St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR

Professional

Both

$1,098.41

Service Code	HCPCS 11462
Min. Negotiated Rate	$823.81
Max. Negotiated Rate	$823.81
Rate for Payer: Cash Price	$299.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$823.81
Rate for Payer: SOMOS Essential	$823.81

PR EXCISION H/P/P/U COMPLEX REPAIR

Professional

Both

$1,534.19

Service Code	HCPCS 11471
Min. Negotiated Rate	$1,150.64
Max. Negotiated Rate	$1,150.64
Rate for Payer: Cash Price	$416.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,150.64
Rate for Payer: SOMOS Essential	$1,150.64

PR EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR

Professional

Both

$1,267.32

Service Code	HCPCS 11470
Min. Negotiated Rate	$950.49
Max. Negotiated Rate	$950.49
Rate for Payer: Cash Price	$342.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$950.49
Rate for Payer: SOMOS Essential	$950.49

PR EXCISION HYDROCELE BILATERAL

Professional

Both

$2,154.99

Service Code	HCPCS 55041
Min. Negotiated Rate	$1,616.24
Max. Negotiated Rate	$1,616.24
Rate for Payer: Cash Price	$592.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,616.24
Rate for Payer: SOMOS Essential	$1,616.24

PR EXCISION HYDROCELE UNILATERAL

Professional

Both

$1,428.00

Service Code	HCPCS 55040
Min. Negotiated Rate	$1,071.00
Max. Negotiated Rate	$1,071.00
Rate for Payer: Cash Price	$393.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,071.00
Rate for Payer: SOMOS Essential	$1,071.00

PR EXCISION INFECTED GRAFT ABDOMEN

Professional

Both

$8,455.37

Service Code	HCPCS 35907
Min. Negotiated Rate	$6,341.53
Max. Negotiated Rate	$6,341.53
Rate for Payer: Cash Price	$2,247.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,341.53
Rate for Payer: SOMOS Essential	$6,341.53

PR EXCISION INFECTED GRAFT EXTREMITY

Professional

Both

$2,507.19

Service Code	HCPCS 35903
Min. Negotiated Rate	$1,880.39
Max. Negotiated Rate	$1,880.39
Rate for Payer: Cash Price	$666.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,880.39
Rate for Payer: SOMOS Essential	$1,880.39

PR EXCISION INFECTED GRAFT THORAX

Professional

Both

$7,476.53

Service Code	HCPCS 35905
Min. Negotiated Rate	$5,607.40
Max. Negotiated Rate	$5,607.40
Rate for Payer: Cash Price	$1,979.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,607.40
Rate for Payer: SOMOS Essential	$5,607.40

PR EXCISION INFECTED NECK GRAFT

Professional

Both

$2,115.33

Service Code	HCPCS 35901
Min. Negotiated Rate	$1,586.50
Max. Negotiated Rate	$1,586.50
Rate for Payer: Cash Price	$564.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,586.50
Rate for Payer: SOMOS Essential	$1,586.50

PR EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE

Professional

Both

$1,820.74

Service Code	HCPCS 30130
Min. Negotiated Rate	$1,365.56
Max. Negotiated Rate	$1,365.56
Rate for Payer: Cash Price	$491.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,365.56
Rate for Payer: SOMOS Essential	$1,365.56

PR EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH

Professional

Both

$1,597.82

Service Code	HCPCS 28080
Min. Negotiated Rate	$1,198.36
Max. Negotiated Rate	$1,198.36
Rate for Payer: Cash Price	$441.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,198.36
Rate for Payer: SOMOS Essential	$1,198.36

PR EXCISION ISCHIAL BURSA

Professional

Both

$2,074.38

Service Code	HCPCS 27060
Min. Negotiated Rate	$1,555.78
Max. Negotiated Rate	$1,555.78
Rate for Payer: Cash Price	$563.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,555.78
Rate for Payer: SOMOS Essential	$1,555.78

PR EXCISION LACRIMAL GLAND XCPT TUMOR PRTL

Professional

Both

$4,393.41

Service Code	HCPCS 68505
Min. Negotiated Rate	$3,295.06
Max. Negotiated Rate	$3,295.06
Rate for Payer: Cash Price	$1,205.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,295.06
Rate for Payer: SOMOS Essential	$3,295.06

