St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC PICC INSERTION W SUBCUTANEOUS PORT > 5 YRS OLD

Facility

$8,393.00

Service Code	CPT 36571 TC
Hospital Charge Code	3613657101
Hospital Revenue Code	361
Min. Negotiated Rate	$4,196.50
Max. Negotiated Rate	$4,196.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.50

HC PICC INSERTION W SUBCUTANEOUS PORT > 5 YRS OLD

Facility

$8,393.00

Service Code	CPT 36571 TC
Hospital Charge Code	3613657101
Hospital Revenue Code	361
Min. Negotiated Rate	$1,414.92
Max. Negotiated Rate	$6,294.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,414.92
Rate for Payer: Aetna Government	$1,414.92
Rate for Payer: Brighton Health Commercial	$6,294.75
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	$4,196.50
Rate for Payer: Group Health Inc Commercial	$4,196.50
Rate for Payer: Group Health Inc Medicare	$2,937.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,588.69
Rate for Payer: United Healthcare Commercial	$1,835.00

HC PINWORM EXAM - PINWORM PREP

Facility

$10.00

Service Code	CPT 87172
Hospital Charge Code	3068717201
Hospital Revenue Code	306
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$7.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.27
Rate for Payer: Aetna Government	$4.27
Rate for Payer: Affinity Essential Plan 1&2	$2.99
Rate for Payer: Affinity Essential Plan 3&4	$2.99
Rate for Payer: Affinity Medicaid/CHP/HARP	$2.99
Rate for Payer: Brighton Health Commercial	$7.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.11
Rate for Payer: Elderplan Medicare Advantage	$4.27
Rate for Payer: EmblemHealth Commercial	$4.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3.84
Rate for Payer: Fidelis Essential Plan Aliesa	$3.63
Rate for Payer: Fidelis Essential Plan QHP	$3.80
Rate for Payer: Fidelis Medicare Advantage	$4.27
Rate for Payer: Fidelis Qualified Health Plan	$3.80
Rate for Payer: Group Health Inc Commercial	$4.27
Rate for Payer: Group Health Inc Medicare	$4.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.27
Rate for Payer: Hamaspik Choice Inc Medicare	$4.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.02
Rate for Payer: Healthfirst Essential Plan	$4.54
Rate for Payer: Healthfirst Medicare Advantage	$4.27
Rate for Payer: Healthfirst QHP	$4.27
Rate for Payer: Humana Medicare	$4.36
Rate for Payer: Senior Whole Health Medicare Advantage	$4.27
Rate for Payer: United Healthcare Commercial	$5.41
Rate for Payer: United Healthcare Medicare Advantage	$4.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2.02
Rate for Payer: Wellcare Medicare	$3.84

HC PINWORM EXAM - PINWORM PREP

Facility

$10.00

Service Code	CPT 87172
Hospital Charge Code	3068717201
Hospital Revenue Code	306
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$5.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00

HC PLACE CATH AORTA

Facility

$1,965.00

Service Code	CPT 36200 TC
Hospital Charge Code	3613620001
Hospital Revenue Code	361
Min. Negotiated Rate	$677.64
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$677.64
Rate for Payer: Aetna Government	$677.64
Rate for Payer: Brighton Health Commercial	$1,473.75
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	$982.50
Rate for Payer: Group Health Inc Commercial	$982.50
Rate for Payer: Group Health Inc Medicare	$687.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$982.50
Rate for Payer: Hamaspik Choice Inc Medicare	$982.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH AORTA

Facility

$1,965.00

Service Code	CPT 36200 TC
Hospital Charge Code	3613620001
Hospital Revenue Code	361
Min. Negotiated Rate	$982.50
Max. Negotiated Rate	$982.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$982.50

HC PLACE CATH EXTREM ARTERY

Facility

$1,475.00

Service Code	CPT 36140 TC
Hospital Charge Code	3613614001
Hospital Revenue Code	361
Min. Negotiated Rate	$737.50
Max. Negotiated Rate	$737.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$737.50

