St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CLTX PROX FIBULA/SHFT FX W/O MANJ

Professional

Both

$1,278.45

Service Code	HCPCS 27780
Min. Negotiated Rate	$958.84
Max. Negotiated Rate	$958.84
Rate for Payer: Cash Price	$350.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$958.84
Rate for Payer: SOMOS Essential	$958.84

PR CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ

Professional

Both

$1,916.36

Service Code	HCPCS 23605
Min. Negotiated Rate	$1,437.27
Max. Negotiated Rate	$1,437.27
Rate for Payer: Cash Price	$523.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,437.27
Rate for Payer: SOMOS Essential	$1,437.27

PR CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION

Professional

Both

$1,418.52

Service Code	HCPCS 23600
Min. Negotiated Rate	$1,063.89
Max. Negotiated Rate	$1,063.89
Rate for Payer: Cash Price	$389.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,063.89
Rate for Payer: SOMOS Essential	$1,063.89

PR CLTX PROX TIBFIB JT DISLC REQ ANES

Professional

Both

$1,828.44

Service Code	HCPCS 27831
Min. Negotiated Rate	$1,371.33
Max. Negotiated Rate	$1,371.33
Rate for Payer: Cash Price	$498.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,371.33
Rate for Payer: SOMOS Essential	$1,371.33

PR CLTX PROX TIBFIB JT DISLC W/O ANES

Professional

Both

$1,616.34

Service Code	HCPCS 27830
Min. Negotiated Rate	$1,212.26
Max. Negotiated Rate	$1,212.26
Rate for Payer: Cash Price	$441.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,212.26
Rate for Payer: SOMOS Essential	$1,212.26

PR CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ

Professional

Both

$2,009.98

Service Code	HCPCS 25660
Min. Negotiated Rate	$1,507.48
Max. Negotiated Rate	$1,507.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,507.48
Rate for Payer: SOMOS Essential	$1,507.48

PR CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ

Professional

Both

$333.41

Service Code	HCPCS 24640
Min. Negotiated Rate	$250.06
Max. Negotiated Rate	$250.06
Rate for Payer: Cash Price	$91.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$250.06
Rate for Payer: SOMOS Essential	$250.06

PR CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT

Professional

Both

$2,436.25

Service Code	HCPCS 25520
Min. Negotiated Rate	$1,827.19
Max. Negotiated Rate	$1,827.19
Rate for Payer: Cash Price	$664.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,827.19
Rate for Payer: SOMOS Essential	$1,827.19

PR CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION

Professional

Both

$1,701.21

Service Code	HCPCS 23575
Min. Negotiated Rate	$1,275.91
Max. Negotiated Rate	$1,275.91
Rate for Payer: Cash Price	$466.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,275.91
Rate for Payer: SOMOS Essential	$1,275.91

PR CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ

Professional

Both

$1,788.57

Service Code	HCPCS 23665
Min. Negotiated Rate	$1,341.43
Max. Negotiated Rate	$1,341.43
Rate for Payer: Cash Price	$491.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,341.43
Rate for Payer: SOMOS Essential	$1,341.43

PR CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ

Professional

Both

$2,230.45

Service Code	HCPCS 23675
Min. Negotiated Rate	$1,672.84
Max. Negotiated Rate	$1,672.84
Rate for Payer: Cash Price	$611.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,672.84
Rate for Payer: SOMOS Essential	$1,672.84

PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ

Professional

Both

$2,545.90

Service Code	HCPCS 24535
Min. Negotiated Rate	$1,909.42
Max. Negotiated Rate	$1,909.42
Rate for Payer: Cash Price	$697.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,909.42
Rate for Payer: SOMOS Essential	$1,909.42

PR CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ

Professional

Both

$1,579.17

Service Code	HCPCS 24530
Min. Negotiated Rate	$1,184.38
Max. Negotiated Rate	$1,184.38
Rate for Payer: Cash Price	$432.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,184.38
Rate for Payer: SOMOS Essential	$1,184.38

PR CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ

Professional

Both

$3,559.15

Service Code	HCPCS 27503
Min. Negotiated Rate	$2,669.36
Max. Negotiated Rate	$2,669.36
Rate for Payer: Cash Price	$957.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,669.36
Rate for Payer: SOMOS Essential	$2,669.36

PR CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ

Professional

Both

$2,217.53

Service Code	HCPCS 27501
Min. Negotiated Rate	$1,663.15
Max. Negotiated Rate	$1,663.15
Rate for Payer: Cash Price	$601.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,663.15
Rate for Payer: SOMOS Essential	$1,663.15

PR CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES

Professional

Both

$1,212.40

Service Code	HCPCS 28545
Min. Negotiated Rate	$909.30
Max. Negotiated Rate	$909.30
Rate for Payer: Cash Price	$332.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$909.30
Rate for Payer: SOMOS Essential	$909.30

PR CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES

Professional

Both

$743.30

Service Code	HCPCS 28540
Min. Negotiated Rate	$557.48
Max. Negotiated Rate	$557.48
Rate for Payer: Cash Price	$207.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$557.48
Rate for Payer: SOMOS Essential	$557.48

PR CLTX TIBIAL FX PROXIMAL W/O MANIPULATION

Professional

Both

$1,296.58

Service Code	HCPCS 27530
Min. Negotiated Rate	$972.44
Max. Negotiated Rate	$972.44
Rate for Payer: Cash Price	$356.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$972.44
Rate for Payer: SOMOS Essential	$972.44

PR CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ

Professional

Both

$2,579.22

Service Code	HCPCS 27532
Min. Negotiated Rate	$1,934.42
Max. Negotiated Rate	$1,934.42
Rate for Payer: Cash Price	$701.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,934.42
Rate for Payer: SOMOS Essential	$1,934.42

PR CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ

Professional

Both

$2,196.67

Service Code	HCPCS 27752
Min. Negotiated Rate	$1,647.50
Max. Negotiated Rate	$1,647.50
Rate for Payer: Cash Price	$595.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,647.50
Rate for Payer: SOMOS Essential	$1,647.50

PR CLTX TIBIAL SHAFT FX W/O MANIPULATION

Professional

Both

$1,448.06

Service Code	HCPCS 27750
Min. Negotiated Rate	$1,086.04
Max. Negotiated Rate	$1,086.04
Rate for Payer: Cash Price	$397.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,086.04
Rate for Payer: SOMOS Essential	$1,086.04

PR CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ

Professional

Both

$2,371.36

Service Code	HCPCS 25680
Min. Negotiated Rate	$1,778.52
Max. Negotiated Rate	$1,778.52
Rate for Payer: Cash Price	$645.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,778.52
Rate for Payer: SOMOS Essential	$1,778.52

PR CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION

Professional

Both

$1,972.04

Service Code	HCPCS 27818
Min. Negotiated Rate	$1,479.03
Max. Negotiated Rate	$1,479.03
Rate for Payer: Cash Price	$537.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,479.03
Rate for Payer: SOMOS Essential	$1,479.03

PR CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION

Professional

Both

$1,315.16

Service Code	HCPCS 27816
Min. Negotiated Rate	$986.37
Max. Negotiated Rate	$986.37
Rate for Payer: Cash Price	$362.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$986.37
Rate for Payer: SOMOS Essential	$986.37

PR CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING

Professional

Both

$1,325.87

Service Code	HCPCS 22310
Min. Negotiated Rate	$994.40
Max. Negotiated Rate	$994.40
Rate for Payer: Cash Price	$360.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$994.40
Rate for Payer: SOMOS Essential	$994.40

Know your out-of-pocket cost for care.

All Charges