St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CORRJ HLX VLGS BNCTY SESMDC PROX PHLX OSTEOT

Professional

Both

$2,138.36

Service Code	HCPCS 28298
Min. Negotiated Rate	$1,603.77
Max. Negotiated Rate	$1,603.77
Rate for Payer: Cash Price	$591.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,603.77
Rate for Payer: SOMOS Essential	$1,603.77

PR CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE

Professional

Both

$2,024.40

Service Code	HCPCS 28292
Min. Negotiated Rate	$1,518.30
Max. Negotiated Rate	$1,518.30
Rate for Payer: Cash Price	$562.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,518.30
Rate for Payer: SOMOS Essential	$1,518.30

PR CORRJ HLX VLGS BNCTY SESMDC W/DOUBLE OSTEOTOMY

Professional

Both

$2,494.87

Service Code	HCPCS 28299
Min. Negotiated Rate	$1,871.15
Max. Negotiated Rate	$1,871.15
Rate for Payer: Cash Price	$691.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,871.15
Rate for Payer: SOMOS Essential	$1,871.15

PR CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD

Professional

Both

$2,030.84

Service Code	HCPCS 67912
Min. Negotiated Rate	$1,523.13
Max. Negotiated Rate	$1,523.13
Rate for Payer: Cash Price	$556.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,523.13
Rate for Payer: SOMOS Essential	$1,523.13

PR CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS

Professional

Both

$6,688.43

Service Code	HCPCS 44055
Min. Negotiated Rate	$5,016.32
Max. Negotiated Rate	$5,016.32
Rate for Payer: Cash Price	$1,785.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,016.32
Rate for Payer: SOMOS Essential	$5,016.32

PR CORRJ TRICHIASIS INC LID MRGN W/FR MUC MEMB GRF

Professional

Both

$1,818.99

Service Code	HCPCS 67835
Min. Negotiated Rate	$1,364.24
Max. Negotiated Rate	$1,364.24
Rate for Payer: Cash Price	$500.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,364.24
Rate for Payer: SOMOS Essential	$1,364.24

PR COSTOTRANSVERSECTOMY SEPARATE PROCEDURE

Professional

Both

$5,282.10

Service Code	HCPCS 21610
Min. Negotiated Rate	$3,961.58
Max. Negotiated Rate	$3,961.58
Rate for Payer: Cash Price	$1,532.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,961.58
Rate for Payer: SOMOS Essential	$3,961.58

PR COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG

Professional

Both

$8,433.81

Service Code	HCPCS 63064
Min. Negotiated Rate	$6,325.36
Max. Negotiated Rate	$6,325.36
Rate for Payer: Cash Price	$2,220.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,325.36
Rate for Payer: SOMOS Essential	$6,325.36

PR COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG

Professional

Both

$995.19

Service Code	HCPCS 63066
Min. Negotiated Rate	$746.39
Max. Negotiated Rate	$746.39
Rate for Payer: Cash Price	$259.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$746.39
Rate for Payer: SOMOS Essential	$746.39

PR CPAP VENTILATION CPAP INITIATION&MGMT

Professional

Both

$150.43

Service Code	HCPCS 94660
Min. Negotiated Rate	$112.82
Max. Negotiated Rate	$112.82
Rate for Payer: Cash Price	$41.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$112.82
Rate for Payer: SOMOS Essential	$112.82

PR CPLX CHRONIC CARE MGMT SVC EA ADDL 30 MIN CAL MO

Professional

Both

$203.35

Service Code	HCPCS 99489
Min. Negotiated Rate	$152.51
Max. Negotiated Rate	$152.51
Rate for Payer: Cash Price	$55.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$152.51
Rate for Payer: SOMOS Essential	$152.51

PR CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ

Professional

Both

$22,350.69

Service Code	HCPCS 61698
Min. Negotiated Rate	$16,763.02
Max. Negotiated Rate	$16,763.02
Rate for Payer: Cash Price	$5,864.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,763.02
Rate for Payer: SOMOS Essential	$16,763.02

PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI

Professional

Both

$695.91

Service Code	HCPCS 0055T
Min. Negotiated Rate	$521.93
Max. Negotiated Rate	$521.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$521.93
Rate for Payer: SOMOS Essential	$521.93

PR CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES

Professional

Both

$695.91

Service Code	HCPCS 0054T
Min. Negotiated Rate	$521.93
Max. Negotiated Rate	$521.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$521.93
Rate for Payer: SOMOS Essential	$521.93

PR CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS

Professional

Both

$638.09

Service Code	HCPCS 20985
Min. Negotiated Rate	$478.57
Max. Negotiated Rate	$478.57
Rate for Payer: Cash Price	$169.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$478.57
Rate for Payer: SOMOS Essential	$478.57

PR CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT

Professional

Both

$14,887.18

Service Code	HCPCS 61582
Min. Negotiated Rate	$11,165.38
Max. Negotiated Rate	$11,165.38
Rate for Payer: Cash Price	$3,719.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$11,165.38
Rate for Payer: SOMOS Essential	$11,165.38

PR CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE

Professional

Both

$13,922.93

Service Code	HCPCS 61583
Min. Negotiated Rate	$10,442.20
Max. Negotiated Rate	$10,442.20
Rate for Payer: Cash Price	$3,654.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,442.20
Rate for Payer: SOMOS Essential	$10,442.20

PR CRANIEC CRANIOSYNOSTOSIS FRONT/PARIET BONE FLAP

Professional

Both

$8,245.34

Service Code	HCPCS 61556
Min. Negotiated Rate	$6,184.00
Max. Negotiated Rate	$6,184.00
Rate for Payer: Cash Price	$2,175.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,184.00
Rate for Payer: SOMOS Essential	$6,184.00

PR CRANIECT CRANIOSYNOSTOSIS MULT CRANIAL SUTURES

Professional

Both

$7,169.65

Service Code	HCPCS 61552
Min. Negotiated Rate	$5,377.24
Max. Negotiated Rate	$5,377.24
Rate for Payer: Cash Price	$1,893.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,377.24
Rate for Payer: SOMOS Essential	$5,377.24

PR CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY

Professional

Both

$11,550.60

Service Code	HCPCS 61323
Min. Negotiated Rate	$8,662.95
Max. Negotiated Rate	$8,662.95
Rate for Payer: Cash Price	$3,040.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,662.95
Rate for Payer: SOMOS Essential	$8,662.95

PR CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY

Professional

Both

$11,483.89

Service Code	HCPCS 61322
Min. Negotiated Rate	$8,612.92
Max. Negotiated Rate	$8,612.92
Rate for Payer: Cash Price	$3,029.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,612.92
Rate for Payer: SOMOS Essential	$8,612.92

PR CRANIECTOMY CRANIOSYNOSTOSIS 1 CRANIAL SUTURE

Professional

Both

$5,751.90

Service Code	HCPCS 61550
Min. Negotiated Rate	$4,313.92
Max. Negotiated Rate	$4,313.92
Rate for Payer: Cash Price	$1,525.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,313.92
Rate for Payer: SOMOS Essential	$4,313.92

PR CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP

Professional

Both

$8,134.42

Service Code	HCPCS 61557
Min. Negotiated Rate	$6,100.82
Max. Negotiated Rate	$6,100.82
Rate for Payer: Cash Price	$2,148.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,100.82
Rate for Payer: SOMOS Essential	$6,100.82

PR CRANIECTOMY/CRANIOTMY DRG ABSCESS INFRATENTORIAL

Professional

Both

$10,258.99

Service Code	HCPCS 61321
Min. Negotiated Rate	$7,694.24
Max. Negotiated Rate	$7,694.24
Rate for Payer: Cash Price	$2,702.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,694.24
Rate for Payer: SOMOS Essential	$7,694.24

PR CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL

Professional

Both

$9,120.27

Service Code	HCPCS 61320
Min. Negotiated Rate	$6,840.20
Max. Negotiated Rate	$6,840.20
Rate for Payer: Cash Price	$2,406.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,840.20
Rate for Payer: SOMOS Essential	$6,840.20

Know your out-of-pocket cost for care.

All Charges