HC PLACE CATH EXTREM ARTERY

Facility

$1,475.00

Service Code	CPT 36140 TC
Hospital Charge Code	3613614001
Hospital Revenue Code	361
Min. Negotiated Rate	$342.00
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$475.11
Rate for Payer: Aetna Government	$475.11
Rate for Payer: Brighton Health Commercial	$1,106.25
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	$737.50
Rate for Payer: Group Health Inc Commercial	$737.50
Rate for Payer: Group Health Inc Medicare	$516.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$737.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH IN LT/RT PULM ART

Facility

$2,545.00

Service Code	CPT 36014 TC
Hospital Charge Code	3613601401
Hospital Revenue Code	361
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$875.05
Rate for Payer: Aetna Government	$875.05
Rate for Payer: Brighton Health Commercial	$1,908.75
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	$1,272.50
Rate for Payer: Group Health Inc Commercial	$1,272.50
Rate for Payer: Group Health Inc Medicare	$890.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,272.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,272.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH IN LT/RT PULM ART

Facility

$2,545.00

Service Code	CPT 36014 TC
Hospital Charge Code	3613601401
Hospital Revenue Code	361
Min. Negotiated Rate	$1,272.50
Max. Negotiated Rate	$1,272.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,272.50

HC PLACE CATH IN SUBSEGMT PULM ART

Facility

$2,787.00

Service Code	CPT 36015 TC
Hospital Charge Code	3613601501
Hospital Revenue Code	361
Min. Negotiated Rate	$1,393.50
Max. Negotiated Rate	$1,393.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,393.50

HC PLACE CATH IN SUBSEGMT PULM ART

Facility

$2,787.00

Service Code	CPT 36015 TC
Hospital Charge Code	3613601501
Hospital Revenue Code	361
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$936.18
Rate for Payer: Aetna Government	$936.18
Rate for Payer: Brighton Health Commercial	$2,090.25
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	$1,393.50
Rate for Payer: Group Health Inc Commercial	$1,393.50
Rate for Payer: Group Health Inc Medicare	$975.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,393.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,393.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH IN VEIN,SELECT

Facility

$2,814.00

Service Code	CPT 36011
Hospital Charge Code	3613601101
Hospital Revenue Code	361
Min. Negotiated Rate	$1,407.00
Max. Negotiated Rate	$1,407.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,407.00

HC PLACE CATH IN VEIN,SELECT

Facility

$2,814.00

Service Code	CPT 36011
Hospital Charge Code	3613601101
Hospital Revenue Code	361
Min. Negotiated Rate	$171.55
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$171.55
Rate for Payer: Aetna Government	$171.55
Rate for Payer: Brighton Health Commercial	$2,110.50
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	$1,407.00
Rate for Payer: Group Health Inc Commercial	$1,407.00
Rate for Payer: Group Health Inc Medicare	$984.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,407.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,407.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$176.02
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH IN VEIN,SUBSELECT

Facility

$2,363.00

Service Code	CPT 36012 TC
Hospital Charge Code	3613601201
Hospital Revenue Code	361
Min. Negotiated Rate	$1,181.50
Max. Negotiated Rate	$1,181.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,181.50

HC PLACE CATH IN VEIN,SUBSELECT

Facility

$2,363.00

Service Code	CPT 36012 TC
Hospital Charge Code	3613601201
Hospital Revenue Code	361
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$930.33
Rate for Payer: Aetna Government	$930.33
Rate for Payer: Brighton Health Commercial	$1,772.25
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	$1,181.50
Rate for Payer: Group Health Inc Commercial	$1,181.50
Rate for Payer: Group Health Inc Medicare	$827.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,181.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,181.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH IN VEIN,SVC,IVC

Facility

$1,769.00

Service Code	CPT 36010 TC
Hospital Charge Code	3613601001
Hospital Revenue Code	361
Min. Negotiated Rate	$884.50
Max. Negotiated Rate	$884.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$884.50

