St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR ENDOMYOCARDIAL BIOPSY

Professional

Both

$969.92

Service Code	HCPCS 93505 26
Min. Negotiated Rate	$727.44
Max. Negotiated Rate	$727.44
Rate for Payer: Cash Price	$260.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$727.44
Rate for Payer: SOMOS Essential	$727.44

PR ENDOMYOCARDIAL BIOPSY

Professional

Both

$1,832.53

Service Code	HCPCS 93505 TC
Min. Negotiated Rate	$1,374.40
Max. Negotiated Rate	$1,374.40
Rate for Payer: Cash Price	$491.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,374.40
Rate for Payer: SOMOS Essential	$1,374.40

PR ENDOMYOCARDIAL BIOPSY

Professional

Both

$2,802.45

Service Code	HCPCS 93505
Min. Negotiated Rate	$2,101.84
Max. Negotiated Rate	$2,101.84
Rate for Payer: Cash Price	$751.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,101.84
Rate for Payer: SOMOS Essential	$2,101.84

PR ENDOSCOPIC HARVEST UXTR ARTERY 1 SEGMENT CAB PX

Professional

Both

$766.89

Service Code	HCPCS 33509
Min. Negotiated Rate	$575.17
Max. Negotiated Rate	$575.17
Rate for Payer: Cash Price	$202.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$575.17
Rate for Payer: SOMOS Essential	$575.17

PR ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC

Professional

Both

$489.83

Service Code	HCPCS 43273
Min. Negotiated Rate	$367.37
Max. Negotiated Rate	$367.37
Rate for Payer: Cash Price	$133.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$367.37
Rate for Payer: SOMOS Essential	$367.37

PR ENDOSCOPIC PLANTAR FASCIOTOMY

Professional

Both

$1,819.20

Service Code	HCPCS 29893
Min. Negotiated Rate	$1,364.40
Max. Negotiated Rate	$1,364.40
Rate for Payer: Cash Price	$506.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,364.40
Rate for Payer: SOMOS Essential	$1,364.40

PR ENDOSCOPY UPPER SMALL INTESTINE

Professional

Both

$596.79

Service Code	HCPCS 44360
Min. Negotiated Rate	$447.59
Max. Negotiated Rate	$447.59
Rate for Payer: Cash Price	$162.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$447.59
Rate for Payer: SOMOS Essential	$447.59

PR ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY

Professional

Both

$656.01

Service Code	HCPCS 44361
Min. Negotiated Rate	$492.01
Max. Negotiated Rate	$492.01
Rate for Payer: Cash Price	$179.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$492.01
Rate for Payer: SOMOS Essential	$492.01

PR ENDOVASC VISCER AORTA REPAIR FENEST 1 ENDOGRAFT

Professional

Both

$5,125.51

Service Code	HCPCS 34841
Min. Negotiated Rate	$3,844.13
Max. Negotiated Rate	$3,844.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,844.13
Rate for Payer: SOMOS Essential	$3,844.13

PR ENDOVASC VISCER AORTA REPAIR FENEST 2 ENDOGRAFT

Professional

Both

$6,453.37

Service Code	HCPCS 34842
Min. Negotiated Rate	$4,840.03
Max. Negotiated Rate	$4,840.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,840.03
Rate for Payer: SOMOS Essential	$4,840.03

PR ENDOVASC VISCER AORTA REPAIR FENEST 3 ENDOGRAFT

Professional

Both

$7,781.17

Service Code	HCPCS 34843
Min. Negotiated Rate	$5,835.88
Max. Negotiated Rate	$5,835.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,835.88
Rate for Payer: SOMOS Essential	$5,835.88

PR ENDOVASC VISCER AORTA REPR FENEST 4+ ENDOGRAFT

Professional

Both

$9,109.00

Service Code	HCPCS 34844
Min. Negotiated Rate	$6,831.75
Max. Negotiated Rate	$6,831.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,831.75
Rate for Payer: SOMOS Essential	$6,831.75

