St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT

Professional

Both

$3,291.65

Service Code	HCPCS 26516
Min. Negotiated Rate	$2,468.74
Max. Negotiated Rate	$2,468.74
Rate for Payer: Cash Price	$888.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,468.74
Rate for Payer: SOMOS Essential	$2,468.74

PR CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON

Professional

Both

$4,188.91

Service Code	HCPCS 23450
Min. Negotiated Rate	$3,141.68
Max. Negotiated Rate	$3,141.68
Rate for Payer: Cash Price	$1,129.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,141.68
Rate for Payer: SOMOS Essential	$3,141.68

PR CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR

Professional

Both

$4,725.00

Service Code	HCPCS 23462
Min. Negotiated Rate	$3,543.75
Max. Negotiated Rate	$3,543.75
Rate for Payer: Cash Price	$1,272.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,543.75
Rate for Payer: SOMOS Essential	$3,543.75

PR CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK

Professional

Both

$4,822.34

Service Code	HCPCS 23460
Min. Negotiated Rate	$3,616.76
Max. Negotiated Rate	$3,616.76
Rate for Payer: Cash Price	$1,300.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,616.76
Rate for Payer: SOMOS Essential	$3,616.76

PR CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR

Professional

Both

$4,354.53

Service Code	HCPCS 23455
Min. Negotiated Rate	$3,265.90
Max. Negotiated Rate	$3,265.90
Rate for Payer: Cash Price	$1,173.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,265.90
Rate for Payer: SOMOS Essential	$3,265.90

PR CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK

Professional

Both

$4,945.75

Service Code	HCPCS 23465
Min. Negotiated Rate	$3,709.31
Max. Negotiated Rate	$3,709.31
Rate for Payer: Cash Price	$1,333.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,709.31
Rate for Payer: SOMOS Essential	$3,709.31

PR CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS

Professional

Both

$4,948.72

Service Code	HCPCS 23466
Min. Negotiated Rate	$3,711.54
Max. Negotiated Rate	$3,711.54
Rate for Payer: Cash Price	$1,339.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,711.54
Rate for Payer: SOMOS Essential	$3,711.54

PR CAPSULOTOMY IPHAL JOINT EACH JOINT SPX

Professional

Both

$1,037.37

Service Code	HCPCS 28272
Min. Negotiated Rate	$778.03
Max. Negotiated Rate	$778.03
Rate for Payer: Cash Price	$289.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$778.03
Rate for Payer: SOMOS Essential	$778.03

PR CAPSULOTOMY MIDFOOT MEDIAL RELEASE ONLY SPX

Professional

Both

$2,288.02

Service Code	HCPCS 28260
Min. Negotiated Rate	$1,716.02
Max. Negotiated Rate	$1,716.02
Rate for Payer: Cash Price	$634.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,716.02
Rate for Payer: SOMOS Essential	$1,716.02

PR CAPSULOTOMY MIDFOOT W/TENDON LENGTHENING

Professional

Both

$4,148.27

Service Code	HCPCS 28261
Min. Negotiated Rate	$3,111.20
Max. Negotiated Rate	$3,111.20
Rate for Payer: Cash Price	$990.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,111.20
Rate for Payer: SOMOS Essential	$3,111.20

PR CAPSULOTOMY MIDTARSAL

Professional

Both

$2,893.14

Service Code	HCPCS 28264
Min. Negotiated Rate	$2,169.86
Max. Negotiated Rate	$2,169.86
Rate for Payer: Cash Price	$782.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,169.86
Rate for Payer: SOMOS Essential	$2,169.86

PR CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE

Professional

Both

$3,589.57

Service Code	HCPCS 27435
Min. Negotiated Rate	$2,692.18
Max. Negotiated Rate	$2,692.18
Rate for Payer: Cash Price	$967.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,692.18
Rate for Payer: SOMOS Essential	$2,692.18

