St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR BIOPSY VERTEBRAL BODY OPEN THORACIC

Professional

Both

$1,754.13

Service Code	HCPCS 20250
Min. Negotiated Rate	$1,315.60
Max. Negotiated Rate	$1,315.60
Rate for Payer: Cash Price	$476.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,315.60
Rate for Payer: SOMOS Essential	$1,315.60

PR BIOPSY VESTIBULE MOUTH

Professional

Both

$377.09

Service Code	HCPCS 40808
Min. Negotiated Rate	$282.82
Max. Negotiated Rate	$282.82
Rate for Payer: Cash Price	$104.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$282.82
Rate for Payer: SOMOS Essential	$282.82

PR BIOPSY VULVA/PERINEUM 1 LESION SPX

Professional

Both

$257.46

Service Code	HCPCS 56605
Min. Negotiated Rate	$193.10
Max. Negotiated Rate	$193.10
Rate for Payer: Cash Price	$68.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$193.10
Rate for Payer: SOMOS Essential	$193.10

PR BIOPSY VULVA/PERINEUM EACH ADDL LESION

Professional

Both

$129.33

Service Code	HCPCS 56606
Min. Negotiated Rate	$97.00
Max. Negotiated Rate	$97.00
Rate for Payer: Cash Price	$33.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$97.00
Rate for Payer: SOMOS Essential	$97.00

PR BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT

Professional

Both

$554.61

Service Code	HCPCS 93702
Min. Negotiated Rate	$415.96
Max. Negotiated Rate	$415.96
Rate for Payer: Cash Price	$144.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$415.96
Rate for Payer: SOMOS Essential	$415.96

PR BKBENCH PREP CADAVER DONOR

Professional

Both

$1,704.22

Service Code	HCPCS 47143
Min. Negotiated Rate	$1,278.16
Max. Negotiated Rate	$1,278.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,278.16
Rate for Payer: SOMOS Essential	$1,278.16

PR BKBENCH PREP CADAVER/LIVING DONOR INTESTINE

Professional

Both

$1,230.32

Service Code	HCPCS 44715
Min. Negotiated Rate	$922.74
Max. Negotiated Rate	$922.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$922.74
Rate for Payer: SOMOS Essential	$922.74

PR BKBENCH PREPJ CADAVER DONOR HEART ALLOGRAFT

Professional

Both

$1,441.02

Service Code	HCPCS 33944
Min. Negotiated Rate	$1,080.76
Max. Negotiated Rate	$1,080.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,080.76
Rate for Payer: SOMOS Essential	$1,080.76

PR BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT

Professional

Both

$1,441.02

Service Code	HCPCS 33933
Min. Negotiated Rate	$1,080.76
Max. Negotiated Rate	$1,080.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,080.76
Rate for Payer: SOMOS Essential	$1,080.76

PR BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT BI

Professional

Both

$952.91

Service Code	HCPCS 32856
Min. Negotiated Rate	$714.68
Max. Negotiated Rate	$714.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$714.68
Rate for Payer: SOMOS Essential	$714.68

PR BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT UNI

Professional

Both

$952.91

Service Code	HCPCS 32855
Min. Negotiated Rate	$714.68
Max. Negotiated Rate	$714.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$714.68
Rate for Payer: SOMOS Essential	$714.68

PR BKBENCH PREPJ CADAVER DONOR PANCREAS ALLOGRAFT

Professional

Both

$792.02

Service Code	HCPCS 48551
Min. Negotiated Rate	$594.02
Max. Negotiated Rate	$594.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$594.02
Rate for Payer: SOMOS Essential	$594.02

PR BKBENCH PREPJ CADAVER DONOR RENAL ALLOGRAFT

Professional

Both

$727.09

Service Code	HCPCS 50323
Min. Negotiated Rate	$545.32
Max. Negotiated Rate	$545.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$545.32
Rate for Payer: SOMOS Essential	$545.32

PR BKBENCH PREPJ CADAVER DONOR WHL LVR GRF I&V VI

Professional

Both

$1,704.22

Service Code	HCPCS 47145
Min. Negotiated Rate	$1,278.16
Max. Negotiated Rate	$1,278.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,278.16
Rate for Payer: SOMOS Essential	$1,278.16

