St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM

Professional

Both

$904.40

Service Code	HCPCS 11604
Min. Negotiated Rate	$678.30
Max. Negotiated Rate	$678.30
Rate for Payer: Cash Price	$245.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$678.30
Rate for Payer: SOMOS Essential	$678.30

PR EXCISION MAXILLARY TORUS PALATINUS

Professional

Both

$1,097.85

Service Code	HCPCS 21032
Min. Negotiated Rate	$823.39
Max. Negotiated Rate	$823.39
Rate for Payer: Cash Price	$301.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$823.39
Rate for Payer: SOMOS Essential	$823.39

PR EXCISION MULLERIAN DUCT CYST

Professional

Both

$1,462.72

Service Code	HCPCS 55680
Min. Negotiated Rate	$1,097.04
Max. Negotiated Rate	$1,097.04
Rate for Payer: Cash Price	$402.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,097.04
Rate for Payer: SOMOS Essential	$1,097.04

PR EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS

Professional

Both

$753.31

Service Code	HCPCS 46230
Min. Negotiated Rate	$564.98
Max. Negotiated Rate	$564.98
Rate for Payer: Cash Price	$205.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$564.98
Rate for Payer: SOMOS Essential	$564.98

PR EXCISION NAIL MATRIX PERMANENT REMOVAL

Professional

Both

$416.15

Service Code	HCPCS 11750
Min. Negotiated Rate	$312.11
Max. Negotiated Rate	$312.11
Rate for Payer: Cash Price	$116.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$312.11
Rate for Payer: SOMOS Essential	$312.11

PR EXCISION NASAL POLYP EXTENSIVE

Professional

Both

$2,043.51

Service Code	HCPCS 30115
Min. Negotiated Rate	$1,532.63
Max. Negotiated Rate	$1,532.63
Rate for Payer: Cash Price	$549.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,532.63
Rate for Payer: SOMOS Essential	$1,532.63

PR EXCISION NASAL POLYP SIMPLE

Professional

Both

$570.92

Service Code	HCPCS 30110
Min. Negotiated Rate	$428.19
Max. Negotiated Rate	$428.19
Rate for Payer: Cash Price	$156.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$428.19
Rate for Payer: SOMOS Essential	$428.19

PR EXCISION NEUROMA DIGITAL NRV EA ADDL DIGIT

Professional

Both

$796.08

Service Code	HCPCS 64778
Min. Negotiated Rate	$597.06
Max. Negotiated Rate	$597.06
Rate for Payer: Cash Price	$211.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$597.06
Rate for Payer: SOMOS Essential	$597.06

PR EXCISION NEUROMA SCIATIC NERVE

Professional

Both

$4,553.33

Service Code	HCPCS 64786
Min. Negotiated Rate	$3,415.00
Max. Negotiated Rate	$3,415.00
Rate for Payer: Cash Price	$1,214.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,415.00
Rate for Payer: SOMOS Essential	$3,415.00

PR EXCISION OF BULBOURETHRAL GLAND

Professional

Both

$1,669.71

Service Code	HCPCS 53250
Min. Negotiated Rate	$1,252.28
Max. Negotiated Rate	$1,252.28
Rate for Payer: Cash Price	$457.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,252.28
Rate for Payer: SOMOS Essential	$1,252.28

PR EXCISION OF PENILE PLAQUE

Professional

Both

$2,616.22

Service Code	HCPCS 54110
Min. Negotiated Rate	$1,962.16
Max. Negotiated Rate	$1,962.16
Rate for Payer: Cash Price	$717.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,962.16
Rate for Payer: SOMOS Essential	$1,962.16

PR EXCISION OLECRANON BURSA

Professional

Both

$1,601.67

Service Code	HCPCS 24105
Min. Negotiated Rate	$1,201.25
Max. Negotiated Rate	$1,201.25
Rate for Payer: Cash Price	$437.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,201.25
Rate for Payer: SOMOS Essential	$1,201.25

PR EXCISION OR FULGURATION SKENES GLANDS

Professional

Both

$776.27

Service Code	HCPCS 53270
Min. Negotiated Rate	$582.20
Max. Negotiated Rate	$582.20
Rate for Payer: Cash Price	$213.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$582.20
Rate for Payer: SOMOS Essential	$582.20

