
Rate for Payer: Brighton Health Commercial	$614.25
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	$409.50
Rate for Payer: Group Health Inc Commercial	$409.50
Rate for Payer: Group Health Inc Medicare	$286.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$409.50
Rate for Payer: Hamaspik Choice Inc Medicare	$409.50
Rate for Payer: United Healthcare Commercial	$1,496.00

HC PERIC DRAINAGE W/ INSERTN CATH, INCL CT

Facility

$901.00

Service Code	CPT 33019 TC
Hospital Charge Code	3613301901
Hospital Revenue Code	361
Min. Negotiated Rate	$450.50
Max. Negotiated Rate	$450.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.50

HC PERIC DRAINAGE W/ INSERTN CATH, INCL CT

Facility

$901.00

Service Code	CPT 33019 TC
Hospital Charge Code	3613301901
Hospital Revenue Code	361
Min. Negotiated Rate	$254.50
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$495.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$254.50
Rate for Payer: Aetna Government	$254.50
Rate for Payer: Brighton Health Commercial	$675.75
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	$450.50
Rate for Payer: Group Health Inc Commercial	$450.50
Rate for Payer: Group Health Inc Medicare	$315.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.50
Rate for Payer: Hamaspik Choice Inc Medicare	$450.50
Rate for Payer: United Healthcare Commercial	$1,496.00

HC PERIC DRAINAGE W/O CONGENITAL CARD ANOM, >6YR

Facility

$745.00

Service Code	CPT 33017 TC
Hospital Charge Code	3613301701
Hospital Revenue Code	361
Min. Negotiated Rate	$260.75
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$409.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.62
Rate for Payer: Aetna Government	$275.62
Rate for Payer: Brighton Health Commercial	$558.75
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	$372.50
Rate for Payer: Group Health Inc Commercial	$372.50
Rate for Payer: Group Health Inc Medicare	$260.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$372.50
Rate for Payer: Hamaspik Choice Inc Medicare	$372.50
Rate for Payer: United Healthcare Commercial	$1,496.00

HC PERIC DRAINAGE W/O CONGENITAL CARD ANOM, >6YR

Facility

$745.00

Service Code	CPT 33017 TC
Hospital Charge Code	3613301701
Hospital Revenue Code	361
Min. Negotiated Rate	$372.50
Max. Negotiated Rate	$372.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$372.50

HC PERI-PX DEVICE EVAL & PRGR - CARD DEVICE IMPLANT/POST-PROCEDURE ICD

Facility

$109.00

Service Code	CPT 93287
Hospital Charge Code	4809328702
Hospital Revenue Code	480
Min. Negotiated Rate	$54.50
Max. Negotiated Rate	$54.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.50

HC PERI-PX DEVICE EVAL & PRGR - CARD DEVICE IMPLANT/POST-PROCEDURE ICD

Facility

$109.00

Service Code	CPT 93287
Hospital Charge Code	4809328702
Hospital Revenue Code	480
Min. Negotiated Rate	$31.48
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.48
Rate for Payer: Aetna Government	$31.48
Rate for Payer: Brighton Health Commercial	$81.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$87.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$74.12
Rate for Payer: EmblemHealth Commercial	$54.50
Rate for Payer: Group Health Inc Commercial	$54.50
Rate for Payer: Group Health Inc Medicare	$38.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.50
Rate for Payer: Hamaspik Choice Inc Medicare	$54.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$58.27
Rate for Payer: United Healthcare Commercial	$316.00

HC PERI-PX DEVICE EVAL & PRGR - CARD DVC IMPLANT/POST-PROC ICD W PROG

Facility

$109.00

Service Code	CPT 93287
Hospital Charge Code	4809328704
Hospital Revenue Code	480
Min. Negotiated Rate	$54.50
Max. Negotiated Rate	$54.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.50

HC PERI-PX DEVICE EVAL & PRGR - CARD DVC IMPLANT/POST-PROC ICD W PROG

Facility

$109.00

Service Code	CPT 93287
Hospital Charge Code	4809328704
Hospital Revenue Code	480
Min. Negotiated Rate	$31.48
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.48
Rate for Payer: Aetna Government	$31.48
Rate for Payer: Brighton Health Commercial	$81.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$87.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$74.12
Rate for Payer: EmblemHealth Commercial	$54.50
Rate for Payer: Group Health Inc Commercial	$54.50
Rate for Payer: Group Health Inc Medicare	$38.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.50
Rate for Payer: Hamaspik Choice Inc Medicare	$54.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$58.27
Rate for Payer: United Healthcare Commercial	$316.00

Know your out-of-pocket cost for care.

All Charges