St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CESAREAN DELIVERY ATTEMPTED VBAC

Professional

Both

$4,372.27

Service Code	HCPCS 59620
Min. Negotiated Rate	$3,279.20
Max. Negotiated Rate	$3,279.20
Rate for Payer: Cash Price	$1,152.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,279.20
Rate for Payer: SOMOS Essential	$3,279.20

PR CESAREAN DELIVERY ONLY

Professional

Both

$4,207.98

Service Code	HCPCS 59514
Min. Negotiated Rate	$3,155.98
Max. Negotiated Rate	$3,155.98
Rate for Payer: Cash Price	$1,109.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,155.98
Rate for Payer: SOMOS Essential	$3,155.98

PR CESAREAN DELIVERY ONLY W/POSTPARTUM CARE

Professional

Both

$6,052.31

Service Code	HCPCS 59515
Min. Negotiated Rate	$4,539.23
Max. Negotiated Rate	$4,539.23
Rate for Payer: Cash Price	$1,645.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,539.23
Rate for Payer: SOMOS Essential	$4,539.23

PR CESAREAN DLVRY & POSTPARTUM CARE ATTEMPTED VBA

Professional

Both

$6,293.18

Service Code	HCPCS 59622
Min. Negotiated Rate	$4,719.88
Max. Negotiated Rate	$4,719.88
Rate for Payer: Cash Price	$1,708.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,719.88
Rate for Payer: SOMOS Essential	$4,719.88

PR CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL

Professional

Both

$521.54

Service Code	HCPCS 37214
Min. Negotiated Rate	$391.16
Max. Negotiated Rate	$391.16
Rate for Payer: Cash Price	$138.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$391.16
Rate for Payer: SOMOS Essential	$391.16

PR CHANGE CYSTOSTOMY TUBE COMPLICATED

Professional

Both

$337.65

Service Code	HCPCS 51710
Min. Negotiated Rate	$253.24
Max. Negotiated Rate	$253.24
Rate for Payer: Cash Price	$91.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$253.24
Rate for Payer: SOMOS Essential	$253.24

PR CHANGE CYSTOSTOMY TUBE SIMPLE

Professional

Both

$216.13

Service Code	HCPCS 51705
Min. Negotiated Rate	$162.10
Max. Negotiated Rate	$162.10
Rate for Payer: Cash Price	$59.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$162.10
Rate for Payer: SOMOS Essential	$162.10

PR CHEMICAL CAUTERIZATION OF GRANULATION TISSUE

Professional

Both

$160.69

Service Code	HCPCS 17250
Min. Negotiated Rate	$120.52
Max. Negotiated Rate	$120.52
Rate for Payer: Cash Price	$44.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$120.52
Rate for Payer: SOMOS Essential	$120.52

PR CHEMICAL EXFOLIATION ACNE

Professional

Both

$393.26

Service Code	HCPCS 17360
Min. Negotiated Rate	$294.94
Max. Negotiated Rate	$294.94
Rate for Payer: Cash Price	$106.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$294.94
Rate for Payer: SOMOS Essential	$294.94

PR CHEMICAL PEEL FACIAL DERMAL

Professional

Both

$1,736.77

Service Code	HCPCS 15789
Min. Negotiated Rate	$1,302.58
Max. Negotiated Rate	$1,302.58
Rate for Payer: Cash Price	$477.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,302.58
Rate for Payer: SOMOS Essential	$1,302.58

PR CHEMICAL PEEL FACIAL EPIDERMAL

Professional

Both

$918.12

Service Code	HCPCS 15788
Min. Negotiated Rate	$688.59
Max. Negotiated Rate	$688.59
Rate for Payer: Cash Price	$253.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$688.59
Rate for Payer: SOMOS Essential	$688.59

PR CHEMICAL PEEL NONFACIAL DERMAL

Professional

Both

$1,509.80

Service Code	HCPCS 15793
Min. Negotiated Rate	$1,132.35
Max. Negotiated Rate	$1,132.35
Rate for Payer: Cash Price	$417.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,132.35
Rate for Payer: SOMOS Essential	$1,132.35

