St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS

Professional

Both

$3,738.39

Service Code	HCPCS 33259
Min. Negotiated Rate	$2,803.79
Max. Negotiated Rate	$2,803.79
Rate for Payer: Cash Price	$1,000.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,803.79
Rate for Payer: SOMOS Essential	$2,803.79

PR ATRIAL SEPTECTOMY/SEPTOSTOMY CLOSED HEART

Professional

Both

$5,776.89

Service Code	HCPCS 33735
Min. Negotiated Rate	$4,332.67
Max. Negotiated Rate	$4,332.67
Rate for Payer: Cash Price	$1,540.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,332.67
Rate for Payer: SOMOS Essential	$4,332.67

PR ATRIAL SEPTECTOMY/SEPTOSTOMY OPEN HEART W/BYPASS

Professional

Both

$6,269.48

Service Code	HCPCS 33736
Min. Negotiated Rate	$4,702.11
Max. Negotiated Rate	$4,702.11
Rate for Payer: Cash Price	$1,670.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,702.11
Rate for Payer: SOMOS Essential	$4,702.11

PR ATRIAL SEPTECT/SEPTOST OPN HRT W/INFL OCCLUSION

Professional

Both

$5,784.00

Service Code	HCPCS 33737
Min. Negotiated Rate	$4,338.00
Max. Negotiated Rate	$4,338.00
Rate for Payer: Cash Price	$1,541.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,338.00
Rate for Payer: SOMOS Essential	$4,338.00

PR ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN

Professional

Both

$294.28

Service Code	HCPCS 99464
Min. Negotiated Rate	$220.71
Max. Negotiated Rate	$220.71
Rate for Payer: Cash Price	$80.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$220.71
Rate for Payer: SOMOS Essential	$220.71

PR AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC

Professional

Both

$845.60

Service Code	HCPCS 20938
Min. Negotiated Rate	$634.20
Max. Negotiated Rate	$634.20
Rate for Payer: Cash Price	$225.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$634.20
Rate for Payer: SOMOS Essential	$634.20

PR AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION

Professional

Both

$764.12

Service Code	HCPCS 20937
Min. Negotiated Rate	$573.09
Max. Negotiated Rate	$573.09
Rate for Payer: Cash Price	$201.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$573.09
Rate for Payer: SOMOS Essential	$573.09

PR AUTOL CELL IMPLT ADPS TISS HRVG CELL IMPLT CRTJ

Professional

Both

$963.76

Service Code	HCPCS 0565T
Min. Negotiated Rate	$722.82
Max. Negotiated Rate	$722.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$722.82
Rate for Payer: SOMOS Essential	$722.82

PR AUTOL CELL IMPLT ADPS TISS NJX IMPLT KNEE UNI

Professional

Both

$422.07

Service Code	HCPCS 0566T
Min. Negotiated Rate	$316.55
Max. Negotiated Rate	$316.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$316.55
Rate for Payer: SOMOS Essential	$316.55

PR AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE

Professional

Both

$7,267.23

Service Code	HCPCS 27412
Min. Negotiated Rate	$5,450.42
Max. Negotiated Rate	$5,450.42
Rate for Payer: Cash Price	$1,957.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,450.42
Rate for Payer: SOMOS Essential	$5,450.42

PR AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1

Professional

Both

$222.11

Service Code	HCPCS 11730
Min. Negotiated Rate	$166.58
Max. Negotiated Rate	$166.58
Rate for Payer: Cash Price	$60.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$166.58
Rate for Payer: SOMOS Essential	$166.58

PR AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL

Professional

Both

$71.47

Service Code	HCPCS 11732
Min. Negotiated Rate	$53.60
Max. Negotiated Rate	$53.60
Rate for Payer: Cash Price	$18.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$53.60
Rate for Payer: SOMOS Essential	$53.60

PR AXILLARY LYMPHADENECTOMY COMPLETE

Professional

Both

$3,974.60

Service Code	HCPCS 38745
Min. Negotiated Rate	$2,980.95
Max. Negotiated Rate	$2,980.95
Rate for Payer: Cash Price	$1,065.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,980.95
Rate for Payer: SOMOS Essential	$2,980.95

