St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CILIARY BODY DESTRUCTION DIATHERMY

Professional

Both

$1,607.38

Service Code	HCPCS 66700
Min. Negotiated Rate	$1,205.54
Max. Negotiated Rate	$1,205.54
Rate for Payer: Cash Price	$444.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,205.54
Rate for Payer: SOMOS Essential	$1,205.54

PR CILIARY BODY DSTRJ CYCLOPHOTOCOAG TRANSSCERAL

Professional

Both

$1,607.38

Service Code	HCPCS 66710
Min. Negotiated Rate	$1,205.54
Max. Negotiated Rate	$1,205.54
Rate for Payer: Cash Price	$443.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,205.54
Rate for Payer: SOMOS Essential	$1,205.54

PR CINEPLASTY UPPER EXTREMITY COMPLETE PROCEDURE

Professional

Both

$2,799.16

Service Code	HCPCS 24940
Min. Negotiated Rate	$2,099.37
Max. Negotiated Rate	$2,099.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,099.37
Rate for Payer: SOMOS Essential	$2,099.37

PR CIRCUMCISION AGE >28 DAYS

Professional

Both

$830.03

Service Code	HCPCS 54161
Min. Negotiated Rate	$622.52
Max. Negotiated Rate	$622.52
Rate for Payer: Cash Price	$227.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$622.52
Rate for Payer: SOMOS Essential	$622.52

PR CIRCUMCISION NEONATE

Professional

Both

$610.26

Service Code	HCPCS 54160
Min. Negotiated Rate	$457.70
Max. Negotiated Rate	$457.70
Rate for Payer: Cash Price	$167.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$457.70
Rate for Payer: SOMOS Essential	$457.70

PR CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK

Professional

Both

$407.02

Service Code	HCPCS 54150
Min. Negotiated Rate	$305.26
Max. Negotiated Rate	$305.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$305.26
Rate for Payer: SOMOS Essential	$305.26

PR CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION

Professional

Both

$511.18

Service Code	HCPCS 61055
Min. Negotiated Rate	$383.38
Max. Negotiated Rate	$383.38
Rate for Payer: Cash Price	$136.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$383.38
Rate for Payer: SOMOS Essential	$383.38

PR CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX

Professional

Both

$328.34

Service Code	HCPCS 61050
Min. Negotiated Rate	$246.26
Max. Negotiated Rate	$246.26
Rate for Payer: Cash Price	$89.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$246.26
Rate for Payer: SOMOS Essential	$246.26

PR CJP RCNSTJ CUL-DE-SAC BUCCAL GRF/XTNSV REARRGMT

Professional

Both

$2,649.68

Service Code	HCPCS 68326
Min. Negotiated Rate	$1,987.26
Max. Negotiated Rate	$1,987.26
Rate for Payer: Cash Price	$730.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,987.26
Rate for Payer: SOMOS Essential	$1,987.26

PR CLAVICULECTOMY PARTIAL

Professional

Both

$2,611.35

Service Code	HCPCS 23120
Min. Negotiated Rate	$1,958.51
Max. Negotiated Rate	$1,958.51
Rate for Payer: Cash Price	$709.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,958.51
Rate for Payer: SOMOS Essential	$1,958.51

PR CLAVICULECTOMY TOTAL

Professional

Both

$3,154.13

Service Code	HCPCS 23125
Min. Negotiated Rate	$2,365.60
Max. Negotiated Rate	$2,365.60
Rate for Payer: Cash Price	$853.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,365.60
Rate for Payer: SOMOS Essential	$2,365.60

PR CLITOROPLASTY INTERSEX STATE

Professional

Both

$5,089.39

Service Code	HCPCS 56805
Min. Negotiated Rate	$3,817.04
Max. Negotiated Rate	$3,817.04
Rate for Payer: Cash Price	$1,370.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,817.04
Rate for Payer: SOMOS Essential	$3,817.04

