St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$1,919.50
Max. Negotiated Rate	$1,919.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,919.50

HC PLACE CATH SELECTIVE ART,NECK, ADD'L 2ND OR 3RD ORDER

Facility

$577.00

Service Code	CPT 36218 TC
Hospital Charge Code	3613621801
Hospital Revenue Code	361
Min. Negotiated Rate	$288.50
Max. Negotiated Rate	$288.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$288.50

HC PLACE CATH SELECTIVE ART,NECK, ADD'L 2ND OR 3RD ORDER

Facility

$577.00

Service Code	CPT 36218 TC
Hospital Charge Code	3613621801
Hospital Revenue Code	361
Min. Negotiated Rate	$201.95
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$208.80
Rate for Payer: Aetna Government	$208.80
Rate for Payer: Brighton Health Commercial	$432.75
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	$288.50
Rate for Payer: Group Health Inc Commercial	$288.50
Rate for Payer: Group Health Inc Medicare	$201.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$288.50
Rate for Payer: Hamaspik Choice Inc Medicare	$288.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH SELECTIVE ART,NECK, FIRST ORDER

Facility

$3,471.00

Service Code	CPT 36215 TC
Hospital Charge Code	3613621501
Hospital Revenue Code	361
Min. Negotiated Rate	$1,735.50
Max. Negotiated Rate	$1,735.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,735.50

HC PLACE CATH SELECTIVE ART,NECK, FIRST ORDER

Facility

$3,471.00

Service Code	CPT 36215 TC
Hospital Charge Code	3613621501
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	$1,215.63
Rate for Payer: Aetna Government	$1,215.63
Rate for Payer: Brighton Health Commercial	$2,603.25
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	$1,735.50
Rate for Payer: Group Health Inc Commercial	$1,735.50
Rate for Payer: Group Health Inc Medicare	$1,214.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,735.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,735.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH SELECTIVE ART,NECK, INITIAL 2ND ORDER

Facility

$3,790.00

Service Code	CPT 36216 TC
Hospital Charge Code	3613621601
Hospital Revenue Code	361
Min. Negotiated Rate	$1,895.00
Max. Negotiated Rate	$1,895.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,895.00

HC PLACE CATH SELECTIVE ART,NECK, INITIAL 2ND ORDER

Facility

$3,790.00

Service Code	CPT 36216 TC
Hospital Charge Code	3613621601
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	$1,293.60
Rate for Payer: Aetna Government	$1,293.60
Rate for Payer: Brighton Health Commercial	$2,842.50
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	$1,895.00
Rate for Payer: Group Health Inc Commercial	$1,895.00
Rate for Payer: Group Health Inc Medicare	$1,326.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,895.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,895.00
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH SELECTIVE ART,NECK, INITIAL 3RD ORDER

Facility

$6,223.00

Service Code	CPT 36217 TC
Hospital Charge Code	3613621701
Hospital Revenue Code	361
Min. Negotiated Rate	$1,113.00
Max. Negotiated Rate	$4,667.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,128.56
Rate for Payer: Aetna Government	$2,128.56
Rate for Payer: Brighton Health Commercial	$4,667.25
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	$3,111.50
Rate for Payer: Group Health Inc Commercial	$3,111.50
Rate for Payer: Group Health Inc Medicare	$2,178.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,111.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,111.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE CATH SELECTIVE ART,NECK, INITIAL 3RD ORDER

Facility

$6,223.00

Service Code	CPT 36217 TC
Hospital Charge Code	3613621701
Hospital Revenue Code	361
Min. Negotiated Rate	$3,111.50
Max. Negotiated Rate	$3,111.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,111.50

HC PLACEMENT CHOLEDOCHAL STENT

Facility

$2,807.00

Service Code	CPT 47801 TC
Hospital Charge Code	3614780101
Hospital Revenue Code	361
Min. Negotiated Rate	$1,403.50
Max. Negotiated Rate	$1,403.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,403.50

