St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CABG W/ARTERIAL GRAFT FOUR/>ARTERIAL GRAFTS

Professional

Both

$11,633.79

Service Code	HCPCS 33536
Min. Negotiated Rate	$8,725.34
Max. Negotiated Rate	$8,725.34
Rate for Payer: Cash Price	$3,096.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,725.34
Rate for Payer: SOMOS Essential	$8,725.34

PR CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT

Professional

Both

$8,292.10

Service Code	HCPCS 33533
Min. Negotiated Rate	$6,219.08
Max. Negotiated Rate	$6,219.08
Rate for Payer: Cash Price	$2,204.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,219.08
Rate for Payer: SOMOS Essential	$6,219.08

PR CABG W/ARTERIAL GRAFT THREE ARTERIAL GRAFTS

Professional

Both

$10,813.25

Service Code	HCPCS 33535
Min. Negotiated Rate	$8,109.94
Max. Negotiated Rate	$8,109.94
Rate for Payer: Cash Price	$2,873.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,109.94
Rate for Payer: SOMOS Essential	$8,109.94

PR CABG W/ARTERIAL GRAFT TWO ARTERIAL GRAFTS

Professional

Both

$9,729.27

Service Code	HCPCS 33534
Min. Negotiated Rate	$7,296.95
Max. Negotiated Rate	$7,296.95
Rate for Payer: Cash Price	$2,588.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,296.95
Rate for Payer: SOMOS Essential	$7,296.95

PR CAD CHEST RADIOGRAPH CONCURRENT W/INTERPRETATION

Professional

Both

$166.15

Service Code	HCPCS 0174T
Min. Negotiated Rate	$124.61
Max. Negotiated Rate	$124.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$124.61
Rate for Payer: SOMOS Essential	$124.61

PR CAFFEINE HALOTHNE CONTRCTN TEST MAL HYPERTHRM

Professional

Both

$259.25

Service Code	HCPCS 89049
Min. Negotiated Rate	$194.44
Max. Negotiated Rate	$194.44
Rate for Payer: Cash Price	$69.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$194.44
Rate for Payer: SOMOS Essential	$194.44

PR CALORIC VESTIBULAR TEST W/REC BI BITHERMAL

Professional

Both

$164.01

Service Code	HCPCS 92537
Min. Negotiated Rate	$123.01
Max. Negotiated Rate	$123.01
Rate for Payer: Cash Price	$44.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$123.01
Rate for Payer: SOMOS Essential	$123.01

PR CALORIC VESTIBULAR TEST W/REC BI BITHERMAL

Professional

Both

$121.00

Service Code	HCPCS 92537 26
Min. Negotiated Rate	$90.75
Max. Negotiated Rate	$90.75
Rate for Payer: Cash Price	$33.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$90.75
Rate for Payer: SOMOS Essential	$90.75

PR CALORIC VESTIBULAR TEST W/REC BI BITHERMAL

Professional

Both

$42.98

Service Code	HCPCS 92537 TC
Min. Negotiated Rate	$32.24
Max. Negotiated Rate	$32.24
Rate for Payer: Cash Price	$11.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$32.24
Rate for Payer: SOMOS Essential	$32.24

PR CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL

Professional

Both

$63.32

Service Code	HCPCS 92538 26
Min. Negotiated Rate	$47.49
Max. Negotiated Rate	$47.49
Rate for Payer: Cash Price	$17.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$47.49
Rate for Payer: SOMOS Essential	$47.49

PR CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL

Professional

Both

$93.35

Service Code	HCPCS 92538
Min. Negotiated Rate	$70.01
Max. Negotiated Rate	$70.01
Rate for Payer: Cash Price	$25.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$70.01
Rate for Payer: SOMOS Essential	$70.01

PR CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL

Professional

Both

$30.07

Service Code	HCPCS 92538 TC
Min. Negotiated Rate	$22.55
Max. Negotiated Rate	$22.55
Rate for Payer: Cash Price	$8.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$22.55
Rate for Payer: SOMOS Essential	$22.55

