St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

EPIDIDYMECTOMY

Facility

$9,142.40

Service Code	HCPCS 54861
Hospital Charge Code	40122985
Hospital Revenue Code	360
Rate for Payer: Cash Price	$4,031.47

EPIDURAL BLOOD CLOT PATCH

Facility

$1,893.13

Service Code	HCPCS 62273
Hospital Charge Code	40009628
Hospital Revenue Code	360
Min. Negotiated Rate	$559.80
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$799.72
Rate for Payer: Aetna Government	$799.72
Rate for Payer: Affinity Essential Plan 1&2	$559.80
Rate for Payer: Affinity Essential Plan 3&4	$559.80
Rate for Payer: Affinity Medicaid/CHP/HARP	$559.80
Rate for Payer: Brighton Health Commercial	$1,419.85
Rate for Payer: Cash Price	$799.72
Rate for Payer: Cash Price	$799.72
Rate for Payer: Cash Price	$799.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$799.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$799.72
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$679.76
Rate for Payer: Fidelis Essential Plan QHP	$711.75
Rate for Payer: Fidelis Medicare Advantage	$799.72
Rate for Payer: Fidelis Qualified Health Plan	$711.75
Rate for Payer: Group Health Inc Commercial	$799.72
Rate for Payer: Group Health Inc Medicare	$799.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$946.56
Rate for Payer: Hamaspik Choice Inc Medicare	$799.72
Rate for Payer: Healthfirst Medicare Advantage	$679.76
Rate for Payer: Healthfirst QHP	$799.72
Rate for Payer: Humana Medicare	$815.71
Rate for Payer: Senior Whole Health Medicare Advantage	$799.72
Rate for Payer: United Healthcare Commercial	$1,188.00
Rate for Payer: United Healthcare Medicare Advantage	$799.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$799.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$639.78
Rate for Payer: Wellcare Medicare	$759.73

EPIDURAL BLOOD CLOT PATCH

Facility

$1,893.13

Service Code	HCPCS 62273
Hospital Charge Code	40009628
Hospital Revenue Code	360
Rate for Payer: Cash Price	$799.72

EPIDURAL BLOOD PATCH

Facility

$1,893.13

Service Code	HCPCS 62273
Hospital Charge Code	41101549
Hospital Revenue Code	361
Rate for Payer: Cash Price	$799.72

EPIDURAL BLOOD PATCH

Facility

$1,893.13

Service Code	HCPCS 62273
Hospital Charge Code	41101549
Hospital Revenue Code	361
Min. Negotiated Rate	$559.80
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$799.72
Rate for Payer: Aetna Government	$799.72
Rate for Payer: Affinity Essential Plan 1&2	$559.80
Rate for Payer: Affinity Essential Plan 3&4	$559.80
Rate for Payer: Affinity Medicaid/CHP/HARP	$559.80
Rate for Payer: Brighton Health Commercial	$1,419.85
Rate for Payer: Cash Price	$799.72
Rate for Payer: Cash Price	$799.72
Rate for Payer: Cash Price	$799.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$799.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$799.72
Rate for Payer: EmblemHealth Commercial	$799.72
Rate for Payer: Fidelis Essential Plan Aliesa	$679.76
Rate for Payer: Fidelis Essential Plan QHP	$711.75
Rate for Payer: Fidelis Medicare Advantage	$799.72
Rate for Payer: Fidelis Qualified Health Plan	$711.75
Rate for Payer: Group Health Inc Commercial	$799.72
Rate for Payer: Group Health Inc Medicare	$799.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$946.56
Rate for Payer: Hamaspik Choice Inc Medicare	$799.72
Rate for Payer: Healthfirst Medicare Advantage	$679.76
Rate for Payer: Healthfirst QHP	$799.72
Rate for Payer: Humana Medicare	$815.71
Rate for Payer: Senior Whole Health Medicare Advantage	$799.72
Rate for Payer: United Healthcare Commercial	$1,188.00
Rate for Payer: United Healthcare Medicare Advantage	$799.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$799.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$639.78
Rate for Payer: Wellcare Medicare	$759.73

EPIDURAL LYSIS ON SINGLE DAY

Facility

$2,459.50

Service Code	HCPCS 62264
Hospital Charge Code	40004069
Hospital Revenue Code	360
Rate for Payer: Cash Price	$1,054.06

EPIDURAL LYSIS ON SINGLE DAY

Facility

$2,459.50

Service Code	HCPCS 62264
Hospital Charge Code	40004069
Hospital Revenue Code	360
Min. Negotiated Rate	$737.84
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,054.06
Rate for Payer: Aetna Government	$1,054.06
Rate for Payer: Affinity Essential Plan 1&2	$737.84
Rate for Payer: Affinity Essential Plan 3&4	$737.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$737.84
Rate for Payer: Brighton Health Commercial	$1,844.62
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,054.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$1,054.06
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$895.95
Rate for Payer: Fidelis Essential Plan QHP	$938.11
Rate for Payer: Fidelis Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Qualified Health Plan	$938.11
Rate for Payer: Group Health Inc Commercial	$1,054.06
Rate for Payer: Group Health Inc Medicare	$1,054.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,229.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,054.06
Rate for Payer: Healthfirst Medicare Advantage	$895.95
Rate for Payer: Healthfirst QHP	$1,054.06
Rate for Payer: Humana Medicare	$1,075.14
Rate for Payer: Senior Whole Health Medicare Advantage	$1,054.06
Rate for Payer: United Healthcare Commercial	$1,188.00
Rate for Payer: United Healthcare Medicare Advantage	$1,054.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,054.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$843.25
Rate for Payer: Wellcare Medicare	$1,001.36

