St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL

Professional

Both

$665.49

Service Code	HCPCS 21920
Min. Negotiated Rate	$499.12
Max. Negotiated Rate	$499.12
Rate for Payer: Cash Price	$181.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$499.12
Rate for Payer: SOMOS Essential	$499.12

PR BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP

Professional

Both

$1,630.30

Service Code	HCPCS 25066
Min. Negotiated Rate	$1,222.72
Max. Negotiated Rate	$1,222.72
Rate for Payer: Cash Price	$443.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,222.72
Rate for Payer: SOMOS Essential	$1,222.72

PR BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL

Professional

Both

$679.84

Service Code	HCPCS 25065
Min. Negotiated Rate	$509.88
Max. Negotiated Rate	$509.88
Rate for Payer: Cash Price	$185.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$509.88
Rate for Payer: SOMOS Essential	$509.88

PR BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP

Professional

Both

$1,816.96

Service Code	HCPCS 27614
Min. Negotiated Rate	$1,362.72
Max. Negotiated Rate	$1,362.72
Rate for Payer: Cash Price	$492.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,362.72
Rate for Payer: SOMOS Essential	$1,362.72

PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL

Professional

Both

$687.89

Service Code	HCPCS 27613
Min. Negotiated Rate	$515.92
Max. Negotiated Rate	$515.92
Rate for Payer: Cash Price	$189.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$515.92
Rate for Payer: SOMOS Essential	$515.92

PR BIOPSY SOFT TISSUE NECK/THORAX

Professional

Both

$671.23

Service Code	HCPCS 21550
Min. Negotiated Rate	$503.42
Max. Negotiated Rate	$503.42
Rate for Payer: Cash Price	$182.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$503.42
Rate for Payer: SOMOS Essential	$503.42

PR BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL

Professional

Both

$855.68

Service Code	HCPCS 27040
Min. Negotiated Rate	$641.76
Max. Negotiated Rate	$641.76
Rate for Payer: Cash Price	$233.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$641.76
Rate for Payer: SOMOS Essential	$641.76

PR BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM

Professional

Both

$3,138.00

Service Code	HCPCS 27041
Min. Negotiated Rate	$2,353.50
Max. Negotiated Rate	$2,353.50
Rate for Payer: Cash Price	$845.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,353.50
Rate for Payer: SOMOS Essential	$2,353.50

PR BIOPSY SOFT TISSUE SHOULDER DEEP

Professional

Both

$1,619.14

Service Code	HCPCS 23066
Min. Negotiated Rate	$1,214.36
Max. Negotiated Rate	$1,214.36
Rate for Payer: Cash Price	$445.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,214.36
Rate for Payer: SOMOS Essential	$1,214.36

PR BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL

Professional

Both

$687.30

Service Code	HCPCS 23065
Min. Negotiated Rate	$515.48
Max. Negotiated Rate	$515.48
Rate for Payer: Cash Price	$187.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$515.48
Rate for Payer: SOMOS Essential	$515.48

PR BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP

Professional

Both

$1,837.43

Service Code	HCPCS 27324
Min. Negotiated Rate	$1,378.07
Max. Negotiated Rate	$1,378.07
Rate for Payer: Cash Price	$497.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,378.07
Rate for Payer: SOMOS Essential	$1,378.07

PR BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL

Professional

Both

$754.29

Service Code	HCPCS 27323
Min. Negotiated Rate	$565.72
Max. Negotiated Rate	$565.72
Rate for Payer: Cash Price	$205.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$565.72
Rate for Payer: SOMOS Essential	$565.72

PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP

Professional

Both

$1,873.52

Service Code	HCPCS 24066
Min. Negotiated Rate	$1,405.14
Max. Negotiated Rate	$1,405.14
Rate for Payer: Cash Price	$510.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,405.14
Rate for Payer: SOMOS Essential	$1,405.14

PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL

Professional

Both

$698.18

Service Code	HCPCS 24065
Min. Negotiated Rate	$523.64
Max. Negotiated Rate	$523.64
Rate for Payer: Cash Price	$191.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$523.64
Rate for Payer: SOMOS Essential	$523.64

PR BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE

Professional

Both

$1,069.88

Service Code	HCPCS 62269
Min. Negotiated Rate	$802.41
Max. Negotiated Rate	$802.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$802.41
Rate for Payer: SOMOS Essential	$802.41

PR BIOPSY STOMACH LAPAROTOMY

Professional

Both

$3,755.40

Service Code	HCPCS 43605
Min. Negotiated Rate	$2,816.55
Max. Negotiated Rate	$2,816.55
Rate for Payer: Cash Price	$1,004.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,816.55
Rate for Payer: SOMOS Essential	$2,816.55

PR BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE

Professional

Both

$882.49

Service Code	HCPCS 54505
Min. Negotiated Rate	$661.87
Max. Negotiated Rate	$661.87
Rate for Payer: Cash Price	$241.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$661.87
Rate for Payer: SOMOS Essential	$661.87

PR BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE

Professional

Both

$314.09

Service Code	HCPCS 54500
Min. Negotiated Rate	$235.57
Max. Negotiated Rate	$235.57
Rate for Payer: Cash Price	$85.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$235.57
Rate for Payer: SOMOS Essential	$235.57

PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE

Professional

Both

$322.25

Service Code	HCPCS 60100
Min. Negotiated Rate	$241.69
Max. Negotiated Rate	$241.69
Rate for Payer: Cash Price	$85.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$241.69
Rate for Payer: SOMOS Essential	$241.69

PR BIOPSY TONGUE ANTERIOR TWO-THIRDS

Professional

Both

$461.27

Service Code	HCPCS 41100
Min. Negotiated Rate	$345.95
Max. Negotiated Rate	$345.95
Rate for Payer: Cash Price	$125.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$345.95
Rate for Payer: SOMOS Essential	$345.95

PR BIOPSY TONGUE POSTERIOR ONE-THIRD

Professional

Both

$471.84

Service Code	HCPCS 41105
Min. Negotiated Rate	$353.88
Max. Negotiated Rate	$353.88
Rate for Payer: Cash Price	$128.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$353.88
Rate for Payer: SOMOS Essential	$353.88

PR BIOPSY URETHRA

Professional

Both

$595.67

Service Code	HCPCS 53200
Min. Negotiated Rate	$446.75
Max. Negotiated Rate	$446.75
Rate for Payer: Cash Price	$162.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$446.75
Rate for Payer: SOMOS Essential	$446.75

PR BIOPSY VAGINAL MUCOSA EXTENSIVE

Professional

Both

$636.79

Service Code	HCPCS 57105
Min. Negotiated Rate	$477.59
Max. Negotiated Rate	$477.59
Rate for Payer: Cash Price	$173.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$477.59
Rate for Payer: SOMOS Essential	$477.59

PR BIOPSY VAGINAL MUCOSA SIMPLE

Professional

Both

$281.33

Service Code	HCPCS 57100
Min. Negotiated Rate	$211.00
Max. Negotiated Rate	$211.00
Rate for Payer: Cash Price	$76.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$211.00
Rate for Payer: SOMOS Essential	$211.00

PR BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL

Professional

Both

$1,915.34

Service Code	HCPCS 20251
Min. Negotiated Rate	$1,436.50
Max. Negotiated Rate	$1,436.50
Rate for Payer: Cash Price	$507.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,436.50
Rate for Payer: SOMOS Essential	$1,436.50

Know your out-of-pocket cost for care.

All Charges