St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC

Professional

Both

$69.51

Service Code	HCPCS 15272
Min. Negotiated Rate	$52.13
Max. Negotiated Rate	$52.13
Rate for Payer: Cash Price	$19.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$52.13
Rate for Payer: SOMOS Essential	$52.13

PR AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT

Professional

Both

$4,684.68

Service Code	HCPCS 66180
Min. Negotiated Rate	$3,513.51
Max. Negotiated Rate	$3,513.51
Rate for Payer: Cash Price	$1,291.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,513.51
Rate for Payer: SOMOS Essential	$3,513.51

PR AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT

Professional

Both

$4,445.56

Service Code	HCPCS 66179
Min. Negotiated Rate	$3,334.17
Max. Negotiated Rate	$3,334.17
Rate for Payer: Cash Price	$1,226.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,334.17
Rate for Payer: SOMOS Essential	$3,334.17

PR A-ROOT TLCJ VSD PULM STNS RPR W/O C OST RIMPLTJ

Professional

Both

$14,340.73

Service Code	HCPCS 33782
Min. Negotiated Rate	$10,755.55
Max. Negotiated Rate	$10,755.55
Rate for Payer: Cash Price	$3,801.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,755.55
Rate for Payer: SOMOS Essential	$10,755.55

PR A-ROOT TLCJ VSD PULM STNS RPR W/RIMPLTJ C OSTIA

Professional

Both

$15,499.30

Service Code	HCPCS 33783
Min. Negotiated Rate	$11,624.48
Max. Negotiated Rate	$11,624.48
Rate for Payer: Cash Price	$4,109.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$11,624.48
Rate for Payer: SOMOS Essential	$11,624.48

PR ARREST EPIPHYSEAL ANY METHOD TIBIA & FIBULA

Professional

Both

$3,146.08

Service Code	HCPCS 27740
Min. Negotiated Rate	$2,359.56
Max. Negotiated Rate	$2,359.56
Rate for Payer: Cash Price	$851.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,359.56
Rate for Payer: SOMOS Essential	$2,359.56

PR ARREST EPIPHYSEAL DISTAL FEMUR

Professional

Both

$2,946.55

Service Code	HCPCS 27475
Min. Negotiated Rate	$2,209.91
Max. Negotiated Rate	$2,209.91
Rate for Payer: Cash Price	$797.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,209.91
Rate for Payer: SOMOS Essential	$2,209.91

PR ARREST EPIPHYSEAL OPEN DISTAL FIBULA

Professional

Both

$2,024.02

Service Code	HCPCS 27732
Min. Negotiated Rate	$1,518.02
Max. Negotiated Rate	$1,518.02
Rate for Payer: Cash Price	$550.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,518.02
Rate for Payer: SOMOS Essential	$1,518.02

PR ARREST EPIPHYSEAL OPEN DISTAL TIBIA

Professional

Both

$2,616.15

Service Code	HCPCS 27730
Min. Negotiated Rate	$1,962.11
Max. Negotiated Rate	$1,962.11
Rate for Payer: Cash Price	$709.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,962.11
Rate for Payer: SOMOS Essential	$1,962.11

PR ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA

Professional

Both

$2,922.82

Service Code	HCPCS 27734
Min. Negotiated Rate	$2,192.12
Max. Negotiated Rate	$2,192.12
Rate for Payer: Cash Price	$791.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,192.12
Rate for Payer: SOMOS Essential	$2,192.12

PR ARREST EPIPHYSEAL TIBIA & FIBULA PROXIMAL

Professional

Both

$3,257.07

Service Code	HCPCS 27477
Min. Negotiated Rate	$2,442.80
Max. Negotiated Rate	$2,442.80
Rate for Payer: Cash Price	$880.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,442.80
Rate for Payer: SOMOS Essential	$2,442.80

PR ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR

Professional

Both

$3,447.85

Service Code	HCPCS 27742
Min. Negotiated Rate	$2,585.89
Max. Negotiated Rate	$2,585.89
Rate for Payer: Cash Price	$933.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,585.89
Rate for Payer: SOMOS Essential	$2,585.89