PR EXCISION LACRIMAL GLAND XCPT TUMOR TOTAL

Professional

Both

$4,413.36

Service Code	HCPCS 68500
Min. Negotiated Rate	$3,310.02
Max. Negotiated Rate	$3,310.02
Rate for Payer: Cash Price	$1,210.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,310.02
Rate for Payer: SOMOS Essential	$3,310.02

PR EXCISION LACRIMAL SAC

Professional

Both

$3,079.02

Service Code	HCPCS 68520
Min. Negotiated Rate	$2,309.26
Max. Negotiated Rate	$2,309.26
Rate for Payer: Cash Price	$842.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,309.26
Rate for Payer: SOMOS Essential	$2,309.26

PR EXCISION LACTIFEROUS DUCT FISTULA

Professional

Both

$1,445.82

Service Code	HCPCS 19112
Min. Negotiated Rate	$1,084.36
Max. Negotiated Rate	$1,084.36
Rate for Payer: Cash Price	$391.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,084.36
Rate for Payer: SOMOS Essential	$1,084.36

PR EXCISION LESION CONJUNCTIVA <1 CM

Professional

Both

$611.24

Service Code	HCPCS 68110
Min. Negotiated Rate	$458.43
Max. Negotiated Rate	$458.43
Rate for Payer: Cash Price	$168.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$458.43
Rate for Payer: SOMOS Essential	$458.43

PR EXCISION LESION CONJUNCTIVA > 1 CM

Professional

Both

$753.45

Service Code	HCPCS 68115
Min. Negotiated Rate	$565.09
Max. Negotiated Rate	$565.09
Rate for Payer: Cash Price	$207.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$565.09
Rate for Payer: SOMOS Essential	$565.09

PR EXCISION LESION CONJUNCTIVA ADJACENT SCLERA

Professional

Both

$1,694.35

Service Code	HCPCS 68130
Min. Negotiated Rate	$1,270.76
Max. Negotiated Rate	$1,270.76
Rate for Payer: Cash Price	$470.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,270.76
Rate for Payer: SOMOS Essential	$1,270.76

PR EXCISION LESION CORNEA XCP PTERYGIUM

Professional

Both

$2,488.12

Service Code	HCPCS 65400
Min. Negotiated Rate	$1,866.09
Max. Negotiated Rate	$1,866.09
Rate for Payer: Cash Price	$685.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,866.09
Rate for Payer: SOMOS Essential	$1,866.09

PR EXCISION LESION FLOOR MOUTH

Professional

Both

$929.04

Service Code	HCPCS 41116
Min. Negotiated Rate	$696.78
Max. Negotiated Rate	$696.78
Rate for Payer: Cash Price	$253.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$696.78
Rate for Payer: SOMOS Essential	$696.78

PR EXCISION LESION MENISCUS/CAPSULE KNEE

Professional

Both

$2,344.02

Service Code	HCPCS 27347
Min. Negotiated Rate	$1,758.02
Max. Negotiated Rate	$1,758.02
Rate for Payer: Cash Price	$635.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,758.02
Rate for Payer: SOMOS Essential	$1,758.02

PR EXCISION LESION MESENTERY SEPARATE PROCEDURE

Professional

Both

$3,855.46

Service Code	HCPCS 44820
Min. Negotiated Rate	$2,891.60
Max. Negotiated Rate	$2,891.60
Rate for Payer: Cash Price	$1,029.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,891.60
Rate for Payer: SOMOS Essential	$2,891.60

PR EXCISION LESION PANCREAS

Professional

Both

$5,047.81

Service Code	HCPCS 48120
Min. Negotiated Rate	$3,785.86
Max. Negotiated Rate	$3,785.86
Rate for Payer: Cash Price	$1,342.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,785.86
Rate for Payer: SOMOS Essential	$3,785.86

PR EXCISION LESION SCLERA

Professional

Both

$2,316.55

Service Code	HCPCS 66130
Min. Negotiated Rate	$1,737.41
Max. Negotiated Rate	$1,737.41
Rate for Payer: Cash Price	$638.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,737.41
Rate for Payer: SOMOS Essential	$1,737.41

Know your out-of-pocket cost for care.

All Charges