St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK

Professional

Both

$1,529.43

Service Code	HCPCS 27630
Min. Negotiated Rate	$1,147.07
Max. Negotiated Rate	$1,147.07
Rate for Payer: Cash Price	$422.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,147.07
Rate for Payer: SOMOS Essential	$1,147.07

PR EXCISION LESION TENDON SHEATH FOREARM&/WRIST

Professional

Both

$1,540.67

Service Code	HCPCS 25110
Min. Negotiated Rate	$1,155.50
Max. Negotiated Rate	$1,155.50
Rate for Payer: Cash Price	$418.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,155.50
Rate for Payer: SOMOS Essential	$1,155.50

PR EXCISION LESION TONGUE W/O CLOSURE

Professional

Both

$561.79

Service Code	HCPCS 41110
Min. Negotiated Rate	$421.34
Max. Negotiated Rate	$421.34
Rate for Payer: Cash Price	$152.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$421.34
Rate for Payer: SOMOS Essential	$421.34

PR EXCISION LINGUAL FRENUM FRENECTOMY

Professional

Both

$631.86

Service Code	HCPCS 41115
Min. Negotiated Rate	$473.90
Max. Negotiated Rate	$473.90
Rate for Payer: Cash Price	$171.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$473.90
Rate for Payer: SOMOS Essential	$473.90

PR EXCISION LOCAL LESION EPIDIDYMIS

Professional

Both

$1,570.73

Service Code	HCPCS 54830
Min. Negotiated Rate	$1,178.05
Max. Negotiated Rate	$1,178.05
Rate for Payer: Cash Price	$431.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,178.05
Rate for Payer: SOMOS Essential	$1,178.05

PR EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<

Professional

Both

$535.57

Service Code	HCPCS 11640
Min. Negotiated Rate	$401.68
Max. Negotiated Rate	$401.68
Rate for Payer: Cash Price	$147.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$401.68
Rate for Payer: SOMOS Essential	$401.68

PR EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM

Professional

Both

$659.05

Service Code	HCPCS 11641
Min. Negotiated Rate	$494.29
Max. Negotiated Rate	$494.29
Rate for Payer: Cash Price	$179.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$494.29
Rate for Payer: SOMOS Essential	$494.29

PR EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM

Professional

Both

$766.61

Service Code	HCPCS 11642
Min. Negotiated Rate	$574.96
Max. Negotiated Rate	$574.96
Rate for Payer: Cash Price	$210.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$574.96
Rate for Payer: SOMOS Essential	$574.96

PR EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM

Professional

Both

$962.75

Service Code	HCPCS 11643
Min. Negotiated Rate	$722.06
Max. Negotiated Rate	$722.06
Rate for Payer: Cash Price	$262.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$722.06
Rate for Payer: SOMOS Essential	$722.06

PR EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM

Professional

Both

$1,199.38

Service Code	HCPCS 11644
Min. Negotiated Rate	$899.54
Max. Negotiated Rate	$899.54
Rate for Payer: Cash Price	$325.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$899.54
Rate for Payer: SOMOS Essential	$899.54

PR EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM

Professional

Both

$1,672.02

Service Code	HCPCS 11646
Min. Negotiated Rate	$1,254.02
Max. Negotiated Rate	$1,254.02
Rate for Payer: Cash Price	$451.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,254.02
Rate for Payer: SOMOS Essential	$1,254.02

PR EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<

Professional

Both

$524.34

Service Code	HCPCS 11620
Min. Negotiated Rate	$393.26
Max. Negotiated Rate	$393.26
Rate for Payer: Cash Price	$143.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$393.26
Rate for Payer: SOMOS Essential	$393.26

PR EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM

Professional

Both

$633.54

Service Code	HCPCS 11621
Min. Negotiated Rate	$475.16
Max. Negotiated Rate	$475.16
Rate for Payer: Cash Price	$172.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$475.16
Rate for Payer: SOMOS Essential	$475.16

PR EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM

Professional

Both

$712.11

Service Code	HCPCS 11622
Min. Negotiated Rate	$534.08
Max. Negotiated Rate	$534.08
Rate for Payer: Cash Price	$195.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$534.08
Rate for Payer: SOMOS Essential	$534.08

PR EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM

Professional

Both

$888.55

Service Code	HCPCS 11623
Min. Negotiated Rate	$666.41
Max. Negotiated Rate	$666.41
Rate for Payer: Cash Price	$241.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$666.41
Rate for Payer: SOMOS Essential	$666.41

PR EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM

Professional

Both

$1,014.13

Service Code	HCPCS 11624
Min. Negotiated Rate	$760.60
Max. Negotiated Rate	$760.60
Rate for Payer: Cash Price	$275.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$760.60
Rate for Payer: SOMOS Essential	$760.60

PR EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM

Professional

Both

$1,256.99

Service Code	HCPCS 11626
Min. Negotiated Rate	$942.74
Max. Negotiated Rate	$942.74
Rate for Payer: Cash Price	$339.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$942.74
Rate for Payer: SOMOS Essential	$942.74

PR EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM

Professional

Both

$1,364.72

Service Code	HCPCS 11606
Min. Negotiated Rate	$1,023.54
Max. Negotiated Rate	$1,023.54
Rate for Payer: Cash Price	$369.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,023.54
Rate for Payer: SOMOS Essential	$1,023.54

PR EXCISION MALIGNANT TUMOR MANDIBLE

Professional

Both

$3,699.33

Service Code	HCPCS 21044
Min. Negotiated Rate	$2,774.50
Max. Negotiated Rate	$2,774.50
Rate for Payer: Cash Price	$1,005.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,774.50
Rate for Payer: SOMOS Essential	$2,774.50

PR EXCISION MALIGNANT TUMOR MANDIBLE RADICAL

Professional

Both

$5,143.95

Service Code	HCPCS 21045
Min. Negotiated Rate	$3,857.96
Max. Negotiated Rate	$3,857.96
Rate for Payer: Cash Price	$1,394.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,857.96
Rate for Payer: SOMOS Essential	$3,857.96

PR EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA

Professional

Both

$4,831.61

Service Code	HCPCS 21034
Min. Negotiated Rate	$3,623.71
Max. Negotiated Rate	$3,623.71
Rate for Payer: Cash Price	$1,307.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,623.71
Rate for Payer: SOMOS Essential	$3,623.71

PR EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<

Professional

Both

$521.68

Service Code	HCPCS 11600
Min. Negotiated Rate	$391.26
Max. Negotiated Rate	$391.26
Rate for Payer: Cash Price	$142.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$391.26
Rate for Payer: SOMOS Essential	$391.26

PR EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM

Professional

Both

$628.11

Service Code	HCPCS 11601
Min. Negotiated Rate	$471.08
Max. Negotiated Rate	$471.08
Rate for Payer: Cash Price	$171.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$471.08
Rate for Payer: SOMOS Essential	$471.08

PR EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM

Professional

Both

$679.04

Service Code	HCPCS 11602
Min. Negotiated Rate	$509.28
Max. Negotiated Rate	$509.28
Rate for Payer: Cash Price	$185.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$509.28
Rate for Payer: SOMOS Essential	$509.28

PR EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM

Professional

Both

$818.41

Service Code	HCPCS 11603
Min. Negotiated Rate	$613.81
Max. Negotiated Rate	$613.81
Rate for Payer: Cash Price	$222.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$613.81
Rate for Payer: SOMOS Essential	$613.81

Know your out-of-pocket cost for care.

All Charges