PR CLOSED TREATMENT COCCYGEAL FRACTURE

Professional

Both

$841.96

Service Code	HCPCS 27200
Min. Negotiated Rate	$631.47
Max. Negotiated Rate	$631.47
Rate for Payer: Cash Price	$235.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$631.47
Rate for Payer: SOMOS Essential	$631.47

PR CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ

Professional

Both

$2,002.28

Service Code	HCPCS 27768
Min. Negotiated Rate	$1,501.71
Max. Negotiated Rate	$1,501.71
Rate for Payer: Cash Price	$547.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,501.71
Rate for Payer: SOMOS Essential	$1,501.71

PR CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ

Professional

Both

$1,297.03

Service Code	HCPCS 27767
Min. Negotiated Rate	$972.77
Max. Negotiated Rate	$972.77
Rate for Payer: Cash Price	$355.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$972.77
Rate for Payer: SOMOS Essential	$972.77

PR CLOSED TREATMENT SESAMOID FRACTURE

Professional

Both

$430.75

Service Code	HCPCS 28530
Min. Negotiated Rate	$323.06
Max. Negotiated Rate	$323.06
Rate for Payer: Cash Price	$122.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$323.06
Rate for Payer: SOMOS Essential	$323.06

PR CLOSED TREATMENT STERNUM FRACTURE

Professional

Both

$659.65

Service Code	HCPCS 21820
Min. Negotiated Rate	$494.74
Max. Negotiated Rate	$494.74
Rate for Payer: Cash Price	$181.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$494.74
Rate for Payer: SOMOS Essential	$494.74

PR CLOSED TREATMENT ULNAR STYLOID FRACTURE

Professional

Both

$1,383.24

Service Code	HCPCS 25650
Min. Negotiated Rate	$1,037.43
Max. Negotiated Rate	$1,037.43
Rate for Payer: Cash Price	$376.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,037.43
Rate for Payer: SOMOS Essential	$1,037.43

PR CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA

Professional

Both

$1,734.25

Service Code	HCPCS 27840
Min. Negotiated Rate	$1,300.69
Max. Negotiated Rate	$1,300.69
Rate for Payer: Cash Price	$473.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,300.69
Rate for Payer: SOMOS Essential	$1,300.69

PR CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ

Professional

Both

$1,918.04

Service Code	HCPCS 27810
Min. Negotiated Rate	$1,438.53
Max. Negotiated Rate	$1,438.53
Rate for Payer: Cash Price	$523.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,438.53
Rate for Payer: SOMOS Essential	$1,438.53

PR CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ

Professional

Both

$1,367.91

Service Code	HCPCS 27808
Min. Negotiated Rate	$1,025.93
Max. Negotiated Rate	$1,025.93
Rate for Payer: Cash Price	$375.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,025.93
Rate for Payer: SOMOS Essential	$1,025.93

PR CLOSED TX CALCANEAL FRACTURE W/MANIPULATION

Professional

Both

$1,813.88

Service Code	HCPCS 28405
Min. Negotiated Rate	$1,360.41
Max. Negotiated Rate	$1,360.41
Rate for Payer: Cash Price	$495.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,360.41
Rate for Payer: SOMOS Essential	$1,360.41

PR CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION

Professional

Both

$1,011.71

Service Code	HCPCS 28400
Min. Negotiated Rate	$758.78
Max. Negotiated Rate	$758.78
Rate for Payer: Cash Price	$279.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$758.78
Rate for Payer: SOMOS Essential	$758.78

PR CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ

Professional

Both

$1,997.17

Service Code	HCPCS 25624
Min. Negotiated Rate	$1,497.88
Max. Negotiated Rate	$1,497.88
Rate for Payer: Cash Price	$546.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,497.88
Rate for Payer: SOMOS Essential	$1,497.88

PR CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ

Professional

Both

$1,277.89

Service Code	HCPCS 25622
Min. Negotiated Rate	$958.42
Max. Negotiated Rate	$958.42
Rate for Payer: Cash Price	$350.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$958.42
Rate for Payer: SOMOS Essential	$958.42

Know your out-of-pocket cost for care.

All Charges