St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR ENTERORRHAPHY MULTIPLE PERFORATIONS

Professional

Both

$7,208.50

Service Code	HCPCS 44603
Min. Negotiated Rate	$5,406.38
Max. Negotiated Rate	$5,406.38
Rate for Payer: Cash Price	$1,923.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,406.38
Rate for Payer: SOMOS Essential	$5,406.38

PR ENTERORRHAPHY SINGLE PERFORATION

Professional

Both

$6,315.96

Service Code	HCPCS 44602
Min. Negotiated Rate	$4,736.97
Max. Negotiated Rate	$4,736.97
Rate for Payer: Cash Price	$1,680.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,736.97
Rate for Payer: SOMOS Essential	$4,736.97

PR ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE

Professional

Both

$1,244.81

Service Code	HCPCS 44377
Min. Negotiated Rate	$933.61
Max. Negotiated Rate	$933.61
Rate for Payer: Cash Price	$337.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$933.61
Rate for Payer: SOMOS Essential	$933.61

PR ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX

Professional

Both

$1,176.04

Service Code	HCPCS 44376
Min. Negotiated Rate	$882.03
Max. Negotiated Rate	$882.03
Rate for Payer: Cash Price	$318.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$882.03
Rate for Payer: SOMOS Essential	$882.03

PR ENTEROSCOPY > 2ND PRTN ABLTJ LESION

Professional

Both

$1,016.89

Service Code	HCPCS 44369
Min. Negotiated Rate	$762.67
Max. Negotiated Rate	$762.67
Rate for Payer: Cash Price	$276.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$762.67
Rate for Payer: SOMOS Essential	$762.67

PR ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE

Professional

Both

$802.31

Service Code	HCPCS 44373
Min. Negotiated Rate	$601.73
Max. Negotiated Rate	$601.73
Rate for Payer: Cash Price	$216.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$601.73
Rate for Payer: SOMOS Essential	$601.73

PR ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING

Professional

Both

$1,591.21

Service Code	HCPCS 44378
Min. Negotiated Rate	$1,193.41
Max. Negotiated Rate	$1,193.41
Rate for Payer: Cash Price	$432.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,193.41
Rate for Payer: SOMOS Essential	$1,193.41

PR ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT

Professional

Both

$1,108.77

Service Code	HCPCS 44370
Min. Negotiated Rate	$831.58
Max. Negotiated Rate	$831.58
Rate for Payer: Cash Price	$301.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$831.58
Rate for Payer: SOMOS Essential	$831.58

PR ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING

Professional

Both

$994.63

Service Code	HCPCS 44366
Min. Negotiated Rate	$745.97
Max. Negotiated Rate	$745.97
Rate for Payer: Cash Price	$269.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$745.97
Rate for Payer: SOMOS Essential	$745.97

PR ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT

Professional

Both

$1,694.91

Service Code	HCPCS 44379
Min. Negotiated Rate	$1,271.18
Max. Negotiated Rate	$1,271.18
Rate for Payer: Cash Price	$461.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,271.18
Rate for Payer: SOMOS Essential	$1,271.18

PR ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE

Professional

Both

$1,002.30

Service Code	HCPCS 44372
Min. Negotiated Rate	$751.72
Max. Negotiated Rate	$751.72
Rate for Payer: Cash Price	$271.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$751.72
Rate for Payer: SOMOS Essential	$751.72

PR ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY

Professional

Both

$797.09

Service Code	HCPCS 44363
Min. Negotiated Rate	$597.82
Max. Negotiated Rate	$597.82
Rate for Payer: Cash Price	$216.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$597.82
Rate for Payer: SOMOS Essential	$597.82

PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY

Professional

Both

$754.85

Service Code	HCPCS 44365
Min. Negotiated Rate	$566.14
Max. Negotiated Rate	$566.14
Rate for Payer: Cash Price	$206.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$566.14
Rate for Payer: SOMOS Essential	$566.14

