St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR DNRVTJ HIP JT INTRAPEL/XTRPEL INTRA-ARTCLR BRNCH

Professional

Both

$4,613.84

Service Code	HCPCS 27035
Min. Negotiated Rate	$3,460.38
Max. Negotiated Rate	$3,460.38
Rate for Payer: Cash Price	$1,276.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,460.38
Rate for Payer: SOMOS Essential	$3,460.38

PR DONOR HEPATECTOMY LIVING DONOR SEG II & III

Professional

Both

$16,119.64

Service Code	HCPCS 47140
Min. Negotiated Rate	$12,089.73
Max. Negotiated Rate	$12,089.73
Rate for Payer: Cash Price	$4,299.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$12,089.73
Rate for Payer: SOMOS Essential	$12,089.73

PR DONOR HEPATECTOMY LIVING DONOR SEG II III & IV

Professional

Both

$19,271.95

Service Code	HCPCS 47141
Min. Negotiated Rate	$14,453.96
Max. Negotiated Rate	$14,453.96
Rate for Payer: Cash Price	$5,136.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$14,453.96
Rate for Payer: SOMOS Essential	$14,453.96

PR DONOR HEPATECTOMY LIVING DONOR SEG V VI VII &VI

Professional

Both

$21,119.35

Service Code	HCPCS 47142
Min. Negotiated Rate	$15,839.51
Max. Negotiated Rate	$15,839.51
Rate for Payer: Cash Price	$5,654.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15,839.51
Rate for Payer: SOMOS Essential	$15,839.51

PR DONOR NEPHRECTOMY OPEN LIVING DONOR

Professional

Both

$6,855.35

Service Code	HCPCS 50320
Min. Negotiated Rate	$5,141.51
Max. Negotiated Rate	$5,141.51
Rate for Payer: Cash Price	$1,840.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,141.51
Rate for Payer: SOMOS Essential	$5,141.51

PR DOP ECHOCARD COLOR FLOW VELOCITY MAPPING

Professional

Both

$87.68

Service Code	HCPCS 93325 TC
Min. Negotiated Rate	$65.76
Max. Negotiated Rate	$65.76
Rate for Payer: Cash Price	$23.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$65.76
Rate for Payer: SOMOS Essential	$65.76

PR DOP ECHOCARD COLOR FLOW VELOCITY MAPPING

Professional

Both

$99.33

Service Code	HCPCS 93325
Min. Negotiated Rate	$74.50
Max. Negotiated Rate	$74.50
Rate for Payer: Cash Price	$27.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$74.50
Rate for Payer: SOMOS Essential	$74.50

PR DOP ECHOCARD COLOR FLOW VELOCITY MAPPING

Professional

Both

$11.66

Service Code	HCPCS 93325 26
Min. Negotiated Rate	$8.74
Max. Negotiated Rate	$8.74
Rate for Payer: Cash Price	$3.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.74
Rate for Payer: SOMOS Essential	$8.74

PR DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD

Professional

Both

$77.63

Service Code	HCPCS 93321 TC
Min. Negotiated Rate	$58.22
Max. Negotiated Rate	$58.22
Rate for Payer: Cash Price	$21.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$58.22
Rate for Payer: SOMOS Essential	$58.22

PR DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD

Professional

Both

$28.70

Service Code	HCPCS 93321 26
Min. Negotiated Rate	$21.52
Max. Negotiated Rate	$21.52
Rate for Payer: Cash Price	$7.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21.52
Rate for Payer: SOMOS Essential	$21.52

PR DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD

Professional

Both

$106.33

Service Code	HCPCS 93321
Min. Negotiated Rate	$79.75
Max. Negotiated Rate	$79.75
Rate for Payer: Cash Price	$29.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$79.75
Rate for Payer: SOMOS Essential	$79.75

PR DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY

Professional

Both

$212.63

Service Code	HCPCS 93320
Min. Negotiated Rate	$159.47
Max. Negotiated Rate	$159.47
Rate for Payer: Cash Price	$58.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$159.47
Rate for Payer: SOMOS Essential	$159.47

