St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC TRACH TUBE CHANGE

Facility

$616.00

Service Code	CPT 31502
Hospital Charge Code	3613150201
Hospital Revenue Code	361
Min. Negotiated Rate	$38.98
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$283.73
Rate for Payer: Aetna Government	$283.73
Rate for Payer: Affinity Essential Plan 1&2	$198.61
Rate for Payer: Affinity Essential Plan 3&4	$198.61
Rate for Payer: Affinity Medicaid/CHP/HARP	$198.61
Rate for Payer: Brighton Health Commercial	$462.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$283.73
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	$283.73
Rate for Payer: EmblemHealth Commercial	$283.73
Rate for Payer: Fidelis CHP/HARP/Medicaid	$255.36
Rate for Payer: Fidelis Essential Plan Aliesa	$241.17
Rate for Payer: Fidelis Essential Plan QHP	$252.52
Rate for Payer: Fidelis Medicare Advantage	$283.73
Rate for Payer: Fidelis Qualified Health Plan	$252.52
Rate for Payer: Group Health Inc Commercial	$283.73
Rate for Payer: Group Health Inc Medicare	$283.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$283.73
Rate for Payer: Hamaspik Choice Inc Medicare	$124.13
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$38.98
Rate for Payer: Healthfirst Medicare Advantage	$241.17
Rate for Payer: Healthfirst QHP	$283.73
Rate for Payer: Humana Medicare	$289.40
Rate for Payer: Senior Whole Health Medicare Advantage	$283.73
Rate for Payer: United Healthcare Commercial	$1,113.00
Rate for Payer: United Healthcare Medicare Advantage	$283.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$283.73
Rate for Payer: Wellcare CHP/FHP/Medicaid	$269.54
Rate for Payer: Wellcare Medicare	$269.54

HC TRACH TUBE CHANGE

Facility

$616.00

Service Code	CPT 31502
Hospital Charge Code	3613150201
Hospital Revenue Code	361
Min. Negotiated Rate	$308.00
Max. Negotiated Rate	$308.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$308.00

HC TRANSCATHETER BIOPSY

Facility

$13,920.00

Service Code	CPT 37200 TC
Hospital Charge Code	3613720001
Hospital Revenue Code	361
Min. Negotiated Rate	$234.13
Max. Negotiated Rate	$10,440.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$234.13
Rate for Payer: Aetna Government	$234.13
Rate for Payer: Brighton Health Commercial	$10,440.00
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	$6,960.00
Rate for Payer: Group Health Inc Commercial	$6,960.00
Rate for Payer: Group Health Inc Medicare	$4,872.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,009.55
Rate for Payer: United Healthcare Commercial	$2,546.00

HC TRANSCATHETER BIOPSY

Facility

$13,920.00

Service Code	CPT 37200 TC
Hospital Charge Code	3613720001
Hospital Revenue Code	361
Min. Negotiated Rate	$6,960.00
Max. Negotiated Rate	$6,960.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.00

HC TRANSCATH PLCMNT INTRAVASCULAR STENT

Facility

$9,552.00

Service Code	CPT 61635 TC
Hospital Charge Code	3616163501
Hospital Revenue Code	361
Min. Negotiated Rate	$4,776.00
Max. Negotiated Rate	$4,776.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,776.00

HC TRANSCATH PLCMNT INTRAVASCULAR STENT

Facility

$9,552.00

Service Code	CPT 61635 TC
Hospital Charge Code	3616163501
Hospital Revenue Code	361
Min. Negotiated Rate	$1,496.00
Max. Negotiated Rate	$7,164.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,253.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,724.47
Rate for Payer: Aetna Government	$1,724.47
Rate for Payer: Brighton Health Commercial	$7,164.00
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	$4,776.00
Rate for Payer: Group Health Inc Commercial	$4,776.00
Rate for Payer: Group Health Inc Medicare	$3,343.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,776.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,776.00
Rate for Payer: United Healthcare Commercial	$1,496.00

HC TRANSCATH RETRIEVAL FOREIGN BODY, PERCUTANEOUS

Facility

$8,393.00

Service Code	CPT 37197 TC
Hospital Charge Code	3613719701
Hospital Revenue Code	361
Min. Negotiated Rate	$1,588.69
Max. Negotiated Rate	$6,294.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,646.50
Rate for Payer: Aetna Government	$1,646.50
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 TRANSCATH RETRIEVAL FOREIGN BODY, PERCUTANEOUS

