St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS

Professional

Both

$11,484.87

Service Code	HCPCS 33514
Min. Negotiated Rate	$8,613.65
Max. Negotiated Rate	$8,613.65
Rate for Payer: Cash Price	$3,048.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,613.65
Rate for Payer: SOMOS Essential	$8,613.65

PR CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT

Professional

Both

$11,885.65

Service Code	HCPCS 33516
Min. Negotiated Rate	$8,914.24
Max. Negotiated Rate	$8,914.24
Rate for Payer: Cash Price	$3,154.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,914.24
Rate for Payer: SOMOS Essential	$8,914.24

PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN

Professional

Both

$824.43

Service Code	HCPCS 33517
Min. Negotiated Rate	$618.32
Max. Negotiated Rate	$618.32
Rate for Payer: Cash Price	$219.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$618.32
Rate for Payer: SOMOS Essential	$618.32

PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN

Professional

Both

$1,821.26

Service Code	HCPCS 33518
Min. Negotiated Rate	$1,365.94
Max. Negotiated Rate	$1,365.94
Rate for Payer: Cash Price	$480.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,365.94
Rate for Payer: SOMOS Essential	$1,365.94

PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN

Professional

Both

$2,405.41

Service Code	HCPCS 33519
Min. Negotiated Rate	$1,804.06
Max. Negotiated Rate	$1,804.06
Rate for Payer: Cash Price	$636.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,804.06
Rate for Payer: SOMOS Essential	$1,804.06

PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN

Professional

Both

$2,880.40

Service Code	HCPCS 33521
Min. Negotiated Rate	$2,160.30
Max. Negotiated Rate	$2,160.30
Rate for Payer: Cash Price	$761.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,160.30
Rate for Payer: SOMOS Essential	$2,160.30

PR CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN

Professional

Both

$3,238.90

Service Code	HCPCS 33522
Min. Negotiated Rate	$2,429.18
Max. Negotiated Rate	$2,429.18
Rate for Payer: Cash Price	$856.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,429.18
Rate for Payer: SOMOS Essential	$2,429.18

PR CORONARY ARTERY BYP W/VEIN &ARTERY GRAFT 6 VEIN

Professional

Both

$3,637.13

Service Code	HCPCS 33523
Min. Negotiated Rate	$2,727.85
Max. Negotiated Rate	$2,727.85
Rate for Payer: Cash Price	$961.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,727.85
Rate for Payer: SOMOS Essential	$2,727.85

PR CORONARY ENDARTERCOMY OPEN ANY METHOD

Professional

Both

$1,024.38

Service Code	HCPCS 33572
Min. Negotiated Rate	$768.28
Max. Negotiated Rate	$768.28
Rate for Payer: Cash Price	$270.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$768.28
Rate for Payer: SOMOS Essential	$768.28

PR CORONOIDECTOMY SEPARATE PROCEDURE

Professional

Both

$2,635.47

Service Code	HCPCS 21070
Min. Negotiated Rate	$1,976.60
Max. Negotiated Rate	$1,976.60
Rate for Payer: Cash Price	$716.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,976.60
Rate for Payer: SOMOS Essential	$1,976.60

PR CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI

Professional

Both

$2,679.50

Service Code	HCPCS 54430
Min. Negotiated Rate	$2,009.62
Max. Negotiated Rate	$2,009.62
Rate for Payer: Cash Price	$734.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,009.62
Rate for Payer: SOMOS Essential	$2,009.62

PR CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM

Professional

Both

$1,743.14

Service Code	HCPCS 54435
Min. Negotiated Rate	$1,307.36
Max. Negotiated Rate	$1,307.36
Rate for Payer: Cash Price	$478.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,307.36
Rate for Payer: SOMOS Essential	$1,307.36

PR CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI

Professional

Both

$2,945.78

Service Code	HCPCS 54420
Min. Negotiated Rate	$2,209.34
Max. Negotiated Rate	$2,209.34
Rate for Payer: Cash Price	$806.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,209.34
Rate for Payer: SOMOS Essential	$2,209.34