PR ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE

Professional

Both

$848.44

Service Code	HCPCS 44364
Min. Negotiated Rate	$636.33
Max. Negotiated Rate	$636.33
Rate for Payer: Cash Price	$230.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$636.33
Rate for Payer: SOMOS Essential	$636.33

PR ENTEROTOMY SM INT OTH/THN DUO DCMPRN

Professional

Both

$4,373.88

Service Code	HCPCS 44021
Min. Negotiated Rate	$3,280.41
Max. Negotiated Rate	$3,280.41
Rate for Payer: Cash Price	$1,164.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,280.41
Rate for Payer: SOMOS Essential	$3,280.41

PR ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL

Professional

Both

$4,379.87

Service Code	HCPCS 44020
Min. Negotiated Rate	$3,284.90
Max. Negotiated Rate	$3,284.90
Rate for Payer: Cash Price	$1,168.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,284.90
Rate for Payer: SOMOS Essential	$3,284.90

PR ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS

Professional

Both

$1,098.30

Service Code	HCPCS 44128
Min. Negotiated Rate	$823.72
Max. Negotiated Rate	$823.72
Rate for Payer: Cash Price	$291.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$823.72
Rate for Payer: SOMOS Essential	$823.72

PR ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING

Professional

Both

$12,900.13

Service Code	HCPCS 44127
Min. Negotiated Rate	$9,675.10
Max. Negotiated Rate	$9,675.10
Rate for Payer: Cash Price	$3,428.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,675.10
Rate for Payer: SOMOS Essential	$9,675.10

PR ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING

Professional

Both

$11,166.79

Service Code	HCPCS 44126
Min. Negotiated Rate	$8,375.09
Max. Negotiated Rate	$8,375.09
Rate for Payer: Cash Price	$2,969.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,375.09
Rate for Payer: SOMOS Essential	$8,375.09

PR ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST

Professional

Both

$5,483.49

Service Code	HCPCS 44120
Min. Negotiated Rate	$4,112.62
Max. Negotiated Rate	$4,112.62
Rate for Payer: Cash Price	$1,463.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,112.62
Rate for Payer: SOMOS Essential	$4,112.62

PR ENUCLEATION EYE IMPLT MUSC ATTACHED IMPLT

Professional

Both

$4,013.14

Service Code	HCPCS 65105
Min. Negotiated Rate	$3,009.86
Max. Negotiated Rate	$3,009.86
Rate for Payer: Cash Price	$1,096.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,009.86
Rate for Payer: SOMOS Essential	$3,009.86

PR ENUCLEATION EYE IMPLT MUSC X ATTACHED IMPLT

Professional

Both

$3,683.93

Service Code	HCPCS 65103
Min. Negotiated Rate	$2,762.95
Max. Negotiated Rate	$2,762.95
Rate for Payer: Cash Price	$1,009.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,762.95
Rate for Payer: SOMOS Essential	$2,762.95

PR ENUCLEATION OF EYE W/O IMPLANT

Professional

Both

$3,583.51

Service Code	HCPCS 65101
Min. Negotiated Rate	$2,687.63
Max. Negotiated Rate	$2,687.63
Rate for Payer: Cash Price	$978.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,687.63
Rate for Payer: SOMOS Essential	$2,687.63

PR ENZYME HISTOCHEMISTRY

Professional

Both

$574.84

Service Code	HCPCS 88319
Min. Negotiated Rate	$431.13
Max. Negotiated Rate	$431.13
Rate for Payer: Cash Price	$159.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$431.13
Rate for Payer: SOMOS Essential	$431.13

PR ENZYME HISTOCHEMISTRY

Professional

Both

$103.60

Service Code	HCPCS 88319 26
Min. Negotiated Rate	$77.70
Max. Negotiated Rate	$77.70
Rate for Payer: Cash Price	$28.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$77.70
Rate for Payer: SOMOS Essential	$77.70

Know your out-of-pocket cost for care.

All Charges