St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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

Professional

Both

$3,555.83

Service Code	HCPCS 93456 TC
Min. Negotiated Rate	$2,666.87
Max. Negotiated Rate	$2,666.87
Rate for Payer: Cash Price	$952.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,666.87
Rate for Payer: SOMOS Essential	$2,666.87

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

Professional

Both

$4,884.95

Service Code	HCPCS 93456
Min. Negotiated Rate	$3,663.71
Max. Negotiated Rate	$3,663.71
Rate for Payer: Cash Price	$1,308.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,663.71
Rate for Payer: SOMOS Essential	$3,663.71

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

Professional

Both

$1,329.16

Service Code	HCPCS 93456 26
Min. Negotiated Rate	$996.87
Max. Negotiated Rate	$996.87
Rate for Payer: Cash Price	$356.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$996.87
Rate for Payer: SOMOS Essential	$996.87

PR CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI

Professional

Both

$247.70

Service Code	HCPCS 58340
Min. Negotiated Rate	$185.78
Max. Negotiated Rate	$185.78
Rate for Payer: Cash Price	$67.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$185.78
Rate for Payer: SOMOS Essential	$185.78

PR CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT

Professional

Both

$640.99

Service Code	HCPCS 57511
Min. Negotiated Rate	$480.74
Max. Negotiated Rate	$480.74
Rate for Payer: Cash Price	$174.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$480.74
Rate for Payer: SOMOS Essential	$480.74

PR CAUTERY CERVIX ELECTRO/THERMAL

Professional

Both

$486.82

Service Code	HCPCS 57510
Min. Negotiated Rate	$365.12
Max. Negotiated Rate	$365.12
Rate for Payer: Cash Price	$133.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$365.12
Rate for Payer: SOMOS Essential	$365.12

PR CAUTERY CERVIX LASER ABLATION

Professional

Both

$639.56

Service Code	HCPCS 57513
Min. Negotiated Rate	$479.67
Max. Negotiated Rate	$479.67
Rate for Payer: Cash Price	$173.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$479.67
Rate for Payer: SOMOS Essential	$479.67

PR CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE

Professional

Both

$75.42

Service Code	HCPCS 90674
Min. Negotiated Rate	$56.56
Max. Negotiated Rate	$56.56
Rate for Payer: Cash Price	$34.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$56.56
Rate for Payer: SOMOS Essential	$56.56

PR CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT

Professional

Both

$132.51

Service Code	HCPCS 92548 26
Min. Negotiated Rate	$99.38
Max. Negotiated Rate	$99.38
Rate for Payer: Cash Price	$36.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$99.38
Rate for Payer: SOMOS Essential	$99.38

PR CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT

Professional

Both

$61.67

Service Code	HCPCS 92548 TC
Min. Negotiated Rate	$46.25
Max. Negotiated Rate	$46.25
Rate for Payer: Cash Price	$16.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$46.25
Rate for Payer: SOMOS Essential	$46.25

PR CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT

Professional

Both

$194.18

Service Code	HCPCS 92548
Min. Negotiated Rate	$145.64
Max. Negotiated Rate	$145.64
Rate for Payer: Cash Price	$53.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$145.64
Rate for Payer: SOMOS Essential	$145.64

PR CDP-SOT 6 CONDITIONS W/I&R W/MCT & ADT

Professional

Both

$174.97

Service Code	HCPCS 92549 26
Min. Negotiated Rate	$131.23
Max. Negotiated Rate	$131.23
Rate for Payer: Cash Price	$48.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$131.23
Rate for Payer: SOMOS Essential	$131.23

PR CDP-SOT 6 CONDITIONS W/I&R W/MCT & ADT

Professional

Both

$263.94

Service Code	HCPCS 92549
Min. Negotiated Rate	$197.96
Max. Negotiated Rate	$197.96
Rate for Payer: Cash Price	$72.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$197.96
Rate for Payer: SOMOS Essential	$197.96

