St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR ANALYSIS, NERVE

Professional

Both

$953.61

Service Code	HCPCS 88356
Min. Negotiated Rate	$715.21
Max. Negotiated Rate	$715.21
Rate for Payer: Cash Price	$266.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$715.21
Rate for Payer: SOMOS Essential	$715.21

PR ANALYSIS, TUMOR

Professional

Both

$390.85

Service Code	HCPCS 88358 TC
Min. Negotiated Rate	$293.14
Max. Negotiated Rate	$293.14
Rate for Payer: Cash Price	$105.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$293.14
Rate for Payer: SOMOS Essential	$293.14

PR ANALYSIS, TUMOR

Professional

Both

$192.01

Service Code	HCPCS 88358 26
Min. Negotiated Rate	$144.01
Max. Negotiated Rate	$144.01
Rate for Payer: Cash Price	$52.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$144.01
Rate for Payer: SOMOS Essential	$144.01

PR ANALYSIS, TUMOR

Professional

Both

$582.89

Service Code	HCPCS 88358
Min. Negotiated Rate	$437.17
Max. Negotiated Rate	$437.17
Rate for Payer: Cash Price	$157.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$437.17
Rate for Payer: SOMOS Essential	$437.17

PR ANALYSIS W/PRGRMG AUD BRAINSTEM IMPLANT PR HR

Professional

Both

$370.83

Service Code	HCPCS 92640
Min. Negotiated Rate	$278.12
Max. Negotiated Rate	$278.12
Rate for Payer: Cash Price	$101.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$278.12
Rate for Payer: SOMOS Essential	$278.12

PR ANAST ARTL EXTRACRANIAL-INTRACRANIAL ARTERIES

Professional

Both

$12,316.15

Service Code	HCPCS 61711
Min. Negotiated Rate	$9,237.11
Max. Negotiated Rate	$9,237.11
Rate for Payer: Cash Price	$3,312.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,237.11
Rate for Payer: SOMOS Essential	$9,237.11

PR ANAST INTRAHEPATC DUCTS & GI TRACT

Professional

Both

$13,155.84

Service Code	HCPCS 47765
Min. Negotiated Rate	$9,866.88
Max. Negotiated Rate	$9,866.88
Rate for Payer: Cash Price	$3,640.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,866.88
Rate for Payer: SOMOS Essential	$9,866.88

PR ANASTOMOSIS CAVOPULMARY 2ND SUPRIOR VENA CAVA

Professional

Both

$1,850.63

Service Code	HCPCS 33768
Min. Negotiated Rate	$1,387.97
Max. Negotiated Rate	$1,387.97
Rate for Payer: Cash Price	$489.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,387.97
Rate for Payer: SOMOS Essential	$1,387.97

PR ANASTOMOSIS FACIAL HYPOGLOSSAL

Professional

Both

$4,290.86

Service Code	HCPCS 64868
Min. Negotiated Rate	$3,218.14
Max. Negotiated Rate	$3,218.14
Rate for Payer: Cash Price	$1,159.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,218.14
Rate for Payer: SOMOS Essential	$3,218.14

PR ANASTOMOSIS FACIAL-SPINAL ACCESSORY

Professional

Both

$5,441.10

Service Code	HCPCS 64866
Min. Negotiated Rate	$4,080.82
Max. Negotiated Rate	$4,080.82
Rate for Payer: Cash Price	$1,462.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,080.82
Rate for Payer: SOMOS Essential	$4,080.82

PR ANAST PULMONARY ART AORTA DAMUS-KAYE-STANSEL PX

Professional

Both

$7,916.13

Service Code	HCPCS 33606
Min. Negotiated Rate	$5,937.10
Max. Negotiated Rate	$5,937.10
Rate for Payer: Cash Price	$2,105.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,937.10
Rate for Payer: SOMOS Essential	$5,937.10

PR ANAST ROUX-EN-Y INTRAHEPATC BILIARY DUCTS & GI

Professional

Both

$14,588.42

Service Code	HCPCS 47785
Min. Negotiated Rate	$10,941.32
Max. Negotiated Rate	$10,941.32
Rate for Payer: Cash Price	$3,880.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,941.32
Rate for Payer: SOMOS Essential	$10,941.32

