St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR ARTHRODESIS GLENOHUMERAL JT W/AUTOGENOUS GRAFT

Professional

Both

$5,669.48

Service Code	HCPCS 23802
Min. Negotiated Rate	$4,252.11
Max. Negotiated Rate	$4,252.11
Rate for Payer: Cash Price	$1,529.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,252.11
Rate for Payer: SOMOS Essential	$4,252.11

PR ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT

Professional

Both

$1,414.32

Service Code	HCPCS 28755
Min. Negotiated Rate	$1,060.74
Max. Negotiated Rate	$1,060.74
Rate for Payer: Cash Price	$390.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,060.74
Rate for Payer: SOMOS Essential	$1,060.74

PR ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT

Professional

Both

$2,469.32

Service Code	HCPCS 28750
Min. Negotiated Rate	$1,851.99
Max. Negotiated Rate	$1,851.99
Rate for Payer: Cash Price	$674.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,851.99
Rate for Payer: SOMOS Essential	$1,851.99

PR ARTHRODESIS HIP JOINT W/OBTAINING GRAFT

Professional

Both

$7,066.43

Service Code	HCPCS 27284
Min. Negotiated Rate	$5,299.82
Max. Negotiated Rate	$5,299.82
Rate for Payer: Cash Price	$1,900.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,299.82
Rate for Payer: SOMOS Essential	$5,299.82

PR ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ

Professional

Both

$2,714.57

Service Code	HCPCS 26860
Min. Negotiated Rate	$2,035.93
Max. Negotiated Rate	$2,035.93
Rate for Payer: Cash Price	$733.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,035.93
Rate for Payer: SOMOS Essential	$2,035.93

PR ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT

Professional

Both

$439.32

Service Code	HCPCS 26861
Min. Negotiated Rate	$329.49
Max. Negotiated Rate	$329.49
Rate for Payer: Cash Price	$119.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$329.49
Rate for Payer: SOMOS Essential	$329.49

PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT

Professional

Both

$991.97

Service Code	HCPCS 26863
Min. Negotiated Rate	$743.98
Max. Negotiated Rate	$743.98
Rate for Payer: Cash Price	$265.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$743.98
Rate for Payer: SOMOS Essential	$743.98

PR ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT

Professional

Both

$3,387.41

Service Code	HCPCS 26862
Min. Negotiated Rate	$2,540.56
Max. Negotiated Rate	$2,540.56
Rate for Payer: Cash Price	$916.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,540.56
Rate for Payer: SOMOS Essential	$2,540.56

PR ARTHRODESIS KNEE ANY TECHNIQUE

Professional

Both

$6,507.20

Service Code	HCPCS 27580
Min. Negotiated Rate	$4,880.40
Max. Negotiated Rate	$4,880.40
Rate for Payer: Cash Price	$1,756.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,880.40
Rate for Payer: SOMOS Essential	$4,880.40

PR ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR

Professional

Both

$7,465.85

Service Code	HCPCS 22533
Min. Negotiated Rate	$5,599.39
Max. Negotiated Rate	$5,599.39
Rate for Payer: Cash Price	$2,013.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,599.39
Rate for Payer: SOMOS Essential	$5,599.39

PR ARTHRODESIS LATERAL EXTRACAVITARY THORACIC

Professional

Both

$8,355.66

Service Code	HCPCS 22532
Min. Negotiated Rate	$6,266.74
Max. Negotiated Rate	$6,266.74
Rate for Payer: Cash Price	$2,217.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,266.74
Rate for Payer: SOMOS Essential	$6,266.74

PR ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR

Professional

Both

$1,654.70

Service Code	HCPCS 22534
Min. Negotiated Rate	$1,241.02
Max. Negotiated Rate	$1,241.02
Rate for Payer: Cash Price	$438.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,241.02
Rate for Payer: SOMOS Essential	$1,241.02

PR ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ

Professional

Both

$3,255.00

Service Code	HCPCS 26850
Min. Negotiated Rate	$2,441.25
Max. Negotiated Rate	$2,441.25
Rate for Payer: Cash Price	$877.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,441.25
Rate for Payer: SOMOS Essential	$2,441.25

