St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC SLEEP STUDY, ATTENDED

Facility

$1,470.00

Service Code	CPT 95807 TC
Hospital Charge Code	9209580701
Hospital Revenue Code	920
Min. Negotiated Rate	$374.90
Max. Negotiated Rate	$1,176.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$808.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$374.90
Rate for Payer: Aetna Government	$374.90
Rate for Payer: Brighton Health Commercial	$1,102.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,176.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$999.60
Rate for Payer: EmblemHealth Commercial	$735.00
Rate for Payer: Group Health Inc Commercial	$735.00
Rate for Payer: Group Health Inc Medicare	$514.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$735.00
Rate for Payer: Hamaspik Choice Inc Medicare	$735.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$417.70
Rate for Payer: United Healthcare Commercial	$822.00

HC SLEEP STUDY, UNATTENDED

Facility

$419.00

Service Code	CPT 95806 TC
Hospital Charge Code	9209580601
Hospital Revenue Code	920
Min. Negotiated Rate	$62.18
Max. Negotiated Rate	$2,342.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$96.46
Rate for Payer: Aetna Government	$96.46
Rate for Payer: Brighton Health Commercial	$2,342.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$335.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.92
Rate for Payer: EmblemHealth Commercial	$209.50
Rate for Payer: Group Health Inc Commercial	$209.50
Rate for Payer: Group Health Inc Medicare	$146.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.50
Rate for Payer: Hamaspik Choice Inc Medicare	$209.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$62.18
Rate for Payer: United Healthcare Commercial	$822.00

HC SLEEP STUDY, UNATTENDED

Facility

$419.00

Service Code	CPT 95806 TC
Hospital Charge Code	9209580601
Hospital Revenue Code	920
Min. Negotiated Rate	$209.50
Max. Negotiated Rate	$209.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.50

HC SLEEP STUDY, UNATTENDED, RECORD HEART RATE/O2 SAT/RESP ANL/SLEEP

Facility

$419.00

Service Code	CPT 95800 TC
Hospital Charge Code	9209580001
Hospital Revenue Code	920
Min. Negotiated Rate	$209.50
Max. Negotiated Rate	$209.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.50

HC SLEEP STUDY, UNATTENDED, RECORD HEART RATE/O2 SAT/RESP ANL/SLEEP

Facility

$419.00

Service Code	CPT 95800 TC
Hospital Charge Code	9209580001
Hospital Revenue Code	920
Min. Negotiated Rate	$105.26
Max. Negotiated Rate	$2,342.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$113.63
Rate for Payer: Aetna Government	$113.63
Rate for Payer: Brighton Health Commercial	$2,342.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$335.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.92
Rate for Payer: EmblemHealth Commercial	$209.50
Rate for Payer: Group Health Inc Commercial	$209.50
Rate for Payer: Group Health Inc Medicare	$146.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.50
Rate for Payer: Hamaspik Choice Inc Medicare	$209.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$105.26
Rate for Payer: United Healthcare Commercial	$822.00

HC SLEEP STUDY, UNATTENDED, RECORD HEART RATE/O2 SAT/RESP ANL/SLEEP

Facility

$419.00

Service Code	CPT 95800 TC
Hospital Charge Code	5109580001
Hospital Revenue Code	510
Min. Negotiated Rate	$105.26
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$113.63
Rate for Payer: Aetna Government	$113.63
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$217.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.48
Rate for Payer: EmblemHealth Commercial	$250.00
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	$209.50
Rate for Payer: Hamaspik Choice Inc Medicare	$209.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$105.26
Rate for Payer: United Healthcare Commercial	$222.00

HC SLEEP STUDY, UNATTENDED, RECORD HEART RATE/O2 SAT/RESP ANL/SLEEP

Facility

$419.00

Service Code	CPT 95800 TC
Hospital Charge Code	5109580001
Hospital Revenue Code	510
Min. Negotiated Rate	$209.50
Max. Negotiated Rate	$209.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.50

HC SLITTING OF PREPUCE (EXCEPT NB)

Facility

$5,365.00

Service Code	CPT 54001
Hospital Charge Code	3615400101
Hospital Revenue Code	361
Min. Negotiated Rate	$2,682.50
Max. Negotiated Rate	$2,682.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,682.50

