St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR CRTJ SHUNT VENTRICULO-ATR-JUG-AUR

Professional

Both

$4,611.60

Service Code	HCPCS 62220
Min. Negotiated Rate	$3,458.70
Max. Negotiated Rate	$3,458.70
Rate for Payer: Cash Price	$1,229.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,458.70
Rate for Payer: SOMOS Essential	$3,458.70

PR CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS

Professional

Both

$4,912.99

Service Code	HCPCS 62223
Min. Negotiated Rate	$3,684.74
Max. Negotiated Rate	$3,684.74
Rate for Payer: Cash Price	$1,299.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,684.74
Rate for Payer: SOMOS Essential	$3,684.74

PR CRTJ SUBQ INSJ IMPLTBL GLUCOSE SENSOR SYS TRAIN

Professional

Both

$226.63

Service Code	HCPCS 0446T
Min. Negotiated Rate	$169.97
Max. Negotiated Rate	$169.97
Rate for Payer: Cash Price	$62.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$169.97
Rate for Payer: SOMOS Essential	$169.97

PR CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA

Professional

Both

$7,360.82

Service Code	HCPCS 62100
Min. Negotiated Rate	$5,520.62
Max. Negotiated Rate	$5,520.62
Rate for Payer: Cash Price	$1,959.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,520.62
Rate for Payer: SOMOS Essential	$5,520.62

PR CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI

Professional

Both

$3,200.44

Service Code	HCPCS 55873
Min. Negotiated Rate	$2,400.33
Max. Negotiated Rate	$2,400.33
Rate for Payer: Cash Price	$875.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,400.33
Rate for Payer: SOMOS Essential	$2,400.33

PR CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE

Professional

Both

$210.04

Service Code	HCPCS 17340
Min. Negotiated Rate	$157.53
Max. Negotiated Rate	$157.53
Rate for Payer: Cash Price	$56.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$157.53
Rate for Payer: SOMOS Essential	$157.53

PR CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC

Professional

Both

$9,095.03

Service Code	HCPCS 51595
Min. Negotiated Rate	$6,821.27
Max. Negotiated Rate	$6,821.27
Rate for Payer: Cash Price	$2,480.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,821.27
Rate for Payer: SOMOS Essential	$6,821.27

PR CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR

Professional

Both

$9,834.79

Service Code	HCPCS 51596
Min. Negotiated Rate	$7,376.09
Max. Negotiated Rate	$7,376.09
Rate for Payer: Cash Price	$2,674.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,376.09
Rate for Payer: SOMOS Essential	$7,376.09

PR CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST

Professional

Both

$8,043.67

Service Code	HCPCS 51590
Min. Negotiated Rate	$6,032.75
Max. Negotiated Rate	$6,032.75
Rate for Payer: Cash Price	$2,192.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,032.75
Rate for Payer: SOMOS Essential	$6,032.75

PR CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST

Professional

Both

$5,374.78

Service Code	HCPCS 51565
Min. Negotiated Rate	$4,031.08
Max. Negotiated Rate	$4,031.08
Rate for Payer: Cash Price	$1,466.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,031.08
Rate for Payer: SOMOS Essential	$4,031.08

PR CSTOPLASTY/CSTOURTP PLSTC ANY

Professional

Both

$4,336.99

Service Code	HCPCS 51800
Min. Negotiated Rate	$3,252.74
Max. Negotiated Rate	$3,252.74
Rate for Payer: Cash Price	$1,184.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,252.74
Rate for Payer: SOMOS Essential	$3,252.74

PR CSTOTOMY/CSTOST CRYOSURG DSTRJ INTRAVESICAL LES

Professional

Both

$1,987.62

Service Code	HCPCS 51030
Min. Negotiated Rate	$1,490.72
Max. Negotiated Rate	$1,490.72
Rate for Payer: Cash Price	$548.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,490.72
Rate for Payer: SOMOS Essential	$1,490.72

