St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CARTILAGE GRAFT COSTOCHONDRAL

Professional

Both

$2,105.95

Service Code	HCPCS 20910
Min. Negotiated Rate	$1,579.46
Max. Negotiated Rate	$1,579.46
Rate for Payer: Cash Price	$574.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,579.46
Rate for Payer: SOMOS Essential	$1,579.46

PR CARTILAGE GRAFT NASAL SEPTUM

Professional

Both

$2,087.75

Service Code	HCPCS 20912
Min. Negotiated Rate	$1,565.81
Max. Negotiated Rate	$1,565.81
Rate for Payer: Cash Price	$569.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,565.81
Rate for Payer: SOMOS Essential	$1,565.81

PR CAR-T THERAPY AUTOLOGOUS CELL ADMINISTRATION

Professional

Both

$727.90

Service Code	HCPCS 0540T
Min. Negotiated Rate	$545.92
Max. Negotiated Rate	$545.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$545.92
Rate for Payer: SOMOS Essential	$545.92

PR CA SCREEN;FLEXI SIGMOIDSCOPE

Professional

Both

$235.94

Service Code	HCPCS G0104
Min. Negotiated Rate	$176.96
Max. Negotiated Rate	$176.96
Rate for Payer: Cash Price	$65.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$176.96
Rate for Payer: SOMOS Essential	$176.96

PR CA SCREEN;PELVIC/BREAST EXAM

Professional

Both

$118.65

Service Code	HCPCS G0101
Min. Negotiated Rate	$88.99
Max. Negotiated Rate	$88.99
Rate for Payer: Cash Price	$31.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$88.99
Rate for Payer: SOMOS Essential	$88.99

PR CATH ASPIR TRACHEOBRNCL FIBERSCOPE BEDSIDE SPX

Professional

Both

$314.58

Service Code	HCPCS 31725
Min. Negotiated Rate	$235.94
Max. Negotiated Rate	$235.94
Rate for Payer: Cash Price	$86.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$235.94
Rate for Payer: SOMOS Essential	$235.94

PR CATHETER ASPIRATION NASOTRACHEAL SPX

Professional

Both

$196.35

Service Code	HCPCS 31720
Min. Negotiated Rate	$147.26
Max. Negotiated Rate	$147.26
Rate for Payer: Cash Price	$53.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$147.26
Rate for Payer: SOMOS Essential	$147.26

PR CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY

Professional

Both

$276.01

Service Code	HCPCS 36660
Min. Negotiated Rate	$207.01
Max. Negotiated Rate	$207.01
Rate for Payer: Cash Price	$75.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$207.01
Rate for Payer: SOMOS Essential	$207.01

PR CATHETERIZATION W/BRONCHIAL BRUSH BIOPSY

Professional

Both

$431.20

Service Code	HCPCS 31717
Min. Negotiated Rate	$323.40
Max. Negotiated Rate	$323.40
Rate for Payer: Cash Price	$117.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$323.40
Rate for Payer: SOMOS Essential	$323.40

PR CATHJ UMBILICAL VEIN DX/THER NB

Professional

Both

$215.92

Service Code	HCPCS 36510
Min. Negotiated Rate	$161.94
Max. Negotiated Rate	$161.94
Rate for Payer: Cash Price	$58.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$161.94
Rate for Payer: SOMOS Essential	$161.94

PR CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I

Professional

Both

$1,019.97

Service Code	HCPCS 93454 26
Min. Negotiated Rate	$764.98
Max. Negotiated Rate	$764.98
Rate for Payer: Cash Price	$273.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$764.98
Rate for Payer: SOMOS Essential	$764.98

PR CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I

Professional

Both

$2,906.05

Service Code	HCPCS 93454 TC
Min. Negotiated Rate	$2,179.54
Max. Negotiated Rate	$2,179.54
Rate for Payer: Cash Price	$778.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,179.54
Rate for Payer: SOMOS Essential	$2,179.54

