St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR ARTHRODESIS PRESACRAL INTRBDY W/INSTRUMENT L5-S1

Professional

Both

$9,775.40

Service Code	HCPCS 22586
Min. Negotiated Rate	$7,331.55
Max. Negotiated Rate	$7,331.55
Rate for Payer: Cash Price	$2,583.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,331.55
Rate for Payer: SOMOS Essential	$7,331.55

PR ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC

Professional

Both

$1,815.31

Service Code	HCPCS 22614
Min. Negotiated Rate	$1,361.48
Max. Negotiated Rate	$1,361.48
Rate for Payer: Cash Price	$479.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,361.48
Rate for Payer: SOMOS Essential	$1,361.48

PR ARTHRODESIS SACROILIAC JOINT PERCUTANEOUS

Professional

Both

$3,615.54

Service Code	HCPCS 27279
Min. Negotiated Rate	$2,711.66
Max. Negotiated Rate	$2,711.66
Rate for Payer: Cash Price	$952.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,711.66
Rate for Payer: SOMOS Essential	$2,711.66

PR ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ

Professional

Both

$6,262.31

Service Code	HCPCS 27280
Min. Negotiated Rate	$4,696.73
Max. Negotiated Rate	$4,696.73
Rate for Payer: Cash Price	$1,667.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,696.73
Rate for Payer: SOMOS Essential	$4,696.73

PR ARTHRODESIS SUBTALAR

Professional

Both

$3,374.25

Service Code	HCPCS 28725
Min. Negotiated Rate	$2,530.69
Max. Negotiated Rate	$2,530.69
Rate for Payer: Cash Price	$918.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,530.69
Rate for Payer: SOMOS Essential	$2,530.69

PR ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT

Professional

Both

$3,814.13

Service Code	HCPCS 27282
Min. Negotiated Rate	$2,860.60
Max. Negotiated Rate	$2,860.60
Rate for Payer: Cash Price	$1,029.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,860.60
Rate for Payer: SOMOS Essential	$2,860.60

PR ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL

Professional

Both

$3,046.09

Service Code	HCPCS 27871
Min. Negotiated Rate	$2,284.57
Max. Negotiated Rate	$2,284.57
Rate for Payer: Cash Price	$824.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,284.57
Rate for Payer: SOMOS Essential	$2,284.57

PR ARTHRODESIS TRIPLE

Professional

Both

$4,095.95

Service Code	HCPCS 28715
Min. Negotiated Rate	$3,071.96
Max. Negotiated Rate	$3,071.96
Rate for Payer: Cash Price	$1,109.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,071.96
Rate for Payer: SOMOS Essential	$3,071.96

PR ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT

Professional

Both

$3,234.70

Service Code	HCPCS 25800
Min. Negotiated Rate	$2,426.02
Max. Negotiated Rate	$2,426.02
Rate for Payer: Cash Price	$873.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,426.02
Rate for Payer: SOMOS Essential	$2,426.02

PR ARTHRODESIS WRIST LIMITED W/AUTOGRAFT

Professional

Both

$3,499.13

Service Code	HCPCS 25825
Min. Negotiated Rate	$2,624.35
Max. Negotiated Rate	$2,624.35
Rate for Payer: Cash Price	$948.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,624.35
Rate for Payer: SOMOS Essential	$2,624.35

PR ARTHRODESIS WRIST LIMITED W/O BONE GRAFT

Professional

Both

$2,876.09

Service Code	HCPCS 25820
Min. Negotiated Rate	$2,157.07
Max. Negotiated Rate	$2,157.07
Rate for Payer: Cash Price	$778.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,157.07
Rate for Payer: SOMOS Essential	$2,157.07

PR ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT

Professional

Both

$3,823.26

Service Code	HCPCS 25810
Min. Negotiated Rate	$2,867.44
Max. Negotiated Rate	$2,867.44
Rate for Payer: Cash Price	$1,034.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,867.44
Rate for Payer: SOMOS Essential	$2,867.44

PR ARTHRODESIS WRIST W/SLIDING GRAFT

Professional

Both

$3,760.82

Service Code	HCPCS 25805
Min. Negotiated Rate	$2,820.62
Max. Negotiated Rate	$2,820.62
Rate for Payer: Cash Price	$1,016.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,820.62
Rate for Payer: SOMOS Essential	$2,820.62