Facility

$8,393.00

Service Code	CPT 37197 TC
Hospital Charge Code	3613719701
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 TRANSCATH STENT CERVICAL CAROTID ARTERY, W/EMBOLIC PROTECTION

Facility

$8,432.00

Service Code	CPT 37215 TC
Hospital Charge Code	3613721501
Hospital Revenue Code	361
Min. Negotiated Rate	$4,216.00
Max. Negotiated Rate	$4,216.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,216.00

HC TRANSCATH STENT CERVICAL CAROTID ARTERY, W/EMBOLIC PROTECTION

Facility

$8,432.00

Service Code	CPT 37215 TC
Hospital Charge Code	3613721501
Hospital Revenue Code	361
Min. Negotiated Rate	$1,132.16
Max. Negotiated Rate	$6,324.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,637.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,132.16
Rate for Payer: Aetna Government	$1,132.16
Rate for Payer: Brighton Health Commercial	$6,324.00
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	$4,216.00
Rate for Payer: Group Health Inc Commercial	$4,216.00
Rate for Payer: Group Health Inc Medicare	$2,951.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,216.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,216.00
Rate for Payer: United Healthcare Commercial	$1,496.00

HC TRANSCATH STENT CERVICAL CAROTID ARTERY, W/O EMBOLIC PROTECTION

Facility

$8,432.00

Service Code	CPT 37216 TC
Hospital Charge Code	3613721601
Hospital Revenue Code	361
Min. Negotiated Rate	$4,216.00
Max. Negotiated Rate	$4,216.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,216.00

HC TRANSCATH STENT CERVICAL CAROTID ARTERY, W/O EMBOLIC PROTECTION

Facility

$8,432.00

Service Code	CPT 37216 TC
Hospital Charge Code	3613721601
Hospital Revenue Code	361
Min. Negotiated Rate	$1,496.00
Max. Negotiated Rate	$6,324.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,614.84
Rate for Payer: Aetna Government	$4,614.84
Rate for Payer: Brighton Health Commercial	$6,324.00
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	$4,216.00
Rate for Payer: Group Health Inc Commercial	$4,216.00
Rate for Payer: Group Health Inc Medicare	$2,951.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,216.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,216.00
Rate for Payer: United Healthcare Commercial	$1,496.00

HC TRANSCATH STENT PLACEMT, CAROTID, ANTEGRADE

Facility

$6,859.00

Service Code	CPT 37218 TC
Hospital Charge Code	3613721801
Hospital Revenue Code	361
Min. Negotiated Rate	$3,429.50
Max. Negotiated Rate	$3,429.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,429.50

HC TRANSCATH STENT PLACEMT, CAROTID, ANTEGRADE

Facility

$6,859.00

Service Code	CPT 37218 TC
Hospital Charge Code	3613721801
Hospital Revenue Code	361
Min. Negotiated Rate	$917.96
Max. Negotiated Rate	$5,144.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,772.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$917.96
Rate for Payer: Aetna Government	$917.96
Rate for Payer: Brighton Health Commercial	$5,144.25
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	$3,429.50
Rate for Payer: Group Health Inc Commercial	$3,429.50
Rate for Payer: Group Health Inc Medicare	$2,400.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,429.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,429.50
Rate for Payer: United Healthcare Commercial	$1,496.00

HC TRANSCATH STENT PLACEMT, CAROTID, RETROGRADE

Facility

$9,114.00

Service Code	CPT 37217 TC
Hospital Charge Code	3613721701
Hospital Revenue Code	361
Min. Negotiated Rate	$4,557.00
Max. Negotiated Rate	$4,557.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,557.00

HC TRANSCATH STENT PLACEMT, CAROTID, RETROGRADE

Facility

$9,114.00

Service Code	CPT 37217 TC
Hospital Charge Code	3613721701
Hospital Revenue Code	361
Min. Negotiated Rate	$1,235.36
Max. Negotiated Rate	$6,835.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,012.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,235.36
Rate for Payer: Aetna Government	$1,235.36
Rate for Payer: Brighton Health Commercial	$6,835.50
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	$4,557.00
Rate for Payer: Group Health Inc Commercial	$4,557.00
Rate for Payer: Group Health Inc Medicare	$3,189.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,557.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,557.00
Rate for Payer: United Healthcare Commercial	$1,496.00

