St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

EQ ADRENAL, BILAT. ART

Facility

$8,393.53

Service Code	HCPCS 75733 TC
Hospital Charge Code	41102580
Hospital Revenue Code	320
Min. Negotiated Rate	$2,580.26
Max. Negotiated Rate	$4,616.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,616.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,686.08
Rate for Payer: Aetna Government	$3,686.08
Rate for Payer: Affinity Essential Plan 1&2	$2,580.26
Rate for Payer: Affinity Essential Plan 3&4	$2,580.26
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,580.26
Rate for Payer: Brighton Health Commercial	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,686.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,056.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,432.09
Rate for Payer: Elderplan Medicare Advantage	$3,686.08
Rate for Payer: EmblemHealth Commercial	$2,580.26
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3,133.17
Rate for Payer: Fidelis Essential Plan Aliesa	$3,133.17
Rate for Payer: Fidelis Essential Plan QHP	$3,280.61
Rate for Payer: Fidelis Medicare Advantage	$3,686.08
Rate for Payer: Fidelis Qualified Health Plan	$3,280.61
Rate for Payer: Group Health Inc Commercial	$3,317.47
Rate for Payer: Group Health Inc Medicare	$3,317.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.76
Rate for Payer: Hamaspik Choice Inc Medicare	$3,686.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,317.47
Rate for Payer: Healthfirst Medicare Advantage	$3,686.08
Rate for Payer: Healthfirst QHP	$3,686.08
Rate for Payer: Humana Medicare	$3,759.80
Rate for Payer: Senior Whole Health Medicare Advantage	$3,686.08
Rate for Payer: United Healthcare Medicare Advantage	$3,686.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,686.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,948.86
Rate for Payer: Wellcare Medicare	$3,501.78

EQ ADRENAL VEN. BIL

Facility

$13,920.70

Service Code	HCPCS 75842 TC
Hospital Charge Code	41102694
Hospital Revenue Code	320
Min. Negotiated Rate	$3,432.09
Max. Negotiated Rate	$7,656.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,656.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,354.94
Rate for Payer: Aetna Government	$6,354.94
Rate for Payer: Affinity Essential Plan 1&2	$4,448.46
Rate for Payer: Affinity Essential Plan 3&4	$4,448.46
Rate for Payer: Affinity Medicaid/CHP/HARP	$4,448.46
Rate for Payer: Brighton Health Commercial	$6,354.94
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6,354.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,056.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,432.09
Rate for Payer: Elderplan Medicare Advantage	$6,354.94
Rate for Payer: EmblemHealth Commercial	$4,448.46
Rate for Payer: Fidelis CHP/HARP/Medicaid	$5,401.70
Rate for Payer: Fidelis Essential Plan Aliesa	$5,401.70
Rate for Payer: Fidelis Essential Plan QHP	$5,655.90
Rate for Payer: Fidelis Medicare Advantage	$6,354.94
Rate for Payer: Fidelis Qualified Health Plan	$5,655.90
Rate for Payer: Group Health Inc Commercial	$5,719.45
Rate for Payer: Group Health Inc Medicare	$5,719.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.35
Rate for Payer: Hamaspik Choice Inc Medicare	$6,354.94
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5,719.45
Rate for Payer: Healthfirst Medicare Advantage	$6,354.94
Rate for Payer: Healthfirst QHP	$6,354.94
Rate for Payer: Humana Medicare	$6,482.04
Rate for Payer: Senior Whole Health Medicare Advantage	$6,354.94
Rate for Payer: United Healthcare Medicare Advantage	$6,354.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,354.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5,083.95
Rate for Payer: Wellcare Medicare	$6,037.19

EQ ADRENAL VEN. BIL

Facility

$13,920.70

Service Code	HCPCS 75842 TC
Hospital Charge Code	41102694
Hospital Revenue Code	320
Rate for Payer: Cash Price	$6,354.94

