St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD

Professional

Both

$1,131.27

Service Code	HCPCS 41113
Min. Negotiated Rate	$848.45
Max. Negotiated Rate	$848.45
Rate for Payer: Cash Price	$306.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$848.45
Rate for Payer: SOMOS Essential	$848.45

PR EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP

Professional

Both

$2,682.82

Service Code	HCPCS 41114
Min. Negotiated Rate	$2,012.12
Max. Negotiated Rate	$2,012.12
Rate for Payer: Cash Price	$726.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,012.12
Rate for Payer: SOMOS Essential	$2,012.12

PR EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR

Professional

Both

$1,218.49

Service Code	HCPCS 41827
Min. Negotiated Rate	$913.87
Max. Negotiated Rate	$913.87
Rate for Payer: Cash Price	$333.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$913.87
Rate for Payer: SOMOS Essential	$913.87

PR EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR

Professional

Both

$517.79

Service Code	HCPCS 41825
Min. Negotiated Rate	$388.34
Max. Negotiated Rate	$388.34
Rate for Payer: Cash Price	$141.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$388.34
Rate for Payer: SOMOS Essential	$388.34

PR EXC LESION/TUMOR DENTOALVEOLAR STRUX W/SMPL RPR

Professional

Both

$836.01

Service Code	HCPCS 41826
Min. Negotiated Rate	$627.01
Max. Negotiated Rate	$627.01
Rate for Payer: Cash Price	$225.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$627.01
Rate for Payer: SOMOS Essential	$627.01

PR EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR

Professional

Both

$528.64

Service Code	HCPCS 40810
Min. Negotiated Rate	$396.48
Max. Negotiated Rate	$396.48
Rate for Payer: Cash Price	$143.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$396.48
Rate for Payer: SOMOS Essential	$396.48

PR EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP

Professional

Both

$2,711.56

Service Code	HCPCS 40527
Min. Negotiated Rate	$2,033.67
Max. Negotiated Rate	$2,033.67
Rate for Payer: Cash Price	$737.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,033.67
Rate for Payer: SOMOS Essential	$2,033.67

PR EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP

Professional

Both

$2,392.08

Service Code	HCPCS 40525
Min. Negotiated Rate	$1,794.06
Max. Negotiated Rate	$1,794.06
Rate for Payer: Cash Price	$649.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,794.06
Rate for Payer: SOMOS Essential	$1,794.06

PR EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR

Professional

Both

$1,498.84

Service Code	HCPCS 40510
Min. Negotiated Rate	$1,124.13
Max. Negotiated Rate	$1,124.13
Rate for Payer: Cash Price	$409.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,124.13
Rate for Payer: SOMOS Essential	$1,124.13

PR EXC LIP V-EXC W/PRIM DIR LINR CLSR

Professional

Both

$1,550.19

Service Code	HCPCS 40520
Min. Negotiated Rate	$1,162.64
Max. Negotiated Rate	$1,162.64
Rate for Payer: Cash Price	$419.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,162.64
Rate for Payer: SOMOS Essential	$1,162.64

PR EXC LOCAL MALIGNANT TUMOR STOMACH

Professional

Both

$5,519.64

Service Code	HCPCS 43611
Min. Negotiated Rate	$4,139.73
Max. Negotiated Rate	$4,139.73
Rate for Payer: Cash Price	$1,476.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,139.73
Rate for Payer: SOMOS Essential	$4,139.73

PR EXC LOCAL ULCER/BENIGN TUMOR STOMACH

Professional

Both

$4,415.50

Service Code	HCPCS 43610
Min. Negotiated Rate	$3,311.62
Max. Negotiated Rate	$3,311.62
Rate for Payer: Cash Price	$1,174.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,311.62
Rate for Payer: SOMOS Essential	$3,311.62

PR EXCLUSION LAA OPEN TM STRNT/THRCM ANY METHOD

Professional

Both

$575.61

Service Code	HCPCS 33268
Min. Negotiated Rate	$431.71
Max. Negotiated Rate	$431.71
Rate for Payer: Cash Price	$151.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$431.71
Rate for Payer: SOMOS Essential	$431.71

