St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY

Professional

Both

$1,877.54

Service Code	HCPCS 50593
Min. Negotiated Rate	$1,408.16
Max. Negotiated Rate	$1,408.16
Rate for Payer: Cash Price	$508.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,408.16
Rate for Payer: SOMOS Essential	$1,408.16

PR ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION

Professional

Both

$1,791.09

Service Code	HCPCS 32994
Min. Negotiated Rate	$1,343.32
Max. Negotiated Rate	$1,343.32
Rate for Payer: Cash Price	$484.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,343.32
Rate for Payer: SOMOS Essential	$1,343.32

PR ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY

Professional

Both

$1,802.05

Service Code	HCPCS 32998
Min. Negotiated Rate	$1,351.54
Max. Negotiated Rate	$1,351.54
Rate for Payer: Cash Price	$485.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,351.54
Rate for Payer: SOMOS Essential	$1,351.54

PR ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD

Professional

Both

$1,414.81

Service Code	HCPCS 20983
Min. Negotiated Rate	$1,061.11
Max. Negotiated Rate	$1,061.11
Rate for Payer: Cash Price	$383.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,061.11
Rate for Payer: SOMOS Essential	$1,061.11

PR ABLTJ 1/> LVR TUM PRQ RF

Professional

Both

$3,027.89

Service Code	HCPCS 47382
Min. Negotiated Rate	$2,270.92
Max. Negotiated Rate	$2,270.92
Rate for Payer: Cash Price	$815.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,270.92
Rate for Payer: SOMOS Essential	$2,270.92

PR ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY

Professional

Both

$1,406.48

Service Code	HCPCS 50592
Min. Negotiated Rate	$1,054.86
Max. Negotiated Rate	$1,054.86
Rate for Payer: Cash Price	$381.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,054.86
Rate for Payer: SOMOS Essential	$1,054.86

PR ABLTJ CRYOSURGICAL W/US GID EA FIBROADENOMA

Professional

Both

$945.46

Service Code	HCPCS 19105
Min. Negotiated Rate	$709.10
Max. Negotiated Rate	$709.10
Rate for Payer: Cash Price	$252.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$709.10
Rate for Payer: SOMOS Essential	$709.10

PR ABLTJ OPN 1/> LVR TUM CRYOSURG

Professional

Both

$6,705.37

Service Code	HCPCS 47381
Min. Negotiated Rate	$5,029.03
Max. Negotiated Rate	$5,029.03
Rate for Payer: Cash Price	$1,784.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,029.03
Rate for Payer: SOMOS Essential	$5,029.03

PR ABLTJ OPN 1/> LVR TUM RF

Professional

Both

$6,501.36

Service Code	HCPCS 47380
Min. Negotiated Rate	$4,876.02
Max. Negotiated Rate	$4,876.02
Rate for Payer: Cash Price	$1,734.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,876.02
Rate for Payer: SOMOS Essential	$4,876.02

PR ABLTJ PERC CRYOABLTJ IMG GDN LXTR/PERPH NERVE

Professional

Both

$927.33

Service Code	HCPCS 0441T
Min. Negotiated Rate	$695.50
Max. Negotiated Rate	$695.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$695.50
Rate for Payer: SOMOS Essential	$695.50

PR ABLTJ PERC CRYOABLTJ IMG GDN NRV PLEX/TRNCL NRV

Professional

Both

$927.33

Service Code	HCPCS 0442T
Min. Negotiated Rate	$695.50
Max. Negotiated Rate	$695.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$695.50
Rate for Payer: SOMOS Essential	$695.50

PR ABLTJ PERC CRYOABLTJ IMG GDN UXTR/PERPH NERVE

Professional

Both

$927.33

Service Code	HCPCS 0440T
Min. Negotiated Rate	$695.50
Max. Negotiated Rate	$695.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$695.50
Rate for Payer: SOMOS Essential	$695.50

PR ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL

Professional

Both

$881.79

Service Code	HCPCS 30802
Min. Negotiated Rate	$661.34
Max. Negotiated Rate	$661.34
Rate for Payer: Cash Price	$238.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$661.34
Rate for Payer: SOMOS Essential	$661.34

