St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ

Professional

Both

$1,328.32

Service Code	HCPCS 24560
Min. Negotiated Rate	$996.24
Max. Negotiated Rate	$996.24
Rate for Payer: Cash Price	$363.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$996.24
Rate for Payer: SOMOS Essential	$996.24

PR CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ

Professional

Both

$2,026.01

Service Code	HCPCS 24505
Min. Negotiated Rate	$1,519.51
Max. Negotiated Rate	$1,519.51
Rate for Payer: Cash Price	$553.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,519.51
Rate for Payer: SOMOS Essential	$1,519.51

PR CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN

Professional

Both

$2,012.26

Service Code	HCPCS 27538
Min. Negotiated Rate	$1,509.20
Max. Negotiated Rate	$1,509.20
Rate for Payer: Cash Price	$549.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,509.20
Rate for Payer: SOMOS Essential	$1,509.20

PR CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ

Professional

Both

$2,082.92

Service Code	HCPCS 27238
Min. Negotiated Rate	$1,562.19
Max. Negotiated Rate	$1,562.19
Rate for Payer: Cash Price	$567.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,562.19
Rate for Payer: SOMOS Essential	$1,562.19

PR CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES

Professional

Both

$521.68

Service Code	HCPCS 28665
Min. Negotiated Rate	$391.26
Max. Negotiated Rate	$391.26
Rate for Payer: Cash Price	$146.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$391.26
Rate for Payer: SOMOS Essential	$391.26

PR CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES

Professional

Both

$407.40

Service Code	HCPCS 28660
Min. Negotiated Rate	$305.55
Max. Negotiated Rate	$305.55
Rate for Payer: Cash Price	$113.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$305.55
Rate for Payer: SOMOS Essential	$305.55

PR CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ

Professional

Both

$4,234.16

Service Code	HCPCS 27240
Min. Negotiated Rate	$3,175.62
Max. Negotiated Rate	$3,175.62
Rate for Payer: Cash Price	$1,136.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,175.62
Rate for Payer: SOMOS Essential	$3,175.62

PR CLTX IPHAL JT DISLC W/MANJ REQ ANES

Professional

Both

$1,590.96

Service Code	HCPCS 26775
Min. Negotiated Rate	$1,193.22
Max. Negotiated Rate	$1,193.22
Rate for Payer: Cash Price	$435.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,193.22
Rate for Payer: SOMOS Essential	$1,193.22

PR CLTX IPHAL JT DISLC W/MANJ W/O ANES

Professional

Both

$1,179.71

Service Code	HCPCS 26770
Min. Negotiated Rate	$884.78
Max. Negotiated Rate	$884.78
Rate for Payer: Cash Price	$324.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$884.78
Rate for Payer: SOMOS Essential	$884.78

PR CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX

Professional

Both

$2,374.96

Service Code	HCPCS 21440
Min. Negotiated Rate	$1,781.22
Max. Negotiated Rate	$1,781.22
Rate for Payer: Cash Price	$709.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,781.22
Rate for Payer: SOMOS Essential	$1,781.22

PR CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION

Professional

Both

$1,364.72

Service Code	HCPCS 27760
Min. Negotiated Rate	$1,023.54
Max. Negotiated Rate	$1,023.54
Rate for Payer: Cash Price	$377.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,023.54
Rate for Payer: SOMOS Essential	$1,023.54

PR CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ

Professional

Both

$1,955.52

Service Code	HCPCS 27762
Min. Negotiated Rate	$1,466.64
Max. Negotiated Rate	$1,466.64
Rate for Payer: Cash Price	$538.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,466.64
Rate for Payer: SOMOS Essential	$1,466.64

PR CLTX METACARPAL FX W/MANIPULATION EACH BONE

Professional

Both

$1,337.46

Service Code	HCPCS 26605
Min. Negotiated Rate	$1,003.10
Max. Negotiated Rate	$1,003.10
Rate for Payer: Cash Price	$366.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,003.10
Rate for Payer: SOMOS Essential	$1,003.10

