St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR BIOPSY FLOOR MOUTH

Professional

Both

$397.04

Service Code	HCPCS 41108
Min. Negotiated Rate	$297.78
Max. Negotiated Rate	$297.78
Rate for Payer: Cash Price	$107.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$297.78
Rate for Payer: SOMOS Essential	$297.78

PR BIOPSY INTRANASAL

Professional

Both

$288.58

Service Code	HCPCS 30100
Min. Negotiated Rate	$216.44
Max. Negotiated Rate	$216.44
Rate for Payer: Cash Price	$79.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$216.44
Rate for Payer: SOMOS Essential	$216.44

PR BIOPSY LACRIMAL GLAND

Professional

Both

$1,169.28

Service Code	HCPCS 68510
Min. Negotiated Rate	$876.96
Max. Negotiated Rate	$876.96
Rate for Payer: Cash Price	$321.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$876.96
Rate for Payer: SOMOS Essential	$876.96

PR BIOPSY LACRIMAL SAC

Professional

Both

$1,053.01

Service Code	HCPCS 68525
Min. Negotiated Rate	$789.76
Max. Negotiated Rate	$789.76
Rate for Payer: Cash Price	$288.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$789.76
Rate for Payer: SOMOS Essential	$789.76

PR BIOPSY LIVER NEEDLE PERCUTANEOUS

Professional

Both

$363.86

Service Code	HCPCS 47000
Min. Negotiated Rate	$272.90
Max. Negotiated Rate	$272.90
Rate for Payer: Cash Price	$98.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$272.90
Rate for Payer: SOMOS Essential	$272.90

PR BIOPSY LIVER WEDGE

Professional

Both

$3,817.73

Service Code	HCPCS 47100
Min. Negotiated Rate	$2,863.30
Max. Negotiated Rate	$2,863.30
Rate for Payer: Cash Price	$1,022.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,863.30
Rate for Payer: SOMOS Essential	$2,863.30

PR BIOPSY MUSCLE DEEP

Professional

Both

$703.61

Service Code	HCPCS 20205
Min. Negotiated Rate	$527.71
Max. Negotiated Rate	$527.71
Rate for Payer: Cash Price	$188.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$527.71
Rate for Payer: SOMOS Essential	$527.71

PR BIOPSY MUSCLE PERCUTANEOUS NEEDLE

Professional

Both

$237.62

Service Code	HCPCS 20206
Min. Negotiated Rate	$178.22
Max. Negotiated Rate	$178.22
Rate for Payer: Cash Price	$64.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$178.22
Rate for Payer: SOMOS Essential	$178.22

PR BIOPSY MUSCLE SUPERFICIAL

Professional

Both

$427.84

Service Code	HCPCS 20200
Min. Negotiated Rate	$320.88
Max. Negotiated Rate	$320.88
Rate for Payer: Cash Price	$114.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$320.88
Rate for Payer: SOMOS Essential	$320.88

PR BIOPSY NAIL UNIT SEPARATE PROCEDURE

Professional

Both

$247.17

Service Code	HCPCS 11755
Min. Negotiated Rate	$185.38
Max. Negotiated Rate	$185.38
Rate for Payer: Cash Price	$67.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$185.38
Rate for Payer: SOMOS Essential	$185.38

PR BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE

Professional

Both

$532.67

Service Code	HCPCS 42804
Min. Negotiated Rate	$399.50
Max. Negotiated Rate	$399.50
Rate for Payer: Cash Price	$145.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$399.50
Rate for Payer: SOMOS Essential	$399.50

PR BIOPSY NERVE

Professional

Both

$879.10

Service Code	HCPCS 64795
Min. Negotiated Rate	$659.32
Max. Negotiated Rate	$659.32
Rate for Payer: Cash Price	$237.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$659.32
Rate for Payer: SOMOS Essential	$659.32

PR BIOPSY OF LIP

Professional

Both

$287.70

Service Code	HCPCS 40490
Min. Negotiated Rate	$215.78
Max. Negotiated Rate	$215.78
Rate for Payer: Cash Price	$78.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$215.78
Rate for Payer: SOMOS Essential	$215.78

