St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR BYP GRF W/DESCENDING THORACIC AORTA RPR NECK INC

Professional

Both

$4,284.81

Service Code	HCPCS 33891
Min. Negotiated Rate	$3,213.61
Max. Negotiated Rate	$3,213.61
Rate for Payer: Cash Price	$1,130.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,213.61
Rate for Payer: SOMOS Essential	$3,213.61

PR BYP OTH/THN VEIN AORTOBIFEMORAL

Professional

Both

$7,573.69

Service Code	HCPCS 35646
Min. Negotiated Rate	$5,680.27
Max. Negotiated Rate	$5,680.27
Rate for Payer: Cash Price	$2,004.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,680.27
Rate for Payer: SOMOS Essential	$5,680.27

PR BYP OTH/THN VEIN AORTOBI-ILIAC

Professional

Both

$7,709.35

Service Code	HCPCS 35638
Min. Negotiated Rate	$5,782.01
Max. Negotiated Rate	$5,782.01
Rate for Payer: Cash Price	$2,039.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,782.01
Rate for Payer: SOMOS Essential	$5,782.01

PR BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL

Professional

Both

$8,208.62

Service Code	HCPCS 35631
Min. Negotiated Rate	$6,156.46
Max. Negotiated Rate	$6,156.46
Rate for Payer: Cash Price	$2,177.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,156.46
Rate for Payer: SOMOS Essential	$6,156.46

PR BYP OTH/THN VEIN AORTOFEMORAL

Professional

Both

$6,889.82

Service Code	HCPCS 35647
Min. Negotiated Rate	$5,167.36
Max. Negotiated Rate	$5,167.36
Rate for Payer: Cash Price	$1,823.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,167.36
Rate for Payer: SOMOS Essential	$5,167.36

PR BYP OTH/THN VEIN AORTOILIAC

Professional

Both

$7,377.62

Service Code	HCPCS 35637
Min. Negotiated Rate	$5,533.22
Max. Negotiated Rate	$5,533.22
Rate for Payer: Cash Price	$1,953.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,533.22
Rate for Payer: SOMOS Essential	$5,533.22

PR BYP OTH/THN VEIN AXILLARY-AXILLARY

Professional

Both

$4,547.24

Service Code	HCPCS 35650
Min. Negotiated Rate	$3,410.43
Max. Negotiated Rate	$3,410.43
Rate for Payer: Cash Price	$1,203.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,410.43
Rate for Payer: SOMOS Essential	$3,410.43

PR BYP OTH/THN VEIN AXILLARY-FEMORAL

Professional

Both

$4,876.24

Service Code	HCPCS 35621
Min. Negotiated Rate	$3,657.18
Max. Negotiated Rate	$3,657.18
Rate for Payer: Cash Price	$1,289.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,657.18
Rate for Payer: SOMOS Essential	$3,657.18

PR BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL

Professional

Both

$6,054.06

Service Code	HCPCS 35654
Min. Negotiated Rate	$4,540.54
Max. Negotiated Rate	$4,540.54
Rate for Payer: Cash Price	$1,603.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,540.54
Rate for Payer: SOMOS Essential	$4,540.54

PR BYP OTH/THN VEIN AXILLARY-POPLITEAL/-TIBIAL

Professional

Both

$5,851.41

Service Code	HCPCS 35623
Min. Negotiated Rate	$4,388.56
Max. Negotiated Rate	$4,388.56
Rate for Payer: Cash Price	$1,548.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,388.56
Rate for Payer: SOMOS Essential	$4,388.56

PR BYP OTH/THN VEIN CAROTID-SUBCLAVIAN

Professional

Both

$5,206.57

Service Code	HCPCS 35606
Min. Negotiated Rate	$3,904.93
Max. Negotiated Rate	$3,904.93
Rate for Payer: Cash Price	$1,384.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,904.93
Rate for Payer: SOMOS Essential	$3,904.93

PR BYP OTH/THN VEIN CAROTID-VERTEBRAL

Professional

Both

$4,395.72

Service Code	HCPCS 35642
Min. Negotiated Rate	$3,296.79
Max. Negotiated Rate	$3,296.79
Rate for Payer: Cash Price	$1,165.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,296.79
Rate for Payer: SOMOS Essential	$3,296.79