PR ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN

Professional

Both

$775.22

Service Code	HCPCS 36482
Min. Negotiated Rate	$581.42
Max. Negotiated Rate	$581.42
Rate for Payer: Cash Price	$207.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$581.42
Rate for Payer: SOMOS Essential	$581.42

PR ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN

Professional

Both

$387.98

Service Code	HCPCS 36483
Min. Negotiated Rate	$290.98
Max. Negotiated Rate	$290.98
Rate for Payer: Cash Price	$103.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$290.98
Rate for Payer: SOMOS Essential	$290.98

PR ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM 1ST VEIN

Professional

Both

$787.89

Service Code	HCPCS 36473
Min. Negotiated Rate	$590.92
Max. Negotiated Rate	$590.92
Rate for Payer: Cash Price	$210.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$590.92
Rate for Payer: SOMOS Essential	$590.92

PR ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM SBSQ VEINS

Professional

Both

$389.83

Service Code	HCPCS 36474
Min. Negotiated Rate	$292.37
Max. Negotiated Rate	$292.37
Rate for Payer: Cash Price	$102.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$292.37
Rate for Payer: SOMOS Essential	$292.37

PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN

Professional

Both

$1,206.84

Service Code	HCPCS 36478
Min. Negotiated Rate	$905.13
Max. Negotiated Rate	$905.13
Rate for Payer: Cash Price	$322.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$905.13
Rate for Payer: SOMOS Essential	$905.13

PR ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS

Professional

Both

$590.35

Service Code	HCPCS 36479
Min. Negotiated Rate	$442.76
Max. Negotiated Rate	$442.76
Rate for Payer: Cash Price	$157.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$442.76
Rate for Payer: SOMOS Essential	$442.76

PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN

Professional

Both

$1,214.78

Service Code	HCPCS 36475
Min. Negotiated Rate	$911.08
Max. Negotiated Rate	$911.08
Rate for Payer: Cash Price	$323.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$911.08
Rate for Payer: SOMOS Essential	$911.08

PR ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND+ VEINS

Professional

Both

$587.20

Service Code	HCPCS 36476
Min. Negotiated Rate	$440.40
Max. Negotiated Rate	$440.40
Rate for Payer: Cash Price	$154.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$440.40
Rate for Payer: SOMOS Essential	$440.40

PR ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA

Professional

Both

$1,076.57

Service Code	HCPCS 44121
Min. Negotiated Rate	$807.43
Max. Negotiated Rate	$807.43
Rate for Payer: Cash Price	$286.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$807.43
Rate for Payer: SOMOS Essential	$807.43

PR ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY

Professional

Both

$5,231.66

Service Code	HCPCS 44125
Min. Negotiated Rate	$3,923.74
Max. Negotiated Rate	$3,923.74
Rate for Payer: Cash Price	$1,401.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,923.74
Rate for Payer: SOMOS Essential	$3,923.74

PR ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS

Professional

Both

$5,771.43

Service Code	HCPCS 51960
Min. Negotiated Rate	$4,328.57
Max. Negotiated Rate	$4,328.57
Rate for Payer: Cash Price	$1,576.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,328.57
Rate for Payer: SOMOS Essential	$4,328.57

PR ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX

Professional

Both

$5,896.17

Service Code	HCPCS 44130
Min. Negotiated Rate	$4,422.13
Max. Negotiated Rate	$4,422.13
Rate for Payer: Cash Price	$1,573.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,422.13
Rate for Payer: SOMOS Essential	$4,422.13

PR ENTEROLSS FRING INTSTINAL ADHESION SPX

Professional

Both

$4,901.02

Service Code	HCPCS 44005
Min. Negotiated Rate	$3,675.76
Max. Negotiated Rate	$3,675.76
Rate for Payer: Cash Price	$1,307.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,675.76
Rate for Payer: SOMOS Essential	$3,675.76

Know your out-of-pocket cost for care.

All Charges