PR CDP-SOT 6 CONDITIONS W/I&R W/MCT & ADT

Professional

Both

$88.97

Service Code	HCPCS 92549 TC
Min. Negotiated Rate	$66.73
Max. Negotiated Rate	$66.73
Rate for Payer: Cash Price	$24.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$66.73
Rate for Payer: SOMOS Essential	$66.73

PR CEFTRIAXONE SODIUM INJECTION

Professional

Both

$15.19

Service Code	HCPCS J0696
Min. Negotiated Rate	$11.39
Max. Negotiated Rate	$11.39
Rate for Payer: Cash Price	$0.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$11.39
Rate for Payer: SOMOS Essential	$11.39

PR CENTRALIZATION WRST ULNA

Professional

Both

$4,188.14

Service Code	HCPCS 25335
Min. Negotiated Rate	$3,141.10
Max. Negotiated Rate	$3,141.10
Rate for Payer: Cash Price	$1,129.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,141.10
Rate for Payer: SOMOS Essential	$3,141.10

PR CERCLAGE CERVIX PREGNANCY ABDOMINAL

Professional

Both

$1,115.59

Service Code	HCPCS 59325
Min. Negotiated Rate	$836.69
Max. Negotiated Rate	$836.69
Rate for Payer: Cash Price	$295.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$836.69
Rate for Payer: SOMOS Essential	$836.69

PR CERCLAGE CERVIX PREGNANCY VAGINAL

Professional

Both

$699.97

Service Code	HCPCS 59320
Min. Negotiated Rate	$524.98
Max. Negotiated Rate	$524.98
Rate for Payer: Cash Price	$185.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$524.98
Rate for Payer: SOMOS Essential	$524.98

PR CERCLAGE UTERINE CERVIX NONOBSTETRICAL

Professional

Both

$1,562.65

Service Code	HCPCS 57700
Min. Negotiated Rate	$1,171.99
Max. Negotiated Rate	$1,171.99
Rate for Payer: Cash Price	$423.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,171.99
Rate for Payer: SOMOS Essential	$1,171.99

PR CEREBRAL PERFUSION ANALYS CT W/BLOOD FLOW&VOLUME

Professional

Both

$382.24

Service Code	HCPCS 0042T
Min. Negotiated Rate	$286.68
Max. Negotiated Rate	$286.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$286.68
Rate for Payer: SOMOS Essential	$286.68

PR CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ

Professional

Both

$6,271.34

Service Code	HCPCS 38724
Min. Negotiated Rate	$4,703.50
Max. Negotiated Rate	$4,703.50
Rate for Payer: Cash Price	$1,694.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,703.50
Rate for Payer: SOMOS Essential	$4,703.50

PR CERVICAL LYMPHADENECTOMY

Professional

Both

$5,829.39

Service Code	HCPCS 38720
Min. Negotiated Rate	$4,372.04
Max. Negotiated Rate	$4,372.04
Rate for Payer: Cash Price	$1,579.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,372.04
Rate for Payer: SOMOS Essential	$4,372.04

PR CERVICAL & OCULAR VEMP TESTING W/I&R

Professional

Both

$254.70

Service Code	HCPCS 92519
Min. Negotiated Rate	$191.02
Max. Negotiated Rate	$191.02
Rate for Payer: Cash Price	$69.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$191.02
Rate for Payer: SOMOS Essential	$191.02

PR CERVICAL VEMP TESTING W/I&R

Professional

Both

$170.07

Service Code	HCPCS 92517
Min. Negotiated Rate	$127.55
Max. Negotiated Rate	$127.55
Rate for Payer: Cash Price	$46.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$127.55
Rate for Payer: SOMOS Essential	$127.55

PR CERVICOPLASTY

Professional

Both

$3,494.96

Service Code	HCPCS 15819
Min. Negotiated Rate	$2,621.22
Max. Negotiated Rate	$2,621.22
Rate for Payer: Cash Price	$945.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,621.22
Rate for Payer: SOMOS Essential	$2,621.22

Know your out-of-pocket cost for care.

All Charges