St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC VASC ILIAC ART ANGIO,CARDIAC CATH

Facility

$934.00

Service Code	CPT G0278
Hospital Charge Code	921G027801
Hospital Revenue Code	921
Min. Negotiated Rate	$467.00
Max. Negotiated Rate	$467.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$467.00

HC VASC LEFT HEART CATH BY TRANSEPTAL PUNCTURE

Facility

$8,094.00

Service Code	CPT 93462
Hospital Charge Code	9219346201
Hospital Revenue Code	921
Min. Negotiated Rate	$195.09
Max. Negotiated Rate	$6,475.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$195.09
Rate for Payer: Aetna Government	$195.09
Rate for Payer: Brighton Health Commercial	$6,070.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,475.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,503.92
Rate for Payer: EmblemHealth Commercial	$4,047.00
Rate for Payer: Group Health Inc Commercial	$4,047.00
Rate for Payer: Group Health Inc Medicare	$2,832.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,047.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,047.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$238.02
Rate for Payer: United Healthcare Commercial	$4,047.00

HC VASC LEFT HEART CATH BY TRANSEPTAL PUNCTURE

Facility

$8,094.00

Service Code	CPT 93462
Hospital Charge Code	9219346201
Hospital Revenue Code	921
Min. Negotiated Rate	$4,047.00
Max. Negotiated Rate	$4,047.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,047.00

HC VASC NON-INVASIVE LOWER EXTREM ART STRESS/REST, COMPLETE,BILATERAL

Facility

$419.00

Service Code	CPT 93924 50
Hospital Charge Code	9219392401
Hospital Revenue Code	921
Min. Negotiated Rate	$134.77
Max. Negotiated Rate	$335.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.77
Rate for Payer: Aetna Government	$134.77
Rate for Payer: Brighton Health Commercial	$314.25
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: United Healthcare Commercial	$209.50

HC VASC NON-INVASIVE LOWER EXTREM ART STRESS/REST, COMPLETE,BILATERAL

Facility

$419.00

Service Code	CPT 93924 50
Hospital Charge Code	9219392401
Hospital Revenue Code	921
Min. Negotiated Rate	$209.50
Max. Negotiated Rate	$209.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.50

HC VASC NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVELS

Facility

$419.00

Service Code	CPT 93923
Hospital Charge Code	9219392301
Hospital Revenue Code	921
Min. Negotiated Rate	$133.82
Max. Negotiated Rate	$335.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$191.17
Rate for Payer: Aetna Government	$191.17
Rate for Payer: Affinity Essential Plan 1&2	$133.82
Rate for Payer: Affinity Essential Plan 3&4	$133.82
Rate for Payer: Affinity Medicaid/CHP/HARP	$133.82
Rate for Payer: Brighton Health Commercial	$314.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$191.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$335.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.92
Rate for Payer: Elderplan Medicare Advantage	$191.17
Rate for Payer: EmblemHealth Commercial	$191.17
Rate for Payer: Fidelis CHP/HARP/Medicaid	$172.05
Rate for Payer: Fidelis Essential Plan Aliesa	$162.49
Rate for Payer: Fidelis Essential Plan QHP	$170.14
Rate for Payer: Fidelis Medicare Advantage	$191.17
Rate for Payer: Fidelis Qualified Health Plan	$170.14
Rate for Payer: Group Health Inc Commercial	$191.17
Rate for Payer: Group Health Inc Medicare	$191.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$191.17
Rate for Payer: Hamaspik Choice Inc Medicare	$191.17
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$150.87
Rate for Payer: Healthfirst Medicare Advantage	$162.49
Rate for Payer: Healthfirst QHP	$191.17
Rate for Payer: Humana Medicare	$194.99
Rate for Payer: Senior Whole Health Medicare Advantage	$191.17
Rate for Payer: United Healthcare Commercial	$209.50
Rate for Payer: United Healthcare Medicare Advantage	$191.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$191.17
Rate for Payer: Wellcare CHP/FHP/Medicaid	$181.61
Rate for Payer: Wellcare Medicare	$181.61

HC VASC NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVELS

Facility

$419.00

Service Code	CPT 93923
Hospital Charge Code	9219392301
Hospital Revenue Code	921
Min. Negotiated Rate	$209.50
Max. Negotiated Rate	$209.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.50

HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL

Facility

$339.00

Service Code	CPT 93922
Hospital Charge Code	9219392203
Hospital Revenue Code	921
Min. Negotiated Rate	$95.16
Max. Negotiated Rate	$271.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$157.49
Rate for Payer: Aetna Government	$157.49
Rate for Payer: Affinity Essential Plan 1&2	$110.24
Rate for Payer: Affinity Essential Plan 3&4	$110.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$110.24
Rate for Payer: Brighton Health Commercial	$254.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$157.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.52
Rate for Payer: Elderplan Medicare Advantage	$157.49
Rate for Payer: EmblemHealth Commercial	$157.49
Rate for Payer: Fidelis CHP/HARP/Medicaid	$141.74
Rate for Payer: Fidelis Essential Plan Aliesa	$133.87
Rate for Payer: Fidelis Essential Plan QHP	$140.17
Rate for Payer: Fidelis Medicare Advantage	$157.49
Rate for Payer: Fidelis Qualified Health Plan	$140.17
Rate for Payer: Group Health Inc Commercial	$157.49
Rate for Payer: Group Health Inc Medicare	$157.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$157.49
Rate for Payer: Hamaspik Choice Inc Medicare	$157.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$95.16
Rate for Payer: Healthfirst Medicare Advantage	$133.87
Rate for Payer: Healthfirst QHP	$157.49
Rate for Payer: Humana Medicare	$160.64
Rate for Payer: Senior Whole Health Medicare Advantage	$157.49
Rate for Payer: United Healthcare Commercial	$169.50
Rate for Payer: United Healthcare Medicare Advantage	$157.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$157.49
Rate for Payer: Wellcare CHP/FHP/Medicaid	$149.62
Rate for Payer: Wellcare Medicare	$149.62

HC VASC NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 1-2 LEVEL

Facility

$339.00

Service Code	CPT 93922
Hospital Charge Code	9219392203
Hospital Revenue Code	921
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$169.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50

HC VASC RECON, CTA FOR SURG PLAN

Facility

$146.00

Service Code	CPT G0288
Hospital Charge Code	921G028801
Hospital Revenue Code	921
Min. Negotiated Rate	$73.00
Max. Negotiated Rate	$73.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.00

HC VASC RECON, CTA FOR SURG PLAN

Facility

$146.00

Service Code	CPT G0288
Hospital Charge Code	921G028801
Hospital Revenue Code	921
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$116.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.85
Rate for Payer: Aetna Government	$23.85
Rate for Payer: Brighton Health Commercial	$109.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$116.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.28
Rate for Payer: EmblemHealth Commercial	$73.00
Rate for Payer: Group Health Inc Commercial	$73.00
Rate for Payer: Group Health Inc Medicare	$51.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.00
Rate for Payer: Hamaspik Choice Inc Medicare	$73.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$55.95
Rate for Payer: United Healthcare Commercial	$73.00

HC VASC TRANSCRAN DOPP INTRACRAN, EMBOLI W/INJ

Facility

$339.00

Service Code	CPT 93893
Hospital Charge Code	9219389301
Hospital Revenue Code	921
Min. Negotiated Rate	$90.95
Max. Negotiated Rate	$385.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$129.93
Rate for Payer: Aetna Government	$129.93
Rate for Payer: Affinity Essential Plan 1&2	$90.95
Rate for Payer: Affinity Essential Plan 3&4	$90.95
Rate for Payer: Affinity Medicaid/CHP/HARP	$90.95
Rate for Payer: Brighton Health Commercial	$254.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$129.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.52
Rate for Payer: Elderplan Medicare Advantage	$129.93
Rate for Payer: EmblemHealth Commercial	$129.93
Rate for Payer: Fidelis CHP/HARP/Medicaid	$116.94
Rate for Payer: Fidelis Essential Plan Aliesa	$110.44
Rate for Payer: Fidelis Essential Plan QHP	$115.64
Rate for Payer: Fidelis Medicare Advantage	$129.93
Rate for Payer: Fidelis Qualified Health Plan	$115.64
Rate for Payer: Group Health Inc Commercial	$129.93
Rate for Payer: Group Health Inc Medicare	$129.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$129.93
Rate for Payer: Hamaspik Choice Inc Medicare	$129.93
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$385.82
Rate for Payer: Healthfirst Medicare Advantage	$110.44
Rate for Payer: Healthfirst QHP	$129.93
Rate for Payer: Humana Medicare	$132.53
Rate for Payer: Senior Whole Health Medicare Advantage	$129.93
Rate for Payer: United Healthcare Commercial	$169.50
Rate for Payer: United Healthcare Medicare Advantage	$129.93
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$129.93
Rate for Payer: Wellcare CHP/FHP/Medicaid	$123.43
Rate for Payer: Wellcare Medicare	$123.43