HC PLACEMENT CHOLEDOCHAL STENT

Facility

$2,807.00

Service Code	CPT 47801 TC
Hospital Charge Code	3614780101
Hospital Revenue Code	361
Min. Negotiated Rate	$982.45
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,543.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,149.13
Rate for Payer: Aetna Government	$1,149.13
Rate for Payer: Brighton Health Commercial	$2,105.25
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	$1,403.50
Rate for Payer: Group Health Inc Commercial	$1,403.50
Rate for Payer: Group Health Inc Medicare	$982.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,403.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,403.50
Rate for Payer: United Healthcare Commercial	$1,496.00

HC PLACEMENT NG/OG TUBE BY PHYSICIAN

Facility

$1,132.00

Service Code	CPT 43752 TC
Hospital Charge Code	3614375202
Hospital Revenue Code	361
Min. Negotiated Rate	$566.00
Max. Negotiated Rate	$566.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$566.00

HC PLACEMENT NG/OG TUBE BY PHYSICIAN

Facility

$1,132.00

Service Code	CPT 43752 TC
Hospital Charge Code	3614375201
Hospital Revenue Code	361
Min. Negotiated Rate	$46.16
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$46.16
Rate for Payer: Aetna Government	$46.16
Rate for Payer: Brighton Health Commercial	$849.00
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	$566.00
Rate for Payer: Group Health Inc Commercial	$566.00
Rate for Payer: Group Health Inc Medicare	$396.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$566.00
Rate for Payer: Hamaspik Choice Inc Medicare	$211.72
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACEMENT NG/OG TUBE BY PHYSICIAN

Facility

$1,132.00

Service Code	CPT 43752 TC
Hospital Charge Code	3614375202
Hospital Revenue Code	361
Min. Negotiated Rate	$46.16
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$46.16
Rate for Payer: Aetna Government	$46.16
Rate for Payer: Brighton Health Commercial	$849.00
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	$566.00
Rate for Payer: Group Health Inc Commercial	$566.00
Rate for Payer: Group Health Inc Medicare	$396.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$566.00
Rate for Payer: Hamaspik Choice Inc Medicare	$211.72
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACEMENT NG/OG TUBE BY PHYSICIAN

Facility

$1,132.00

Service Code	CPT 43752 TC
Hospital Charge Code	3614375201
Hospital Revenue Code	361
Min. Negotiated Rate	$566.00
Max. Negotiated Rate	$566.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$566.00

HC PLACEMENT OF OCCLUSIVE DEVICE

Facility

$776.00

Service Code	CPT G0269 TC
Hospital Charge Code	320G026901
Hospital Revenue Code	320
Min. Negotiated Rate	$388.00
Max. Negotiated Rate	$388.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$388.00

HC PLACEMENT OF OCCLUSIVE DEVICE

Facility

$776.00

Service Code	CPT G0269 TC
Hospital Charge Code	320G026901
Hospital Revenue Code	320
Min. Negotiated Rate	$14.12
Max. Negotiated Rate	$620.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$426.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.12
Rate for Payer: Aetna Government	$14.12
Rate for Payer: Brighton Health Commercial	$582.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$620.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$527.68
Rate for Payer: EmblemHealth Commercial	$388.00
Rate for Payer: Group Health Inc Commercial	$388.00
Rate for Payer: Group Health Inc Medicare	$271.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$388.00
Rate for Payer: Hamaspik Choice Inc Medicare	$388.00

HC PLACE NEEDLE INTRAOSSEOUS INFUSION

Facility

$1,101.00

Service Code	CPT 36680
Hospital Charge Code	3613668001
Hospital Revenue Code	361
Min. Negotiated Rate	$68.68
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$487.56
Rate for Payer: Aetna Government	$487.56
Rate for Payer: Affinity Essential Plan 1&2	$341.29
Rate for Payer: Affinity Essential Plan 3&4	$341.29
Rate for Payer: Affinity Medicaid/CHP/HARP	$341.29
Rate for Payer: Brighton Health Commercial	$825.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$487.56
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	$487.56
Rate for Payer: EmblemHealth Commercial	$487.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$438.80
Rate for Payer: Fidelis Essential Plan Aliesa	$414.43
Rate for Payer: Fidelis Essential Plan QHP	$433.93
Rate for Payer: Fidelis Medicare Advantage	$487.56
Rate for Payer: Fidelis Qualified Health Plan	$433.93
Rate for Payer: Group Health Inc Commercial	$487.56
Rate for Payer: Group Health Inc Medicare	$487.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$487.56
Rate for Payer: Hamaspik Choice Inc Medicare	$487.56
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$68.68
Rate for Payer: Healthfirst Medicare Advantage	$414.43
Rate for Payer: Healthfirst QHP	$487.56
Rate for Payer: Humana Medicare	$497.31
Rate for Payer: Senior Whole Health Medicare Advantage	$487.56
Rate for Payer: United Healthcare Commercial	$1,113.00
Rate for Payer: United Healthcare Medicare Advantage	$487.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$487.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$463.18
Rate for Payer: Wellcare Medicare	$463.18