EPIFIX 14MM DISK

Facility

$53.00

Service Code	HCPCS Q4186
Hospital Charge Code	64905605
Hospital Revenue Code	636
Min. Negotiated Rate	$18.55
Max. Negotiated Rate	$162.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$155.49
Rate for Payer: Aetna Government	$155.49
Rate for Payer: Brighton Health Commercial	$31.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.48
Rate for Payer: Group Health Inc Commercial	$26.50
Rate for Payer: Group Health Inc Medicare	$18.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.50
Rate for Payer: Hamaspik Choice Inc Medicare	$26.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$162.66
Rate for Payer: SOMOS Essential	$162.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.45

EPIFIX 14MM DISK

Facility

$53.00

Service Code	HCPCS Q4186
Hospital Charge Code	64905605
Hospital Revenue Code	636
Min. Negotiated Rate	$26.50
Max. Negotiated Rate	$26.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.50
Rate for Payer: Hamaspik Choice Inc Medicare	$26.50

EPIFIX 1 SQ CM

Facility

$535.00

Service Code	HCPCS Q4186
Hospital Charge Code	30307932
Hospital Revenue Code	636
Min. Negotiated Rate	$155.49
Max. Negotiated Rate	$347.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$294.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$155.49
Rate for Payer: Aetna Government	$155.49
Rate for Payer: Brighton Health Commercial	$321.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$267.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$307.62
Rate for Payer: Group Health Inc Commercial	$267.50
Rate for Payer: Group Health Inc Medicare	$187.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$267.50
Rate for Payer: Hamaspik Choice Inc Medicare	$267.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$162.66
Rate for Payer: SOMOS Essential	$162.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$347.75

EPIFIX 1 SQ CM

Facility

$535.00

Service Code	HCPCS Q4186
Hospital Charge Code	30307932
Hospital Revenue Code	636
Min. Negotiated Rate	$267.50
Max. Negotiated Rate	$267.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$267.50
Rate for Payer: Hamaspik Choice Inc Medicare	$267.50

EPIFIX 1 SQ CM

Facility

$535.00

Service Code	HCPCS Q4186
Hospital Charge Code	42501056
Hospital Revenue Code	636
Min. Negotiated Rate	$267.50
Max. Negotiated Rate	$267.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$267.50
Rate for Payer: Hamaspik Choice Inc Medicare	$267.50

EPIFIX 1 SQ CM

Facility

$535.00

Service Code	HCPCS Q4186
Hospital Charge Code	42501056
Hospital Revenue Code	636
Min. Negotiated Rate	$155.49
Max. Negotiated Rate	$347.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$294.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$155.49
Rate for Payer: Aetna Government	$155.49
Rate for Payer: Brighton Health Commercial	$321.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$267.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$307.62
Rate for Payer: Group Health Inc Commercial	$267.50
Rate for Payer: Group Health Inc Medicare	$187.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$267.50
Rate for Payer: Hamaspik Choice Inc Medicare	$267.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$162.66
Rate for Payer: SOMOS Essential	$162.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$347.75

EPIFIX 2 X 3 CM

Facility

$497.92

Service Code	HCPCS Q4186
Hospital Charge Code	64903221
Hospital Revenue Code	636
Min. Negotiated Rate	$155.49
Max. Negotiated Rate	$323.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$273.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$155.49
Rate for Payer: Aetna Government	$155.49
Rate for Payer: Brighton Health Commercial	$298.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$248.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$286.30
Rate for Payer: Group Health Inc Commercial	$248.96
Rate for Payer: Group Health Inc Medicare	$174.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.96
Rate for Payer: Hamaspik Choice Inc Medicare	$248.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$162.66
Rate for Payer: SOMOS Essential	$162.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$323.65

EPIFIX 2 X 3 CM

Facility

$497.92

Service Code	HCPCS Q4186
Hospital Charge Code	64903221
Hospital Revenue Code	636
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$248.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.96
Rate for Payer: Hamaspik Choice Inc Medicare	$248.96

EPIFIX 4 X 4CM

Facility

$529.22

Service Code	HCPCS Q4186
Hospital Charge Code	64903222
Hospital Revenue Code	636
Min. Negotiated Rate	$264.61
Max. Negotiated Rate	$264.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$264.61
Rate for Payer: Hamaspik Choice Inc Medicare	$264.61

