St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST

Professional

Both

$597.03

Service Code	HCPCS 31645
Min. Negotiated Rate	$447.77
Max. Negotiated Rate	$447.77
Rate for Payer: Cash Price	$163.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$447.77
Rate for Payer: SOMOS Essential	$447.77

PR BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ

Professional

Both

$576.03

Service Code	HCPCS 31646
Min. Negotiated Rate	$432.02
Max. Negotiated Rate	$432.02
Rate for Payer: Cash Price	$157.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$432.02
Rate for Payer: SOMOS Essential	$432.02

PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE

Professional

Both

$709.28

Service Code	HCPCS 31628
Min. Negotiated Rate	$531.96
Max. Negotiated Rate	$531.96
Rate for Payer: Cash Price	$193.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$531.96
Rate for Payer: SOMOS Essential	$531.96

PR BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE

Professional

Both

$200.94

Service Code	HCPCS 31632
Min. Negotiated Rate	$150.70
Max. Negotiated Rate	$150.70
Rate for Payer: Cash Price	$53.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$150.70
Rate for Payer: SOMOS Essential	$150.70

PR BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE

Professional

Both

$254.24

Service Code	HCPCS 31633
Min. Negotiated Rate	$190.68
Max. Negotiated Rate	$190.68
Rate for Payer: Cash Price	$69.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$190.68
Rate for Payer: SOMOS Essential	$190.68

PR BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY

Professional

Both

$9,406.29

Service Code	HCPCS 58954
Min. Negotiated Rate	$7,054.72
Max. Negotiated Rate	$7,054.72
Rate for Payer: Cash Price	$2,547.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,054.72
Rate for Payer: SOMOS Essential	$7,054.72

PR BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION

Professional

Both

$8,699.67

Service Code	HCPCS 58953
Min. Negotiated Rate	$6,524.75
Max. Negotiated Rate	$6,524.75
Rate for Payer: Cash Price	$2,352.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,524.75
Rate for Payer: SOMOS Essential	$6,524.75

PR BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC

Professional

Both

$5,912.48

Service Code	HCPCS 58956
Min. Negotiated Rate	$4,434.36
Max. Negotiated Rate	$4,434.36
Rate for Payer: Cash Price	$1,601.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,434.36
Rate for Payer: SOMOS Essential	$4,434.36

PR BUNDLE OF HIS RECORDING

Professional

Both

$909.37

Service Code	HCPCS 93600
Min. Negotiated Rate	$682.03
Max. Negotiated Rate	$682.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$682.03
Rate for Payer: SOMOS Essential	$682.03

PR BUNDLE OF HIS RECORDING

Professional

Both

$507.22

Service Code	HCPCS 93600 26
Min. Negotiated Rate	$380.42
Max. Negotiated Rate	$380.42
Rate for Payer: Cash Price	$132.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$380.42
Rate for Payer: SOMOS Essential	$380.42

PR BUNDLE OF HIS RECORDING

Professional

Both

$402.15

Service Code	HCPCS 93600 TC
Min. Negotiated Rate	$301.61
Max. Negotiated Rate	$301.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$301.61
Rate for Payer: SOMOS Essential	$301.61

PR BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE

Professional

Both

$1,777.13

Service Code	HCPCS 61210
Min. Negotiated Rate	$1,332.85
Max. Negotiated Rate	$1,332.85
Rate for Payer: Cash Price	$463.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,332.85
Rate for Payer: SOMOS Essential	$1,332.85

PR BURR HOLE/TREPHINE INFRATENTORIAL UNI/BI

Professional

Both

$4,787.79

Service Code	HCPCS 61253
Min. Negotiated Rate	$3,590.84
Max. Negotiated Rate	$3,590.84
Rate for Payer: Cash Price	$1,265.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,590.84
Rate for Payer: SOMOS Essential	$3,590.84

PR BURR HOLE/TREPHINE SUPRATENTORIAL W/O OTH SURG

Professional

Both

$4,183.17

Service Code	HCPCS 61250
Min. Negotiated Rate	$3,137.38
Max. Negotiated Rate	$3,137.38
Rate for Payer: Cash Price	$1,105.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,137.38
Rate for Payer: SOMOS Essential	$3,137.38

PR BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION

Professional

Both

$6,102.78

Service Code	HCPCS 61140
Min. Negotiated Rate	$4,577.08
Max. Negotiated Rate	$4,577.08
Rate for Payer: Cash Price	$1,619.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,577.08
Rate for Payer: SOMOS Essential	$4,577.08

PR BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST

Professional

Both

$6,514.55

Service Code	HCPCS 61150
Min. Negotiated Rate	$4,885.91
Max. Negotiated Rate	$4,885.91
Rate for Payer: Cash Price	$1,719.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,885.91
Rate for Payer: SOMOS Essential	$4,885.91

PR BURR HOLE/TREPHINE W/SBSQ TAPPING ICRA ABSC/CST

Professional

Both

$4,787.79

Service Code	HCPCS 61151
Min. Negotiated Rate	$3,590.84
Max. Negotiated Rate	$3,590.84
Rate for Payer: Cash Price	$1,265.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,590.84
Rate for Payer: SOMOS Essential	$3,590.84

PR BURR HOLE VENTRICULAR PUNCTURE

Professional

Both

$3,598.04

Service Code	HCPCS 61120
Min. Negotiated Rate	$2,698.53
Max. Negotiated Rate	$2,698.53
Rate for Payer: Cash Price	$955.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,698.53
Rate for Payer: SOMOS Essential	$2,698.53

PR BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL

Professional

Both

$5,925.33

Service Code	HCPCS 61156
Min. Negotiated Rate	$4,444.00
Max. Negotiated Rate	$4,444.00
Rate for Payer: Cash Price	$1,578.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,444.00
Rate for Payer: SOMOS Essential	$4,444.00

PR BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL

Professional

Both

$6,135.19

Service Code	HCPCS 61154
Min. Negotiated Rate	$4,601.39
Max. Negotiated Rate	$4,601.39
Rate for Payer: Cash Price	$1,625.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,601.39
Rate for Payer: SOMOS Essential	$4,601.39

PR BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE

Professional

Both

$343.56

Service Code	HCPCS 49180
Min. Negotiated Rate	$257.67
Max. Negotiated Rate	$257.67
Rate for Payer: Cash Price	$91.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$257.67
Rate for Payer: SOMOS Essential	$257.67

PR BX ANORECTAL WALL ANAL APPROACH

Professional

Both

$1,326.61

Service Code	HCPCS 45100
Min. Negotiated Rate	$994.96
Max. Negotiated Rate	$994.96
Rate for Payer: Cash Price	$360.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$994.96
Rate for Payer: SOMOS Essential	$994.96

PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX

Professional

Both

$310.14

Service Code	HCPCS 19100
Min. Negotiated Rate	$232.60
Max. Negotiated Rate	$232.60
Rate for Payer: Cash Price	$82.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$232.60
Rate for Payer: SOMOS Essential	$232.60

PR BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID

Professional

Both

$730.49

Service Code	HCPCS 19085
Min. Negotiated Rate	$547.87
Max. Negotiated Rate	$547.87
Rate for Payer: Cash Price	$198.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$547.87
Rate for Payer: SOMOS Essential	$547.87

PR BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID

Professional

Both

$676.17

Service Code	HCPCS 19081
Min. Negotiated Rate	$507.13
Max. Negotiated Rate	$507.13
Rate for Payer: Cash Price	$181.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$507.13
Rate for Payer: SOMOS Essential	$507.13

Know your out-of-pocket cost for care.

All Charges