PR CAPSULOTOMY WRIST

Professional

Both

$1,984.40

Service Code	HCPCS 25085
Min. Negotiated Rate	$1,488.30
Max. Negotiated Rate	$1,488.30
Rate for Payer: Cash Price	$541.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,488.30
Rate for Payer: SOMOS Essential	$1,488.30

PR CARDIOASSIST-METH CIRCULATORY ASSIST EXTERNAL

Professional

Both

$440.37

Service Code	HCPCS 92971
Min. Negotiated Rate	$330.28
Max. Negotiated Rate	$330.28
Rate for Payer: Cash Price	$116.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$330.28
Rate for Payer: SOMOS Essential	$330.28

PR CARDIOASSIST-METH CIRCULATORY ASSIST INTERNAL

Professional

Both

$826.84

Service Code	HCPCS 92970
Min. Negotiated Rate	$620.13
Max. Negotiated Rate	$620.13
Rate for Payer: Cash Price	$219.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$620.13
Rate for Payer: SOMOS Essential	$620.13

PR CARDIOKYMOGRAPHY

Professional

Both

$41.55

Service Code	HCPCS Q0035 TC
Min. Negotiated Rate	$31.16
Max. Negotiated Rate	$31.16
Rate for Payer: Cash Price	$11.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$31.16
Rate for Payer: SOMOS Essential	$31.16

PR CARDIOKYMOGRAPHY

Professional

Both

$74.20

Service Code	HCPCS Q0035
Min. Negotiated Rate	$55.65
Max. Negotiated Rate	$55.65
Rate for Payer: Cash Price	$20.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$55.65
Rate for Payer: SOMOS Essential	$55.65

PR CARDIOKYMOGRAPHY

Professional

Both

$32.66

Service Code	HCPCS Q0035 26
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$24.50
Rate for Payer: Cash Price	$8.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24.50
Rate for Payer: SOMOS Essential	$24.50

PR CARDIOPULMONARY EXERCISE TESTING

Professional

Both

$644.81

Service Code	HCPCS 94621
Min. Negotiated Rate	$483.61
Max. Negotiated Rate	$483.61
Rate for Payer: Cash Price	$178.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$483.61
Rate for Payer: SOMOS Essential	$483.61

PR CARDIOPULMONARY EXERCISE TESTING

Professional

Both

$270.17

Service Code	HCPCS 94621 26
Min. Negotiated Rate	$202.63
Max. Negotiated Rate	$202.63
Rate for Payer: Cash Price	$73.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$202.63
Rate for Payer: SOMOS Essential	$202.63

PR CARDIOPULMONARY EXERCISE TESTING

Professional

Both

$374.64

Service Code	HCPCS 94621 TC
Min. Negotiated Rate	$280.98
Max. Negotiated Rate	$280.98
Rate for Payer: Cash Price	$104.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$280.98
Rate for Payer: SOMOS Essential	$280.98

PR CARDIOPULMONARY RESUSCITATION

Professional

Both

$748.72

Service Code	HCPCS 92950
Min. Negotiated Rate	$561.54
Max. Negotiated Rate	$561.54
Rate for Payer: Cash Price	$204.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$561.54
Rate for Payer: SOMOS Essential	$561.54

PR CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP

Professional

Both

$8,493.21

Service Code	HCPCS 33315
Min. Negotiated Rate	$6,369.91
Max. Negotiated Rate	$6,369.91
Rate for Payer: Cash Price	$2,257.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,369.91
Rate for Payer: SOMOS Essential	$6,369.91

PR CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP

Professional

Both

$5,157.57

Service Code	HCPCS 33310
Min. Negotiated Rate	$3,868.18
Max. Negotiated Rate	$3,868.18
Rate for Payer: Cash Price	$1,371.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,868.18
Rate for Payer: SOMOS Essential	$3,868.18

PR CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR

Professional

Both

$307.06

Service Code	HCPCS 93660 TC
Min. Negotiated Rate	$230.30
Max. Negotiated Rate	$230.30
Rate for Payer: Cash Price	$86.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$230.30
Rate for Payer: SOMOS Essential	$230.30

Know your out-of-pocket cost for care.

All Charges