St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH

Professional

Both

$144.90

Service Code	HCPCS 36593
Min. Negotiated Rate	$108.68
Max. Negotiated Rate	$108.68
Rate for Payer: Cash Price	$41.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$108.68
Rate for Payer: SOMOS Essential	$108.68

PR DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI

Professional

Both

$3,960.85

Service Code	HCPCS 27027
Min. Negotiated Rate	$2,970.64
Max. Negotiated Rate	$2,970.64
Rate for Payer: Cash Price	$1,057.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,970.64
Rate for Payer: SOMOS Essential	$2,970.64

PR DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT

Professional

Both

$2,434.81

Service Code	HCPCS 27496
Min. Negotiated Rate	$1,826.11
Max. Negotiated Rate	$1,826.11
Rate for Payer: Cash Price	$663.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,826.11
Rate for Payer: SOMOS Essential	$1,826.11

PR DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL

Professional

Both

$4,091.75

Service Code	HCPCS 24495
Min. Negotiated Rate	$3,068.81
Max. Negotiated Rate	$3,068.81
Rate for Payer: Cash Price	$1,098.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,068.81
Rate for Payer: SOMOS Essential	$3,068.81

PR DECOMPRESSION FINGERS&/HAND INJECTION INJURY

Professional

Both

$3,817.35

Service Code	HCPCS 26035
Min. Negotiated Rate	$2,863.01
Max. Negotiated Rate	$2,863.01
Rate for Payer: Cash Price	$1,033.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,863.01
Rate for Payer: SOMOS Essential	$2,863.01

PR DECOMPRESSION INTERNAL AUDITORY CANAL

Professional

Both

$8,130.29

Service Code	HCPCS 69960
Min. Negotiated Rate	$6,097.72
Max. Negotiated Rate	$6,097.72
Rate for Payer: Cash Price	$2,192.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,097.72
Rate for Payer: SOMOS Essential	$6,097.72

PR DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH

Professional

Both

$8,653.02

Service Code	HCPCS 61330
Min. Negotiated Rate	$6,489.76
Max. Negotiated Rate	$6,489.76
Rate for Payer: Cash Price	$2,284.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,489.76
Rate for Payer: SOMOS Essential	$6,489.76

PR DECOMPRESSION PLANTAR DIGITAL NERVE

Professional

Both

$1,128.96

Service Code	HCPCS 64726
Min. Negotiated Rate	$846.72
Max. Negotiated Rate	$846.72
Rate for Payer: Cash Price	$309.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$846.72
Rate for Payer: SOMOS Essential	$846.72

PR DECOMPRESSION UNSPECIFIED NERVE

Professional

Both

$1,621.94

Service Code	HCPCS 64722
Min. Negotiated Rate	$1,216.46
Max. Negotiated Rate	$1,216.46
Rate for Payer: Cash Price	$447.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,216.46
Rate for Payer: SOMOS Essential	$1,216.46

PR DECOMPRESSIVE FASCIOTOMY HAND

Professional

Both

$2,489.13

Service Code	HCPCS 26037
Min. Negotiated Rate	$1,866.85
Max. Negotiated Rate	$1,866.85
Rate for Payer: Cash Price	$673.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,866.85
Rate for Payer: SOMOS Essential	$1,866.85

PR DECORTICATION & PARIETAL PLEURECTOMY

Professional

Both

$7,145.22

Service Code	HCPCS 32320
Min. Negotiated Rate	$5,358.92
Max. Negotiated Rate	$5,358.92
Rate for Payer: Cash Price	$1,902.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,358.92
Rate for Payer: SOMOS Essential	$5,358.92

PR DECORTICATION PULMONARY PARTIAL SEPARATE PROC

Professional

Both

$4,433.49

Service Code	HCPCS 32225
Min. Negotiated Rate	$3,325.12
Max. Negotiated Rate	$3,325.12
Rate for Payer: Cash Price	$1,179.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,325.12
Rate for Payer: SOMOS Essential	$3,325.12

