St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CONTINUOUS NEGATIVE PRESSURE VENTJ INITIAT&MGM

Professional

Both

$141.79

Service Code	HCPCS 94662
Min. Negotiated Rate	$106.34
Max. Negotiated Rate	$106.34
Rate for Payer: Cash Price	$38.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$106.34
Rate for Payer: SOMOS Essential	$106.34

PR CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE

Professional

Both

$125.69

Service Code	HCPCS 49465
Min. Negotiated Rate	$94.27
Max. Negotiated Rate	$94.27
Rate for Payer: Cash Price	$33.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$94.27
Rate for Payer: SOMOS Essential	$94.27

PR CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX

Professional

Both

$337.33

Service Code	HCPCS 30903
Min. Negotiated Rate	$253.00
Max. Negotiated Rate	$253.00
Rate for Payer: Cash Price	$89.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$253.00
Rate for Payer: SOMOS Essential	$253.00

PR CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE

Professional

Both

$247.28

Service Code	HCPCS 30901
Min. Negotiated Rate	$185.46
Max. Negotiated Rate	$185.46
Rate for Payer: Cash Price	$65.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$185.46
Rate for Payer: SOMOS Essential	$185.46

PR CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE

Professional

Both

$687.79

Service Code	HCPCS 42960
Min. Negotiated Rate	$515.84
Max. Negotiated Rate	$515.84
Rate for Payer: Cash Price	$189.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$515.84
Rate for Payer: SOMOS Essential	$515.84

PR CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ

Professional

Both

$598.89

Service Code	HCPCS 49446
Min. Negotiated Rate	$449.17
Max. Negotiated Rate	$449.17
Rate for Payer: Cash Price	$161.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$449.17
Rate for Payer: SOMOS Essential	$449.17

PR CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ

Professional

Both

$779.35

Service Code	HCPCS 50434
Min. Negotiated Rate	$584.51
Max. Negotiated Rate	$584.51
Rate for Payer: Cash Price	$211.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$584.51
Rate for Payer: SOMOS Essential	$584.51

PR CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH

Professional

Both

$799.68

Service Code	HCPCS 47535
Min. Negotiated Rate	$599.76
Max. Negotiated Rate	$599.76
Rate for Payer: Cash Price	$215.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$599.76
Rate for Payer: SOMOS Essential	$599.76

PR CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT

Professional

Both

$7,362.32

Service Code	HCPCS 27132
Min. Negotiated Rate	$5,521.74
Max. Negotiated Rate	$5,521.74
Rate for Payer: Cash Price	$1,980.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,521.74
Rate for Payer: SOMOS Essential	$5,521.74

PR CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY

Professional

Both

$3,099.74

Service Code	HCPCS 23415
Min. Negotiated Rate	$2,324.80
Max. Negotiated Rate	$2,324.80
Rate for Payer: Cash Price	$838.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,324.80
Rate for Payer: SOMOS Essential	$2,324.80

PR CORDOCENTESIS INTRAUTERINE

Professional

Both

$934.05

Service Code	HCPCS 59012
Min. Negotiated Rate	$700.54
Max. Negotiated Rate	$700.54
Rate for Payer: Cash Price	$247.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$700.54
Rate for Payer: SOMOS Essential	$700.54

PR CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG

Professional

Both

$622.69

Service Code	HCPCS 32408
Min. Negotiated Rate	$467.02
Max. Negotiated Rate	$467.02
Rate for Payer: Cash Price	$168.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$467.02
Rate for Payer: SOMOS Essential	$467.02

PR COR FFR CTA DATA ALYS & GNRJ ESTIMATED FFR MODEL

Professional

Both

$3,822.18

Service Code	HCPCS 0503T
Min. Negotiated Rate	$2,866.64
Max. Negotiated Rate	$2,866.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,866.64
Rate for Payer: SOMOS Essential	$2,866.64

PR COR FFR CTA DATA REVIEW W/INTERPJ & FINAL REPORT

Professional

Both

$145.29

Service Code	HCPCS 0504T
Min. Negotiated Rate	$108.97
Max. Negotiated Rate	$108.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$108.97
Rate for Payer: SOMOS Essential	$108.97

PR COR FFR DERIVED CTA DATA ASSESS COR ART DISEASE

Professional

Both

$4,248.86

Service Code	HCPCS 0501T
Min. Negotiated Rate	$3,186.64
Max. Negotiated Rate	$3,186.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,186.64
Rate for Payer: SOMOS Essential	$3,186.64

PR CORF RELATED SERV 15 MINS EA

Professional

Both

$99.05

Service Code	HCPCS G0409
Min. Negotiated Rate	$74.29
Max. Negotiated Rate	$74.29
Rate for Payer: Cash Price	$28.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$74.29
Rate for Payer: SOMOS Essential	$74.29

PR CORF SKILLED NURSING SERVICE

Professional

Both

$40.11

Service Code	HCPCS G0128
Min. Negotiated Rate	$30.08
Max. Negotiated Rate	$30.08
Rate for Payer: Cash Price	$11.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30.08
Rate for Payer: SOMOS Essential	$30.08

PR CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI

Professional

Both

$22.44

Service Code	HCPCS 92145 26
Min. Negotiated Rate	$16.83
Max. Negotiated Rate	$16.83
Rate for Payer: Cash Price	$6.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16.83
Rate for Payer: SOMOS Essential	$16.83

PR CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI

Professional

Both

$32.94

Service Code	HCPCS 92145 TC
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$24.70
Rate for Payer: Cash Price	$9.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24.70
Rate for Payer: SOMOS Essential	$24.70

PR CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI

Professional

Both

$55.37

Service Code	HCPCS 92145
Min. Negotiated Rate	$41.53
Max. Negotiated Rate	$41.53
Rate for Payer: Cash Price	$15.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$41.53
Rate for Payer: SOMOS Essential	$41.53

PR CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE

Professional

Both

$414.02

Service Code	HCPCS 65430
Min. Negotiated Rate	$310.52
Max. Negotiated Rate	$310.52
Rate for Payer: Cash Price	$113.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$310.52
Rate for Payer: SOMOS Essential	$310.52

PR CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT

Professional

Both

$8,559.25

Service Code	HCPCS 33510
Min. Negotiated Rate	$6,419.44
Max. Negotiated Rate	$6,419.44
Rate for Payer: Cash Price	$2,274.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,419.44
Rate for Payer: SOMOS Essential	$6,419.44

PR CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS

Professional

Both

$9,392.57

Service Code	HCPCS 33511
Min. Negotiated Rate	$7,044.43
Max. Negotiated Rate	$7,044.43
Rate for Payer: Cash Price	$2,498.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,044.43
Rate for Payer: SOMOS Essential	$7,044.43

PR CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS

Professional

Both

$10,715.32

Service Code	HCPCS 33512
Min. Negotiated Rate	$8,036.49
Max. Negotiated Rate	$8,036.49
Rate for Payer: Cash Price	$2,847.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,036.49
Rate for Payer: SOMOS Essential	$8,036.49

PR CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS

Professional

Both

$10,968.09

Service Code	HCPCS 33513
Min. Negotiated Rate	$8,226.07
Max. Negotiated Rate	$8,226.07
Rate for Payer: Cash Price	$2,906.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,226.07
Rate for Payer: SOMOS Essential	$8,226.07

Know your out-of-pocket cost for care.

All Charges