St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH

Professional

Both

$3,047.17

Service Code	HCPCS 57283
Min. Negotiated Rate	$2,285.38
Max. Negotiated Rate	$2,285.38
Rate for Payer: Cash Price	$820.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,285.38
Rate for Payer: SOMOS Essential	$2,285.38

PR COLPORRHAPHY SUTURE INJURY VAGINA

Professional

Both

$1,446.34

Service Code	HCPCS 57200
Min. Negotiated Rate	$1,084.76
Max. Negotiated Rate	$1,084.76
Rate for Payer: Cash Price	$394.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,084.76
Rate for Payer: SOMOS Essential	$1,084.76

PR COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE

Professional

Both

$574.18

Service Code	HCPCS 57454
Min. Negotiated Rate	$430.64
Max. Negotiated Rate	$430.64
Rate for Payer: Cash Price	$156.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$430.64
Rate for Payer: SOMOS Essential	$430.64

PR COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE

Professional

Both

$437.43

Service Code	HCPCS 57456
Min. Negotiated Rate	$328.07
Max. Negotiated Rate	$328.07
Rate for Payer: Cash Price	$118.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$328.07
Rate for Payer: SOMOS Essential	$328.07

PR COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA

Professional

Both

$394.28

Service Code	HCPCS 57452
Min. Negotiated Rate	$295.71
Max. Negotiated Rate	$295.71
Rate for Payer: Cash Price	$106.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$295.71
Rate for Payer: SOMOS Essential	$295.71

PR COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX

Professional

Both

$467.74

Service Code	HCPCS 57455
Min. Negotiated Rate	$350.80
Max. Negotiated Rate	$350.80
Rate for Payer: Cash Price	$126.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$350.80
Rate for Payer: SOMOS Essential	$350.80

PR COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX

Professional

Both

$794.15

Service Code	HCPCS 57461
Min. Negotiated Rate	$595.61
Max. Negotiated Rate	$595.61
Rate for Payer: Cash Price	$213.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$595.61
Rate for Payer: SOMOS Essential	$595.61

PR COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX

Professional

Both

$690.20

Service Code	HCPCS 57460
Min. Negotiated Rate	$517.65
Max. Negotiated Rate	$517.65
Rate for Payer: Cash Price	$186.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$517.65
Rate for Payer: SOMOS Essential	$517.65

PR COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT

Professional

Both

$385.25

Service Code	HCPCS 57420
Min. Negotiated Rate	$288.94
Max. Negotiated Rate	$288.94
Rate for Payer: Cash Price	$104.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$288.94
Rate for Payer: SOMOS Essential	$288.94

PR COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX

Professional

Both

$525.00

Service Code	HCPCS 57421
Min. Negotiated Rate	$393.75
Max. Negotiated Rate	$393.75
Rate for Payer: Cash Price	$142.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$393.75
Rate for Payer: SOMOS Essential	$393.75

PR COLPOSCOPY VULVA

Professional

Both

$366.98

Service Code	HCPCS 56820
Min. Negotiated Rate	$275.24
Max. Negotiated Rate	$275.24
Rate for Payer: Cash Price	$97.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$275.24
Rate for Payer: SOMOS Essential	$275.24

PR COLPOSCOPY VULVA W/BIOPSY

Professional

Both

$493.40

Service Code	HCPCS 56821
Min. Negotiated Rate	$370.05
Max. Negotiated Rate	$370.05
Rate for Payer: Cash Price	$132.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$370.05
Rate for Payer: SOMOS Essential	$370.05

PR COLPOTOMY W/DRAINAGE PELVIC ABSCESS

Professional

Both

$2,002.49

Service Code	HCPCS 57010
Min. Negotiated Rate	$1,501.87
Max. Negotiated Rate	$1,501.87
Rate for Payer: Cash Price	$542.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,501.87
Rate for Payer: SOMOS Essential	$1,501.87

PR COLPOTOMY W/EXPLORATION

Professional

Both

$884.49

Service Code	HCPCS 57000
Min. Negotiated Rate	$663.37
Max. Negotiated Rate	$663.37
Rate for Payer: Cash Price	$238.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$663.37
Rate for Payer: SOMOS Essential	$663.37

PR COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD

Professional

Both

$1,076.25

Service Code	HCPCS 45382
Min. Negotiated Rate	$807.19
Max. Negotiated Rate	$807.19
Rate for Payer: Cash Price	$291.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$807.19
Rate for Payer: SOMOS Essential	$807.19

PR COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT

Professional

Both

$883.96

Service Code	HCPCS 45386
Min. Negotiated Rate	$662.97
Max. Negotiated Rate	$662.97
Rate for Payer: Cash Price	$240.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$662.97
Rate for Payer: SOMOS Essential	$662.97

PR COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST

Professional

Both

$835.24

Service Code	HCPCS 45381
Min. Negotiated Rate	$626.43
Max. Negotiated Rate	$626.43
Rate for Payer: Cash Price	$226.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$626.43
Rate for Payer: SOMOS Essential	$626.43

PR COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX

Professional

Both

$1,071.04

Service Code	HCPCS 45391
Min. Negotiated Rate	$803.28
Max. Negotiated Rate	$803.28
Rate for Payer: Cash Price	$290.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$803.28
Rate for Payer: SOMOS Essential	$803.28

PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS

Professional

Both

$962.99

Service Code	HCPCS 45384
Min. Negotiated Rate	$722.24
Max. Negotiated Rate	$722.24
Rate for Payer: Cash Price	$261.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$722.24
Rate for Payer: SOMOS Essential	$722.24

PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ

Professional

Both

$1,057.81

Service Code	HCPCS 45385
Min. Negotiated Rate	$793.36
Max. Negotiated Rate	$793.36
Rate for Payer: Cash Price	$287.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$793.36
Rate for Payer: SOMOS Essential	$793.36

PR COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL

Professional

Both

$1,264.90

Service Code	HCPCS 45392
Min. Negotiated Rate	$948.68
Max. Negotiated Rate	$948.68
Rate for Payer: Cash Price	$343.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$948.68
Rate for Payer: SOMOS Essential	$948.68

PR COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN

Professional

Both

$128.98

Service Code	HCPCS 97537
Min. Negotiated Rate	$96.74
Max. Negotiated Rate	$96.74
Rate for Payer: Cash Price	$35.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$96.74
Rate for Payer: SOMOS Essential	$96.74

PR COMP ASSES CARE PLAN CCM SVC

Professional

Both

$178.57

Service Code	HCPCS G0506
Min. Negotiated Rate	$133.93
Max. Negotiated Rate	$133.93
Rate for Payer: Cash Price	$49.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$133.93
Rate for Payer: SOMOS Essential	$133.93

PR COMPLETE REPLACEMENT PICC RS&I

Professional

Both

$240.63

Service Code	HCPCS 36584
Min. Negotiated Rate	$180.47
Max. Negotiated Rate	$180.47
Rate for Payer: Cash Price	$64.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$180.47
Rate for Payer: SOMOS Essential	$180.47

PR COMPLETE RPR ANOMALOUS PULMONARY VENOUS RETURN

Professional

Both

$8,925.32

Service Code	HCPCS 33730
Min. Negotiated Rate	$6,693.99
Max. Negotiated Rate	$6,693.99
Rate for Payer: Cash Price	$2,372.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,693.99
Rate for Payer: SOMOS Essential	$6,693.99

Know your out-of-pocket cost for care.

All Charges