HC VASC TRANSCRAN DOPP INTRACRAN, EMBOLI W/INJ

Facility

$339.00

Service Code	CPT 93893
Hospital Charge Code	9219389301
Hospital Revenue Code	921
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$169.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50

HC VASC TRANSCRAN DOPPLER INTRACRAN ART

Facility

$705.00

Service Code	CPT 93886
Hospital Charge Code	9219388602
Hospital Revenue Code	921
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.50

HC VASC TRANSCRAN DOPPLER INTRACRAN ART

Facility

$705.00

Service Code	CPT 93886
Hospital Charge Code	9219388602
Hospital Revenue Code	921
Min. Negotiated Rate	$206.74
Max. Negotiated Rate	$564.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$387.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$295.34
Rate for Payer: Aetna Government	$295.34
Rate for Payer: Affinity Essential Plan 1&2	$206.74
Rate for Payer: Affinity Essential Plan 3&4	$206.74
Rate for Payer: Affinity Medicaid/CHP/HARP	$206.74
Rate for Payer: Brighton Health Commercial	$528.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$295.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$564.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$479.40
Rate for Payer: Elderplan Medicare Advantage	$295.34
Rate for Payer: EmblemHealth Commercial	$295.34
Rate for Payer: Fidelis CHP/HARP/Medicaid	$265.81
Rate for Payer: Fidelis Essential Plan Aliesa	$251.04
Rate for Payer: Fidelis Essential Plan QHP	$262.85
Rate for Payer: Fidelis Medicare Advantage	$295.34
Rate for Payer: Fidelis Qualified Health Plan	$262.85
Rate for Payer: Group Health Inc Commercial	$295.34
Rate for Payer: Group Health Inc Medicare	$295.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$295.34
Rate for Payer: Hamaspik Choice Inc Medicare	$295.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$295.79
Rate for Payer: Healthfirst Medicare Advantage	$251.04
Rate for Payer: Healthfirst QHP	$295.34
Rate for Payer: Humana Medicare	$301.25
Rate for Payer: Senior Whole Health Medicare Advantage	$295.34
Rate for Payer: United Healthcare Commercial	$352.50
Rate for Payer: United Healthcare Medicare Advantage	$295.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$295.34
Rate for Payer: Wellcare CHP/FHP/Medicaid	$280.57
Rate for Payer: Wellcare Medicare	$280.57

HC VASC TRANSCRAN DOPPL INTRACRAN, VASOREACT

Facility

$705.00

Service Code	CPT 93890
Hospital Charge Code	9219389001
Hospital Revenue Code	921
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.50

HC VASC TRANSCRAN DOPPL INTRACRAN, VASOREACT

Facility

$705.00

Service Code	CPT 93890
Hospital Charge Code	9219389001
Hospital Revenue Code	921
Min. Negotiated Rate	$180.73
Max. Negotiated Rate	$564.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$387.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.73
Rate for Payer: Aetna Government	$180.73
Rate for Payer: Brighton Health Commercial	$528.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$564.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$479.40
Rate for Payer: EmblemHealth Commercial	$352.50
Rate for Payer: Group Health Inc Commercial	$352.50
Rate for Payer: Group Health Inc Medicare	$246.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.50
Rate for Payer: Hamaspik Choice Inc Medicare	$352.50
Rate for Payer: United Healthcare Commercial	$352.50