PR CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE

Professional

Both

$2,270.87

Service Code	HCPCS 26607
Min. Negotiated Rate	$1,703.15
Max. Negotiated Rate	$1,703.15
Rate for Payer: Cash Price	$614.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,703.15
Rate for Payer: SOMOS Essential	$1,703.15

PR CLTX METACARPAL FX W/O MANIPULATION EACH BONE

Professional

Both

$1,286.29

Service Code	HCPCS 26600
Min. Negotiated Rate	$964.72
Max. Negotiated Rate	$964.72
Rate for Payer: Cash Price	$354.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$964.72
Rate for Payer: SOMOS Essential	$964.72

PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES

Professional

Both

$1,782.55

Service Code	HCPCS 26705
Min. Negotiated Rate	$1,336.91
Max. Negotiated Rate	$1,336.91
Rate for Payer: Cash Price	$487.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,336.91
Rate for Payer: SOMOS Essential	$1,336.91

PR CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES

Professional

Both

$1,412.29

Service Code	HCPCS 26700
Min. Negotiated Rate	$1,059.22
Max. Negotiated Rate	$1,059.22
Rate for Payer: Cash Price	$385.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,059.22
Rate for Payer: SOMOS Essential	$1,059.22

PR CLTX METAR FX W/MANJ

Professional

Both

$978.78

Service Code	HCPCS 28475
Min. Negotiated Rate	$734.08
Max. Negotiated Rate	$734.08
Rate for Payer: Cash Price	$273.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$734.08
Rate for Payer: SOMOS Essential	$734.08

PR CLTX METATARSOPHLNGL JT DISLC REQ ANES

Professional

Both

$571.48

Service Code	HCPCS 28635
Min. Negotiated Rate	$428.61
Max. Negotiated Rate	$428.61
Rate for Payer: Cash Price	$152.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$428.61
Rate for Payer: SOMOS Essential	$428.61

PR CLTX METATARSOPHLNGL JT DISLC W/O ANES

Professional

Both

$478.63

Service Code	HCPCS 28630
Min. Negotiated Rate	$358.97
Max. Negotiated Rate	$358.97
Rate for Payer: Cash Price	$130.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$358.97
Rate for Payer: SOMOS Essential	$358.97

PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA

Professional

Both

$1,369.55

Service Code	HCPCS 26725
Min. Negotiated Rate	$1,027.16
Max. Negotiated Rate	$1,027.16
Rate for Payer: Cash Price	$375.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,027.16
Rate for Payer: SOMOS Essential	$1,027.16

PR CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA

Professional

Both

$849.66

Service Code	HCPCS 26720
Min. Negotiated Rate	$637.24
Max. Negotiated Rate	$637.24
Rate for Payer: Cash Price	$234.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$637.24
Rate for Payer: SOMOS Essential	$637.24

PR CLTX POST HIP ARTHRP DISLC REQ ANES

Professional

Both

$2,597.42

Service Code	HCPCS 27266
Min. Negotiated Rate	$1,948.06
Max. Negotiated Rate	$1,948.06
Rate for Payer: Cash Price	$701.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,948.06
Rate for Payer: SOMOS Essential	$1,948.06

PR CLTX POST HIP ARTHRP DISLC W/O ANES

Professional

Both

$1,862.04

Service Code	HCPCS 27265
Min. Negotiated Rate	$1,396.53
Max. Negotiated Rate	$1,396.53
Rate for Payer: Cash Price	$509.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,396.53
Rate for Payer: SOMOS Essential	$1,396.53

PR CLTX PROX FIBULA/SHFT FX W/MANJ

Professional

Both

$1,808.56

Service Code	HCPCS 27781
Min. Negotiated Rate	$1,356.42
Max. Negotiated Rate	$1,356.42
Rate for Payer: Cash Price	$493.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,356.42
Rate for Payer: SOMOS Essential	$1,356.42

Know your out-of-pocket cost for care.

All Charges