PR CSTOURTP W/UNI/BI URTRONEOCSTOST

Professional

Both

$4,532.96

Service Code	HCPCS 51820
Min. Negotiated Rate	$3,399.72
Max. Negotiated Rate	$3,399.72
Rate for Payer: Cash Price	$1,238.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,399.72
Rate for Payer: SOMOS Essential	$3,399.72

PR CSTO W/TRURL RESCJ/INC EJACULATORY DUXS

Professional

Both

$1,102.54

Service Code	HCPCS 52402
Min. Negotiated Rate	$826.90
Max. Negotiated Rate	$826.90
Rate for Payer: Cash Price	$298.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$826.90
Rate for Payer: SOMOS Essential	$826.90

PR CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ

Professional

Both

$2,192.02

Service Code	HCPCS 42972
Min. Negotiated Rate	$1,644.02
Max. Negotiated Rate	$1,644.02
Rate for Payer: Cash Price	$595.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,644.02
Rate for Payer: SOMOS Essential	$1,644.02

PR CTRL NASOPHARYNGEAL HEMRRG COMP REQ HOSPIZATION

Professional

Both

$1,956.68

Service Code	HCPCS 42971
Min. Negotiated Rate	$1,467.51
Max. Negotiated Rate	$1,467.51
Rate for Payer: Cash Price	$532.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,467.51
Rate for Payer: SOMOS Essential	$1,467.51

PR CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS

Professional

Both

$1,778.42

Service Code	HCPCS 42970
Min. Negotiated Rate	$1,333.82
Max. Negotiated Rate	$1,333.82
Rate for Payer: Cash Price	$484.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,333.82
Rate for Payer: SOMOS Essential	$1,333.82

PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST

Professional

Both

$463.26

Service Code	HCPCS 30905
Min. Negotiated Rate	$347.44
Max. Negotiated Rate	$347.44
Rate for Payer: Cash Price	$123.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$347.44
Rate for Payer: SOMOS Essential	$347.44

PR CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ

Professional

Both

$574.70

Service Code	HCPCS 30906
Min. Negotiated Rate	$431.02
Max. Negotiated Rate	$431.02
Rate for Payer: Cash Price	$154.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$431.02
Rate for Payer: SOMOS Essential	$431.02

PR CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ

Professional

Both

$1,815.31

Service Code	HCPCS 42961
Min. Negotiated Rate	$1,361.48
Max. Negotiated Rate	$1,361.48
Rate for Payer: Cash Price	$494.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,361.48
Rate for Payer: SOMOS Essential	$1,361.48

PR CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ

Professional

Both

$2,246.13

Service Code	HCPCS 42962
Min. Negotiated Rate	$1,684.60
Max. Negotiated Rate	$1,684.60
Rate for Payer: Cash Price	$607.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,684.60
Rate for Payer: SOMOS Essential	$1,684.60

PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS

Professional

Both

$699.79

Service Code	HCPCS 95929 TC
Min. Negotiated Rate	$524.84
Max. Negotiated Rate	$524.84
Rate for Payer: Cash Price	$196.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$524.84
Rate for Payer: SOMOS Essential	$524.84

PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS

Professional

Both

$1,010.45

Service Code	HCPCS 95929
Min. Negotiated Rate	$757.84
Max. Negotiated Rate	$757.84
Rate for Payer: Cash Price	$282.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$757.84
Rate for Payer: SOMOS Essential	$757.84

PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS

Professional

Both

$310.66

Service Code	HCPCS 95929 26
Min. Negotiated Rate	$233.00
Max. Negotiated Rate	$233.00
Rate for Payer: Cash Price	$85.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$233.00
Rate for Payer: SOMOS Essential	$233.00

PR CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS

Professional

Both

$313.39

Service Code	HCPCS 95928 26
Min. Negotiated Rate	$235.04
Max. Negotiated Rate	$235.04
Rate for Payer: Cash Price	$86.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$235.04
Rate for Payer: SOMOS Essential	$235.04

Know your out-of-pocket cost for care.

All Charges