St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD

Professional

Both

$93.70

Service Code	HCPCS 93979 26
Min. Negotiated Rate	$70.28
Max. Negotiated Rate	$70.28
Rate for Payer: Cash Price	$26.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$70.28
Rate for Payer: SOMOS Essential	$70.28

PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD

Professional

Both

$503.09

Service Code	HCPCS 93979
Min. Negotiated Rate	$377.32
Max. Negotiated Rate	$377.32
Rate for Payer: Cash Price	$138.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$377.32
Rate for Payer: SOMOS Essential	$377.32

PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD

Professional

Both

$409.40

Service Code	HCPCS 93979 TC
Min. Negotiated Rate	$307.05
Max. Negotiated Rate	$307.05
Rate for Payer: Cash Price	$112.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$307.05
Rate for Payer: SOMOS Essential	$307.05

PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM

Professional

Both

$1,143.84

Service Code	HCPCS 93975
Min. Negotiated Rate	$857.88
Max. Negotiated Rate	$857.88
Rate for Payer: Cash Price	$309.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$857.88
Rate for Payer: SOMOS Essential	$857.88

PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM

Professional

Both

$227.29

Service Code	HCPCS 93975 26
Min. Negotiated Rate	$170.47
Max. Negotiated Rate	$170.47
Rate for Payer: Cash Price	$60.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$170.47
Rate for Payer: SOMOS Essential	$170.47

PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM

Professional

Both

$916.58

Service Code	HCPCS 93975 TC
Min. Negotiated Rate	$687.44
Max. Negotiated Rate	$687.44
Rate for Payer: Cash Price	$248.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$687.44
Rate for Payer: SOMOS Essential	$687.44

PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT

Professional

Both

$456.86

Service Code	HCPCS 93976 TC
Min. Negotiated Rate	$342.64
Max. Negotiated Rate	$342.64
Rate for Payer: Cash Price	$143.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$342.64
Rate for Payer: SOMOS Essential	$342.64

PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT

Professional

Both

$608.23

Service Code	HCPCS 93976
Min. Negotiated Rate	$456.17
Max. Negotiated Rate	$456.17
Rate for Payer: Cash Price	$185.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$456.17
Rate for Payer: SOMOS Essential	$456.17

PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT

Professional

Both

$151.38

Service Code	HCPCS 93976 26
Min. Negotiated Rate	$113.54
Max. Negotiated Rate	$113.54
Rate for Payer: Cash Price	$41.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$113.54
Rate for Payer: SOMOS Essential	$113.54

PR DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL

Professional

Both

$232.19

Service Code	HCPCS 93980 26
Min. Negotiated Rate	$174.14
Max. Negotiated Rate	$174.14
Rate for Payer: Cash Price	$64.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$174.14
Rate for Payer: SOMOS Essential	$174.14

PR DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL

Professional

Both

$248.54

Service Code	HCPCS 93980 TC
Min. Negotiated Rate	$186.40
Max. Negotiated Rate	$186.40
Rate for Payer: Cash Price	$69.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$186.40
Rate for Payer: SOMOS Essential	$186.40

PR DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL

Professional

Both

$480.73

Service Code	HCPCS 93980
Min. Negotiated Rate	$360.55
Max. Negotiated Rate	$360.55
Rate for Payer: Cash Price	$133.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$360.55
Rate for Payer: SOMOS Essential	$360.55

PR DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD

Professional

Both

$87.61

Service Code	HCPCS 93981 26
Min. Negotiated Rate	$65.71
Max. Negotiated Rate	$65.71
Rate for Payer: Cash Price	$23.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$65.71
Rate for Payer: SOMOS Essential	$65.71

PR DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD

Professional

Both

$300.23

Service Code	HCPCS 93981
Min. Negotiated Rate	$225.17
Max. Negotiated Rate	$225.17
Rate for Payer: Cash Price	$82.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$225.17
Rate for Payer: SOMOS Essential	$225.17

PR DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD

Professional

Both

$212.63

Service Code	HCPCS 93981 TC
Min. Negotiated Rate	$159.47
Max. Negotiated Rate	$159.47
Rate for Payer: Cash Price	$59.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$159.47
Rate for Payer: SOMOS Essential	$159.47

PR DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY

Professional

Both

$151.13

Service Code	HCPCS 93925 26
Min. Negotiated Rate	$113.35
Max. Negotiated Rate	$113.35
Rate for Payer: Cash Price	$41.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$113.35
Rate for Payer: SOMOS Essential	$113.35

PR DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY

Professional

Both

$882.07

Service Code	HCPCS 93925 TC
Min. Negotiated Rate	$661.55
Max. Negotiated Rate	$661.55
Rate for Payer: Cash Price	$240.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$661.55
Rate for Payer: SOMOS Essential	$661.55

PR DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY

Professional

Both

$1,033.17

Service Code	HCPCS 93925
Min. Negotiated Rate	$774.88
Max. Negotiated Rate	$774.88
Rate for Payer: Cash Price	$282.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$774.88
Rate for Payer: SOMOS Essential	$774.88

PR DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY

Professional

Both

$92.26

Service Code	HCPCS 93926 26
Min. Negotiated Rate	$69.20
Max. Negotiated Rate	$69.20
Rate for Payer: Cash Price	$25.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$69.20
Rate for Payer: SOMOS Essential	$69.20

PR DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY

Professional

Both

$456.86

Service Code	HCPCS 93926 TC
Min. Negotiated Rate	$342.64
Max. Negotiated Rate	$342.64
Rate for Payer: Cash Price	$143.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$342.64
Rate for Payer: SOMOS Essential	$342.64

PR DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY

Professional

Both

$549.12

Service Code	HCPCS 93926
Min. Negotiated Rate	$411.84
Max. Negotiated Rate	$411.84
Rate for Payer: Cash Price	$169.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$411.84
Rate for Payer: SOMOS Essential	$411.84

PR DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY

Professional

Both

$844.59

Service Code	HCPCS 93930
Min. Negotiated Rate	$633.44
Max. Negotiated Rate	$633.44
Rate for Payer: Cash Price	$232.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$633.44
Rate for Payer: SOMOS Essential	$633.44

PR DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY

Professional

Both

$688.00

Service Code	HCPCS 93930 TC
Min. Negotiated Rate	$516.00
Max. Negotiated Rate	$516.00
Rate for Payer: Cash Price	$190.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$516.00
Rate for Payer: SOMOS Essential	$516.00

PR DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY

Professional

Both

$156.59

Service Code	HCPCS 93930 26
Min. Negotiated Rate	$117.44
Max. Negotiated Rate	$117.44
Rate for Payer: Cash Price	$42.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$117.44
Rate for Payer: SOMOS Essential	$117.44

PR DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY

Professional

Both

$530.43

Service Code	HCPCS 93931
Min. Negotiated Rate	$397.82
Max. Negotiated Rate	$397.82
Rate for Payer: Cash Price	$145.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$397.82
Rate for Payer: SOMOS Essential	$397.82

Know your out-of-pocket cost for care.

All Charges