PR BIOPSY OROPHARYNX

Professional

Both

$502.46

Service Code	HCPCS 42800
Min. Negotiated Rate	$376.84
Max. Negotiated Rate	$376.84
Rate for Payer: Cash Price	$138.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$376.84
Rate for Payer: SOMOS Essential	$376.84

PR BIOPSY OVARY UNI/BI SEPARATE PROCEDURE

Professional

Both

$1,916.99

Service Code	HCPCS 58900
Min. Negotiated Rate	$1,437.74
Max. Negotiated Rate	$1,437.74
Rate for Payer: Cash Price	$517.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,437.74
Rate for Payer: SOMOS Essential	$1,437.74

PR BIOPSY PALATE UVULA

Professional

Both

$472.57

Service Code	HCPCS 42100
Min. Negotiated Rate	$354.43
Max. Negotiated Rate	$354.43
Rate for Payer: Cash Price	$129.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$354.43
Rate for Payer: SOMOS Essential	$354.43

PR BIOPSY PANCREA PERCUTANEOUS NEEDLE

Professional

Both

$967.54

Service Code	HCPCS 48102
Min. Negotiated Rate	$725.66
Max. Negotiated Rate	$725.66
Rate for Payer: Cash Price	$261.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$725.66
Rate for Payer: SOMOS Essential	$725.66

PR BIOPSY PANCREAS OPEN

Professional

Both

$3,994.34

Service Code	HCPCS 48100
Min. Negotiated Rate	$2,995.76
Max. Negotiated Rate	$2,995.76
Rate for Payer: Cash Price	$1,073.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,995.76
Rate for Payer: SOMOS Essential	$2,995.76

PR BIOPSY PENIS DEEP STRUCTURES

Professional

Both

$893.24

Service Code	HCPCS 54105
Min. Negotiated Rate	$669.93
Max. Negotiated Rate	$669.93
Rate for Payer: Cash Price	$245.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$669.93
Rate for Payer: SOMOS Essential	$669.93

PR BIOPSY PENIS SEPARATE PROCEDURE

Professional

Both

$505.44

Service Code	HCPCS 54100
Min. Negotiated Rate	$379.08
Max. Negotiated Rate	$379.08
Rate for Payer: Cash Price	$139.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$379.08
Rate for Payer: SOMOS Essential	$379.08

PR BIOPSY PLEURA PERCUTANEOUS NEEDLE

Professional

Both

$347.31

Service Code	HCPCS 32400
Min. Negotiated Rate	$260.48
Max. Negotiated Rate	$260.48
Rate for Payer: Cash Price	$93.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$260.48
Rate for Payer: SOMOS Essential	$260.48

PR BIOPSY PROSTATE INCISIONAL ANY APPROACH

Professional

Both

$1,111.71

Service Code	HCPCS 55705
Min. Negotiated Rate	$833.78
Max. Negotiated Rate	$833.78
Rate for Payer: Cash Price	$303.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$833.78
Rate for Payer: SOMOS Essential	$833.78

PR BIOPSY SALIVARY GLAND INCISIONAL

Professional

Both

$976.89

Service Code	HCPCS 42405
Min. Negotiated Rate	$732.67
Max. Negotiated Rate	$732.67
Rate for Payer: Cash Price	$265.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$732.67
Rate for Payer: SOMOS Essential	$732.67

PR BIOPSY SALIVARY GLAND NEEDLE

Professional

Both

$221.66

Service Code	HCPCS 42400
Min. Negotiated Rate	$166.24
Max. Negotiated Rate	$166.24
Rate for Payer: Cash Price	$60.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$166.24
Rate for Payer: SOMOS Essential	$166.24

PR BIOPSY SOFT TISSUE BACK/FLANK DEEP

Professional

Both

$1,674.61

Service Code	HCPCS 21925
Min. Negotiated Rate	$1,255.96
Max. Negotiated Rate	$1,255.96
Rate for Payer: Cash Price	$457.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,255.96
Rate for Payer: SOMOS Essential	$1,255.96

Know your out-of-pocket cost for care.

All Charges