PR EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL

Professional

Both

$3,638.25

Service Code	HCPCS 42425
Min. Negotiated Rate	$2,728.69
Max. Negotiated Rate	$2,728.69
Rate for Payer: Cash Price	$982.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,728.69
Rate for Payer: SOMOS Essential	$2,728.69

PR EXCISION PERINEPHRIC CYST

Professional

Both

$3,759.77

Service Code	HCPCS 50290
Min. Negotiated Rate	$2,819.83
Max. Negotiated Rate	$2,819.83
Rate for Payer: Cash Price	$1,028.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,819.83
Rate for Payer: SOMOS Essential	$2,819.83

PR EXCISION PILONIDAL CYST/SINUS COMPLICATED

Professional

Both

$2,571.49

Service Code	HCPCS 11772
Min. Negotiated Rate	$1,928.62
Max. Negotiated Rate	$1,928.62
Rate for Payer: Cash Price	$694.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,928.62
Rate for Payer: SOMOS Essential	$1,928.62

PR EXCISION PILONIDAL CYST/SINUS EXTENSIVE

Professional

Both

$2,004.28

Service Code	HCPCS 11771
Min. Negotiated Rate	$1,503.21
Max. Negotiated Rate	$1,503.21
Rate for Payer: Cash Price	$540.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,503.21
Rate for Payer: SOMOS Essential	$1,503.21

PR EXCISION PILONIDAL CYST/SINUS SIMPLE

Professional

Both

$825.23

Service Code	HCPCS 11770
Min. Negotiated Rate	$618.92
Max. Negotiated Rate	$618.92
Rate for Payer: Cash Price	$222.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$618.92
Rate for Payer: SOMOS Essential	$618.92

PR EXCISION PREPATELLAR BURSA

Professional

Both

$1,666.32

Service Code	HCPCS 27340
Min. Negotiated Rate	$1,249.74
Max. Negotiated Rate	$1,249.74
Rate for Payer: Cash Price	$455.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,249.74
Rate for Payer: SOMOS Essential	$1,249.74

PR EXCISION RADIAL HEAD

Professional

Both

$2,278.99

Service Code	HCPCS 24130
Min. Negotiated Rate	$1,709.24
Max. Negotiated Rate	$1,709.24
Rate for Payer: Cash Price	$615.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,709.24
Rate for Payer: SOMOS Essential	$1,709.24

PR EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN

Professional

Both

$1,868.93

Service Code	HCPCS 67961
Min. Negotiated Rate	$1,401.70
Max. Negotiated Rate	$1,401.70
Rate for Payer: Cash Price	$515.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,401.70
Rate for Payer: SOMOS Essential	$1,401.70

PR EXCISION & REPAIR EYELID ONE-FOURTH LID MARGIN

Professional

Both

$2,690.28

Service Code	HCPCS 67966
Min. Negotiated Rate	$2,017.71
Max. Negotiated Rate	$2,017.71
Rate for Payer: Cash Price	$740.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,017.71
Rate for Payer: SOMOS Essential	$2,017.71

PR EXCISION RIB PARTIAL

Professional

Both

$2,515.63

Service Code	HCPCS 21600
Min. Negotiated Rate	$1,886.72
Max. Negotiated Rate	$1,886.72
Rate for Payer: Cash Price	$682.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,886.72
Rate for Payer: SOMOS Essential	$1,886.72

PR EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE

Professional

Both

$3,160.61

Service Code	HCPCS 15931
Min. Negotiated Rate	$2,370.46
Max. Negotiated Rate	$2,370.46
Rate for Payer: Cash Price	$845.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,370.46
Rate for Payer: SOMOS Essential	$2,370.46

PR EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR

Professional

Both

$4,199.79

Service Code	HCPCS 15934
Min. Negotiated Rate	$3,149.84
Max. Negotiated Rate	$3,149.84
Rate for Payer: Cash Price	$1,162.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,149.84
Rate for Payer: SOMOS Essential	$3,149.84

Know your out-of-pocket cost for care.

All Charges