EPIFIX 4 X 4CM

Facility

$529.22

Service Code	HCPCS Q4186
Hospital Charge Code	64903222
Hospital Revenue Code	636
Min. Negotiated Rate	$155.49
Max. Negotiated Rate	$343.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$291.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$155.49
Rate for Payer: Aetna Government	$155.49
Rate for Payer: Brighton Health Commercial	$317.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$264.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$304.30
Rate for Payer: Group Health Inc Commercial	$264.61
Rate for Payer: Group Health Inc Medicare	$185.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$264.61
Rate for Payer: Hamaspik Choice Inc Medicare	$264.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$162.66
Rate for Payer: SOMOS Essential	$162.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$343.99

EPIFIX 5X6CM (GS-5560)

Facility

$108.33

Service Code	HCPCS Q4186
Hospital Charge Code	64901198
Hospital Revenue Code	636
Min. Negotiated Rate	$54.16
Max. Negotiated Rate	$54.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.16
Rate for Payer: Hamaspik Choice Inc Medicare	$54.16

EPIFIX 5X6CM (GS-5560)

Facility

$108.33

Service Code	HCPCS Q4186
Hospital Charge Code	64901198
Hospital Revenue Code	636
Min. Negotiated Rate	$37.92
Max. Negotiated Rate	$162.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$155.49
Rate for Payer: Aetna Government	$155.49
Rate for Payer: Brighton Health Commercial	$65.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$54.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$62.29
Rate for Payer: Group Health Inc Commercial	$54.16
Rate for Payer: Group Health Inc Medicare	$37.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.16
Rate for Payer: Hamaspik Choice Inc Medicare	$54.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$162.66
Rate for Payer: SOMOS Essential	$162.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.41

EPIFIX, PER SQ CM

Facility

$219.52

Service Code	HCPCS Q4186
Hospital Charge Code	42500457
Hospital Revenue Code	636
Min. Negotiated Rate	$109.76
Max. Negotiated Rate	$109.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.76
Rate for Payer: Hamaspik Choice Inc Medicare	$109.76

EPIFIX, PER SQ CM

Facility

$219.52

Service Code	HCPCS Q4186
Hospital Charge Code	42500457
Hospital Revenue Code	636
Min. Negotiated Rate	$76.83
Max. Negotiated Rate	$162.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$120.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$155.49
Rate for Payer: Aetna Government	$155.49
Rate for Payer: Brighton Health Commercial	$131.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$109.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$126.22
Rate for Payer: Group Health Inc Commercial	$109.76
Rate for Payer: Group Health Inc Medicare	$76.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.76
Rate for Payer: Hamaspik Choice Inc Medicare	$109.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$162.66
Rate for Payer: SOMOS Essential	$162.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$142.69

EPIFIX, PER SQ CM

Facility

$535.00

Service Code	HCPCS Q4186
Hospital Charge Code	30305451
Hospital Revenue Code	636
Min. Negotiated Rate	$155.49
Max. Negotiated Rate	$347.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$294.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$155.49
Rate for Payer: Aetna Government	$155.49
Rate for Payer: Brighton Health Commercial	$321.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$267.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$307.62
Rate for Payer: Group Health Inc Commercial	$267.50
Rate for Payer: Group Health Inc Medicare	$187.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$267.50
Rate for Payer: Hamaspik Choice Inc Medicare	$267.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$162.66
Rate for Payer: SOMOS Essential	$162.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$347.75

EPIFIX, PER SQ CM

Facility

$535.00

Service Code	HCPCS Q4186
Hospital Charge Code	30305451
Hospital Revenue Code	636
Min. Negotiated Rate	$267.50
Max. Negotiated Rate	$267.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$267.50
Rate for Payer: Hamaspik Choice Inc Medicare	$267.50

EPILATION BY FORCEPS

Facility

$330.23

Service Code	HCPCS 67820
Hospital Charge Code	42101701
Hospital Revenue Code	510
Min. Negotiated Rate	$103.40
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$147.72
Rate for Payer: Aetna Government	$147.72
Rate for Payer: Affinity Essential Plan 1&2	$103.40
Rate for Payer: Affinity Essential Plan 3&4	$103.40
Rate for Payer: Affinity Medicaid/CHP/HARP	$103.40
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$147.72
Rate for Payer: Cash Price	$147.72
Rate for Payer: Cash Price	$147.72
Rate for Payer: Cash Price	$147.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$147.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$147.72
Rate for Payer: Fidelis Essential Plan Aliesa	$125.56
Rate for Payer: Fidelis Essential Plan QHP	$131.47
Rate for Payer: Fidelis Medicare Advantage	$147.72
Rate for Payer: Fidelis Qualified Health Plan	$131.47
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	$165.12
Rate for Payer: Hamaspik Choice Inc Medicare	$147.72
Rate for Payer: Healthfirst Medicare Advantage	$125.56
Rate for Payer: Healthfirst QHP	$147.72
Rate for Payer: Humana Medicare	$150.67
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$147.72
Rate for Payer: Senior Whole Health Medicare Advantage	$147.72
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$147.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$147.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$118.18
Rate for Payer: Wellcare Medicare	$140.33

EPILATION BY FORCEPS

Facility

$330.23

Service Code	HCPCS 67820
Hospital Charge Code	42101701
Hospital Revenue Code	510
Rate for Payer: Cash Price	$147.72

Know your out-of-pocket cost for care.

All Charges