HC SLITTING OF PREPUCE (EXCEPT NB)

Facility

$5,365.00

Service Code	CPT 54001
Hospital Charge Code	3615400101
Hospital Revenue Code	361
Min. Negotiated Rate	$162.40
Max. Negotiated Rate	$4,023.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,502.91
Rate for Payer: Aetna Government	$2,502.91
Rate for Payer: Affinity Essential Plan 1&2	$1,752.04
Rate for Payer: Affinity Essential Plan 3&4	$1,752.04
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,752.04
Rate for Payer: Brighton Health Commercial	$4,023.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,502.91
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	$2,502.91
Rate for Payer: EmblemHealth Commercial	$2,502.91
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2,252.62
Rate for Payer: Fidelis Essential Plan Aliesa	$2,127.47
Rate for Payer: Fidelis Essential Plan QHP	$2,227.59
Rate for Payer: Fidelis Medicare Advantage	$2,502.91
Rate for Payer: Fidelis Qualified Health Plan	$2,227.59
Rate for Payer: Group Health Inc Commercial	$2,502.91
Rate for Payer: Group Health Inc Medicare	$2,502.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,502.91
Rate for Payer: Hamaspik Choice Inc Medicare	$959.88
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$162.40
Rate for Payer: Healthfirst Medicare Advantage	$2,127.47
Rate for Payer: Healthfirst QHP	$2,502.91
Rate for Payer: Humana Medicare	$2,552.97
Rate for Payer: Senior Whole Health Medicare Advantage	$2,502.91
Rate for Payer: United Healthcare Commercial	$1,468.00
Rate for Payer: United Healthcare Medicare Advantage	$2,502.91
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,502.91
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,377.76
Rate for Payer: Wellcare Medicare	$2,377.76

HC SLP ASSESSMENT OF APHASIA

Facility

$298.00

Service Code	CPT 96105 GN
Hospital Charge Code	4409610501
Hospital Revenue Code	440
Min. Negotiated Rate	$149.00
Max. Negotiated Rate	$149.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$149.00

HC SLP ASSESSMENT OF APHASIA

Facility

$298.00

Service Code	CPT 96105 GN
Hospital Charge Code	4409610501
Hospital Revenue Code	440
Min. Negotiated Rate	$55.00
Max. Negotiated Rate	$222.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$163.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$92.08
Rate for Payer: Aetna Government	$92.08
Rate for Payer: Brighton Health Commercial	$182.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.56
Rate for Payer: EmblemHealth Commercial	$149.00
Rate for Payer: Group Health Inc Commercial	$149.00
Rate for Payer: Group Health Inc Medicare	$120.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$149.00
Rate for Payer: Hamaspik Choice Inc Medicare	$149.00
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: Wellcare Medicare	$55.00

HC SLP DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM

Facility

$318.00

Service Code	CPT 96110 GN
Hospital Charge Code	4409611001
Hospital Revenue Code	440
Min. Negotiated Rate	$8.11
Max. Negotiated Rate	$222.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.11
Rate for Payer: Aetna Government	$8.11
Rate for Payer: Brighton Health Commercial	$182.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.56
Rate for Payer: EmblemHealth Commercial	$159.00
Rate for Payer: Group Health Inc Commercial	$159.00
Rate for Payer: Group Health Inc Medicare	$120.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00
Rate for Payer: Hamaspik Choice Inc Medicare	$159.00
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: Wellcare Medicare	$55.00

HC SLP DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM

Facility

$318.00

Service Code	CPT 96110 GN
Hospital Charge Code	4409611001
Hospital Revenue Code	440
Min. Negotiated Rate	$159.00
Max. Negotiated Rate	$159.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00

HC SLP ENDOSCOP EVAL,LARYNG SENS TEST,CINE/VID

Facility

$194.00

Service Code	CPT 92614 GN
Hospital Charge Code	4449261401
Hospital Revenue Code	444
Min. Negotiated Rate	$97.00
Max. Negotiated Rate	$97.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.00