EQ ADRENAL VEN. UNI

Facility

$8,393.53

Service Code	HCPCS 75840 TC
Hospital Charge Code	41102693
Hospital Revenue Code	320
Min. Negotiated Rate	$2,580.26
Max. Negotiated Rate	$4,616.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,616.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,686.08
Rate for Payer: Aetna Government	$3,686.08
Rate for Payer: Affinity Essential Plan 1&2	$2,580.26
Rate for Payer: Affinity Essential Plan 3&4	$2,580.26
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,580.26
Rate for Payer: Brighton Health Commercial	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,686.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,056.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,432.09
Rate for Payer: Elderplan Medicare Advantage	$3,686.08
Rate for Payer: EmblemHealth Commercial	$2,580.26
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3,133.17
Rate for Payer: Fidelis Essential Plan Aliesa	$3,133.17
Rate for Payer: Fidelis Essential Plan QHP	$3,280.61
Rate for Payer: Fidelis Medicare Advantage	$3,686.08
Rate for Payer: Fidelis Qualified Health Plan	$3,280.61
Rate for Payer: Group Health Inc Commercial	$3,317.47
Rate for Payer: Group Health Inc Medicare	$3,317.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.76
Rate for Payer: Hamaspik Choice Inc Medicare	$3,686.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,317.47
Rate for Payer: Healthfirst Medicare Advantage	$3,686.08
Rate for Payer: Healthfirst QHP	$3,686.08
Rate for Payer: Humana Medicare	$3,759.80
Rate for Payer: Senior Whole Health Medicare Advantage	$3,686.08
Rate for Payer: United Healthcare Medicare Advantage	$3,686.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,686.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,948.86
Rate for Payer: Wellcare Medicare	$3,501.78

EQ ADRENAL VEN. UNI

Facility

$8,393.53

Service Code	HCPCS 75840 TC
Hospital Charge Code	41102693
Hospital Revenue Code	320
Rate for Payer: Cash Price	$3,686.08

EQ ANGIO THRU EXIST. CTH

Facility

$4,940.28

Service Code	HCPCS 75898 TC
Hospital Charge Code	41102608
Hospital Revenue Code	320
Rate for Payer: Cash Price	$3,686.08

EQ ANGIO THRU EXIST. CTH

Facility

$4,940.28

Service Code	HCPCS 75898 TC
Hospital Charge Code	41102608
Hospital Revenue Code	320
Min. Negotiated Rate	$128.48
Max. Negotiated Rate	$3,759.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,717.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,686.08
Rate for Payer: Aetna Government	$3,686.08
Rate for Payer: Affinity Essential Plan 1&2	$2,580.26
Rate for Payer: Affinity Essential Plan 3&4	$2,580.26
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,580.26
Rate for Payer: Brighton Health Commercial	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,686.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$151.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.48
Rate for Payer: Elderplan Medicare Advantage	$3,686.08
Rate for Payer: EmblemHealth Commercial	$2,580.26
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3,133.17
Rate for Payer: Fidelis Essential Plan Aliesa	$3,133.17
Rate for Payer: Fidelis Essential Plan QHP	$3,280.61
Rate for Payer: Fidelis Medicare Advantage	$3,686.08
Rate for Payer: Fidelis Qualified Health Plan	$3,280.61
Rate for Payer: Group Health Inc Commercial	$3,317.47
Rate for Payer: Group Health Inc Medicare	$3,317.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,470.14
Rate for Payer: Hamaspik Choice Inc Medicare	$3,686.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,317.47
Rate for Payer: Healthfirst Medicare Advantage	$3,686.08
Rate for Payer: Healthfirst QHP	$3,686.08
Rate for Payer: Humana Medicare	$3,759.80
Rate for Payer: Senior Whole Health Medicare Advantage	$3,686.08
Rate for Payer: United Healthcare Medicare Advantage	$3,686.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,686.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,948.86
Rate for Payer: Wellcare Medicare	$3,501.78

EQ ANKLE ARTHROGRAM

Facility

$1,156.53

Service Code	HCPCS 73615 TC
Hospital Charge Code	41102490
Hospital Revenue Code	320
Rate for Payer: Cash Price	$444.73