PR CHEMICAL PEEL NONFACIAL EPIDERMAL

Professional

Both

$891.17

Service Code	HCPCS 15792
Min. Negotiated Rate	$668.38
Max. Negotiated Rate	$668.38
Rate for Payer: Cash Price	$247.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$668.38
Rate for Payer: SOMOS Essential	$668.38

PR CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES

Professional

Both

$515.52

Service Code	HCPCS 64644
Min. Negotiated Rate	$386.64
Max. Negotiated Rate	$386.64
Rate for Payer: Cash Price	$138.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$386.64
Rate for Payer: SOMOS Essential	$386.64

PR CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE

Professional

Both

$310.35

Service Code	HCPCS 64643
Min. Negotiated Rate	$232.76
Max. Negotiated Rate	$232.76
Rate for Payer: Cash Price	$82.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$232.76
Rate for Payer: SOMOS Essential	$232.76

PR CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES

Professional

Both

$367.75

Service Code	HCPCS 64645
Min. Negotiated Rate	$275.81
Max. Negotiated Rate	$275.81
Rate for Payer: Cash Price	$97.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$275.81
Rate for Payer: SOMOS Essential	$275.81

PR CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE

Professional

Both

$176.58

Service Code	HCPCS 64650
Min. Negotiated Rate	$132.44
Max. Negotiated Rate	$132.44
Rate for Payer: Cash Price	$47.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$132.44
Rate for Payer: SOMOS Essential	$132.44

PR CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY

Professional

Both

$228.48

Service Code	HCPCS 64653
Min. Negotiated Rate	$171.36
Max. Negotiated Rate	$171.36
Rate for Payer: Cash Price	$61.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$171.36
Rate for Payer: SOMOS Essential	$171.36

PR CHEMODENERVATION EXTRAOCULAR MUSCLE

Professional

Both

$913.12

Service Code	HCPCS 67345
Min. Negotiated Rate	$684.84
Max. Negotiated Rate	$684.84
Rate for Payer: Cash Price	$249.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$684.84
Rate for Payer: SOMOS Essential	$684.84

PR CHEMODENERVATION INTERNAL ANAL SPHINCTER

Professional

Both

$1,095.01

Service Code	HCPCS 46505
Min. Negotiated Rate	$821.26
Max. Negotiated Rate	$821.26
Rate for Payer: Cash Price	$295.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$821.26
Rate for Payer: SOMOS Essential	$821.26

PR CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG

Professional

Both

$464.21

Service Code	HCPCS 64617
Min. Negotiated Rate	$348.16
Max. Negotiated Rate	$348.16
Rate for Payer: Cash Price	$125.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$348.16
Rate for Payer: SOMOS Essential	$348.16

PR CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA

Professional

Both

$505.12

Service Code	HCPCS 64616
Min. Negotiated Rate	$378.84
Max. Negotiated Rate	$378.84
Rate for Payer: Cash Price	$135.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$378.84
Rate for Payer: SOMOS Essential	$378.84

PR CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES

Professional

Both

$609.70

Service Code	HCPCS 64647
Min. Negotiated Rate	$457.28
Max. Negotiated Rate	$457.28
Rate for Payer: Cash Price	$162.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$457.28
Rate for Payer: SOMOS Essential	$457.28

PR CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES

Professional

Both

$526.26

Service Code	HCPCS 64646
Min. Negotiated Rate	$394.70
Max. Negotiated Rate	$394.70
Rate for Payer: Cash Price	$140.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$394.70
Rate for Payer: SOMOS Essential	$394.70

PR CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE

Professional

Both

$473.06

Service Code	HCPCS 64642
Min. Negotiated Rate	$354.80
Max. Negotiated Rate	$354.80
Rate for Payer: Cash Price	$128.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$354.80
Rate for Payer: SOMOS Essential	$354.80

Know your out-of-pocket cost for care.

All Charges