HC SLP ENDOSCOP EVAL,LARYNG SENS TEST,CINE/VID

Facility

$194.00

Service Code	CPT 92614 GN
Hospital Charge Code	4449261401
Hospital Revenue Code	444
Min. Negotiated Rate	$55.00
Max. Negotiated Rate	$222.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$106.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$128.55
Rate for Payer: Aetna Government	$128.55
Rate for Payer: Brighton Health Commercial	$182.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.56
Rate for Payer: EmblemHealth Commercial	$97.00
Rate for Payer: Group Health Inc Commercial	$97.00
Rate for Payer: Group Health Inc Medicare	$120.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.00
Rate for Payer: Hamaspik Choice Inc Medicare	$97.00
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: Wellcare Medicare	$55.00

HC SLP ENDOSCOPIC EVAL,SWALLOW,CINE/VIDEO

Facility

$198.00

Service Code	CPT 92612 GN
Hospital Charge Code	4449261201
Hospital Revenue Code	444
Min. Negotiated Rate	$55.00
Max. Negotiated Rate	$222.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$108.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$164.78
Rate for Payer: Aetna Government	$164.78
Rate for Payer: Brighton Health Commercial	$182.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.56
Rate for Payer: EmblemHealth Commercial	$99.00
Rate for Payer: Group Health Inc Commercial	$99.00
Rate for Payer: Group Health Inc Medicare	$120.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$99.00
Rate for Payer: Hamaspik Choice Inc Medicare	$99.00
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: Wellcare Medicare	$55.00

HC SLP ENDOSCOPIC EVAL,SWALLOW,CINE/VIDEO

Facility

$198.00

Service Code	CPT 92612 GN
Hospital Charge Code	4449261201
Hospital Revenue Code	444
Min. Negotiated Rate	$99.00
Max. Negotiated Rate	$99.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$99.00

HC SLP ENDOS EVAL,SWAL+LARYN SEN TST,CINE/VID

Facility

$289.00

Service Code	CPT 92616 GN
Hospital Charge Code	4449261601
Hospital Revenue Code	444
Min. Negotiated Rate	$55.00
Max. Negotiated Rate	$222.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$158.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$183.53
Rate for Payer: Aetna Government	$183.53
Rate for Payer: Brighton Health Commercial	$182.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.56
Rate for Payer: EmblemHealth Commercial	$144.50
Rate for Payer: Group Health Inc Commercial	$144.50
Rate for Payer: Group Health Inc Medicare	$120.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$144.50
Rate for Payer: Hamaspik Choice Inc Medicare	$144.50
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: Wellcare Medicare	$55.00

HC SLP ENDOS EVAL,SWAL+LARYN SEN TST,CINE/VID

Facility

$289.00

Service Code	CPT 92616 GN
Hospital Charge Code	4449261601
Hospital Revenue Code	444
Min. Negotiated Rate	$144.50
Max. Negotiated Rate	$144.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$144.50

HC SLP EVAL,ORAL & PHARYNGEAL SWALLOW FUNCTION

Facility

$209.00

Service Code	CPT 92610 GN
Hospital Charge Code	4449261001
Hospital Revenue Code	444
Min. Negotiated Rate	$55.00
Max. Negotiated Rate	$222.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$114.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.47
Rate for Payer: Aetna Government	$73.47
Rate for Payer: Brighton Health Commercial	$182.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.56
Rate for Payer: EmblemHealth Commercial	$104.50
Rate for Payer: Group Health Inc Commercial	$104.50
Rate for Payer: Group Health Inc Medicare	$120.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.50
Rate for Payer: Hamaspik Choice Inc Medicare	$104.50
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: Wellcare Medicare	$55.00

HC SLP EVAL,ORAL & PHARYNGEAL SWALLOW FUNCTION

Facility

$209.00

Service Code	CPT 92610 GN
Hospital Charge Code	4449261001
Hospital Revenue Code	444
Min. Negotiated Rate	$104.50
Max. Negotiated Rate	$104.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.50

HC SLP EVAL,SPEECH-GEN AUG/ALT COMM DEV,1ST HR

Facility

$375.00

Service Code	CPT 92607 GN
Hospital Charge Code	4449260701
Hospital Revenue Code	444
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.50