EQ ANKLE ARTHROGRAM

Facility

$1,156.53

Service Code	HCPCS 73615 TC
Hospital Charge Code	41102490
Hospital Revenue Code	320
Min. Negotiated Rate	$311.31
Max. Negotiated Rate	$636.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$636.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$444.73
Rate for Payer: Aetna Government	$444.73
Rate for Payer: Affinity Essential Plan 1&2	$311.31
Rate for Payer: Affinity Essential Plan 3&4	$311.31
Rate for Payer: Affinity Medicaid/CHP/HARP	$311.31
Rate for Payer: Brighton Health Commercial	$444.73
Rate for Payer: Cash Price	$444.73
Rate for Payer: Cash Price	$444.73
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$444.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$550.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$465.78
Rate for Payer: Elderplan Medicare Advantage	$444.73
Rate for Payer: EmblemHealth Commercial	$311.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$378.02
Rate for Payer: Fidelis Essential Plan Aliesa	$378.02
Rate for Payer: Fidelis Essential Plan QHP	$395.81
Rate for Payer: Fidelis Medicare Advantage	$444.73
Rate for Payer: Fidelis Qualified Health Plan	$395.81
Rate for Payer: Group Health Inc Commercial	$400.26
Rate for Payer: Group Health Inc Medicare	$400.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.26
Rate for Payer: Hamaspik Choice Inc Medicare	$444.73
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$400.26
Rate for Payer: Healthfirst Medicare Advantage	$444.73
Rate for Payer: Healthfirst QHP	$444.73
Rate for Payer: Humana Medicare	$453.62
Rate for Payer: Senior Whole Health Medicare Advantage	$444.73
Rate for Payer: United Healthcare Medicare Advantage	$444.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$444.73
Rate for Payer: Wellcare CHP/FHP/Medicaid	$355.78
Rate for Payer: Wellcare Medicare	$422.49

EQ BRONCH BRUSH/BIOPSY

Facility

$8,895.18

Service Code	HCPCS 31628
Hospital Charge Code	30303385
Hospital Revenue Code	510
Rate for Payer: Cash Price	$4,330.61

EQ BRONCH BRUSH/BIOPSY

Facility

$8,895.18

Service Code	HCPCS 31628
Hospital Charge Code	30303385
Hospital Revenue Code	510
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$4,447.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,330.61
Rate for Payer: Aetna Government	$4,330.61
Rate for Payer: Affinity Essential Plan 1&2	$3,031.43
Rate for Payer: Affinity Essential Plan 3&4	$3,031.43
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,031.43
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$4,330.61
Rate for Payer: Cash Price	$4,330.61
Rate for Payer: Cash Price	$4,330.61
Rate for Payer: Cash Price	$4,330.61
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4,330.61
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	$4,330.61
Rate for Payer: Fidelis Essential Plan Aliesa	$3,681.02
Rate for Payer: Fidelis Essential Plan QHP	$3,854.24
Rate for Payer: Fidelis Medicare Advantage	$4,330.61
Rate for Payer: Fidelis Qualified Health Plan	$3,854.24
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	$4,447.59
Rate for Payer: Hamaspik Choice Inc Medicare	$4,330.61
Rate for Payer: Healthfirst Medicare Advantage	$3,681.02
Rate for Payer: Healthfirst QHP	$4,330.61
Rate for Payer: Humana Medicare	$4,417.22
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$4,330.61
Rate for Payer: Senior Whole Health Medicare Advantage	$4,330.61
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$4,330.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,330.61
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,464.49
Rate for Payer: Wellcare Medicare	$4,114.08

EQ BRONCH BRUSH/BIOPSY

Facility

$8,895.18

Service Code	HCPCS 31628 TC
Hospital Charge Code	41102420
Hospital Revenue Code	360
Rate for Payer: Cash Price	$4,330.61

