St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC SYNCH AUDIO-ONLY NEW MOD 45

Facility

$335.00

Service Code	CPT 98010
Hospital Charge Code	5109801001
Hospital Revenue Code	510
Min. Negotiated Rate	$167.50
Max. Negotiated Rate	$167.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$167.50

HC SYNCH AUDIO-ONLY NEW MOD 45

Facility

$335.00

Service Code	CPT 98010
Hospital Charge Code	5109801001
Hospital Revenue Code	510
Min. Negotiated Rate	$167.50
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$184.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$167.50
Rate for Payer: Aetna Government	$167.50
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	$167.50
Rate for Payer: Hamaspik Choice Inc Medicare	$167.50
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-ONLY NEW SF 15

Facility

$289.00

Service Code	CPT 98008
Hospital Charge Code	5109800801
Hospital Revenue Code	510
Min. Negotiated Rate	$144.50
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$158.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$144.50
Rate for Payer: Aetna Government	$144.50
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	$144.50
Rate for Payer: Hamaspik Choice Inc Medicare	$144.50
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-ONLY NEW SF 15

Facility

$289.00

Service Code	CPT 98008
Hospital Charge Code	5109800801
Hospital Revenue Code	510
Min. Negotiated Rate	$144.50
Max. Negotiated Rate	$144.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$144.50

HC SYNCH AUDIO-VIDEO EST HI 40

Facility

$474.00

Service Code	CPT 98007
Hospital Charge Code	5109800701
Hospital Revenue Code	510
Min. Negotiated Rate	$184.48
Max. Negotiated Rate	$260.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$260.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$237.00
Rate for Payer: Aetna Government	$237.00
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	$237.00
Rate for Payer: Hamaspik Choice Inc Medicare	$237.00
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-VIDEO EST HI 40

Facility

$474.00

Service Code	CPT 98007
Hospital Charge Code	5109800701
Hospital Revenue Code	510
Min. Negotiated Rate	$237.00
Max. Negotiated Rate	$237.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$237.00

HC SYNCH AUDIO-VIDEO EST LOW 20

Facility

$395.00

Service Code	CPT 98005
Hospital Charge Code	5109800501
Hospital Revenue Code	510
Min. Negotiated Rate	$184.48
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$217.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$197.50
Rate for Payer: Aetna Government	$197.50
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	$197.50
Rate for Payer: Hamaspik Choice Inc Medicare	$197.50
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-VIDEO EST LOW 20

Facility

$395.00

Service Code	CPT 98005
Hospital Charge Code	5109800501
Hospital Revenue Code	510
Min. Negotiated Rate	$197.50
Max. Negotiated Rate	$197.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$197.50

HC SYNCH AUDIO-VIDEO EST MOD 30

Facility

$395.00

Service Code	CPT 98006
Hospital Charge Code	5109800601
Hospital Revenue Code	510
Min. Negotiated Rate	$184.48
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$217.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$197.50
Rate for Payer: Aetna Government	$197.50
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	$197.50
Rate for Payer: Hamaspik Choice Inc Medicare	$197.50
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-VIDEO EST MOD 30

Facility

$395.00

Service Code	CPT 98006
Hospital Charge Code	5109800601
Hospital Revenue Code	510
Min. Negotiated Rate	$197.50
Max. Negotiated Rate	$197.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$197.50

HC SYNCH AUDIO-VIDEO EST SF 10

Facility

$355.00

Service Code	CPT 98004
Hospital Charge Code	5109800401
Hospital Revenue Code	510
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$195.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$177.50
Rate for Payer: Aetna Government	$177.50
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	$177.50
Rate for Payer: Hamaspik Choice Inc Medicare	$177.50
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-VIDEO EST SF 10

Facility

$355.00

Service Code	CPT 98004
Hospital Charge Code	5109800401
Hospital Revenue Code	510
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$177.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.50

HC SYNCH AUDIO-VIDEO NEW HI 60

Facility

$498.00

Service Code	CPT 98003
Hospital Charge Code	5109800301
Hospital Revenue Code	510
Min. Negotiated Rate	$249.00
Max. Negotiated Rate	$249.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$249.00

HC SYNCH AUDIO-VIDEO NEW HI 60

Facility

$498.00

Service Code	CPT 98003
Hospital Charge Code	5109800301
Hospital Revenue Code	510
Min. Negotiated Rate	$184.48
Max. Negotiated Rate	$273.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$273.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$249.00
Rate for Payer: Aetna Government	$249.00
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	$249.00
Rate for Payer: Hamaspik Choice Inc Medicare	$249.00
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-VIDEO NEW LOW 30

Facility

$415.00

Service Code	CPT 98001
Hospital Charge Code	5109800101
Hospital Revenue Code	510
Min. Negotiated Rate	$207.50
Max. Negotiated Rate	$207.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.50

