St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC

Professional

Both

$7,033.01

Service Code	HCPCS 35121
Min. Negotiated Rate	$5,274.76
Max. Negotiated Rate	$5,274.76
Rate for Payer: Cash Price	$1,861.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,274.76
Rate for Payer: SOMOS Essential	$5,274.76

PR DIR RPR ANEURYSM INNOMINATE/SUBCLAVIAN ARTERY

Professional

Both

$5,555.17

Service Code	HCPCS 35021
Min. Negotiated Rate	$4,166.38
Max. Negotiated Rate	$4,166.38
Rate for Payer: Cash Price	$1,477.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,166.38
Rate for Payer: SOMOS Essential	$4,166.38

PR DIR RPR ANEURYSM SPLENIC ARTERY

Professional

Both

$5,919.55

Service Code	HCPCS 35111
Min. Negotiated Rate	$4,439.66
Max. Negotiated Rate	$4,439.66
Rate for Payer: Cash Price	$1,566.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,439.66
Rate for Payer: SOMOS Essential	$4,439.66

PR DIR RPR ANEURYSM VERTEBRAL ARTERY

Professional

Both

$4,432.72

Service Code	HCPCS 35005
Min. Negotiated Rate	$3,324.54
Max. Negotiated Rate	$3,324.54
Rate for Payer: Cash Price	$1,175.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,324.54
Rate for Payer: SOMOS Essential	$3,324.54

PR DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS

Professional

Both

$11,483.15

Service Code	HCPCS 35092
Min. Negotiated Rate	$8,612.36
Max. Negotiated Rate	$8,612.36
Rate for Payer: Cash Price	$3,053.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,612.36
Rate for Payer: SOMOS Essential	$8,612.36

PR DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN

Professional

Both

$8,407.60

Service Code	HCPCS 35122
Min. Negotiated Rate	$6,305.70
Max. Negotiated Rate	$6,305.70
Rate for Payer: Cash Price	$2,227.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,305.70
Rate for Payer: SOMOS Essential	$6,305.70

PR DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS

Professional

Both

$9,876.62

Service Code	HCPCS 35103
Min. Negotiated Rate	$7,407.46
Max. Negotiated Rate	$7,407.46
Rate for Payer: Cash Price	$2,609.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,407.46
Rate for Payer: SOMOS Essential	$7,407.46

PR DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA

Professional

Both

$9,609.88

Service Code	HCPCS 35082
Min. Negotiated Rate	$7,207.41
Max. Negotiated Rate	$7,207.41
Rate for Payer: Cash Price	$2,542.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,207.41
Rate for Payer: SOMOS Essential	$7,207.41

PR DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS

Professional

Both

$5,643.12

Service Code	HCPCS 35013
Min. Negotiated Rate	$4,232.34
Max. Negotiated Rate	$4,232.34
Rate for Payer: Cash Price	$1,496.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,232.34
Rate for Payer: SOMOS Essential	$4,232.34

PR DIR RPR RUPTD ANEURYSM CAROTID-SUBCLAVIAN ARTERY

Professional

Both

$5,062.75

Service Code	HCPCS 35002
Min. Negotiated Rate	$3,797.06
Max. Negotiated Rate	$3,797.06
Rate for Payer: Cash Price	$1,342.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,797.06
Rate for Payer: SOMOS Essential	$3,797.06

PR DIR RPR RUPTD ANEURYSM & GRAFT ILIAC ARTERY

Professional

Both

$7,273.04

Service Code	HCPCS 35132
Min. Negotiated Rate	$5,454.78
Max. Negotiated Rate	$5,454.78
Rate for Payer: Cash Price	$1,925.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,454.78
Rate for Payer: SOMOS Essential	$5,454.78

PR DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART

Professional

Both

$5,863.20

Service Code	HCPCS 35142
Min. Negotiated Rate	$4,397.40
Max. Negotiated Rate	$4,397.40
Rate for Payer: Cash Price	$1,553.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,397.40
Rate for Payer: SOMOS Essential	$4,397.40

PR DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY

Professional

Both

$6,220.34

Service Code	HCPCS 35152
Min. Negotiated Rate	$4,665.26
Max. Negotiated Rate	$4,665.26
Rate for Payer: Cash Price	$1,646.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,665.26
Rate for Payer: SOMOS Essential	$4,665.26

