St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR ELECTROCORTICOGRAM SURGERY SPX

Professional

Both

$6,231.58

Service Code	HCPCS 95829 TC
Min. Negotiated Rate	$4,673.68
Max. Negotiated Rate	$4,673.68
Rate for Payer: Cash Price	$1,708.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,673.68
Rate for Payer: SOMOS Essential	$4,673.68

PR ELECTROCORTICOGRAM SURGERY SPX

Professional

Both

$1,327.31

Service Code	HCPCS 95829 26
Min. Negotiated Rate	$995.48
Max. Negotiated Rate	$995.48
Rate for Payer: Cash Price	$360.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$995.48
Rate for Payer: SOMOS Essential	$995.48

PR ELECTROEJACULATION

Professional

Both

$586.36

Service Code	HCPCS 55870
Min. Negotiated Rate	$439.77
Max. Negotiated Rate	$439.77
Rate for Payer: Cash Price	$161.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$439.77
Rate for Payer: SOMOS Essential	$439.77

PR ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY

Professional

Both

$155.37

Service Code	HCPCS 95824 26
Min. Negotiated Rate	$116.53
Max. Negotiated Rate	$116.53
Rate for Payer: Cash Price	$42.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$116.53
Rate for Payer: SOMOS Essential	$116.53

PR ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY

Professional

Both

$534.03

Service Code	HCPCS 95824
Min. Negotiated Rate	$400.52
Max. Negotiated Rate	$400.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$400.52
Rate for Payer: SOMOS Essential	$400.52

PR ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY

Professional

Both

$378.67

Service Code	HCPCS 95824 TC
Min. Negotiated Rate	$284.00
Max. Negotiated Rate	$284.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$284.00
Rate for Payer: SOMOS Essential	$284.00

PR ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN

Professional

Both

$1,473.89

Service Code	HCPCS 95812
Min. Negotiated Rate	$1,105.42
Max. Negotiated Rate	$1,105.42
Rate for Payer: Cash Price	$410.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,105.42
Rate for Payer: SOMOS Essential	$1,105.42

PR ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN

Professional

Both

$222.39

Service Code	HCPCS 95812 26
Min. Negotiated Rate	$166.79
Max. Negotiated Rate	$166.79
Rate for Payer: Cash Price	$62.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$166.79
Rate for Payer: SOMOS Essential	$166.79

PR ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN

Professional

Both

$1,251.50

Service Code	HCPCS 95812 TC
Min. Negotiated Rate	$938.62
Max. Negotiated Rate	$938.62
Rate for Payer: Cash Price	$348.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$938.62
Rate for Payer: SOMOS Essential	$938.62

PR ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY

Professional

Both

$1,777.23

Service Code	HCPCS 95822
Min. Negotiated Rate	$1,332.92
Max. Negotiated Rate	$1,332.92
Rate for Payer: Cash Price	$484.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,332.92
Rate for Payer: SOMOS Essential	$1,332.92

PR ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY

Professional

Both

$1,553.37

Service Code	HCPCS 95822 TC
Min. Negotiated Rate	$1,165.03
Max. Negotiated Rate	$1,165.03
Rate for Payer: Cash Price	$422.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,165.03
Rate for Payer: SOMOS Essential	$1,165.03

PR ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY

Professional

Both

$223.83

Service Code	HCPCS 95822 26
Min. Negotiated Rate	$167.87
Max. Negotiated Rate	$167.87
Rate for Payer: Cash Price	$62.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$167.87
Rate for Payer: SOMOS Essential	$167.87

PR ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP

Professional

Both

$1,897.98

Service Code	HCPCS 95819
Min. Negotiated Rate	$1,423.48
Max. Negotiated Rate	$1,423.48
Rate for Payer: Cash Price	$534.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,423.48
Rate for Payer: SOMOS Essential	$1,423.48

PR ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP

Professional

Both

$1,675.56

Service Code	HCPCS 95819 TC
Min. Negotiated Rate	$1,256.67
Max. Negotiated Rate	$1,256.67
Rate for Payer: Cash Price	$472.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,256.67
Rate for Payer: SOMOS Essential	$1,256.67

PR ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP

Professional

Both

$222.39

Service Code	HCPCS 95819 26
Min. Negotiated Rate	$166.79
Max. Negotiated Rate	$166.79
Rate for Payer: Cash Price	$62.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$166.79
Rate for Payer: SOMOS Essential	$166.79

PR ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY

Professional

Both

$1,412.50

Service Code	HCPCS 95816 TC
Min. Negotiated Rate	$1,059.38
Max. Negotiated Rate	$1,059.38
Rate for Payer: Cash Price	$401.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,059.38
Rate for Payer: SOMOS Essential	$1,059.38

PR ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY

Professional

Both

$1,634.89

Service Code	HCPCS 95816
Min. Negotiated Rate	$1,226.17
Max. Negotiated Rate	$1,226.17
Rate for Payer: Cash Price	$463.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,226.17
Rate for Payer: SOMOS Essential	$1,226.17

PR ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY

Professional

Both

$222.39

Service Code	HCPCS 95816 26
Min. Negotiated Rate	$166.79
Max. Negotiated Rate	$166.79
Rate for Payer: Cash Price	$62.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$166.79
Rate for Payer: SOMOS Essential	$166.79

PR ELECTROGASTROGRAPHY DX TRANSCUTANEOUS

Professional

Both

$1,914.78

Service Code	HCPCS 91132
Min. Negotiated Rate	$1,436.08
Max. Negotiated Rate	$1,436.08
Rate for Payer: Cash Price	$513.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,436.08
Rate for Payer: SOMOS Essential	$1,436.08

PR ELECTROGASTROGRAPHY DX TRANSCUTANEOUS

Professional

Both

$103.67

Service Code	HCPCS 91132 26
Min. Negotiated Rate	$77.75
Max. Negotiated Rate	$77.75
Rate for Payer: Cash Price	$28.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$77.75
Rate for Payer: SOMOS Essential	$77.75

PR ELECTROGASTROGRAPHY DX TRANSCUTANEOUS

Professional

Both

$1,811.11

Service Code	HCPCS 91132 TC
Min. Negotiated Rate	$1,358.33
Max. Negotiated Rate	$1,358.33
Rate for Payer: Cash Price	$485.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,358.33
Rate for Payer: SOMOS Essential	$1,358.33

PR ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG

Professional

Both

$1,882.97

Service Code	HCPCS 91133 TC
Min. Negotiated Rate	$1,412.23
Max. Negotiated Rate	$1,412.23
Rate for Payer: Cash Price	$503.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,412.23
Rate for Payer: SOMOS Essential	$1,412.23

PR ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG

Professional

Both

$129.82

Service Code	HCPCS 91133 26
Min. Negotiated Rate	$97.36
Max. Negotiated Rate	$97.36
Rate for Payer: Cash Price	$35.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$97.36
Rate for Payer: SOMOS Essential	$97.36

PR ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG

Professional

Both

$2,012.82

Service Code	HCPCS 91133
Min. Negotiated Rate	$1,509.62
Max. Negotiated Rate	$1,509.62
Rate for Payer: Cash Price	$539.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,509.62
Rate for Payer: SOMOS Essential	$1,509.62

PR ELECTROMAGNTIC TX FOR ULCERS

Professional

Both

$47.64

Service Code	HCPCS G0329
Min. Negotiated Rate	$35.73
Max. Negotiated Rate	$35.73
Rate for Payer: Cash Price	$12.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35.73
Rate for Payer: SOMOS Essential	$35.73

Know your out-of-pocket cost for care.

All Charges