HC SYNCH AUDIO-VIDEO NEW LOW 30

Facility

$415.00

Service Code	CPT 98001
Hospital Charge Code	5109800101
Hospital Revenue Code	510
Min. Negotiated Rate	$184.48
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$228.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$207.50
Rate for Payer: Aetna Government	$207.50
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	$207.50
Rate for Payer: Hamaspik Choice Inc Medicare	$207.50
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-VIDEO NEW MOD 45

Facility

$415.00

Service Code	CPT 98002
Hospital Charge Code	5109800201
Hospital Revenue Code	510
Min. Negotiated Rate	$207.50
Max. Negotiated Rate	$207.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.50

HC SYNCH AUDIO-VIDEO NEW MOD 45

Facility

$415.00

Service Code	CPT 98002
Hospital Charge Code	5109800201
Hospital Revenue Code	510
Min. Negotiated Rate	$184.48
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$228.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$207.50
Rate for Payer: Aetna Government	$207.50
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	$207.50
Rate for Payer: Hamaspik Choice Inc Medicare	$207.50
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-VIDEO NEW SF 15

Facility

$373.00

Service Code	CPT 98000
Hospital Charge Code	5109800001
Hospital Revenue Code	510
Min. Negotiated Rate	$184.48
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$205.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$186.50
Rate for Payer: Aetna Government	$186.50
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	$186.50
Rate for Payer: Hamaspik Choice Inc Medicare	$186.50
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-VIDEO NEW SF 15

Facility

$373.00

Service Code	CPT 98000
Hospital Charge Code	5109800001
Hospital Revenue Code	510
Min. Negotiated Rate	$186.50
Max. Negotiated Rate	$186.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$186.50

HC SYNTHETIC SENTENCE ID TEST

Facility

$101.00

Service Code	CPT 92576
Hospital Charge Code	4719257601
Hospital Revenue Code	471
Min. Negotiated Rate	$33.57
Max. Negotiated Rate	$158.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$47.96
Rate for Payer: Aetna Government	$47.96
Rate for Payer: Affinity Essential Plan 1&2	$33.57
Rate for Payer: Affinity Essential Plan 3&4	$33.57
Rate for Payer: Affinity Medicaid/CHP/HARP	$33.57
Rate for Payer: Brighton Health Commercial	$75.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$47.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.68
Rate for Payer: Elderplan Medicare Advantage	$47.96
Rate for Payer: EmblemHealth Commercial	$47.96
Rate for Payer: Fidelis CHP/HARP/Medicaid	$43.16
Rate for Payer: Fidelis Essential Plan Aliesa	$40.77
Rate for Payer: Fidelis Essential Plan QHP	$42.68
Rate for Payer: Fidelis Medicare Advantage	$47.96
Rate for Payer: Fidelis Qualified Health Plan	$42.68
Rate for Payer: Group Health Inc Commercial	$47.96
Rate for Payer: Group Health Inc Medicare	$47.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.96
Rate for Payer: Hamaspik Choice Inc Medicare	$47.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$53.02
Rate for Payer: Healthfirst Medicare Advantage	$40.77
Rate for Payer: Healthfirst QHP	$47.96
Rate for Payer: Humana Medicare	$48.92
Rate for Payer: Senior Whole Health Medicare Advantage	$47.96
Rate for Payer: United Healthcare Commercial	$158.00
Rate for Payer: United Healthcare Medicare Advantage	$47.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$47.96
Rate for Payer: Wellcare CHP/FHP/Medicaid	$45.56
Rate for Payer: Wellcare Medicare	$45.56

HC SYNTHETIC SENTENCE ID TEST

Facility

$101.00

Service Code	CPT 92576
Hospital Charge Code	4719257601
Hospital Revenue Code	471
Min. Negotiated Rate	$50.50
Max. Negotiated Rate	$50.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.50

HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - RAPID PLASMA REAGIN-SYP

Facility

$10.00

Service Code	CPT 86592
Hospital Charge Code	3028659202
Hospital Revenue Code	302
Min. Negotiated Rate	$2.99
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	$3.30
Rate for Payer: Healthfirst Essential Plan	$7.42
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	$3.30
Rate for Payer: Wellcare Medicare	$3.84

HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - RAPID PLASMA REAGIN-SYP

Facility

$10.00

Service Code	CPT 86592
Hospital Charge Code	3028659202
Hospital Revenue Code	302
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$5.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00

HC SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL - VDRL

Facility

$10.00

Service Code	CPT 86592
Hospital Charge Code	3028659203
Hospital Revenue Code	302
Min. Negotiated Rate	$2.99
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	$3.30
Rate for Payer: Healthfirst Essential Plan	$7.42
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	$3.30
Rate for Payer: Wellcare Medicare	$3.84

Know your out-of-pocket cost for care.

All Charges