PR BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID

Professional

Both

$6,235.71

Service Code	HCPCS 35601
Min. Negotiated Rate	$4,676.78
Max. Negotiated Rate	$4,676.78
Rate for Payer: Cash Price	$1,648.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,676.78
Rate for Payer: SOMOS Essential	$4,676.78

PR BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL

Professional

Both

$5,717.29

Service Code	HCPCS 35666
Min. Negotiated Rate	$4,287.97
Max. Negotiated Rate	$4,287.97
Rate for Payer: Cash Price	$1,514.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,287.97
Rate for Payer: SOMOS Essential	$4,287.97

PR BYP OTH/THN VEIN FEMORAL-FEMORAL

Professional

Both

$4,809.39

Service Code	HCPCS 35661
Min. Negotiated Rate	$3,607.04
Max. Negotiated Rate	$3,607.04
Rate for Payer: Cash Price	$1,273.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,607.04
Rate for Payer: SOMOS Essential	$3,607.04

PR BYP OTH/THN VEIN FEMORAL-POPLITEAL

Professional

Both

$4,770.82

Service Code	HCPCS 35656
Min. Negotiated Rate	$3,578.12
Max. Negotiated Rate	$3,578.12
Rate for Payer: Cash Price	$1,261.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,578.12
Rate for Payer: SOMOS Essential	$3,578.12

PR BYP OTH/THN VEIN ILIOFEMORAL

Professional

Both

$5,201.98

Service Code	HCPCS 35665
Min. Negotiated Rate	$3,901.48
Max. Negotiated Rate	$3,901.48
Rate for Payer: Cash Price	$1,379.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,901.48
Rate for Payer: SOMOS Essential	$3,901.48

PR BYP OTH/THN VEIN ILIOILIAC

Professional

Both

$5,419.37

Service Code	HCPCS 35663
Min. Negotiated Rate	$4,064.53
Max. Negotiated Rate	$4,064.53
Rate for Payer: Cash Price	$1,437.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,064.53
Rate for Payer: SOMOS Essential	$4,064.53

PR BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART

Professional

Both

$5,035.98

Service Code	HCPCS 35671
Min. Negotiated Rate	$3,776.98
Max. Negotiated Rate	$3,776.98
Rate for Payer: Cash Price	$1,332.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,776.98
Rate for Payer: SOMOS Essential	$3,776.98

PR BYP OTH/THN VEIN SPLENORENAL

Professional

Both

$7,099.65

Service Code	HCPCS 35636
Min. Negotiated Rate	$5,324.74
Max. Negotiated Rate	$5,324.74
Rate for Payer: Cash Price	$1,878.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,324.74
Rate for Payer: SOMOS Essential	$5,324.74

PR BYP OTH/THN VEIN SUBCLAVIAN-AXILLARY

Professional

Both

$4,901.96

Service Code	HCPCS 35616
Min. Negotiated Rate	$3,676.47
Max. Negotiated Rate	$3,676.47
Rate for Payer: Cash Price	$1,298.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,676.47
Rate for Payer: SOMOS Essential	$3,676.47

PR BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN

Professional

Both

$4,652.27

Service Code	HCPCS 35612
Min. Negotiated Rate	$3,489.20
Max. Negotiated Rate	$3,489.20
Rate for Payer: Cash Price	$1,233.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,489.20
Rate for Payer: SOMOS Essential	$3,489.20

PR BYP OTH/THN VEIN SUBCLAVIAN-VERTEBRAL

Professional

Both

$4,215.65

Service Code	HCPCS 35645
Min. Negotiated Rate	$3,161.74
Max. Negotiated Rate	$3,161.74
Rate for Payer: Cash Price	$1,117.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,161.74
Rate for Payer: SOMOS Essential	$3,161.74

PR BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL

Professional

Both

$6,551.58

Service Code	HCPCS 35570
Min. Negotiated Rate	$4,913.68
Max. Negotiated Rate	$4,913.68
Rate for Payer: Cash Price	$1,737.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,913.68
Rate for Payer: SOMOS Essential	$4,913.68

PR BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL

Professional

Both

$5,883.19

Service Code	HCPCS 35571
Min. Negotiated Rate	$4,412.39
Max. Negotiated Rate	$4,412.39
Rate for Payer: Cash Price	$1,556.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,412.39
Rate for Payer: SOMOS Essential	$4,412.39

Know your out-of-pocket cost for care.

All Charges