PR ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB

Professional

Both

$4,068.16

Service Code	HCPCS 27479
Min. Negotiated Rate	$3,051.12
Max. Negotiated Rate	$3,051.12
Rate for Payer: Cash Price	$1,097.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,051.12
Rate for Payer: SOMOS Essential	$3,051.12

PR ARRST HEMIEPIPHYSL DSTL FEMUR/PROX TIBIA/FIBULA

Professional

Both

$2,989.46

Service Code	HCPCS 27485
Min. Negotiated Rate	$2,242.10
Max. Negotiated Rate	$2,242.10
Rate for Payer: Cash Price	$807.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,242.10
Rate for Payer: SOMOS Essential	$2,242.10

PR ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX

Professional

Both

$59.92

Service Code	HCPCS 36600
Min. Negotiated Rate	$44.94
Max. Negotiated Rate	$44.94
Rate for Payer: Cash Price	$16.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$44.94
Rate for Payer: SOMOS Essential	$44.94

PR ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT

Professional

Both

$2,935.56

Service Code	HCPCS 36821
Min. Negotiated Rate	$2,201.67
Max. Negotiated Rate	$2,201.67
Rate for Payer: Cash Price	$777.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,201.67
Rate for Payer: SOMOS Essential	$2,201.67

PR ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS

Professional

Both

$913.12

Service Code	HCPCS 33987
Min. Negotiated Rate	$684.84
Max. Negotiated Rate	$684.84
Rate for Payer: Cash Price	$242.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$684.84
Rate for Payer: SOMOS Essential	$684.84

PR ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2

Professional

Both

$7,943.22

Service Code	HCPCS 22551
Min. Negotiated Rate	$5,957.42
Max. Negotiated Rate	$5,957.42
Rate for Payer: Cash Price	$2,107.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,957.42
Rate for Payer: SOMOS Essential	$5,957.42

PR ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC

Professional

Both

$1,846.11

Service Code	HCPCS 22552
Min. Negotiated Rate	$1,384.58
Max. Negotiated Rate	$1,384.58
Rate for Payer: Cash Price	$486.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,384.58
Rate for Payer: SOMOS Essential	$1,384.58

PR ARTHRD ANT MIN DISCECT INTERBODY CERV BELOW C2

Professional

Both

$5,869.99

Service Code	HCPCS 22554
Min. Negotiated Rate	$4,402.49
Max. Negotiated Rate	$4,402.49
Rate for Payer: Cash Price	$1,564.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,402.49
Rate for Payer: SOMOS Essential	$4,402.49

PR ARTHRD ANT MIN DISCECTOMY INTERBODY THORACIC

Professional

Both

$7,709.73

Service Code	HCPCS 22556
Min. Negotiated Rate	$5,782.30
Max. Negotiated Rate	$5,782.30
Rate for Payer: Cash Price	$2,079.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,782.30
Rate for Payer: SOMOS Essential	$5,782.30

PR ARTHRD ANT TRANSORL/XTRORAL C1-C2 W/WO EXC ODNTD

Professional

Both

$9,447.34

Service Code	HCPCS 22548
Min. Negotiated Rate	$7,085.50
Max. Negotiated Rate	$7,085.50
Rate for Payer: Cash Price	$2,497.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,085.50
Rate for Payer: SOMOS Essential	$7,085.50

PR ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH

Professional

Both

$3,481.35

Service Code	HCPCS 26843
Min. Negotiated Rate	$2,611.01
Max. Negotiated Rate	$2,611.01
Rate for Payer: Cash Price	$938.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,611.01
Rate for Payer: SOMOS Essential	$2,611.01

PR ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT

Professional

Both

$3,828.09

Service Code	HCPCS 26844
Min. Negotiated Rate	$2,871.07
Max. Negotiated Rate	$2,871.07
Rate for Payer: Cash Price	$1,030.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,871.07
Rate for Payer: SOMOS Essential	$2,871.07

PR ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ

Professional

Both

$3,421.36

Service Code	HCPCS 26841
Min. Negotiated Rate	$2,566.02
Max. Negotiated Rate	$2,566.02
Rate for Payer: Cash Price	$927.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,566.02
Rate for Payer: SOMOS Essential	$2,566.02

Know your out-of-pocket cost for care.

All Charges