HC TRANSCATH THERAPY, ARTERIAL INFUSION FOR THROMBOLYSIS

Facility

$13,920.00

Service Code	CPT 37211 TC
Hospital Charge Code	3613721101
Hospital Revenue Code	361
Min. Negotiated Rate	$441.24
Max. Negotiated Rate	$10,440.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$441.24
Rate for Payer: Aetna Government	$441.24
Rate for Payer: Brighton Health Commercial	$10,440.00
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	$6,960.00
Rate for Payer: Group Health Inc Commercial	$6,960.00
Rate for Payer: Group Health Inc Medicare	$4,872.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,987.18
Rate for Payer: United Healthcare Commercial	$2,546.00

HC TRANSCATH THERAPY, ARTERIAL INFUSION FOR THROMBOLYSIS

Facility

$13,920.00

Service Code	CPT 37211 TC
Hospital Charge Code	3613721101
Hospital Revenue Code	361
Min. Negotiated Rate	$6,960.00
Max. Negotiated Rate	$6,960.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.00

HC TRANSCATH THERAPY, ART/VEN INFUSION FOR THROMBOLYSIS, NONCORONARY

Facility

$4,940.00

Service Code	CPT 37213 TC
Hospital Charge Code	3613721301
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 TRANSCATH THERAPY, ART/VEN INFUSION FOR THROMBOLYSIS, NONCORONARY

Facility

$4,940.00

Service Code	CPT 37213 TC
Hospital Charge Code	3613721301
Hospital Revenue Code	361
Min. Negotiated Rate	$269.85
Max. Negotiated Rate	$3,705.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$269.85
Rate for Payer: Aetna Government	$269.85
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	$2,470.00
Rate for Payer: United Healthcare Commercial	$1,188.00

HC TRANSCATH THERAPY, VENOUS INFUSION FOR THROMBOLYSIS

Facility

$8,393.00

Service Code	CPT 37212 TC
Hospital Charge Code	3613721201
Hospital Revenue Code	361
Min. Negotiated Rate	$387.05
Max. Negotiated Rate	$6,294.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$387.05
Rate for Payer: Aetna Government	$387.05
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 TRANSCATH THERAPY, VENOUS INFUSION FOR THROMBOLYSIS

Facility

$8,393.00

Service Code	CPT 37212 TC
Hospital Charge Code	3613721201
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 TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE

Facility

$1,147.00

Service Code	CPT 74742 TC
Hospital Charge Code	3207474201
Hospital Revenue Code	320
Min. Negotiated Rate	$573.50
Max. Negotiated Rate	$573.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$573.50

HC TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE

Facility

$1,147.00

Service Code	CPT 74742 TC
Hospital Charge Code	3207474201
Hospital Revenue Code	320
Min. Negotiated Rate	$44.65
Max. Negotiated Rate	$917.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$630.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.65
Rate for Payer: Aetna Government	$44.65
Rate for Payer: Brighton Health Commercial	$860.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$917.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$779.96
Rate for Payer: EmblemHealth Commercial	$573.50
Rate for Payer: Group Health Inc Commercial	$573.50
Rate for Payer: Group Health Inc Medicare	$401.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$573.50
Rate for Payer: Hamaspik Choice Inc Medicare	$573.50
Rate for Payer: Healthfirst Essential Plan	$217.17
Rate for Payer: Wellcare CHP/FHP/Medicaid	$96.52

HC TRANSCERVICAL INTRODUCTION FALLOPIAN TUBE CATHETER

Facility

$7,566.00

Service Code	CPT 58345 TC
Hospital Charge Code	3615834501
Hospital Revenue Code	361
Min. Negotiated Rate	$334.33
Max. Negotiated Rate	$5,674.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$334.33
Rate for Payer: Aetna Government	$334.33
Rate for Payer: Brighton Health Commercial	$5,674.50
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	$3,783.00
Rate for Payer: Group Health Inc Commercial	$3,783.00
Rate for Payer: Group Health Inc Medicare	$2,648.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,783.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,674.26
Rate for Payer: United Healthcare Commercial	$1,468.00

Know your out-of-pocket cost for care.

All Charges