PR CANALITH REPOSITIONING PROCEDURE

Professional

Both

$145.15

Service Code	HCPCS 95992
Min. Negotiated Rate	$108.86
Max. Negotiated Rate	$108.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$108.86
Rate for Payer: SOMOS Essential	$108.86

PR CANNULATION THORACIC DUCT

Professional

Both

$1,172.43

Service Code	HCPCS 38794
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$879.32
Rate for Payer: Cash Price	$319.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$879.32
Rate for Payer: SOMOS Essential	$879.32

PR CANTHOPLASTY

Professional

Both

$1,914.43

Service Code	HCPCS 67950
Min. Negotiated Rate	$1,435.82
Max. Negotiated Rate	$1,435.82
Rate for Payer: Cash Price	$525.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,435.82
Rate for Payer: SOMOS Essential	$1,435.82

PR CANTHOTOMY SEPARATE PROCEDURE

Professional

Both

$461.30

Service Code	HCPCS 67715
Min. Negotiated Rate	$345.98
Max. Negotiated Rate	$345.98
Rate for Payer: Cash Price	$124.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$345.98
Rate for Payer: SOMOS Essential	$345.98

PR CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC

Professional

Both

$4,498.10

Service Code	HCPCS 27036
Min. Negotiated Rate	$3,373.58
Max. Negotiated Rate	$3,373.58
Rate for Payer: Cash Price	$1,215.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,373.58
Rate for Payer: SOMOS Essential	$3,373.58

PR CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS

Professional

Both

$4,350.01

Service Code	HCPCS 25320
Min. Negotiated Rate	$3,262.51
Max. Negotiated Rate	$3,262.51
Rate for Payer: Cash Price	$1,183.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,262.51
Rate for Payer: SOMOS Essential	$3,262.51

PR CAPSULAR CONTRACTURE RELEASE

Professional

Both

$3,061.38

Service Code	HCPCS 23020
Min. Negotiated Rate	$2,296.04
Max. Negotiated Rate	$2,296.04
Rate for Payer: Cash Price	$827.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,296.04
Rate for Payer: SOMOS Essential	$2,296.04

PR CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH

Professional

Both

$3,036.50

Service Code	HCPCS 26525
Min. Negotiated Rate	$2,277.38
Max. Negotiated Rate	$2,277.38
Rate for Payer: Cash Price	$819.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,277.38
Rate for Payer: SOMOS Essential	$2,277.38

PR CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH

Professional

Both

$3,021.52

Service Code	HCPCS 26520
Min. Negotiated Rate	$2,266.14
Max. Negotiated Rate	$2,266.14
Rate for Payer: Cash Price	$814.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,266.14
Rate for Payer: SOMOS Essential	$2,266.14

PR CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH

Professional

Both

$4,917.89

Service Code	HCPCS 28262
Min. Negotiated Rate	$3,688.42
Max. Negotiated Rate	$3,688.42
Rate for Payer: Cash Price	$1,305.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,688.42
Rate for Payer: SOMOS Essential	$3,688.42

PR CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX

Professional

Both

$1,404.17

Service Code	HCPCS 28270
Min. Negotiated Rate	$1,053.13
Max. Negotiated Rate	$1,053.13
Rate for Payer: Cash Price	$387.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,053.13
Rate for Payer: SOMOS Essential	$1,053.13

PR CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS

Professional

Both

$3,858.75

Service Code	HCPCS 26517
Min. Negotiated Rate	$2,894.06
Max. Negotiated Rate	$2,894.06
Rate for Payer: Cash Price	$1,037.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,894.06
Rate for Payer: SOMOS Essential	$2,894.06

PR CAPSULODESIS MTCARPHLNGL JOINT 3/4 DIGITS

Professional

Both

$3,907.89

Service Code	HCPCS 26518
Min. Negotiated Rate	$2,930.92
Max. Negotiated Rate	$2,930.92
Rate for Payer: Cash Price	$1,050.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,930.92
Rate for Payer: SOMOS Essential	$2,930.92

Know your out-of-pocket cost for care.

All Charges