PR AXILLARY LYMPHADENECTOMY SUPERFICIAL

Professional

Both

$3,162.60

Service Code	HCPCS 38740
Min. Negotiated Rate	$2,371.95
Max. Negotiated Rate	$2,371.95
Rate for Payer: Cash Price	$848.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,371.95
Rate for Payer: SOMOS Essential	$2,371.95

PRAZIQUANTEL 600 MG PO TABS [11113]

Facility

$89.68

Service Code	NDC 49884023183
Hospital Charge Code	49884023183
Hospital Revenue Code	250
Min. Negotiated Rate	$31.39
Max. Negotiated Rate	$71.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.84
Rate for Payer: Aetna Government	$44.84
Rate for Payer: Brighton Health Commercial	$67.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.98
Rate for Payer: Group Health Inc Commercial	$44.84
Rate for Payer: Group Health Inc Medicare	$31.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.84
Rate for Payer: Hamaspik Choice Inc Medicare	$44.84
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$58.29

PRAZOSIN HCL 1 MG PO CAPS [6468]

Facility

$1.62

Service Code	NDC 00904702061
Hospital Charge Code	00904702061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.81
Rate for Payer: Aetna Government	$0.81
Rate for Payer: Brighton Health Commercial	$1.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.10
Rate for Payer: Group Health Inc Commercial	$0.81
Rate for Payer: Group Health Inc Medicare	$0.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.81
Rate for Payer: Hamaspik Choice Inc Medicare	$0.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.05

PR B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA

Professional

Both

$5,180.42

Service Code	HCPCS 27170
Min. Negotiated Rate	$3,885.32
Max. Negotiated Rate	$3,885.32
Rate for Payer: Cash Price	$1,391.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,885.32
Rate for Payer: SOMOS Essential	$3,885.32

PR BACKBENCH PREPJ CORNEAL ENDOTHELIAL ALLOGRAFT

Professional

Both

$388.75

Service Code	HCPCS 65757
Min. Negotiated Rate	$291.56
Max. Negotiated Rate	$291.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$291.56
Rate for Payer: SOMOS Essential	$291.56

PR BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS

Professional

Both

$6,307.84

Service Code	HCPCS 61630
Min. Negotiated Rate	$4,730.88
Max. Negotiated Rate	$4,730.88
Rate for Payer: Cash Price	$1,665.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,730.88
Rate for Payer: SOMOS Essential	$4,730.88

PR BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT

Professional

Both

$554.19

Service Code	HCPCS 47542
Min. Negotiated Rate	$415.64
Max. Negotiated Rate	$415.64
Rate for Payer: Cash Price	$148.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$415.64
Rate for Payer: SOMOS Essential	$415.64

PR BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I

Professional

Both

$735.18

Service Code	HCPCS 50706
Min. Negotiated Rate	$551.38
Max. Negotiated Rate	$551.38
Rate for Payer: Cash Price	$198.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$551.38
Rate for Payer: SOMOS Essential	$551.38

PR BANDING PULMONARY ARTERY

Professional

Both

$5,355.46

Service Code	HCPCS 33690
Min. Negotiated Rate	$4,016.60
Max. Negotiated Rate	$4,016.60
Rate for Payer: Cash Price	$1,428.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,016.60
Rate for Payer: SOMOS Essential	$4,016.60

PR BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT

Professional

Both

$21.42

Service Code	HCPCS 96127
Min. Negotiated Rate	$16.06
Max. Negotiated Rate	$16.06
Rate for Payer: Cash Price	$5.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16.06
Rate for Payer: SOMOS Essential	$16.06

PR BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE

Professional

Both

$443.63

Service Code	HCPCS 92524
Min. Negotiated Rate	$332.72
Max. Negotiated Rate	$332.72
Rate for Payer: Cash Price	$122.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$332.72
Rate for Payer: SOMOS Essential	$332.72

PR BEHAVIOR COUNSEL OBESITY 15M

Professional

Both

$94.61

Service Code	HCPCS G0447
Min. Negotiated Rate	$70.96
Max. Negotiated Rate	$70.96
Rate for Payer: Cash Price	$25.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$70.96
Rate for Payer: SOMOS Essential	$70.96

Know your out-of-pocket cost for care.

All Charges