PR ANAST ROUX-EN-Y XTRHEPATC BILIARY DUCTS & GI

Professional

Both

$11,158.98

Service Code	HCPCS 47780
Min. Negotiated Rate	$8,369.24
Max. Negotiated Rate	$8,369.24
Rate for Payer: Cash Price	$2,973.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,369.24
Rate for Payer: SOMOS Essential	$8,369.24

PR ANAST XTRHEPATC BILIARY DUCTS & GI TRACT

Professional

Both

$10,136.46

Service Code	HCPCS 47760
Min. Negotiated Rate	$7,602.34
Max. Negotiated Rate	$7,602.34
Rate for Payer: Cash Price	$2,700.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,602.34
Rate for Payer: SOMOS Essential	$7,602.34

PR ANATOMIC GUIDE 3D PRINTED 1ST ANATOMIC GUIDE

Professional

Both

$157.29

Service Code	HCPCS 0561T
Min. Negotiated Rate	$117.97
Max. Negotiated Rate	$117.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$117.97
Rate for Payer: SOMOS Essential	$117.97

PR ANATOMIC GUIDE 3D PRINTED EA ADDL ANATOMIC GUIDE

Professional

Both

$78.65

Service Code	HCPCS 0562T
Min. Negotiated Rate	$58.99
Max. Negotiated Rate	$58.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$58.99
Rate for Payer: SOMOS Essential	$58.99

PR ANATOMIC MODEL 3D PRINTED 1ST COMPNT ANTMC STRUX

Professional

Both

$39.27

Service Code	HCPCS 0559T
Min. Negotiated Rate	$29.45
Max. Negotiated Rate	$29.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$29.45
Rate for Payer: SOMOS Essential	$29.45

PR ANATOMIC MODEL 3D PRINTED EA ADDL COMPONENT

Professional

Both

$19.64

Service Code	HCPCS 0560T
Min. Negotiated Rate	$14.73
Max. Negotiated Rate	$14.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$14.73
Rate for Payer: SOMOS Essential	$14.73

PR ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS THER IVNTJ

Professional

Both

$654.68

Service Code	HCPCS 35400
Min. Negotiated Rate	$491.01
Max. Negotiated Rate	$491.01
Rate for Payer: Cash Price	$173.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$491.01
Rate for Payer: SOMOS Essential	$491.01

PR ANKLE DISARTICULATION

Professional

Both

$2,814.91

Service Code	HCPCS 27889
Min. Negotiated Rate	$2,111.18
Max. Negotiated Rate	$2,111.18
Rate for Payer: Cash Price	$759.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,111.18
Rate for Payer: SOMOS Essential	$2,111.18

PR ANNUAL ALCOHOL SCREEN 15 MIN

Professional

Both

$36.79

Service Code	HCPCS G0442
Min. Negotiated Rate	$27.59
Max. Negotiated Rate	$27.59
Rate for Payer: Cash Price	$10.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27.59
Rate for Payer: SOMOS Essential	$27.59

PR ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG

Professional

Both

$344.02

Service Code	HCPCS 99170
Min. Negotiated Rate	$258.02
Max. Negotiated Rate	$258.02
Rate for Payer: Cash Price	$93.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$258.02
Rate for Payer: SOMOS Essential	$258.02

PR ANOPLASTY PLASTIC OPERATION STRICTURE ADULT

Professional

Both

$2,841.48

Service Code	HCPCS 46700
Min. Negotiated Rate	$2,131.11
Max. Negotiated Rate	$2,131.11
Rate for Payer: Cash Price	$765.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,131.11
Rate for Payer: SOMOS Essential	$2,131.11

PR ANOPLASTY PLASTIC OPERATION STRICTURE INFANT

Professional

Both

$2,582.06

Service Code	HCPCS 46705
Min. Negotiated Rate	$1,936.54
Max. Negotiated Rate	$1,936.54
Rate for Payer: Cash Price	$690.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,936.54
Rate for Payer: SOMOS Essential	$1,936.54

PR ANORECTAL MANOMETRY

Professional

Both

$351.12

Service Code	HCPCS 91122 26
Min. Negotiated Rate	$263.34
Max. Negotiated Rate	$263.34
Rate for Payer: Cash Price	$95.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$263.34
Rate for Payer: SOMOS Essential	$263.34

Know your out-of-pocket cost for care.

All Charges