HC PLACE NEEDLE INTRAOSSEOUS INFUSION

Facility

$1,101.00

Service Code	CPT 36680
Hospital Charge Code	3613668001
Hospital Revenue Code	361
Min. Negotiated Rate	$550.50
Max. Negotiated Rate	$550.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$550.50

HC PLACE NEEDLE IN VEIN

Facility

$285.00

Service Code	CPT 36000 TC
Hospital Charge Code	3613600001
Hospital Revenue Code	361
Min. Negotiated Rate	$27.49
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$27.49
Rate for Payer: Aetna Government	$27.49
Rate for Payer: Brighton Health Commercial	$213.75
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	$142.50
Rate for Payer: Group Health Inc Commercial	$142.50
Rate for Payer: Group Health Inc Medicare	$99.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50
Rate for Payer: United Healthcare Commercial	$1,113.00

HC PLACE NEEDLE IN VEIN

Facility

$285.00

Service Code	CPT 36000 TC
Hospital Charge Code	3613600001
Hospital Revenue Code	361
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$142.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50

HC PLAN OF CARE 4 PAIN DOCD

Facility

$10.00

Service Code	CPT 0521F
Hospital Charge Code	9690521F01
Hospital Revenue Code	969
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$5.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00

HC PLAN OF CARE 4 PAIN DOCD

Facility

$10.00

Service Code	CPT 0521F
Hospital Charge Code	9690521F01
Hospital Revenue Code	969
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$8.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$7.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.80
Rate for Payer: EmblemHealth Commercial	$5.00
Rate for Payer: Group Health Inc Commercial	$5.00
Rate for Payer: Group Health Inc Medicare	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5.00

HC PLATELET ANTIBODIES - HEPARIN-INDUCED PLATELET ANTIBODY

Facility

$45.00

Service Code	CPT 86022
Hospital Charge Code	3028602201
Hospital Revenue Code	302
Min. Negotiated Rate	$12.86
Max. Negotiated Rate	$33.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.37
Rate for Payer: Aetna Government	$18.37
Rate for Payer: Affinity Essential Plan 1&2	$12.86
Rate for Payer: Affinity Essential Plan 3&4	$12.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$12.86
Rate for Payer: Brighton Health Commercial	$33.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$18.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$31.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.28
Rate for Payer: Elderplan Medicare Advantage	$18.37
Rate for Payer: EmblemHealth Commercial	$18.37
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16.53
Rate for Payer: Fidelis Essential Plan Aliesa	$15.61
Rate for Payer: Fidelis Essential Plan QHP	$16.35
Rate for Payer: Fidelis Medicare Advantage	$18.37
Rate for Payer: Fidelis Qualified Health Plan	$16.35
Rate for Payer: Group Health Inc Commercial	$18.37
Rate for Payer: Group Health Inc Medicare	$18.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.37
Rate for Payer: Hamaspik Choice Inc Medicare	$18.37
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18.37
Rate for Payer: Healthfirst Medicare Advantage	$18.37
Rate for Payer: Healthfirst QHP	$18.37
Rate for Payer: Humana Medicare	$18.74
Rate for Payer: Senior Whole Health Medicare Advantage	$18.37
Rate for Payer: United Healthcare Commercial	$23.27
Rate for Payer: United Healthcare Medicare Advantage	$18.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.37
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17.45
Rate for Payer: Wellcare Medicare	$16.53

HC PLATELET ANTIBODIES - HEPARIN-INDUCED PLATELET ANTIBODY

Facility

$45.00

Service Code	CPT 86022
Hospital Charge Code	3028602201
Hospital Revenue Code	302
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.50

Know your out-of-pocket cost for care.

All Charges