PR DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE

Professional

Both

$7,101.19

Service Code	HCPCS 32220
Min. Negotiated Rate	$5,325.89
Max. Negotiated Rate	$5,325.89
Rate for Payer: Cash Price	$1,896.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,325.89
Rate for Payer: SOMOS Essential	$5,325.89

PR DELAYED CREATION EXIT SITE EMBEDDED CATHETER

Professional

Both

$834.65

Service Code	HCPCS 49436
Min. Negotiated Rate	$625.99
Max. Negotiated Rate	$625.99
Rate for Payer: Cash Price	$224.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$625.99
Rate for Payer: SOMOS Essential	$625.99

PR DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS

Professional

Both

$1,470.81

Service Code	HCPCS 15630
Min. Negotiated Rate	$1,103.11
Max. Negotiated Rate	$1,103.11
Rate for Payer: Cash Price	$402.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,103.11
Rate for Payer: SOMOS Essential	$1,103.11

PR DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F

Professional

Both

$1,410.36

Service Code	HCPCS 15620
Min. Negotiated Rate	$1,057.77
Max. Negotiated Rate	$1,057.77
Rate for Payer: Cash Price	$384.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,057.77
Rate for Payer: SOMOS Essential	$1,057.77

PR DELAY FLAP/SECTIONING FLAP SCALP ARMS/LEGS

Professional

Both

$1,061.48

Service Code	HCPCS 15610
Min. Negotiated Rate	$796.11
Max. Negotiated Rate	$796.11
Rate for Payer: Cash Price	$290.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$796.11
Rate for Payer: SOMOS Essential	$796.11

PR DELAY FLAP/SECTIONING FLAP TRUNK

Professional

Both

$920.92

Service Code	HCPCS 15600
Min. Negotiated Rate	$690.69
Max. Negotiated Rate	$690.69
Rate for Payer: Cash Price	$252.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$690.69
Rate for Payer: SOMOS Essential	$690.69

PR DELIGATION URETER

Professional

Both

$3,716.69

Service Code	HCPCS 50940
Min. Negotiated Rate	$2,787.52
Max. Negotiated Rate	$2,787.52
Rate for Payer: Cash Price	$1,014.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,787.52
Rate for Payer: SOMOS Essential	$2,787.52

PR DELIVERY/BIRTHING ROOM RESUSCITATION

Professional

Both

$571.34

Service Code	HCPCS 99465
Min. Negotiated Rate	$428.50
Max. Negotiated Rate	$428.50
Rate for Payer: Cash Price	$157.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$428.50
Rate for Payer: SOMOS Essential	$428.50

PR DELIVERY COMP IMRT

Professional

Both

$1,545.18

Service Code	HCPCS G6016
Min. Negotiated Rate	$1,158.88
Max. Negotiated Rate	$1,158.88
Rate for Payer: Cash Price	$417.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,158.88
Rate for Payer: SOMOS Essential	$1,158.88

PR DELIVERY PLACENTA SEPARATE PROCEDURE

Professional

Both

$420.81

Service Code	HCPCS 59414
Min. Negotiated Rate	$315.61
Max. Negotiated Rate	$315.61
Rate for Payer: Cash Price	$111.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$315.61
Rate for Payer: SOMOS Essential	$315.61

PR DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP

Professional

Both

$74.62

Service Code	HCPCS 94664
Min. Negotiated Rate	$55.96
Max. Negotiated Rate	$55.96
Rate for Payer: Cash Price	$21.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$55.96
Rate for Payer: SOMOS Essential	$55.96

PR DEMONSTRATE USE HOME INR MON

Professional

Both

$423.50

Service Code	HCPCS G0248
Min. Negotiated Rate	$317.62
Max. Negotiated Rate	$317.62
Rate for Payer: Cash Price	$118.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$317.62
Rate for Payer: SOMOS Essential	$317.62

PR DEMO-SMOKING CESSATION COUN

Professional

Both

$10.00

Service Code	HCPCS G9016
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7.50
Rate for Payer: SOMOS Essential	$7.50

Know your out-of-pocket cost for care.

All Charges