HC PLACE CATH IN VEIN,SVC,IVC

Facility

$1,769.00

Service Code	CPT 36010 TC
Hospital Charge Code	3613601001
Hospital Revenue Code	361
Min. Negotiated Rate	$134.44
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.44
Rate for Payer: Aetna Government	$134.44
Rate for Payer: Brighton Health Commercial	$1,326.75
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	$884.50
Rate for Payer: Group Health Inc Commercial	$884.50
Rate for Payer: Group Health Inc Medicare	$619.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$884.50
Rate for Payer: Hamaspik Choice Inc Medicare	$884.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH SELECT ART,ABD/PEL, 2ND ORDER

Facility

$3,759.00

Service Code	CPT 36246 TC
Hospital Charge Code	3613624601
Hospital Revenue Code	361
Min. Negotiated Rate	$1,879.50
Max. Negotiated Rate	$1,879.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,879.50

HC PLACE CATH SELECT ART,ABD/PEL, 2ND ORDER

Facility

$3,759.00

Service Code	CPT 36246 TC
Hospital Charge Code	3613624601
Hospital Revenue Code	361
Min. Negotiated Rate	$967.26
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$967.26
Rate for Payer: Aetna Government	$967.26
Rate for Payer: Brighton Health Commercial	$2,819.25
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	$1,879.50
Rate for Payer: Group Health Inc Commercial	$1,879.50
Rate for Payer: Group Health Inc Medicare	$1,315.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,879.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,879.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH SELECT ART,ABD/PEL, 3RD ORDER

Facility

$5,942.00

Service Code	CPT 36247 TC
Hospital Charge Code	3613624701
Hospital Revenue Code	361
Min. Negotiated Rate	$2,971.00
Max. Negotiated Rate	$2,971.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,971.00

HC PLACE CATH SELECT ART,ABD/PEL, 3RD ORDER

Facility

$5,942.00

Service Code	CPT 36247 TC
Hospital Charge Code	3613624701
Hospital Revenue Code	361
Min. Negotiated Rate	$1,113.00
Max. Negotiated Rate	$4,456.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,710.29
Rate for Payer: Aetna Government	$1,710.29
Rate for Payer: Brighton Health Commercial	$4,456.50
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	$2,971.00
Rate for Payer: Group Health Inc Commercial	$2,971.00
Rate for Payer: Group Health Inc Medicare	$2,079.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,971.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,971.00
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH SELECT ART,ABD/PEL, ADD'L 2ND ORDER

Facility

$494.00

Service Code	CPT 36248 TC
Hospital Charge Code	3163624801
Hospital Revenue Code	361
Min. Negotiated Rate	$164.82
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$164.82
Rate for Payer: Aetna Government	$164.82
Rate for Payer: Brighton Health Commercial	$370.50
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	$247.00
Rate for Payer: Group Health Inc Commercial	$247.00
Rate for Payer: Group Health Inc Medicare	$172.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$247.00
Rate for Payer: Hamaspik Choice Inc Medicare	$247.00
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH SELECT ART,ABD/PEL, ADD'L 2ND ORDER

Facility

$494.00

Service Code	CPT 36248 TC
Hospital Charge Code	3163624801
Hospital Revenue Code	361
Min. Negotiated Rate	$247.00
Max. Negotiated Rate	$247.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$247.00

HC PLACE CATH SELECT ART,ABD/PEL, FIRST ORDER

Facility

$3,839.00

Service Code	CPT 36245 TC
Hospital Charge Code	3613624501
Hospital Revenue Code	361
Min. Negotiated Rate	$1,113.00
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,483.68
Rate for Payer: Aetna Government	$1,483.68
Rate for Payer: Brighton Health Commercial	$2,879.25
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	$1,919.50
Rate for Payer: Group Health Inc Commercial	$1,919.50
Rate for Payer: Group Health Inc Medicare	$1,343.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,919.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,919.50
Rate for Payer: United Healthcare Commercial	$1,113.00

Know your out-of-pocket cost for care.

All Charges