HC VASCULAR BIOPSY - IR TRANSCATHETER BIOPSY

Facility

$1,528.00

Service Code	CPT 75970 TC
Hospital Charge Code	3207597001
Hospital Revenue Code	320
Min. Negotiated Rate	$332.66
Max. Negotiated Rate	$1,222.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$840.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$332.66
Rate for Payer: Aetna Government	$332.66
Rate for Payer: Brighton Health Commercial	$1,146.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,222.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,039.04
Rate for Payer: EmblemHealth Commercial	$764.00
Rate for Payer: Group Health Inc Commercial	$764.00
Rate for Payer: Group Health Inc Medicare	$534.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$764.00
Rate for Payer: Hamaspik Choice Inc Medicare	$764.00
Rate for Payer: Healthfirst Essential Plan	$763.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$339.46

HC VASCULAR BIOPSY - IR TRANSCATHETER BIOPSY

Facility

$1,528.00

Service Code	CPT 75970 TC
Hospital Charge Code	3207597001
Hospital Revenue Code	320
Min. Negotiated Rate	$764.00
Max. Negotiated Rate	$764.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$764.00

HC VASCULAR EMBOL/OCCLSN, ARTERIAL

Facility

$30,010.00

Service Code	CPT 37242 TC
Hospital Charge Code	3613724201
Hospital Revenue Code	361
Min. Negotiated Rate	$15,005.00
Max. Negotiated Rate	$15,005.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,005.00

HC VASCULAR EMBOL/OCCLSN, ARTERIAL

Facility

$30,010.00

Service Code	CPT 37242 TC
Hospital Charge Code	3613724201
Hospital Revenue Code	361
Min. Negotiated Rate	$535.62
Max. Negotiated Rate	$22,507.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$535.62
Rate for Payer: Aetna Government	$535.62
Rate for Payer: Brighton Health Commercial	$22,507.50
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	$15,005.00
Rate for Payer: Group Health Inc Commercial	$15,005.00
Rate for Payer: Group Health Inc Medicare	$10,503.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,005.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11,860.98
Rate for Payer: United Healthcare Commercial	$3,190.00

HC VASCULAR EMBOL/OCCLSN, ART/VEN HEMORRHAGE OR EXTRAVERSION

Facility

$30,010.00

Service Code	CPT 37244 TC
Hospital Charge Code	3613724401
Hospital Revenue Code	361
Min. Negotiated Rate	$15,005.00
Max. Negotiated Rate	$15,005.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,005.00

HC VASCULAR EMBOL/OCCLSN, ART/VEN HEMORRHAGE OR EXTRAVERSION

Facility

$30,010.00

Service Code	CPT 37244 TC
Hospital Charge Code	3613724401
Hospital Revenue Code	361
Min. Negotiated Rate	$2,485.00
Max. Negotiated Rate	$22,507.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7,338.83
Rate for Payer: Aetna Government	$7,338.83
Rate for Payer: Brighton Health Commercial	$22,507.50
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	$15,005.00
Rate for Payer: Group Health Inc Commercial	$15,005.00
Rate for Payer: Group Health Inc Medicare	$10,503.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,005.00
Rate for Payer: Hamaspik Choice Inc Medicare	$15,005.00
Rate for Payer: United Healthcare Commercial	$3,190.00

HC VASCULAR EMBOL/OCCLSN, TUMORS/ISCHEMIA/INFARCTION

Facility

$30,948.00

Service Code	CPT 37243 TC
Hospital Charge Code	3613724301
Hospital Revenue Code	361
Min. Negotiated Rate	$15,474.00
Max. Negotiated Rate	$15,474.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,474.00

HC VASCULAR EMBOL/OCCLSN, TUMORS/ISCHEMIA/INFARCTION

Facility

$30,948.00

Service Code	CPT 37243 TC
Hospital Charge Code	3613724301
Hospital Revenue Code	361
Min. Negotiated Rate	$2,628.64
Max. Negotiated Rate	$23,211.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10,546.43
Rate for Payer: Aetna Government	$10,546.43
Rate for Payer: Brighton Health Commercial	$23,211.00
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	$15,474.00
Rate for Payer: Group Health Inc Commercial	$15,474.00
Rate for Payer: Group Health Inc Medicare	$10,831.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,474.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,530.20
Rate for Payer: United Healthcare Commercial	$3,190.00

Know your out-of-pocket cost for care.

All Charges