PR BKBENCH PREPJ CADAVER WHOLE LIVER GRF I&IV VII

Professional

Both

$1,704.22

Service Code	HCPCS 47144
Min. Negotiated Rate	$1,278.16
Max. Negotiated Rate	$1,278.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,278.16
Rate for Payer: SOMOS Essential	$1,278.16

PR BKBENCH PREPJ LIVING RENAL DONOR ALLOGRAFT

Professional

Both

$727.09

Service Code	HCPCS 50325
Min. Negotiated Rate	$545.32
Max. Negotiated Rate	$545.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$545.32
Rate for Payer: SOMOS Essential	$545.32

PR BKBENCH RCNSTJ ALGRFT URETERAL ANAST EA

Professional

Both

$804.41

Service Code	HCPCS 50329
Min. Negotiated Rate	$603.31
Max. Negotiated Rate	$603.31
Rate for Payer: Cash Price	$213.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$603.31
Rate for Payer: SOMOS Essential	$603.31

PR BKBENCH RCNSTJ CDVR PNCRS ALGRFT VEN ANAST EA

Professional

Both

$1,062.64

Service Code	HCPCS 48552
Min. Negotiated Rate	$796.98
Max. Negotiated Rate	$796.98
Rate for Payer: Cash Price	$281.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$796.98
Rate for Payer: SOMOS Essential	$796.98

PR BKBENCH RCNSTJ INT ALGRFT ARTL ANAST EA

Professional

Both

$1,725.15

Service Code	HCPCS 44721
Min. Negotiated Rate	$1,293.86
Max. Negotiated Rate	$1,293.86
Rate for Payer: Cash Price	$456.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,293.86
Rate for Payer: SOMOS Essential	$1,293.86

PR BKBENCH RCNSTJ INT ALGRFT VEN ANAST EA

Professional

Both

$1,236.94

Service Code	HCPCS 44720
Min. Negotiated Rate	$927.70
Max. Negotiated Rate	$927.70
Rate for Payer: Cash Price	$326.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$927.70
Rate for Payer: SOMOS Essential	$927.70

PR BKBENCH RCNSTJ LVR GRF ARTL ANAST EA

Professional

Both

$1,716.93

Service Code	HCPCS 47147
Min. Negotiated Rate	$1,287.70
Max. Negotiated Rate	$1,287.70
Rate for Payer: Cash Price	$455.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,287.70
Rate for Payer: SOMOS Essential	$1,287.70

PR BKBENCH RCNSTJ LVR GRF VENOUS ANAST EA

Professional

Both

$1,475.57

Service Code	HCPCS 47146
Min. Negotiated Rate	$1,106.68
Max. Negotiated Rate	$1,106.68
Rate for Payer: Cash Price	$390.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,106.68
Rate for Payer: SOMOS Essential	$1,106.68

PR BKBENCH RCNSTJ RENAL ALGRFT VENOUS ANAST EA

Professional

Both

$970.80

Service Code	HCPCS 50327
Min. Negotiated Rate	$728.10
Max. Negotiated Rate	$728.10
Rate for Payer: Cash Price	$257.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$728.10
Rate for Payer: SOMOS Essential	$728.10

PR BKBENCH RCNSTJ RENAL ALLOGRAFT ARTERIAL ANAST EA

Professional

Both

$846.72

Service Code	HCPCS 50328
Min. Negotiated Rate	$635.04
Max. Negotiated Rate	$635.04
Rate for Payer: Cash Price	$225.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$635.04
Rate for Payer: SOMOS Essential	$635.04

PR BLADDER INSTILLATION ANTICARCINOGENIC AGENT

Professional

Both

$183.61

Service Code	HCPCS 51720
Min. Negotiated Rate	$137.71
Max. Negotiated Rate	$137.71
Rate for Payer: Cash Price	$49.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$137.71
Rate for Payer: SOMOS Essential	$137.71

Know your out-of-pocket cost for care.

All Charges