PR ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT

Professional

Both

$2,645.37

Service Code	HCPCS 28740
Min. Negotiated Rate	$1,984.03
Max. Negotiated Rate	$1,984.03
Rate for Payer: Cash Price	$721.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,984.03
Rate for Payer: SOMOS Essential	$1,984.03

PR ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT

Professional

Both

$3,682.49

Service Code	HCPCS 26852
Min. Negotiated Rate	$2,761.87
Max. Negotiated Rate	$2,761.87
Rate for Payer: Cash Price	$995.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,761.87
Rate for Payer: SOMOS Essential	$2,761.87

PR ARTHRODESIS PANTALAR

Professional

Both

$5,254.03

Service Code	HCPCS 28705
Min. Negotiated Rate	$3,940.52
Max. Negotiated Rate	$3,940.52
Rate for Payer: Cash Price	$1,425.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,940.52
Rate for Payer: SOMOS Essential	$3,940.52

PR ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2

Professional

Both

$7,152.85

Service Code	HCPCS 22595
Min. Negotiated Rate	$5,364.64
Max. Negotiated Rate	$5,364.64
Rate for Payer: Cash Price	$1,907.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,364.64
Rate for Payer: SOMOS Essential	$5,364.64

PR ARTHRODESIS POSTERIOR CRANIOCERVICAL

Professional

Both

$7,513.45

Service Code	HCPCS 22590
Min. Negotiated Rate	$5,635.09
Max. Negotiated Rate	$5,635.09
Rate for Payer: Cash Price	$1,996.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,635.09
Rate for Payer: SOMOS Essential	$5,635.09

PR ARTHRODESIS POSTERIOR INTERBODY EA ADDL

Professional

Both

$1,507.52

Service Code	HCPCS 22632
Min. Negotiated Rate	$1,130.64
Max. Negotiated Rate	$1,130.64
Rate for Payer: Cash Price	$397.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,130.64
Rate for Payer: SOMOS Essential	$1,130.64

PR ARTHRODESIS POSTERIOR INTERBODY LUMBAR

Professional

Both

$7,330.82

Service Code	HCPCS 22630
Min. Negotiated Rate	$5,498.12
Max. Negotiated Rate	$5,498.12
Rate for Payer: Cash Price	$1,948.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,498.12
Rate for Payer: SOMOS Essential	$5,498.12

PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR

Professional

Both

$7,251.48

Service Code	HCPCS 22612
Min. Negotiated Rate	$5,438.61
Max. Negotiated Rate	$5,438.61
Rate for Payer: Cash Price	$1,930.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,438.61
Rate for Payer: SOMOS Essential	$5,438.61

PR ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC

Professional

Both

$5,956.16

Service Code	HCPCS 22610
Min. Negotiated Rate	$4,467.12
Max. Negotiated Rate	$4,467.12
Rate for Payer: Cash Price	$1,590.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,467.12
Rate for Payer: SOMOS Essential	$4,467.12

PR ARTHRODESIS POSTERIOR SPINAL DFRM 13/> VRT SEG

Professional

Both

$11,087.16

Service Code	HCPCS 22804
Min. Negotiated Rate	$8,315.37
Max. Negotiated Rate	$8,315.37
Rate for Payer: Cash Price	$2,958.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,315.37
Rate for Payer: SOMOS Essential	$8,315.37

PR ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SEG

Professional

Both

$9,678.76

Service Code	HCPCS 22802
Min. Negotiated Rate	$7,259.07
Max. Negotiated Rate	$7,259.07
Rate for Payer: Cash Price	$2,582.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,259.07
Rate for Payer: SOMOS Essential	$7,259.07

PR ARTHRODESIS POSTERIOR SPINAL DFRM UP 6 VRT SEG

Professional

Both

$6,260.17

Service Code	HCPCS 22800
Min. Negotiated Rate	$4,695.13
Max. Negotiated Rate	$4,695.13
Rate for Payer: Cash Price	$1,670.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,695.13
Rate for Payer: SOMOS Essential	$4,695.13

Know your out-of-pocket cost for care.

All Charges