St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM

Professional

Both

$764.33

Service Code	HCPCS 11424
Min. Negotiated Rate	$573.25
Max. Negotiated Rate	$573.25
Rate for Payer: Cash Price	$212.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$573.25
Rate for Payer: SOMOS Essential	$573.25

PR EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM

Professional

Both

$1,164.49

Service Code	HCPCS 11426
Min. Negotiated Rate	$873.37
Max. Negotiated Rate	$873.37
Rate for Payer: Cash Price	$313.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$873.37
Rate for Payer: SOMOS Essential	$873.37

PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<

Professional

Both

$359.73

Service Code	HCPCS 11400
Min. Negotiated Rate	$269.80
Max. Negotiated Rate	$269.80
Rate for Payer: Cash Price	$99.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$269.80
Rate for Payer: SOMOS Essential	$269.80

PR EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM

Professional

Both

$455.39

Service Code	HCPCS 11401
Min. Negotiated Rate	$341.54
Max. Negotiated Rate	$341.54
Rate for Payer: Cash Price	$123.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$341.54
Rate for Payer: SOMOS Essential	$341.54

PR EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM

Professional

Both

$493.78

Service Code	HCPCS 11402
Min. Negotiated Rate	$370.34
Max. Negotiated Rate	$370.34
Rate for Payer: Cash Price	$135.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$370.34
Rate for Payer: SOMOS Essential	$370.34

PR EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM

Professional

Both

$640.71

Service Code	HCPCS 11403
Min. Negotiated Rate	$480.53
Max. Negotiated Rate	$480.53
Rate for Payer: Cash Price	$175.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$480.53
Rate for Payer: SOMOS Essential	$480.53

PR EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM

Professional

Both

$712.22

Service Code	HCPCS 11404
Min. Negotiated Rate	$534.16
Max. Negotiated Rate	$534.16
Rate for Payer: Cash Price	$194.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$534.16
Rate for Payer: SOMOS Essential	$534.16

PR EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM

Professional

Both

$1,081.61

Service Code	HCPCS 11406
Min. Negotiated Rate	$811.21
Max. Negotiated Rate	$811.21
Rate for Payer: Cash Price	$294.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$811.21
Rate for Payer: SOMOS Essential	$811.21

PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM

Professional

Both

$567.07

Service Code	HCPCS 11441
Min. Negotiated Rate	$425.30
Max. Negotiated Rate	$425.30
Rate for Payer: Cash Price	$156.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$425.30
Rate for Payer: SOMOS Essential	$425.30

PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM

Professional

Both

$626.75

Service Code	HCPCS 11442
Min. Negotiated Rate	$470.06
Max. Negotiated Rate	$470.06
Rate for Payer: Cash Price	$172.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$470.06
Rate for Payer: SOMOS Essential	$470.06

PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM

Professional

Both

$763.14

Service Code	HCPCS 11443
Min. Negotiated Rate	$572.36
Max. Negotiated Rate	$572.36
Rate for Payer: Cash Price	$209.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$572.36
Rate for Payer: SOMOS Essential	$572.36

PR EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM

Professional

Both

$964.11

Service Code	HCPCS 11444
Min. Negotiated Rate	$723.08
Max. Negotiated Rate	$723.08
Rate for Payer: Cash Price	$262.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$723.08
Rate for Payer: SOMOS Essential	$723.08

PR EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC

Professional

Both

$4,875.01

Service Code	HCPCS 21049
Min. Negotiated Rate	$3,656.26
Max. Negotiated Rate	$3,656.26
Rate for Payer: Cash Price	$1,319.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,656.26
Rate for Payer: SOMOS Essential	$3,656.26

PR EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDB

Professional

Both

$5,134.40

Service Code	HCPCS 21047
Min. Negotiated Rate	$3,850.80
Max. Negotiated Rate	$3,850.80
Rate for Payer: Cash Price	$1,388.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,850.80
Rate for Payer: SOMOS Essential	$3,850.80

PR EXC BARTHOLINS GLAND/CYST

Professional

Both

$1,378.97

Service Code	HCPCS 56740
Min. Negotiated Rate	$1,034.23
Max. Negotiated Rate	$1,034.23
Rate for Payer: Cash Price	$371.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,034.23
Rate for Payer: SOMOS Essential	$1,034.23

PR EXC BENIGN TUM CRANIAL BONE W/O OPTIC NRV DCMPRN

Professional

Both

$9,570.75

Service Code	HCPCS 61563
Min. Negotiated Rate	$7,178.06
Max. Negotiated Rate	$7,178.06
Rate for Payer: Cash Price	$2,523.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,178.06
Rate for Payer: SOMOS Essential	$7,178.06

PR EXC BENIGN TUM CRANIAL BONE W/OPTIC NRV DCMPRN

Professional

Both

$11,622.17

Service Code	HCPCS 61564
Min. Negotiated Rate	$8,716.63
Max. Negotiated Rate	$8,716.63
Rate for Payer: Cash Price	$3,060.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,716.63
Rate for Payer: SOMOS Essential	$8,716.63

PR EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT

Professional

Both

$4,192.27

Service Code	HCPCS 21048
Min. Negotiated Rate	$3,144.20
Max. Negotiated Rate	$3,144.20
Rate for Payer: Cash Price	$1,142.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,144.20
Rate for Payer: SOMOS Essential	$3,144.20

PR EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG

Professional

Both

$1,518.37

Service Code	HCPCS 21030
Min. Negotiated Rate	$1,138.78
Max. Negotiated Rate	$1,138.78
Rate for Payer: Cash Price	$415.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,138.78
Rate for Payer: SOMOS Essential	$1,138.78

PR EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT

Professional

Both

$4,162.38

Service Code	HCPCS 21046
Min. Negotiated Rate	$3,121.78
Max. Negotiated Rate	$3,121.78
Rate for Payer: Cash Price	$1,133.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,121.78
Rate for Payer: SOMOS Essential	$3,121.78

PR EXC BILE DUX TUM W/WO PRIM RPR INTRAHEPATC

Professional

Both

$9,034.97

Service Code	HCPCS 47712
Min. Negotiated Rate	$6,776.23
Max. Negotiated Rate	$6,776.23
Rate for Payer: Cash Price	$2,400.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,776.23
Rate for Payer: SOMOS Essential	$6,776.23

PR EXC BILE DUX TUM W/WO PRIM RPR XTRHEPATC

Professional

Both

$7,028.95

Service Code	HCPCS 47711
Min. Negotiated Rate	$5,271.71
Max. Negotiated Rate	$5,271.71
Rate for Payer: Cash Price	$1,871.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,271.71
Rate for Payer: SOMOS Essential	$5,271.71

PR EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX

Professional

Both

$2,354.63

Service Code	HCPCS 42815
Min. Negotiated Rate	$1,765.97
Max. Negotiated Rate	$1,765.97
Rate for Payer: Cash Price	$633.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,765.97
Rate for Payer: SOMOS Essential	$1,765.97

PR EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS

Professional

Both

$1,221.82

Service Code	HCPCS 42810
Min. Negotiated Rate	$916.36
Max. Negotiated Rate	$916.36
Rate for Payer: Cash Price	$334.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$916.36
Rate for Payer: SOMOS Essential	$916.36

PR EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES

Professional

Both

$2,085.62

Service Code	HCPCS 19125
Min. Negotiated Rate	$1,564.22
Max. Negotiated Rate	$1,564.22
Rate for Payer: Cash Price	$559.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,564.22
Rate for Payer: SOMOS Essential	$1,564.22

Know your out-of-pocket cost for care.

All Charges