St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR EXCISION AURAL POLYP

Professional

Both

$567.91

Service Code	HCPCS 69540
Min. Negotiated Rate	$425.93
Max. Negotiated Rate	$425.93
Rate for Payer: Cash Price	$154.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$425.93
Rate for Payer: SOMOS Essential	$425.93

PR EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT

Professional

Both

$1,533.91

Service Code	HCPCS 21040
Min. Negotiated Rate	$1,150.43
Max. Negotiated Rate	$1,150.43
Rate for Payer: Cash Price	$416.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,150.43
Rate for Payer: SOMOS Essential	$1,150.43

PR EXCISION BONE CYST/BENIGN TUMOR DEEP

Professional

Both

$3,642.24

Service Code	HCPCS 27066
Min. Negotiated Rate	$2,731.68
Max. Negotiated Rate	$2,731.68
Rate for Payer: Cash Price	$976.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,731.68
Rate for Payer: SOMOS Essential	$2,731.68

PR EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL

Professional

Both

$2,348.54

Service Code	HCPCS 27065
Min. Negotiated Rate	$1,761.40
Max. Negotiated Rate	$1,761.40
Rate for Payer: Cash Price	$629.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,761.40
Rate for Payer: SOMOS Essential	$1,761.40

PR EXCISION BONE MANDIBLE

Professional

Both

$2,778.62

Service Code	HCPCS 21025
Min. Negotiated Rate	$2,083.96
Max. Negotiated Rate	$2,083.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,083.96
Rate for Payer: SOMOS Essential	$2,083.96

PR EXCISION CERVICAL STUMP ABDOMINAL APPROACH

Professional

Both

$3,458.32

Service Code	HCPCS 57540
Min. Negotiated Rate	$2,593.74
Max. Negotiated Rate	$2,593.74
Rate for Payer: Cash Price	$931.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,593.74
Rate for Payer: SOMOS Essential	$2,593.74

PR EXCISION CERVICAL STUMP VAGINAL APPROACH

Professional

Both

$1,892.00

Service Code	HCPCS 57550
Min. Negotiated Rate	$1,419.00
Max. Negotiated Rate	$1,419.00
Rate for Payer: Cash Price	$512.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,419.00
Rate for Payer: SOMOS Essential	$1,419.00

PR EXCISION CHALAZION MULTIPLE DIFFERENT LIDS

Professional

Both

$674.24

Service Code	HCPCS 67805
Min. Negotiated Rate	$505.68
Max. Negotiated Rate	$505.68
Rate for Payer: Cash Price	$184.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$505.68
Rate for Payer: SOMOS Essential	$505.68

PR EXCISION CHALAZION MULTIPLE SAME LID

Professional

Both

$545.93

Service Code	HCPCS 67801
Min. Negotiated Rate	$409.45
Max. Negotiated Rate	$409.45
Rate for Payer: Cash Price	$148.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$409.45
Rate for Payer: SOMOS Essential	$409.45

PR EXCISION CHALAZION SINGLE

Professional

Both

$420.88

Service Code	HCPCS 67800
Min. Negotiated Rate	$315.66
Max. Negotiated Rate	$315.66
Rate for Payer: Cash Price	$115.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$315.66
Rate for Payer: SOMOS Essential	$315.66

PR EXCISION CHEST WALL TUMOR INCLUDING RIBS

Professional

Both

$5,127.01

Service Code	HCPCS 21601
Min. Negotiated Rate	$3,845.26
Max. Negotiated Rate	$3,845.26
Rate for Payer: Cash Price	$1,379.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,845.26
Rate for Payer: SOMOS Essential	$3,845.26

PR EXCISION CHOLEDOCHAL CYST

Professional

Both

$6,021.09

Service Code	HCPCS 47715
Min. Negotiated Rate	$4,515.82
Max. Negotiated Rate	$4,515.82
Rate for Payer: Cash Price	$1,604.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,515.82
Rate for Payer: SOMOS Essential	$4,515.82

