St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR EKG TRACING FOR INITIAL PREV

Professional

Both

$28.60

Service Code	HCPCS G0404
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$21.45
Rate for Payer: Cash Price	$7.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21.45
Rate for Payer: SOMOS Essential	$21.45

PR ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN

Professional

Both

$206.01

Service Code	HCPCS 95983
Min. Negotiated Rate	$154.51
Max. Negotiated Rate	$154.51
Rate for Payer: Cash Price	$55.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$154.51
Rate for Payer: SOMOS Essential	$154.51

PR ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN

Professional

Both

$179.59

Service Code	HCPCS 95984
Min. Negotiated Rate	$134.69
Max. Negotiated Rate	$134.69
Rate for Payer: Cash Price	$48.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$134.69
Rate for Payer: SOMOS Essential	$134.69

PR ELEC ALYS IMPLT CPLX CN NPGT PRGRMG

Professional

Both

$216.41

Service Code	HCPCS 95977
Min. Negotiated Rate	$162.31
Max. Negotiated Rate	$162.31
Rate for Payer: Cash Price	$58.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$162.31
Rate for Payer: SOMOS Essential	$162.31

PR ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG

Professional

Both

$170.70

Service Code	HCPCS 95972
Min. Negotiated Rate	$128.02
Max. Negotiated Rate	$128.02
Rate for Payer: Cash Price	$45.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$128.02
Rate for Payer: SOMOS Essential	$128.02

PR ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING

Professional

Both

$77.77

Service Code	HCPCS 95970
Min. Negotiated Rate	$58.33
Max. Negotiated Rate	$58.33
Rate for Payer: Cash Price	$20.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$58.33
Rate for Payer: SOMOS Essential	$58.33

PR ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG

Professional

Both

$159.99

Service Code	HCPCS 95971
Min. Negotiated Rate	$119.99
Max. Negotiated Rate	$119.99
Rate for Payer: Cash Price	$43.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$119.99
Rate for Payer: SOMOS Essential	$119.99

PR ELEC ALYS IMPLT SMPL CN NPGT PRGRMG

Professional

Both

$160.90

Service Code	HCPCS 95976
Min. Negotiated Rate	$120.68
Max. Negotiated Rate	$120.68
Rate for Payer: Cash Price	$43.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$120.68
Rate for Payer: SOMOS Essential	$120.68

PR ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG

Professional

Both

$78.44

Service Code	HCPCS 95981
Min. Negotiated Rate	$58.83
Max. Negotiated Rate	$58.83
Rate for Payer: Cash Price	$20.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$58.83
Rate for Payer: SOMOS Essential	$58.83

PR ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG

Professional

Both

$203.95

Service Code	HCPCS 95980
Min. Negotiated Rate	$152.96
Max. Negotiated Rate	$152.96
Rate for Payer: Cash Price	$53.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$152.96
Rate for Payer: SOMOS Essential	$152.96

PR ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG

Professional

Both

$158.80

Service Code	HCPCS 95982
Min. Negotiated Rate	$119.10
Max. Negotiated Rate	$119.10
Rate for Payer: Cash Price	$42.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$119.10
Rate for Payer: SOMOS Essential	$119.10

PR ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR PHYS/QHP

Professional

Both

$191.84

Service Code	HCPCS 62370
Min. Negotiated Rate	$143.88
Max. Negotiated Rate	$143.88
Rate for Payer: Cash Price	$51.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$143.88
Rate for Payer: SOMOS Essential	$143.88

PR ELEC STIM OTHER THAN WOUND

Professional

Both

$49.74

Service Code	HCPCS G0283
Min. Negotiated Rate	$37.30
Max. Negotiated Rate	$37.30
Rate for Payer: Cash Price	$13.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$37.30
Rate for Payer: SOMOS Essential	$37.30

PR ELEC STIM UNATTEND FOR PRESS

Professional

Both

$49.74

Service Code	HCPCS G0281
Min. Negotiated Rate	$37.30
Max. Negotiated Rate	$37.30
Rate for Payer: Cash Price	$13.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$37.30
Rate for Payer: SOMOS Essential	$37.30

PR ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG

Professional

Both

$144.62

Service Code	HCPCS 62368
Min. Negotiated Rate	$108.46
Max. Negotiated Rate	$108.46
Rate for Payer: Cash Price	$38.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$108.46
Rate for Payer: SOMOS Essential	$108.46

PR ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL

Professional

Both

$103.85

Service Code	HCPCS 62367
Min. Negotiated Rate	$77.89
Max. Negotiated Rate	$77.89
Rate for Payer: Cash Price	$28.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$77.89
Rate for Payer: SOMOS Essential	$77.89

PR ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL

Professional

Both

$146.06

Service Code	HCPCS 62369
Min. Negotiated Rate	$109.54
Max. Negotiated Rate	$109.54
Rate for Payer: Cash Price	$39.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$109.54
Rate for Payer: SOMOS Essential	$109.54

PR ELECTRICAL STIMULATION BONE HEALING INVASIVE

Professional

Both

$786.70

Service Code	HCPCS 20975
Min. Negotiated Rate	$590.02
Max. Negotiated Rate	$590.02
Rate for Payer: Cash Price	$212.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$590.02
Rate for Payer: SOMOS Essential	$590.02

PR ELECTRICAL STIMULATION BONE HEALING NONINVASIVE

Professional

Both

$229.11

Service Code	HCPCS 20974
Min. Negotiated Rate	$171.83
Max. Negotiated Rate	$171.83
Rate for Payer: Cash Price	$61.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$171.83
Rate for Payer: SOMOS Essential	$171.83

PR ELECTRICAL STIMULATION GUID W/CHEMODENERVATION

Professional

Both

$227.12

Service Code	HCPCS 95873 TC
Min. Negotiated Rate	$170.34
Max. Negotiated Rate	$170.34
Rate for Payer: Cash Price	$60.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$170.34
Rate for Payer: SOMOS Essential	$170.34

PR ELECTRICAL STIMULATION GUID W/CHEMODENERVATION

Professional

Both

$303.52

Service Code	HCPCS 95873
Min. Negotiated Rate	$227.64
Max. Negotiated Rate	$227.64
Rate for Payer: Cash Price	$81.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$227.64
Rate for Payer: SOMOS Essential	$227.64

PR ELECTRICAL STIMULATION GUID W/CHEMODENERVATION

Professional

Both

$76.41

Service Code	HCPCS 95873 26
Min. Negotiated Rate	$57.31
Max. Negotiated Rate	$57.31
Rate for Payer: Cash Price	$20.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$57.31
Rate for Payer: SOMOS Essential	$57.31

PR ELECTROCOCHLEOGRAPHY

Professional

Both

$472.57

Service Code	HCPCS 92584
Min. Negotiated Rate	$354.43
Max. Negotiated Rate	$354.43
Rate for Payer: Cash Price	$126.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$354.43
Rate for Payer: SOMOS Essential	$354.43

PR ELECTROCONVULSIVE THERAPY

Professional

Both

$413.81

Service Code	HCPCS 90870
Min. Negotiated Rate	$310.36
Max. Negotiated Rate	$310.36
Rate for Payer: Cash Price	$113.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$310.36
Rate for Payer: SOMOS Essential	$310.36

PR ELECTROCORTICOGRAM SURGERY SPX

Professional

Both

$7,558.88

Service Code	HCPCS 95829
Min. Negotiated Rate	$5,669.16
Max. Negotiated Rate	$5,669.16
Rate for Payer: Cash Price	$2,069.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,669.16
Rate for Payer: SOMOS Essential	$5,669.16

Know your out-of-pocket cost for care.

All Charges