PR ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC

Professional

Both

$665.11

Service Code	HCPCS 30801
Min. Negotiated Rate	$498.83
Max. Negotiated Rate	$498.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$498.83
Rate for Payer: SOMOS Essential	$498.83

PR ABRASION 1 LESION

Professional

Both

$565.08

Service Code	HCPCS 15786
Min. Negotiated Rate	$423.81
Max. Negotiated Rate	$423.81
Rate for Payer: Cash Price	$154.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$423.81
Rate for Payer: SOMOS Essential	$423.81

PR ABRASION EACH ADDITIONAL 4 LESIONS OR LESS

Professional

Both

$66.92

Service Code	HCPCS 15787
Min. Negotiated Rate	$50.19
Max. Negotiated Rate	$50.19
Rate for Payer: Cash Price	$18.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$50.19
Rate for Payer: SOMOS Essential	$50.19

PR ACETABULOPLASTY

Professional

Both

$5,733.98

Service Code	HCPCS 27120
Min. Negotiated Rate	$4,300.48
Max. Negotiated Rate	$4,300.48
Rate for Payer: Cash Price	$1,544.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,300.48
Rate for Payer: SOMOS Essential	$4,300.48

PR ACETABULOPLASTY RESECTION FEMORAL HEAD

Professional

Both

$4,871.41

Service Code	HCPCS 27122
Min. Negotiated Rate	$3,653.56
Max. Negotiated Rate	$3,653.56
Rate for Payer: Cash Price	$1,315.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,653.56
Rate for Payer: SOMOS Essential	$3,653.56

PR ACNE SURGERY

Professional

Both

$217.53

Service Code	HCPCS 10040
Min. Negotiated Rate	$163.15
Max. Negotiated Rate	$163.15
Rate for Payer: Cash Price	$59.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$163.15
Rate for Payer: SOMOS Essential	$163.15

PR ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY

Professional

Both

$116.06

Service Code	HCPCS 92570
Min. Negotiated Rate	$87.04
Max. Negotiated Rate	$87.04
Rate for Payer: Cash Price	$31.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$87.04
Rate for Payer: SOMOS Essential	$87.04

PR ACOUSTIC REFLEX THRESHOLD

Professional

Both

$61.92

Service Code	HCPCS 92568
Min. Negotiated Rate	$46.44
Max. Negotiated Rate	$46.44
Rate for Payer: Cash Price	$16.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$46.44
Rate for Payer: SOMOS Essential	$46.44

PR ACTIGRAPHY TESTING RECORDING ANALYSIS I&R

Professional

Both

$165.62

Service Code	HCPCS 95803 26
Min. Negotiated Rate	$124.22
Max. Negotiated Rate	$124.22
Rate for Payer: Cash Price	$44.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$124.22
Rate for Payer: SOMOS Essential	$124.22

PR ACTIGRAPHY TESTING RECORDING ANALYSIS I&R

Professional

Both

$418.18

Service Code	HCPCS 95803 TC
Min. Negotiated Rate	$313.64
Max. Negotiated Rate	$313.64
Rate for Payer: Cash Price	$111.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$313.64
Rate for Payer: SOMOS Essential	$313.64

PR ACTIGRAPHY TESTING RECORDING ANALYSIS I&R

Professional

Both

$583.80

Service Code	HCPCS 95803
Min. Negotiated Rate	$437.85
Max. Negotiated Rate	$437.85
Rate for Payer: Cash Price	$156.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$437.85
Rate for Payer: SOMOS Essential	$437.85

PR ACTINOTHERAPY ULTRAVIOLET LIGHT

Professional

Both

$106.23

Service Code	HCPCS 96900
Min. Negotiated Rate	$79.67
Max. Negotiated Rate	$79.67
Rate for Payer: Cash Price	$29.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$79.67
Rate for Payer: SOMOS Essential	$79.67

Know your out-of-pocket cost for care.

All Charges