St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC

Professional

Both

$3,192.53

Service Code	HCPCS 64784
Min. Negotiated Rate	$2,394.40
Max. Negotiated Rate	$2,394.40
Rate for Payer: Cash Price	$861.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,394.40
Rate for Payer: SOMOS Essential	$2,394.40

PR EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS

Professional

Both

$1,595.62

Service Code	HCPCS 41823
Min. Negotiated Rate	$1,196.72
Max. Negotiated Rate	$1,196.72
Rate for Payer: Cash Price	$436.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,196.72
Rate for Payer: SOMOS Essential	$1,196.72

PR EXC PENILE PLAQUE GRAFT &/5 CM LENGTH

Professional

Both

$3,342.01

Service Code	HCPCS 54111
Min. Negotiated Rate	$2,506.51
Max. Negotiated Rate	$2,506.51
Rate for Payer: Cash Price	$914.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,506.51
Rate for Payer: SOMOS Essential	$2,506.51

PR EXC PENILE PLAQUE GRAFT > 5 CM LENGTH

Professional

Both

$3,917.10

Service Code	HCPCS 54112
Min. Negotiated Rate	$2,937.82
Max. Negotiated Rate	$2,937.82
Rate for Payer: Cash Price	$1,071.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,937.82
Rate for Payer: SOMOS Essential	$2,937.82

PR EXC PRESAC/SACROCOCCYGEAL TUMOR

Professional

Both

$9,687.37

Service Code	HCPCS 49215
Min. Negotiated Rate	$7,265.53
Max. Negotiated Rate	$7,265.53
Rate for Payer: Cash Price	$2,636.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,265.53
Rate for Payer: SOMOS Essential	$7,265.53

PR EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR

Professional

Both

$4,569.78

Service Code	HCPCS 42415
Min. Negotiated Rate	$3,427.34
Max. Negotiated Rate	$3,427.34
Rate for Payer: Cash Price	$1,237.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,427.34
Rate for Payer: SOMOS Essential	$3,427.34

PR EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ

Professional

Both

$2,741.80

Service Code	HCPCS 42410
Min. Negotiated Rate	$2,056.35
Max. Negotiated Rate	$2,056.35
Rate for Payer: Cash Price	$741.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,056.35
Rate for Payer: SOMOS Essential	$2,056.35

PR EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR

Professional

Both

$5,117.77

Service Code	HCPCS 42420
Min. Negotiated Rate	$3,838.33
Max. Negotiated Rate	$3,838.33
Rate for Payer: Cash Price	$1,382.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,838.33
Rate for Payer: SOMOS Essential	$3,838.33

PR EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ

Professional

Both

$5,831.21

Service Code	HCPCS 42426
Min. Negotiated Rate	$4,373.41
Max. Negotiated Rate	$4,373.41
Rate for Payer: Cash Price	$1,573.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,373.41
Rate for Payer: SOMOS Essential	$4,373.41

PR EXC RCT PROCIDENTIA W/ANAST ABDL & PRNL APPROACH

Professional

Both

$5,496.44

Service Code	HCPCS 45135
Min. Negotiated Rate	$4,122.33
Max. Negotiated Rate	$4,122.33
Rate for Payer: Cash Price	$1,490.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,122.33
Rate for Payer: SOMOS Essential	$4,122.33

PR EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH

Professional

Both

$4,689.20

Service Code	HCPCS 45130
Min. Negotiated Rate	$3,516.90
Max. Negotiated Rate	$3,516.90
Rate for Payer: Cash Price	$1,263.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,516.90
Rate for Payer: SOMOS Essential	$3,516.90

PR EXC RCT TUM INCL MUSCULARIS PROPRIA

Professional

Both

$3,584.81

Service Code	HCPCS 45172
Min. Negotiated Rate	$2,688.61
Max. Negotiated Rate	$2,688.61
Rate for Payer: Cash Price	$968.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,688.61
Rate for Payer: SOMOS Essential	$2,688.61

PR EXC RCT TUM NOT INCL MUSCULARIS PROPRIA

Professional

Both

$2,710.51

Service Code	HCPCS 45171
Min. Negotiated Rate	$2,032.88
Max. Negotiated Rate	$2,032.88
Rate for Payer: Cash Price	$730.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,032.88
Rate for Payer: SOMOS Essential	$2,032.88