PR EXCLUSION L ATR APPENDAGE THORACOSCOPIC ANY METH

Professional

Both

$3,639.06

Service Code	HCPCS 33269
Min. Negotiated Rate	$2,729.30
Max. Negotiated Rate	$2,729.30
Rate for Payer: Cash Price	$979.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,729.30
Rate for Payer: SOMOS Essential	$2,729.30

PR EXCLUSION LEFT ATRIAL APPENDAGE OPEN ANY METHOD

Professional

Both

$4,606.35

Service Code	HCPCS 33267
Min. Negotiated Rate	$3,454.76
Max. Negotiated Rate	$3,454.76
Rate for Payer: Cash Price	$1,229.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,454.76
Rate for Payer: SOMOS Essential	$3,454.76

PR EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS

Professional

Both

$4,320.30

Service Code	HCPCS 44700
Min. Negotiated Rate	$3,240.22
Max. Negotiated Rate	$3,240.22
Rate for Payer: Cash Price	$1,170.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,240.22
Rate for Payer: SOMOS Essential	$3,240.22

PR EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT

Professional

Both

$3,475.54

Service Code	HCPCS 44800
Min. Negotiated Rate	$2,606.66
Max. Negotiated Rate	$2,606.66
Rate for Payer: Cash Price	$934.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,606.66
Rate for Payer: SOMOS Essential	$2,606.66

PR EXC MUCOSA VESTIBULE MOUTH AS DON GRF

Professional

Both

$1,140.37

Service Code	HCPCS 40818
Min. Negotiated Rate	$855.28
Max. Negotiated Rate	$855.28
Rate for Payer: Cash Price	$309.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$855.28
Rate for Payer: SOMOS Essential	$855.28

PR EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV

Professional

Both

$1,791.58

Service Code	HCPCS 64788
Min. Negotiated Rate	$1,343.68
Max. Negotiated Rate	$1,343.68
Rate for Payer: Cash Price	$490.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,343.68
Rate for Payer: SOMOS Essential	$1,343.68

PR EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV

Professional

Both

$4,796.19

Service Code	HCPCS 64792
Min. Negotiated Rate	$3,597.14
Max. Negotiated Rate	$3,597.14
Rate for Payer: Cash Price	$1,302.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,597.14
Rate for Payer: SOMOS Essential	$3,597.14

PR EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV

Professional

Both

$3,837.16

Service Code	HCPCS 64790
Min. Negotiated Rate	$2,877.87
Max. Negotiated Rate	$2,877.87
Rate for Payer: Cash Price	$1,032.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,877.87
Rate for Payer: SOMOS Essential	$2,877.87

PR EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE

Professional

Both

$1,882.58

Service Code	HCPCS 64774
Min. Negotiated Rate	$1,411.94
Max. Negotiated Rate	$1,411.94
Rate for Payer: Cash Price	$512.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,411.94
Rate for Payer: SOMOS Essential	$1,411.94

PR EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT

Professional

Both

$1,731.35

Service Code	HCPCS 64776
Min. Negotiated Rate	$1,298.51
Max. Negotiated Rate	$1,298.51
Rate for Payer: Cash Price	$480.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,298.51
Rate for Payer: SOMOS Essential	$1,298.51

PR EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT

Professional

Both

$945.88

Service Code	HCPCS 64783
Min. Negotiated Rate	$709.41
Max. Negotiated Rate	$709.41
Rate for Payer: Cash Price	$251.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$709.41
Rate for Payer: SOMOS Essential	$709.41

PR EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE

Professional

Both

$1,955.91

Service Code	HCPCS 64782
Min. Negotiated Rate	$1,466.93
Max. Negotiated Rate	$1,466.93
Rate for Payer: Cash Price	$534.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,466.93
Rate for Payer: SOMOS Essential	$1,466.93

Know your out-of-pocket cost for care.

All Charges