St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY

Professional

Both

$9,067.07

Service Code	HCPCS 44155
Min. Negotiated Rate	$6,800.30
Max. Negotiated Rate	$6,800.30
Rate for Payer: Cash Price	$2,435.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,800.30
Rate for Payer: SOMOS Essential	$6,800.30

PR COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST

Professional

Both

$9,861.36

Service Code	HCPCS 44157
Min. Negotiated Rate	$7,396.02
Max. Negotiated Rate	$7,396.02
Rate for Payer: Cash Price	$2,624.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,396.02
Rate for Payer: SOMOS Essential	$7,396.02

PR COLLAGEN CROSS-LINKING CORNEA&PACHYMTRY

Professional

Both

$1,226.16

Service Code	HCPCS 0402T
Min. Negotiated Rate	$919.62
Max. Negotiated Rate	$919.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$919.62
Rate for Payer: SOMOS Essential	$919.62

PR COLLECT BLOOD FROM CATHETER VENOUS NOS

Professional

Both

$126.35

Service Code	HCPCS 36592
Min. Negotiated Rate	$94.76
Max. Negotiated Rate	$94.76
Rate for Payer: Cash Price	$35.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$94.76
Rate for Payer: SOMOS Essential	$94.76

PR COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE

Professional

Both

$116.31

Service Code	HCPCS 36591
Min. Negotiated Rate	$87.23
Max. Negotiated Rate	$87.23
Rate for Payer: Cash Price	$32.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$87.23
Rate for Payer: SOMOS Essential	$87.23

PR COLLECTION VENOUS BLOOD VENIPUNCTURE

Professional

Both

$8.00

Service Code	HCPCS 36415
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Cash Price	$8.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6.00
Rate for Payer: SOMOS Essential	$6.00

PR COLLECT SWEAT FOR TEST

Professional

Both

$12.81

Service Code	HCPCS 89230
Min. Negotiated Rate	$9.61
Max. Negotiated Rate	$9.61
Rate for Payer: Cash Price	$3.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9.61
Rate for Payer: SOMOS Essential	$9.61

PR COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D

Professional

Both

$220.05

Service Code	HCPCS 99091
Min. Negotiated Rate	$165.04
Max. Negotiated Rate	$165.04
Rate for Payer: Cash Price	$60.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$165.04
Rate for Payer: SOMOS Essential	$165.04

PR COLON CA SCREEN;BARIUM ENEMA

Professional

Both

$714.14

Service Code	HCPCS G0106 TC
Min. Negotiated Rate	$535.60
Max. Negotiated Rate	$535.60
Rate for Payer: Cash Price	$189.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$535.60
Rate for Payer: SOMOS Essential	$535.60

PR COLON CA SCREEN;BARIUM ENEMA

Professional

Both

$955.82

Service Code	HCPCS G0106
Min. Negotiated Rate	$716.86
Max. Negotiated Rate	$716.86
Rate for Payer: Cash Price	$254.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$716.86
Rate for Payer: SOMOS Essential	$716.86

PR COLON CA SCREEN;BARIUM ENEMA

Professional

Both

$241.64

Service Code	HCPCS G0106 26
Min. Negotiated Rate	$181.23
Max. Negotiated Rate	$181.23
Rate for Payer: Cash Price	$64.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$181.23
Rate for Payer: SOMOS Essential	$181.23

PR COLON CA SCRN; BARIUM ENEMA

Professional

Both

$955.82

Service Code	HCPCS G0120
Min. Negotiated Rate	$716.86
Max. Negotiated Rate	$716.86
Rate for Payer: Cash Price	$254.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$716.86
Rate for Payer: SOMOS Essential	$716.86

PR COLON CA SCRN; BARIUM ENEMA

Professional

Both

$241.64

Service Code	HCPCS G0120 26
Min. Negotiated Rate	$181.23
Max. Negotiated Rate	$181.23
Rate for Payer: Cash Price	$64.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$181.23
Rate for Payer: SOMOS Essential	$181.23

PR COLON CA SCRN; BARIUM ENEMA

Professional

Both

$714.14

Service Code	HCPCS G0120 TC
Min. Negotiated Rate	$535.60
Max. Negotiated Rate	$535.60
Rate for Payer: Cash Price	$189.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$535.60
Rate for Payer: SOMOS Essential	$535.60

PR COLON CA SCRN NOT HI RSK IND

Professional

Both

$776.09

Service Code	HCPCS G0121
Min. Negotiated Rate	$582.07
Max. Negotiated Rate	$582.07
Rate for Payer: Cash Price	$210.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$582.07
Rate for Payer: SOMOS Essential	$582.07

PR COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R

Professional

Both

$553.04

Service Code	HCPCS 91117
Min. Negotiated Rate	$414.78
Max. Negotiated Rate	$414.78
Rate for Payer: Cash Price	$151.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$414.78
Rate for Payer: SOMOS Essential	$414.78

PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)

Professional

Both

$1,001.60

Service Code	HCPCS 45398
Min. Negotiated Rate	$751.20
Max. Negotiated Rate	$751.20
Rate for Payer: Cash Price	$269.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$751.20
Rate for Payer: SOMOS Essential	$751.20

PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION

Professional

Both

$1,050.91

Service Code	HCPCS 45393
Min. Negotiated Rate	$788.18
Max. Negotiated Rate	$788.18
Rate for Payer: Cash Price	$284.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$788.18
Rate for Payer: SOMOS Essential	$788.18

PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES

Professional

Both

$1,135.65

Service Code	HCPCS 45388
Min. Negotiated Rate	$851.74
Max. Negotiated Rate	$851.74
Rate for Payer: Cash Price	$306.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$851.74
Rate for Payer: SOMOS Essential	$851.74

PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD

Professional

Both

$773.36

Service Code	HCPCS 45378
Min. Negotiated Rate	$580.02
Max. Negotiated Rate	$580.02
Rate for Payer: Cash Price	$209.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$580.02
Rate for Payer: SOMOS Essential	$580.02

PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION

Professional

Both

$1,380.58

Service Code	HCPCS 45390
Min. Negotiated Rate	$1,035.44
Max. Negotiated Rate	$1,035.44
Rate for Payer: Cash Price	$374.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,035.44
Rate for Payer: SOMOS Essential	$1,035.44

PR COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT

Professional

Both

$1,210.79

Service Code	HCPCS 45389
Min. Negotiated Rate	$908.09
Max. Negotiated Rate	$908.09
Rate for Payer: Cash Price	$326.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$908.09
Rate for Payer: SOMOS Essential	$908.09

PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)

Professional

Both

$995.89

Service Code	HCPCS 45379
Min. Negotiated Rate	$746.92
Max. Negotiated Rate	$746.92
Rate for Payer: Cash Price	$269.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$746.92
Rate for Payer: SOMOS Essential	$746.92

PR COLONOSCOPY STOMA ABLATION LESION

Professional

Both

$1,008.00

Service Code	HCPCS 44401
Min. Negotiated Rate	$756.00
Max. Negotiated Rate	$756.00
Rate for Payer: Cash Price	$273.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$756.00
Rate for Payer: SOMOS Essential	$756.00

PR COLONOSCOPY STOMA CONTROL BLEEDING

Professional

Both

$963.20

Service Code	HCPCS 44391
Min. Negotiated Rate	$722.40
Max. Negotiated Rate	$722.40
Rate for Payer: Cash Price	$260.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$722.40
Rate for Payer: SOMOS Essential	$722.40

Know your out-of-pocket cost for care.

All Charges