PR EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL

Professional

Both

$4,643.59

Service Code	HCPCS 45160
Min. Negotiated Rate	$3,482.69
Max. Negotiated Rate	$3,482.69
Rate for Payer: Cash Price	$1,239.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,482.69
Rate for Payer: SOMOS Essential	$3,482.69

PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR

Professional

Both

$3,996.34

Service Code	HCPCS 15936
Min. Negotiated Rate	$2,997.26
Max. Negotiated Rate	$2,997.26
Rate for Payer: Cash Price	$1,069.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,997.26
Rate for Payer: SOMOS Essential	$2,997.26

PR EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC

Professional

Both

$4,597.92

Service Code	HCPCS 15937
Min. Negotiated Rate	$3,448.44
Max. Negotiated Rate	$3,448.44
Rate for Payer: Cash Price	$1,228.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,448.44
Rate for Payer: SOMOS Essential	$3,448.44

PR EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY

Professional

Both

$3,878.67

Service Code	HCPCS 15933
Min. Negotiated Rate	$2,909.00
Max. Negotiated Rate	$2,909.00
Rate for Payer: Cash Price	$1,043.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,909.00
Rate for Payer: SOMOS Essential	$2,909.00

PR EXC SACRAL PR ULCER W/SKN FLAP CLSR W/OSTECTOMY

Professional

Both

$5,052.04

Service Code	HCPCS 15935
Min. Negotiated Rate	$3,789.03
Max. Negotiated Rate	$3,789.03
Rate for Payer: Cash Price	$1,362.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,789.03
Rate for Payer: SOMOS Essential	$3,789.03

PR EXC SUBLINGUAL SALIVARY CYST RANULA

Professional

Both

$1,474.27

Service Code	HCPCS 42408
Min. Negotiated Rate	$1,105.70
Max. Negotiated Rate	$1,105.70
Rate for Payer: Cash Price	$402.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,105.70
Rate for Payer: SOMOS Essential	$1,105.70

PR EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA

Professional

Both

$2,373.77

Service Code	HCPCS 25109
Min. Negotiated Rate	$1,780.33
Max. Negotiated Rate	$1,780.33
Rate for Payer: Cash Price	$644.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,780.33
Rate for Payer: SOMOS Essential	$1,780.33

PR EXC THROMBOSED HEMORRHOID XTRNL

Professional

Both

$490.60

Service Code	HCPCS 46320
Min. Negotiated Rate	$367.95
Max. Negotiated Rate	$367.95
Rate for Payer: Cash Price	$134.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$367.95
Rate for Payer: SOMOS Essential	$367.95

PR EXC TRACHEAL STENOSIS&ANAST CERVICOTHORACIC

Professional

Both

$6,177.01

Service Code	HCPCS 31781
Min. Negotiated Rate	$4,632.76
Max. Negotiated Rate	$4,632.76
Rate for Payer: Cash Price	$1,667.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,632.76
Rate for Payer: SOMOS Essential	$4,632.76

PR EXC TRCHNTRIC PR ULCER W/PRIM SUTR W/OSTECTOMY

Professional

Both

$3,931.38

Service Code	HCPCS 15951
Min. Negotiated Rate	$2,948.54
Max. Negotiated Rate	$2,948.54
Rate for Payer: Cash Price	$1,062.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,948.54
Rate for Payer: SOMOS Essential	$2,948.54

PR EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC

Professional

Both

$5,180.32

Service Code	HCPCS 15958
Min. Negotiated Rate	$3,885.24
Max. Negotiated Rate	$3,885.24
Rate for Payer: Cash Price	$1,389.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,885.24
Rate for Payer: SOMOS Essential	$3,885.24

PR EXC TRCHNTRIC PR ULC W/SKN FLAP CLSR W/OSTECTOMY

Professional

Both

$4,415.53

Service Code	HCPCS 15953
Min. Negotiated Rate	$3,311.65
Max. Negotiated Rate	$3,311.65
Rate for Payer: Cash Price	$1,191.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,311.65
Rate for Payer: SOMOS Essential	$3,311.65

Know your out-of-pocket cost for care.

All Charges