PR EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC

Professional

Both

$7,517.44

Service Code	HCPCS 21603
Min. Negotiated Rate	$5,638.08
Max. Negotiated Rate	$5,638.08
Rate for Payer: Cash Price	$2,009.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,638.08
Rate for Payer: SOMOS Essential	$5,638.08

PR EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC

Professional

Both

$6,877.43

Service Code	HCPCS 21602
Min. Negotiated Rate	$5,158.07
Max. Negotiated Rate	$5,158.07
Rate for Payer: Cash Price	$1,830.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,158.07
Rate for Payer: SOMOS Essential	$5,158.07

PR EXCISION COARCTATION AORTA W/WO PDA W/GRAFT

Professional

Both

$5,946.29

Service Code	HCPCS 33845
Min. Negotiated Rate	$4,459.72
Max. Negotiated Rate	$4,459.72
Rate for Payer: Cash Price	$1,585.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,459.72
Rate for Payer: SOMOS Essential	$4,459.72

PR EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA

Professional

Both

$2,536.35

Service Code	HCPCS 27635
Min. Negotiated Rate	$1,902.26
Max. Negotiated Rate	$1,902.26
Rate for Payer: Cash Price	$689.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,902.26
Rate for Payer: SOMOS Essential	$1,902.26

PR EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES

Professional

Both

$1,997.63

Service Code	HCPCS 25130
Min. Negotiated Rate	$1,498.22
Max. Negotiated Rate	$1,498.22
Rate for Payer: Cash Price	$544.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,498.22
Rate for Payer: SOMOS Essential	$1,498.22

PR EXCISION/CURETTAGE CYST/TUMOR FEMUR

Professional

Both

$2,703.33

Service Code	HCPCS 27355
Min. Negotiated Rate	$2,027.50
Max. Negotiated Rate	$2,027.50
Rate for Payer: Cash Price	$731.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,027.50
Rate for Payer: SOMOS Essential	$2,027.50

PR EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION

Professional

Both

$1,206.00

Service Code	HCPCS 27358
Min. Negotiated Rate	$904.50
Max. Negotiated Rate	$904.50
Rate for Payer: Cash Price	$322.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$904.50
Rate for Payer: SOMOS Essential	$904.50

PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT

Professional

Both

$3,286.89

Service Code	HCPCS 27356
Min. Negotiated Rate	$2,465.17
Max. Negotiated Rate	$2,465.17
Rate for Payer: Cash Price	$889.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,465.17
Rate for Payer: SOMOS Essential	$2,465.17

PR EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT

Professional

Both

$3,633.46

Service Code	HCPCS 27357
Min. Negotiated Rate	$2,725.10
Max. Negotiated Rate	$2,725.10
Rate for Payer: Cash Price	$980.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,725.10
Rate for Payer: SOMOS Essential	$2,725.10

PR EXCISION/CURETTAGE CYST/TUMOR METACARPAL

Professional

Both

$2,003.93

Service Code	HCPCS 26200
Min. Negotiated Rate	$1,502.95
Max. Negotiated Rate	$1,502.95
Rate for Payer: Cash Price	$543.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,502.95
Rate for Payer: SOMOS Essential	$1,502.95

PR EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER

Professional

Both

$1,985.41

Service Code	HCPCS 26210
Min. Negotiated Rate	$1,489.06
Max. Negotiated Rate	$1,489.06
Rate for Payer: Cash Price	$541.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,489.06
Rate for Payer: SOMOS Essential	$1,489.06

PR EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA

Professional

Both

$2,226.56

Service Code	HCPCS 25120
Min. Negotiated Rate	$1,669.92
Max. Negotiated Rate	$1,669.92
Rate for Payer: Cash Price	$605.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,669.92
Rate for Payer: SOMOS Essential	$1,669.92

PR EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS

Professional

Both

$1,805.13

Service Code	HCPCS 28100
Min. Negotiated Rate	$1,353.85
Max. Negotiated Rate	$1,353.85
Rate for Payer: Cash Price	$491.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,353.85
Rate for Payer: SOMOS Essential	$1,353.85

Know your out-of-pocket cost for care.

All Charges