PR DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY

Professional

Both

$143.61

Service Code	HCPCS 93320 TC
Min. Negotiated Rate	$107.71
Max. Negotiated Rate	$107.71
Rate for Payer: Cash Price	$39.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$107.71
Rate for Payer: SOMOS Essential	$107.71

PR DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY

Professional

Both

$69.02

Service Code	HCPCS 93320 26
Min. Negotiated Rate	$51.76
Max. Negotiated Rate	$51.76
Rate for Payer: Cash Price	$18.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$51.76
Rate for Payer: SOMOS Essential	$51.76

PR DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH

Professional

Both

$525.88

Service Code	HCPCS 30000
Min. Negotiated Rate	$394.41
Max. Negotiated Rate	$394.41
Rate for Payer: Cash Price	$142.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$394.41
Rate for Payer: SOMOS Essential	$394.41

PR DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM

Professional

Both

$530.18

Service Code	HCPCS 30020
Min. Negotiated Rate	$397.64
Max. Negotiated Rate	$397.64
Rate for Payer: Cash Price	$144.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$397.64
Rate for Payer: SOMOS Essential	$397.64

PR DRAINAGE ABSCESS PALATE UVULA

Professional

Both

$471.07

Service Code	HCPCS 42000
Min. Negotiated Rate	$353.30
Max. Negotiated Rate	$353.30
Rate for Payer: Cash Price	$128.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$353.30
Rate for Payer: SOMOS Essential	$353.30

PR DRAINAGE ABSCESS PAROTID COMPLICATED

Professional

Both

$1,822.14

Service Code	HCPCS 42305
Min. Negotiated Rate	$1,366.60
Max. Negotiated Rate	$1,366.60
Rate for Payer: Cash Price	$509.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,366.60
Rate for Payer: SOMOS Essential	$1,366.60

PR DRAINAGE ABSCESS PAROTID SIMPLE

Professional

Both

$678.09

Service Code	HCPCS 42300
Min. Negotiated Rate	$508.57
Max. Negotiated Rate	$508.57
Rate for Payer: Cash Price	$184.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$508.57
Rate for Payer: SOMOS Essential	$508.57

PR DRAINAGE ABSCESS SUBMAXILLARY INTRAORAL

Professional

Both

$777.28

Service Code	HCPCS 42320
Min. Negotiated Rate	$582.96
Max. Negotiated Rate	$582.96
Rate for Payer: Cash Price	$210.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$582.96
Rate for Payer: SOMOS Essential	$582.96

PR DRAINAGE DEEP PERIURETHRAL ABSCESS

Professional

Both

$1,651.93

Service Code	HCPCS 53040
Min. Negotiated Rate	$1,238.95
Max. Negotiated Rate	$1,238.95
Rate for Payer: Cash Price	$452.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,238.95
Rate for Payer: SOMOS Essential	$1,238.95

PR DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS

Professional

Both

$625.59

Service Code	HCPCS 69020
Min. Negotiated Rate	$469.19
Max. Negotiated Rate	$469.19
Rate for Payer: Cash Price	$169.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$469.19
Rate for Payer: SOMOS Essential	$469.19

PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX

Professional

Both

$690.45

Service Code	HCPCS 69005
Min. Negotiated Rate	$517.84
Max. Negotiated Rate	$517.84
Rate for Payer: Cash Price	$190.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$517.84
Rate for Payer: SOMOS Essential	$517.84

PR DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE

Professional

Both

$539.88

Service Code	HCPCS 69000
Min. Negotiated Rate	$404.91
Max. Negotiated Rate	$404.91
Rate for Payer: Cash Price	$148.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$404.91
Rate for Payer: SOMOS Essential	$404.91

PR DRAINAGE FINGER ABSCESS COMPLICATED

Professional

Both

$816.80

Service Code	HCPCS 26011
Min. Negotiated Rate	$612.60
Max. Negotiated Rate	$612.60
Rate for Payer: Cash Price	$220.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$612.60
Rate for Payer: SOMOS Essential	$612.60

Know your out-of-pocket cost for care.

All Charges