PR ARTHRO, LOOSE BODY + CHONDRO

Professional

Both

$373.98

Service Code	HCPCS G0289
Min. Negotiated Rate	$280.48
Max. Negotiated Rate	$280.48
Rate for Payer: Cash Price	$100.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$280.48
Rate for Payer: SOMOS Essential	$280.48

PR ARTHROPLASTY ANKLE

Professional

Both

$2,617.09

Service Code	HCPCS 27700
Min. Negotiated Rate	$1,962.82
Max. Negotiated Rate	$1,962.82
Rate for Payer: Cash Price	$854.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,962.82
Rate for Payer: SOMOS Essential	$1,962.82

PR ARTHROPLASTY ANKLE REVISION TOTAL ANKLE

Professional

Both

$4,866.54

Service Code	HCPCS 27703
Min. Negotiated Rate	$3,649.90
Max. Negotiated Rate	$3,649.90
Rate for Payer: Cash Price	$1,312.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,649.90
Rate for Payer: SOMOS Essential	$3,649.90

PR ARTHROPLASTY ANKLE W/IMPLANT

Professional

Both

$4,205.67

Service Code	HCPCS 27702
Min. Negotiated Rate	$3,154.25
Max. Negotiated Rate	$3,154.25
Rate for Payer: Cash Price	$1,138.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,154.25
Rate for Payer: SOMOS Essential	$3,154.25

PR ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT

Professional

Both

$4,458.58

Service Code	HCPCS 24361
Min. Negotiated Rate	$3,343.94
Max. Negotiated Rate	$3,343.94
Rate for Payer: Cash Price	$1,202.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,343.94
Rate for Payer: SOMOS Essential	$3,343.94

PR ARTHROPLASTY ELBOW W/MEMBRANE

Professional

Both

$4,000.99

Service Code	HCPCS 24360
Min. Negotiated Rate	$3,000.74
Max. Negotiated Rate	$3,000.74
Rate for Payer: Cash Price	$1,080.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,000.74
Rate for Payer: SOMOS Essential	$3,000.74

PR ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE

Professional

Both

$3,860.89

Service Code	HCPCS 27442
Min. Negotiated Rate	$2,895.67
Max. Negotiated Rate	$2,895.67
Rate for Payer: Cash Price	$1,037.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,895.67
Rate for Payer: SOMOS Essential	$2,895.67

PR ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER

Professional

Both

$6,354.95

Service Code	HCPCS 23472
Min. Negotiated Rate	$4,766.21
Max. Negotiated Rate	$4,766.21
Rate for Payer: Cash Price	$1,710.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,766.21
Rate for Payer: SOMOS Essential	$4,766.21

PR ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY

Professional

Both

$5,269.18

Service Code	HCPCS 23470
Min. Negotiated Rate	$3,951.88
Max. Negotiated Rate	$3,951.88
Rate for Payer: Cash Price	$1,422.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,951.88
Rate for Payer: SOMOS Essential	$3,951.88

PR ARTHROPLASTY INTERPHALANGEAL JOINT EACH

Professional

Both

$1,935.15

Service Code	HCPCS 26535
Min. Negotiated Rate	$1,451.36
Max. Negotiated Rate	$1,451.36
Rate for Payer: Cash Price	$527.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,451.36
Rate for Payer: SOMOS Essential	$1,451.36

PR ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA

Professional

Both

$3,316.29

Service Code	HCPCS 26536
Min. Negotiated Rate	$2,487.22
Max. Negotiated Rate	$2,487.22
Rate for Payer: Cash Price	$895.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,487.22
Rate for Payer: SOMOS Essential	$2,487.22

PR ARTHROPLASTY KNEE HINGE PROSTHESIS

Professional

Both

$5,536.69

Service Code	HCPCS 27445
Min. Negotiated Rate	$4,152.52
Max. Negotiated Rate	$4,152.52
Rate for Payer: Cash Price	$1,491.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,152.52
Rate for Payer: SOMOS Essential	$4,152.52

Know your out-of-pocket cost for care.

All Charges