PR DIR RPR RUPTD ANEURYSM INNOMINATE/SUBCLAVIAN

Professional

Both

$6,351.45

Service Code	HCPCS 35022
Min. Negotiated Rate	$4,763.59
Max. Negotiated Rate	$4,763.59
Rate for Payer: Cash Price	$1,690.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,763.59
Rate for Payer: SOMOS Essential	$4,763.59

PR DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY

Professional

Both

$4,308.12

Service Code	HCPCS 35045
Min. Negotiated Rate	$3,231.09
Max. Negotiated Rate	$3,231.09
Rate for Payer: Cash Price	$1,141.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,231.09
Rate for Payer: SOMOS Essential	$3,231.09

PR DIR RPR RUPTD ANEURYSM SPLENIC ARTERY

Professional

Both

$7,273.04

Service Code	HCPCS 35112
Min. Negotiated Rate	$5,454.78
Max. Negotiated Rate	$5,454.78
Rate for Payer: Cash Price	$1,925.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,454.78
Rate for Payer: SOMOS Essential	$5,454.78

PR DISARTICULATION HIP

Professional

Both

$5,560.87

Service Code	HCPCS 27295
Min. Negotiated Rate	$4,170.65
Max. Negotiated Rate	$4,170.65
Rate for Payer: Cash Price	$1,499.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,170.65
Rate for Payer: SOMOS Essential	$4,170.65

PR DISARTICULATION KNEE

Professional

Both

$3,107.69

Service Code	HCPCS 27598
Min. Negotiated Rate	$2,330.77
Max. Negotiated Rate	$2,330.77
Rate for Payer: Cash Price	$829.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,330.77
Rate for Payer: SOMOS Essential	$2,330.77

PR DISARTICULATION SHOULDER

Professional

Both

$4,963.00

Service Code	HCPCS 23920
Min. Negotiated Rate	$3,722.25
Max. Negotiated Rate	$3,722.25
Rate for Payer: Cash Price	$1,340.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,722.25
Rate for Payer: SOMOS Essential	$3,722.25

PR DISARTICULATION THROUGH WRIST

Professional

Both

$3,243.42

Service Code	HCPCS 25920
Min. Negotiated Rate	$2,432.56
Max. Negotiated Rate	$2,432.56
Rate for Payer: Cash Price	$875.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,432.56
Rate for Payer: SOMOS Essential	$2,432.56

PR DISARTICULATION THRU WRIST RE-AMPUTATION

Professional

Both

$3,167.68

Service Code	HCPCS 25924
Min. Negotiated Rate	$2,375.76
Max. Negotiated Rate	$2,375.76
Rate for Payer: Cash Price	$855.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,375.76
Rate for Payer: SOMOS Essential	$2,375.76

PR DISARTICULATION THRU WRIST SEC CLOSURE/SCAR REVJ

Professional

Both

$2,874.52

Service Code	HCPCS 25922
Min. Negotiated Rate	$2,155.89
Max. Negotiated Rate	$2,155.89
Rate for Payer: Cash Price	$777.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,155.89
Rate for Payer: SOMOS Essential	$2,155.89

PR DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC

Professional

Both

$6,318.48

Service Code	HCPCS 63075
Min. Negotiated Rate	$4,738.86
Max. Negotiated Rate	$4,738.86
Rate for Payer: Cash Price	$1,673.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,738.86
Rate for Payer: SOMOS Essential	$4,738.86

PR DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC

Professional

Both

$1,116.50

Service Code	HCPCS 63076
Min. Negotiated Rate	$837.38
Max. Negotiated Rate	$837.38
Rate for Payer: Cash Price	$293.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$837.38
Rate for Payer: SOMOS Essential	$837.38

PR DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC

Professional

Both

$7,126.60

Service Code	HCPCS 63077
Min. Negotiated Rate	$5,344.95
Max. Negotiated Rate	$5,344.95
Rate for Payer: Cash Price	$1,733.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,344.95
Rate for Payer: SOMOS Essential	$5,344.95

Know your out-of-pocket cost for care.

All Charges