PR CORRECTION CLAW FINGER OTHER METHODS

Professional

Both

$3,882.69

Service Code	HCPCS 26499
Min. Negotiated Rate	$2,912.02
Max. Negotiated Rate	$2,912.02
Rate for Payer: Cash Price	$1,043.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,912.02
Rate for Payer: SOMOS Essential	$2,912.02

PR CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE

Professional

Both

$1,228.82

Service Code	HCPCS 28286
Min. Negotiated Rate	$921.62
Max. Negotiated Rate	$921.62
Rate for Payer: Cash Price	$342.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$921.62
Rate for Payer: SOMOS Essential	$921.62

PR CORRECTION EVERTED PUNCTUM CAUTERY

Professional

Both

$685.83

Service Code	HCPCS 68705
Min. Negotiated Rate	$514.37
Max. Negotiated Rate	$514.37
Rate for Payer: Cash Price	$188.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$514.37
Rate for Payer: SOMOS Essential	$514.37

PR CORRECTION HAMMERTOE

Professional

Both

$1,621.59

Service Code	HCPCS 28285
Min. Negotiated Rate	$1,216.19
Max. Negotiated Rate	$1,216.19
Rate for Payer: Cash Price	$449.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,216.19
Rate for Payer: SOMOS Essential	$1,216.19

PR CORRECTION INVERTED NIPPLES

Professional

Both

$2,701.72

Service Code	HCPCS 19355
Min. Negotiated Rate	$2,026.29
Max. Negotiated Rate	$2,026.29
Rate for Payer: Cash Price	$729.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,026.29
Rate for Payer: SOMOS Essential	$2,026.29

PR CORRECTION LID RETRACTION

Professional

Both

$2,299.68

Service Code	HCPCS 67911
Min. Negotiated Rate	$1,724.76
Max. Negotiated Rate	$1,724.76
Rate for Payer: Cash Price	$634.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,724.76
Rate for Payer: SOMOS Essential	$1,724.76

PR CORRECTION TRICHIASIS EPILATION FORCEPS ONLY

Professional

Both

$90.13

Service Code	HCPCS 67820
Min. Negotiated Rate	$67.60
Max. Negotiated Rate	$67.60
Rate for Payer: Cash Price	$24.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$67.60
Rate for Payer: SOMOS Essential	$67.60

PR CORRECTION TRICHIASIS EPILATION OTH/THAN FORCEPS

Professional

Both

$503.90

Service Code	HCPCS 67825
Min. Negotiated Rate	$377.92
Max. Negotiated Rate	$377.92
Rate for Payer: Cash Price	$139.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$377.92
Rate for Payer: SOMOS Essential	$377.92

PR CORRECTION TRICHIASIS INCCISION LID MARGIN

Professional

Both

$567.98

Service Code	HCPCS 67830
Min. Negotiated Rate	$425.98
Max. Negotiated Rate	$425.98
Rate for Payer: Cash Price	$156.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$425.98
Rate for Payer: SOMOS Essential	$425.98

PR CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT

Professional

Both

$2,136.93

Service Code	HCPCS 28296
Min. Negotiated Rate	$1,602.70
Max. Negotiated Rate	$1,602.70
Rate for Payer: Cash Price	$591.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,602.70
Rate for Payer: SOMOS Essential	$1,602.70

PR CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS

Professional

Both

$2,556.89

Service Code	HCPCS 28297
Min. Negotiated Rate	$1,917.67
Max. Negotiated Rate	$1,917.67
Rate for Payer: Cash Price	$699.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,917.67
Rate for Payer: SOMOS Essential	$1,917.67

PR CORRJ HLX VLGS BNCTY SESMDC PROX METAR OSTEOT

Professional

Both

$2,620.56

Service Code	HCPCS 28295
Min. Negotiated Rate	$1,965.42
Max. Negotiated Rate	$1,965.42
Rate for Payer: Cash Price	$707.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,965.42
Rate for Payer: SOMOS Essential	$1,965.42

Know your out-of-pocket cost for care.

All Charges