PR CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I

Professional

Both

$3,926.02

Service Code	HCPCS 93454
Min. Negotiated Rate	$2,944.52
Max. Negotiated Rate	$2,944.52
Rate for Payer: Cash Price	$1,051.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,944.52
Rate for Payer: SOMOS Essential	$2,944.52

PR CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I

Professional

Both

$1,428.84

Service Code	HCPCS 93459 26
Min. Negotiated Rate	$1,071.63
Max. Negotiated Rate	$1,071.63
Rate for Payer: Cash Price	$382.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,071.63
Rate for Payer: SOMOS Essential	$1,071.63

PR CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I

Professional

Both

$3,427.87

Service Code	HCPCS 93459 TC
Min. Negotiated Rate	$2,570.90
Max. Negotiated Rate	$2,570.90
Rate for Payer: Cash Price	$919.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,570.90
Rate for Payer: SOMOS Essential	$2,570.90

PR CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I

Professional

Both

$4,856.71

Service Code	HCPCS 93459
Min. Negotiated Rate	$3,642.53
Max. Negotiated Rate	$3,642.53
Rate for Payer: Cash Price	$1,301.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,642.53
Rate for Payer: SOMOS Essential	$3,642.53

PR CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I

Professional

Both

$3,253.95

Service Code	HCPCS 93458 TC
Min. Negotiated Rate	$2,440.46
Max. Negotiated Rate	$2,440.46
Rate for Payer: Cash Price	$872.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,440.46
Rate for Payer: SOMOS Essential	$2,440.46

PR CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I

Professional

Both

$4,513.15

Service Code	HCPCS 93458
Min. Negotiated Rate	$3,384.86
Max. Negotiated Rate	$3,384.86
Rate for Payer: Cash Price	$1,209.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,384.86
Rate for Payer: SOMOS Essential	$3,384.86

PR CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I

Professional

Both

$1,259.23

Service Code	HCPCS 93458 26
Min. Negotiated Rate	$944.42
Max. Negotiated Rate	$944.42
Rate for Payer: Cash Price	$337.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$944.42
Rate for Payer: SOMOS Essential	$944.42

PR CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I

Professional

Both

$4,374.55

Service Code	HCPCS 93455
Min. Negotiated Rate	$3,280.91
Max. Negotiated Rate	$3,280.91
Rate for Payer: Cash Price	$1,171.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,280.91
Rate for Payer: SOMOS Essential	$3,280.91

PR CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I

Professional

Both

$3,184.93

Service Code	HCPCS 93455 TC
Min. Negotiated Rate	$2,388.70
Max. Negotiated Rate	$2,388.70
Rate for Payer: Cash Price	$853.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,388.70
Rate for Payer: SOMOS Essential	$2,388.70

PR CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I

Professional

Both

$1,189.58

Service Code	HCPCS 93455 26
Min. Negotiated Rate	$892.18
Max. Negotiated Rate	$892.18
Rate for Payer: Cash Price	$318.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$892.18
Rate for Payer: SOMOS Essential	$892.18

PR CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I

Professional

Both

$1,491.91

Service Code	HCPCS 93457 26
Min. Negotiated Rate	$1,118.93
Max. Negotiated Rate	$1,118.93
Rate for Payer: Cash Price	$399.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,118.93
Rate for Payer: SOMOS Essential	$1,118.93

PR CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I

Professional

Both

$3,830.37

Service Code	HCPCS 93457 TC
Min. Negotiated Rate	$2,872.78
Max. Negotiated Rate	$2,872.78
Rate for Payer: Cash Price	$1,026.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,872.78
Rate for Payer: SOMOS Essential	$2,872.78

PR CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I

Professional

Both

$5,322.28

Service Code	HCPCS 93457
Min. Negotiated Rate	$3,991.71
Max. Negotiated Rate	$3,991.71
Rate for Payer: Cash Price	$1,425.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,991.71
Rate for Payer: SOMOS Essential	$3,991.71

Know your out-of-pocket cost for care.

All Charges