EQ BRONCH BRUSH/BIOPSY

Facility

$8,895.18

Service Code	HCPCS 31628 TC
Hospital Charge Code	41102420
Hospital Revenue Code	360
Min. Negotiated Rate	$1,409.00
Max. Negotiated Rate	$6,671.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,330.61
Rate for Payer: Aetna Government	$4,330.61
Rate for Payer: Affinity Essential Plan 1&2	$3,031.43
Rate for Payer: Affinity Essential Plan 3&4	$3,031.43
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,031.43
Rate for Payer: Brighton Health Commercial	$6,671.38
Rate for Payer: Cash Price	$4,330.61
Rate for Payer: Cash Price	$4,330.61
Rate for Payer: Cash Price	$4,330.61
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4,330.61
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	$4,330.61
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,681.02
Rate for Payer: Fidelis Essential Plan QHP	$3,854.24
Rate for Payer: Fidelis Medicare Advantage	$4,330.61
Rate for Payer: Fidelis Qualified Health Plan	$3,854.24
Rate for Payer: Group Health Inc Commercial	$4,330.61
Rate for Payer: Group Health Inc Medicare	$4,330.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,447.59
Rate for Payer: Hamaspik Choice Inc Medicare	$4,330.61
Rate for Payer: Healthfirst Medicare Advantage	$3,681.02
Rate for Payer: Healthfirst QHP	$4,330.61
Rate for Payer: Humana Medicare	$4,417.22
Rate for Payer: Senior Whole Health Medicare Advantage	$4,330.61
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$4,330.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,330.61
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,464.49
Rate for Payer: Wellcare Medicare	$4,114.08

EQ BRONCH BRUSH/BIOPSY ADD ON

Facility

$218.78

Service Code	HCPCS 31632 TC
Hospital Charge Code	41109932
Hospital Revenue Code	360
Min. Negotiated Rate	$50.56
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.56
Rate for Payer: Aetna Government	$50.56
Rate for Payer: Brighton Health Commercial	$164.08
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: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$109.39
Rate for Payer: Group Health Inc Medicare	$76.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.39
Rate for Payer: Hamaspik Choice Inc Medicare	$109.39
Rate for Payer: United Healthcare Commercial	$1,113.00

EQ BRONCHOSCOPY BILAT

Facility

$241.73

Service Code	HCPCS 76499 TC
Hospital Charge Code	41107469
Hospital Revenue Code	320
Min. Negotiated Rate	$73.56
Max. Negotiated Rate	$132.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$105.08
Rate for Payer: Aetna Government	$105.08
Rate for Payer: Affinity Essential Plan 1&2	$73.56
Rate for Payer: Affinity Essential Plan 3&4	$73.56
Rate for Payer: Affinity Medicaid/CHP/HARP	$73.56
Rate for Payer: Brighton Health Commercial	$105.08
Rate for Payer: Cash Price	$105.08
Rate for Payer: Cash Price	$105.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$105.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.27
Rate for Payer: Elderplan Medicare Advantage	$105.08
Rate for Payer: EmblemHealth Commercial	$73.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$89.32
Rate for Payer: Fidelis Essential Plan Aliesa	$89.32
Rate for Payer: Fidelis Essential Plan QHP	$93.52
Rate for Payer: Fidelis Medicare Advantage	$105.08
Rate for Payer: Fidelis Qualified Health Plan	$93.52
Rate for Payer: Group Health Inc Commercial	$94.57
Rate for Payer: Group Health Inc Medicare	$94.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.86
Rate for Payer: Hamaspik Choice Inc Medicare	$105.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$94.57
Rate for Payer: Healthfirst Medicare Advantage	$105.08
Rate for Payer: Healthfirst QHP	$105.08
Rate for Payer: Humana Medicare	$107.18
Rate for Payer: Senior Whole Health Medicare Advantage	$105.08
Rate for Payer: United Healthcare Medicare Advantage	$105.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$84.06
Rate for Payer: Wellcare Medicare	$99.83

EQ BRONCHOSCOPY BILAT

Facility

$241.73

Service Code	HCPCS 76499 TC
Hospital Charge Code	41107469
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