HC SLP EVAL,SPEECH-GEN AUG/ALT COMM DEV,1ST HR

Facility

$375.00

Service Code	CPT 92607 GN
Hospital Charge Code	4449260701
Hospital Revenue Code	444
Min. Negotiated Rate	$55.00
Max. Negotiated Rate	$468.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$108.92
Rate for Payer: Aetna Government	$108.92
Rate for Payer: Affinity Essential Plan 1&2	$468.44
Rate for Payer: Affinity Essential Plan 3&4	$468.44
Rate for Payer: Affinity Medicaid/CHP/HARP	$208.19
Rate for Payer: Amida Care Medicaid	$208.19
Rate for Payer: Brighton Health Commercial	$182.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.56
Rate for Payer: EmblemHealth Commercial	$187.50
Rate for Payer: EmblemHealth Essential Plan 1&2	$468.44
Rate for Payer: EmblemHealth Essential Plan 3&4	$208.19
Rate for Payer: Fidelis CHP/HARP/Medicaid	$208.19
Rate for Payer: Fidelis Essential Plan Aliesa	$468.44
Rate for Payer: Fidelis Essential Plan QHP	$468.44
Rate for Payer: Fidelis Qualified Health Plan	$218.60
Rate for Payer: Group Health Inc Commercial	$187.50
Rate for Payer: Group Health Inc Medicare	$120.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$208.19
Rate for Payer: Hamaspik Choice Inc Medicare	$208.19
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$208.19
Rate for Payer: Healthfirst Essential Plan	$468.44
Rate for Payer: Healthfirst QHP	$339.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$208.19
Rate for Payer: SOMOS Essential	$468.44
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Essential Plan 1&2	$468.44
Rate for Payer: United Healthcare Essential Plan 3&4	$229.01
Rate for Payer: United Healthcare Medicaid	$208.19
Rate for Payer: Wellcare CHP/FHP/Medicaid	$208.19
Rate for Payer: Wellcare Medicare	$55.00

HC SLP EVAL,SPEECH-GEN AUG/ALT COMM DEV,ADDL 30

Facility

$151.00

Service Code	CPT 92608 GN
Hospital Charge Code	4449260801
Hospital Revenue Code	444
Min. Negotiated Rate	$45.63
Max. Negotiated Rate	$234.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$83.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.63
Rate for Payer: Aetna Government	$45.63
Rate for Payer: Affinity Essential Plan 1&2	$234.22
Rate for Payer: Affinity Essential Plan 3&4	$234.22
Rate for Payer: Affinity Medicaid/CHP/HARP	$104.10
Rate for Payer: Amida Care Medicaid	$104.10
Rate for Payer: Brighton Health Commercial	$182.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.56
Rate for Payer: EmblemHealth Commercial	$75.50
Rate for Payer: EmblemHealth Essential Plan 1&2	$234.22
Rate for Payer: EmblemHealth Essential Plan 3&4	$104.10
Rate for Payer: Fidelis CHP/HARP/Medicaid	$104.10
Rate for Payer: Fidelis Essential Plan Aliesa	$234.22
Rate for Payer: Fidelis Essential Plan QHP	$234.22
Rate for Payer: Fidelis Qualified Health Plan	$109.30
Rate for Payer: Group Health Inc Commercial	$75.50
Rate for Payer: Group Health Inc Medicare	$120.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.10
Rate for Payer: Hamaspik Choice Inc Medicare	$104.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$104.10
Rate for Payer: Healthfirst Essential Plan	$234.22
Rate for Payer: Healthfirst QHP	$169.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$104.10
Rate for Payer: SOMOS Essential	$234.22
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Essential Plan 1&2	$234.22
Rate for Payer: United Healthcare Essential Plan 3&4	$114.51
Rate for Payer: United Healthcare Medicaid	$104.10
Rate for Payer: Wellcare CHP/FHP/Medicaid	$104.10
Rate for Payer: Wellcare Medicare	$55.00

HC SLP EVAL,SPEECH-GEN AUG/ALT COMM DEV,ADDL 30

Facility

$151.00

Service Code	CPT 92608 GN
Hospital Charge Code	4449260801
Hospital Revenue Code	444
Min. Negotiated Rate	$75.50
Max. Negotiated Rate	$75.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.50

Know your out-of-pocket cost for care.

All Charges