St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR 1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES

Professional

Both

$706.44

Service Code	HCPCS 99223
Min. Negotiated Rate	$529.83
Max. Negotiated Rate	$529.83
Rate for Payer: Cash Price	$192.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$529.83
Rate for Payer: SOMOS Essential	$529.83

PR 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES

Professional

Both

$533.89

Service Code	HCPCS 99222
Min. Negotiated Rate	$400.42
Max. Negotiated Rate	$400.42
Rate for Payer: Cash Price	$146.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$400.42
Rate for Payer: SOMOS Essential	$400.42

PR 1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES

Professional

Both

$346.85

Service Code	HCPCS 99221
Min. Negotiated Rate	$260.14
Max. Negotiated Rate	$260.14
Rate for Payer: Cash Price	$93.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$260.14
Rate for Payer: SOMOS Essential	$260.14

PR 1ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/<

Professional

Both

$3,615.92

Service Code	HCPCS 99468
Min. Negotiated Rate	$2,711.94
Max. Negotiated Rate	$2,711.94
Rate for Payer: Cash Price	$988.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,711.94
Rate for Payer: SOMOS Essential	$2,711.94

PR 1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS

Professional

Both

$374.68

Service Code	HCPCS 99492
Min. Negotiated Rate	$281.01
Max. Negotiated Rate	$281.01
Rate for Payer: Cash Price	$104.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$281.01
Rate for Payer: SOMOS Essential	$281.01

PR 1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS

Professional

Both

$165.13

Service Code	HCPCS 99494
Min. Negotiated Rate	$123.85
Max. Negotiated Rate	$123.85
Rate for Payer: Cash Price	$45.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$123.85
Rate for Payer: SOMOS Essential	$123.85

PR 1ST SET-UP & PRGRMG PHYS/QHP OF WEARABLE CVDFB

Professional

Both

$134.86

Service Code	HCPCS 93745 TC
Min. Negotiated Rate	$101.14
Max. Negotiated Rate	$101.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$101.14
Rate for Payer: SOMOS Essential	$101.14

PR 1ST SET-UP & PRGRMG PHYS/QHP OF WEARABLE CVDFB

Professional

Both

$351.19

Service Code	HCPCS 93745
Min. Negotiated Rate	$263.39
Max. Negotiated Rate	$263.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$263.39
Rate for Payer: SOMOS Essential	$263.39

PR 1ST SET-UP & PRGRMG PHYS/QHP OF WEARABLE CVDFB

Professional

Both

$216.30

Service Code	HCPCS 93745 26
Min. Negotiated Rate	$162.22
Max. Negotiated Rate	$162.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$162.22
Rate for Payer: SOMOS Essential	$162.22

PR 3D ECHO IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL

Professional

Both

$98.00

Service Code	HCPCS 93319
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$73.50
Rate for Payer: Cash Price	$25.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$73.50
Rate for Payer: SOMOS Essential	$73.50

PR 4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE

Professional

Both

$200.00

Service Code	HCPCS 90649
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$150.00
Rate for Payer: SOMOS Essential	$150.00

PR 9VHPV VACC 2/3 DOSE SCHED IM USE

Professional

Both

$909.94

Service Code	HCPCS 90651
Min. Negotiated Rate	$682.46
Max. Negotiated Rate	$682.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$682.46
Rate for Payer: SOMOS Essential	$682.46

PR ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC

Professional

Both

$1,189.06

Service Code	HCPCS 38747
Min. Negotiated Rate	$891.80
Max. Negotiated Rate	$891.80
Rate for Payer: Cash Price	$317.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$891.80
Rate for Payer: SOMOS Essential	$891.80

PR ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL

Professional

Both

$2,443.42

Service Code	HCPCS 51845
Min. Negotiated Rate	$1,832.56
Max. Negotiated Rate	$1,832.56
Rate for Payer: Cash Price	$669.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,832.56
Rate for Payer: SOMOS Essential	$1,832.56

PR ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE

Professional

Both

$436.17

Service Code	HCPCS 49083
Min. Negotiated Rate	$327.13
Max. Negotiated Rate	$327.13
Rate for Payer: Cash Price	$118.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$327.13
Rate for Payer: SOMOS Essential	$327.13

PR ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE

Professional

Both

$312.24

Service Code	HCPCS 49082
Min. Negotiated Rate	$234.18
Max. Negotiated Rate	$234.18
Rate for Payer: Cash Price	$84.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$234.18
Rate for Payer: SOMOS Essential	$234.18

PR ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN

Professional

Both

$1,357.76

Service Code	HCPCS 93657
Min. Negotiated Rate	$1,018.32
Max. Negotiated Rate	$1,018.32
Rate for Payer: Cash Price	$356.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,018.32
Rate for Payer: SOMOS Essential	$1,018.32

PR ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION

Professional

Both

$1,848.49

Service Code	HCPCS 47383
Min. Negotiated Rate	$1,386.37
Max. Negotiated Rate	$1,386.37
Rate for Payer: Cash Price	$497.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,386.37
Rate for Payer: SOMOS Essential	$1,386.37

PR ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/BYPASS

Professional

Both

$7,243.08

Service Code	HCPCS 33251
Min. Negotiated Rate	$5,432.31
Max. Negotiated Rate	$5,432.31
Rate for Payer: Cash Price	$1,927.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,432.31
Rate for Payer: SOMOS Essential	$5,432.31

PR ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/O BYPASS

Professional

Both

$6,410.43

Service Code	HCPCS 33250
Min. Negotiated Rate	$4,807.82
Max. Negotiated Rate	$4,807.82
Rate for Payer: Cash Price	$1,706.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,807.82
Rate for Payer: SOMOS Essential	$4,807.82

PR ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE

Professional

Both

$1,564.57

Service Code	HCPCS 20982
Min. Negotiated Rate	$1,173.43
Max. Negotiated Rate	$1,173.43
Rate for Payer: Cash Price	$419.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,173.43
Rate for Payer: SOMOS Essential	$1,173.43

PR ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL

Professional

Both

$2,396.35

Service Code	HCPCS 0581T
Min. Negotiated Rate	$1,797.26
Max. Negotiated Rate	$1,797.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,797.26
Rate for Payer: SOMOS Essential	$1,797.26

PR ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS

Professional

Both

$8,484.11

Service Code	HCPCS 33256
Min. Negotiated Rate	$6,363.08
Max. Negotiated Rate	$6,363.08
Rate for Payer: Cash Price	$2,254.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,363.08
Rate for Payer: SOMOS Essential	$6,363.08

PR ABLATION & RCNSTJ ATRIA EXTNSV W/O BYPASS

Professional

Both

$7,152.08

Service Code	HCPCS 33255
Min. Negotiated Rate	$5,364.06
Max. Negotiated Rate	$5,364.06
Rate for Payer: Cash Price	$1,903.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,364.06
Rate for Payer: SOMOS Essential	$5,364.06

PR ABLATION & RECONSTRUCTION ATRIA LIMITED

Professional

Both

$6,021.89

Service Code	HCPCS 33254
Min. Negotiated Rate	$4,516.42
Max. Negotiated Rate	$4,516.42
Rate for Payer: Cash Price	$1,608.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,516.42
Rate for Payer: SOMOS Essential	$4,516.42

Know your out-of-pocket cost for care.

All Charges