EQ BRONCHOSCOPY UNI

Facility

$241.73

Service Code	HCPCS 76499 TC
Hospital Charge Code	41102010
Hospital Revenue Code	320
Rate for Payer: Cash Price	$105.08

EQ BRONCHOSCOPY UNI

Facility

$241.73

Service Code	HCPCS 76499 TC
Hospital Charge Code	41102010
Hospital Revenue Code	320
Min. Negotiated Rate	$73.56
Max. Negotiated Rate	$132.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$105.08
Rate for Payer: Aetna Government	$105.08
Rate for Payer: Affinity Essential Plan 1&2	$73.56
Rate for Payer: Affinity Essential Plan 3&4	$73.56
Rate for Payer: Affinity Medicaid/CHP/HARP	$73.56
Rate for Payer: Brighton Health Commercial	$105.08
Rate for Payer: Cash Price	$105.08
Rate for Payer: Cash Price	$105.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$105.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.27
Rate for Payer: Elderplan Medicare Advantage	$105.08
Rate for Payer: EmblemHealth Commercial	$73.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$89.32
Rate for Payer: Fidelis Essential Plan Aliesa	$89.32
Rate for Payer: Fidelis Essential Plan QHP	$93.52
Rate for Payer: Fidelis Medicare Advantage	$105.08
Rate for Payer: Fidelis Qualified Health Plan	$93.52
Rate for Payer: Group Health Inc Commercial	$94.57
Rate for Payer: Group Health Inc Medicare	$94.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.86
Rate for Payer: Hamaspik Choice Inc Medicare	$105.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$94.57
Rate for Payer: Healthfirst Medicare Advantage	$105.08
Rate for Payer: Healthfirst QHP	$105.08
Rate for Payer: Humana Medicare	$107.18
Rate for Payer: Senior Whole Health Medicare Advantage	$105.08
Rate for Payer: United Healthcare Medicare Advantage	$105.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$84.06
Rate for Payer: Wellcare Medicare	$99.83

EQ BRUSH BIOPSY,TRANSCATH,RENAL

Facility

$1,144.39

Service Code	HCPCS 77002 TC
Hospital Charge Code	41107652
Hospital Revenue Code	320
Min. Negotiated Rate	$50.91
Max. Negotiated Rate	$915.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$629.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.91
Rate for Payer: Aetna Government	$50.91
Rate for Payer: Brighton Health Commercial	$858.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$915.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$778.19
Rate for Payer: Group Health Inc Commercial	$572.20
Rate for Payer: Group Health Inc Medicare	$400.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$572.20
Rate for Payer: Hamaspik Choice Inc Medicare	$572.20

EQ CAVERNOGOGRAM

Facility

$339.45

Service Code	HCPCS 74445 TC
Hospital Charge Code	41107482
Hospital Revenue Code	320
Rate for Payer: Cash Price	$127.14

EQ CAVERNOGOGRAM

Facility

$339.45

Service Code	HCPCS 74445 TC
Hospital Charge Code	41107482
Hospital Revenue Code	320
Min. Negotiated Rate	$89.00
Max. Negotiated Rate	$352.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$127.14
Rate for Payer: Aetna Government	$127.14
Rate for Payer: Affinity Essential Plan 1&2	$89.00
Rate for Payer: Affinity Essential Plan 3&4	$89.00
Rate for Payer: Affinity Medicaid/CHP/HARP	$89.00
Rate for Payer: Brighton Health Commercial	$127.14
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cash Price	$127.14
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$352.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$298.26
Rate for Payer: Elderplan Medicare Advantage	$127.14
Rate for Payer: EmblemHealth Commercial	$89.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$108.07
Rate for Payer: Fidelis Essential Plan Aliesa	$108.07
Rate for Payer: Fidelis Essential Plan QHP	$113.15
Rate for Payer: Fidelis Medicare Advantage	$127.14
Rate for Payer: Fidelis Qualified Health Plan	$113.15
Rate for Payer: Group Health Inc Commercial	$114.43
Rate for Payer: Group Health Inc Medicare	$114.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$127.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$114.43
Rate for Payer: Healthfirst Medicare Advantage	$127.14
Rate for Payer: Healthfirst QHP	$127.14
Rate for Payer: Humana Medicare	$129.68
Rate for Payer: Senior Whole Health Medicare Advantage	$127.14
Rate for Payer: United Healthcare Medicare Advantage	$127.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.14
Rate for Payer: Wellcare CHP/FHP/Medicaid	$101.71
Rate for Payer: Wellcare Medicare	$120.78

