St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION

Professional

Both

$1,688.16

Service Code	HCPCS 93620 TC
Min. Negotiated Rate	$1,266.12
Max. Negotiated Rate	$1,266.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,266.12
Rate for Payer: SOMOS Essential	$1,266.12

PR COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION

Professional

Both

$2,673.93

Service Code	HCPCS 93620 26
Min. Negotiated Rate	$2,005.45
Max. Negotiated Rate	$2,005.45
Rate for Payer: Cash Price	$706.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,005.45
Rate for Payer: SOMOS Essential	$2,005.45

PR COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION

Professional

Both

$4,362.09

Service Code	HCPCS 93620
Min. Negotiated Rate	$3,271.57
Max. Negotiated Rate	$3,271.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,271.57
Rate for Payer: SOMOS Essential	$3,271.57

PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION

Professional

Both

$3,231.52

Service Code	HCPCS 93619
Min. Negotiated Rate	$2,423.64
Max. Negotiated Rate	$2,423.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,423.64
Rate for Payer: SOMOS Essential	$2,423.64

PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION

Professional

Both

$1,572.97

Service Code	HCPCS 93619 TC
Min. Negotiated Rate	$1,179.73
Max. Negotiated Rate	$1,179.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,179.73
Rate for Payer: SOMOS Essential	$1,179.73

PR COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION

Professional

Both

$1,658.55

Service Code	HCPCS 93619 26
Min. Negotiated Rate	$1,243.91
Max. Negotiated Rate	$1,243.91
Rate for Payer: Cash Price	$439.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,243.91
Rate for Payer: SOMOS Essential	$1,243.91

PR COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC

Professional

Both

$353.75

Service Code	HCPCS 93621 26
Min. Negotiated Rate	$265.31
Max. Negotiated Rate	$265.31
Rate for Payer: Cash Price	$94.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$265.31
Rate for Payer: SOMOS Essential	$265.31

PR COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC

Professional

Both

$8,067.89

Service Code	HCPCS 93621 TC
Min. Negotiated Rate	$6,050.92
Max. Negotiated Rate	$6,050.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,050.92
Rate for Payer: SOMOS Essential	$6,050.92

PR COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC

Professional

Both

$8,421.63

Service Code	HCPCS 93621
Min. Negotiated Rate	$6,316.22
Max. Negotiated Rate	$6,316.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,316.22
Rate for Payer: SOMOS Essential	$6,316.22

PR COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC

Professional

Both

$733.85

Service Code	HCPCS 93622 26
Min. Negotiated Rate	$550.39
Max. Negotiated Rate	$550.39
Rate for Payer: Cash Price	$193.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$550.39
Rate for Payer: SOMOS Essential	$550.39

PR COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC

Professional

Both

$8,933.89

Service Code	HCPCS 93622
Min. Negotiated Rate	$6,700.42
Max. Negotiated Rate	$6,700.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,700.42
Rate for Payer: SOMOS Essential	$6,700.42

PR COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC

Professional

Both

$8,200.05

Service Code	HCPCS 93622 TC
Min. Negotiated Rate	$6,150.04
Max. Negotiated Rate	$6,150.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,150.04
Rate for Payer: SOMOS Essential	$6,150.04

PR COMPRE EP EVAL ABLTJ 3D MAPG TX SVT

Professional

Both

$3,705.56

Service Code	HCPCS 93653
Min. Negotiated Rate	$2,779.17
Max. Negotiated Rate	$2,779.17
Rate for Payer: Cash Price	$972.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,779.17
Rate for Payer: SOMOS Essential	$2,779.17

PR COMPRE EP EVAL ABLTJ 3D MAPG TX VT

Professional

Both

$4,466.63

Service Code	HCPCS 93654
Min. Negotiated Rate	$3,349.97
Max. Negotiated Rate	$3,349.97
Rate for Payer: Cash Price	$1,171.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,349.97
Rate for Payer: SOMOS Essential	$3,349.97

PR COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION

Professional

Both

$4,202.80

Service Code	HCPCS 93656
Min. Negotiated Rate	$3,152.10
Max. Negotiated Rate	$3,152.10
Rate for Payer: Cash Price	$1,102.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,152.10
Rate for Payer: SOMOS Essential	$3,152.10

PR COMPUTER-AIDED MAPG CERVIX UTERI DRG COLPOSCOPY

Professional

Both

$187.18

Service Code	HCPCS 57465
Min. Negotiated Rate	$140.38
Max. Negotiated Rate	$140.38
Rate for Payer: Cash Price	$49.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$140.38
Rate for Payer: SOMOS Essential	$140.38

PR COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI W/I&R

Professional

Both

$74.62

Service Code	HCPCS 92025 TC
Min. Negotiated Rate	$55.96
Max. Negotiated Rate	$55.96
Rate for Payer: Cash Price	$20.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$55.96
Rate for Payer: SOMOS Essential	$55.96

PR COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI W/I&R

Professional

Both

$76.76

Service Code	HCPCS 92025 26
Min. Negotiated Rate	$57.57
Max. Negotiated Rate	$57.57
Rate for Payer: Cash Price	$21.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$57.57
Rate for Payer: SOMOS Essential	$57.57

PR COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI W/I&R

Professional

Both

$151.38

Service Code	HCPCS 92025
Min. Negotiated Rate	$113.54
Max. Negotiated Rate	$113.54
Rate for Payer: Cash Price	$41.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$113.54
Rate for Payer: SOMOS Essential	$113.54

PR COMPUTERIZED OPHTHALMIC IMAGING OPTIC NERVE

Professional

Both

$84.46

Service Code	HCPCS 92133 26
Min. Negotiated Rate	$63.34
Max. Negotiated Rate	$63.34
Rate for Payer: Cash Price	$23.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$63.34
Rate for Payer: SOMOS Essential	$63.34

PR COMPUTERIZED OPHTHALMIC IMAGING OPTIC NERVE

Professional

Both

$67.41

Service Code	HCPCS 92133 TC
Min. Negotiated Rate	$50.56
Max. Negotiated Rate	$50.56
Rate for Payer: Cash Price	$18.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$50.56
Rate for Payer: SOMOS Essential	$50.56

PR COMPUTERIZED OPHTHALMIC IMAGING OPTIC NERVE

Professional

Both

$151.90

Service Code	HCPCS 92133
Min. Negotiated Rate	$113.92
Max. Negotiated Rate	$113.92
Rate for Payer: Cash Price	$41.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$113.92
Rate for Payer: SOMOS Essential	$113.92

PR COMPUTERIZED OPHTHALMIC IMAGING RETINA

Professional

Both

$166.78

Service Code	HCPCS 92134
Min. Negotiated Rate	$125.08
Max. Negotiated Rate	$125.08
Rate for Payer: Cash Price	$46.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$125.08
Rate for Payer: SOMOS Essential	$125.08

PR COMPUTERIZED OPHTHALMIC IMAGING RETINA

Professional

Both

$68.85

Service Code	HCPCS 92134 TC
Min. Negotiated Rate	$51.64
Max. Negotiated Rate	$51.64
Rate for Payer: Cash Price	$19.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$51.64
Rate for Payer: SOMOS Essential	$51.64

PR COMPUTERIZED OPHTHALMIC IMAGING RETINA

Professional

Both

$97.90

Service Code	HCPCS 92134 26
Min. Negotiated Rate	$73.42
Max. Negotiated Rate	$73.42
Rate for Payer: Cash Price	$26.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$73.42
Rate for Payer: SOMOS Essential	$73.42

Know your out-of-pocket cost for care.

All Charges