EQ CERVICAL MYELOGRAM

Facility

$2,062.03

Service Code	HCPCS 72240 TC
Hospital Charge Code	41102212
Hospital Revenue Code	320
Min. Negotiated Rate	$648.14
Max. Negotiated Rate	$1,134.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,134.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$925.92
Rate for Payer: Aetna Government	$925.92
Rate for Payer: Affinity Essential Plan 1&2	$648.14
Rate for Payer: Affinity Essential Plan 3&4	$648.14
Rate for Payer: Affinity Medicaid/CHP/HARP	$648.14
Rate for Payer: Brighton Health Commercial	$925.92
Rate for Payer: Cash Price	$925.92
Rate for Payer: Cash Price	$925.92
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$925.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$998.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$845.24
Rate for Payer: Elderplan Medicare Advantage	$925.92
Rate for Payer: EmblemHealth Commercial	$648.14
Rate for Payer: Fidelis CHP/HARP/Medicaid	$787.03
Rate for Payer: Fidelis Essential Plan Aliesa	$787.03
Rate for Payer: Fidelis Essential Plan QHP	$824.07
Rate for Payer: Fidelis Medicare Advantage	$925.92
Rate for Payer: Fidelis Qualified Health Plan	$824.07
Rate for Payer: Group Health Inc Commercial	$833.33
Rate for Payer: Group Health Inc Medicare	$833.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,031.02
Rate for Payer: Hamaspik Choice Inc Medicare	$925.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$833.33
Rate for Payer: Healthfirst Medicare Advantage	$925.92
Rate for Payer: Healthfirst QHP	$925.92
Rate for Payer: Humana Medicare	$944.44
Rate for Payer: Senior Whole Health Medicare Advantage	$925.92
Rate for Payer: United Healthcare Medicare Advantage	$925.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$925.92
Rate for Payer: Wellcare CHP/FHP/Medicaid	$740.74
Rate for Payer: Wellcare Medicare	$879.62

EQ CERVICAL MYELOGRAM

Facility

$2,062.03

Service Code	HCPCS 72240 TC
Hospital Charge Code	41102212
Hospital Revenue Code	320
Rate for Payer: Cash Price	$925.92

EQ CHANGE BILIARY DR. CTH

Facility

$650.40

Service Code	HCPCS 75984 TC
Hospital Charge Code	41102626
Hospital Revenue Code	320
Min. Negotiated Rate	$55.93
Max. Negotiated Rate	$520.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$357.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$55.93
Rate for Payer: Aetna Government	$55.93
Rate for Payer: Brighton Health Commercial	$487.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$520.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$442.27
Rate for Payer: Group Health Inc Commercial	$325.20
Rate for Payer: Group Health Inc Medicare	$227.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$325.20
Rate for Payer: Hamaspik Choice Inc Medicare	$325.20

EQ CHANGE CYSTOSTOMY TUBE

Facility

$650.40

Service Code	HCPCS 75984 TC
Hospital Charge Code	41107646
Hospital Revenue Code	320
Min. Negotiated Rate	$55.93
Max. Negotiated Rate	$520.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$357.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$55.93
Rate for Payer: Aetna Government	$55.93
Rate for Payer: Brighton Health Commercial	$487.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$520.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$442.27
Rate for Payer: Group Health Inc Commercial	$325.20
Rate for Payer: Group Health Inc Medicare	$227.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$325.20
Rate for Payer: Hamaspik Choice Inc Medicare	$325.20

Know your out-of-pocket cost for care.

All Charges