St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR EXPLORATION EPIDIDYMIS W/WO BIOPSY

Professional

Both

$1,519.53

Service Code	HCPCS 54865
Min. Negotiated Rate	$1,139.65
Max. Negotiated Rate	$1,139.65
Rate for Payer: Cash Price	$417.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,139.65
Rate for Payer: SOMOS Essential	$1,139.65

PR EXPLORATION N/FLWD SURG LOWER EXTREMITY ARTERY

Professional

Both

$1,846.71

Service Code	HCPCS 35703
Min. Negotiated Rate	$1,385.03
Max. Negotiated Rate	$1,385.03
Rate for Payer: Cash Price	$489.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,385.03
Rate for Payer: SOMOS Essential	$1,385.03

PR EXPLORATION N/FLWD SURG NECK ARTERY

Professional

Both

$1,904.84

Service Code	HCPCS 35701
Min. Negotiated Rate	$1,428.63
Max. Negotiated Rate	$1,428.63
Rate for Payer: Cash Price	$508.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,428.63
Rate for Payer: SOMOS Essential	$1,428.63

PR EXPLORATION N/FLWD SURG UPPER EXTREMITY ARTERY

Professional

Both

$1,818.32

Service Code	HCPCS 35702
Min. Negotiated Rate	$1,363.74
Max. Negotiated Rate	$1,363.74
Rate for Payer: Cash Price	$482.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,363.74
Rate for Payer: SOMOS Essential	$1,363.74

PR EXPLORATION PENETRATING WOUND SPX CHEST

Professional

Both

$945.46

Service Code	HCPCS 20101
Min. Negotiated Rate	$709.10
Max. Negotiated Rate	$709.10
Rate for Payer: Cash Price	$252.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$709.10
Rate for Payer: SOMOS Essential	$709.10

PR EXPLORATION PENETRATING WOUND SPX EXTREMITY

Professional

Both

$1,509.10

Service Code	HCPCS 20103
Min. Negotiated Rate	$1,131.82
Max. Negotiated Rate	$1,131.82
Rate for Payer: Cash Price	$408.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,131.82
Rate for Payer: SOMOS Essential	$1,131.82

PR EXPLORATION PENETRATING WOUND SPX NECK

Professional

Both

$2,648.03

Service Code	HCPCS 20100
Min. Negotiated Rate	$1,986.02
Max. Negotiated Rate	$1,986.02
Rate for Payer: Cash Price	$712.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,986.02
Rate for Payer: SOMOS Essential	$1,986.02

PR EXPLORATION SPINAL FUSION

Professional

Both

$3,776.33

Service Code	HCPCS 22830
Min. Negotiated Rate	$2,832.25
Max. Negotiated Rate	$2,832.25
Rate for Payer: Cash Price	$1,012.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,832.25
Rate for Payer: SOMOS Essential	$2,832.25

PR EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX

Professional

Both

$3,443.79

Service Code	HCPCS 49000
Min. Negotiated Rate	$2,582.84
Max. Negotiated Rate	$2,582.84
Rate for Payer: Cash Price	$920.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,582.84
Rate for Payer: SOMOS Essential	$2,582.84

PR EXPL ORBIT TRANSCRANIAL APPROACH W/RMVL LESION

Professional

Both

$9,741.83

Service Code	HCPCS 61333
Min. Negotiated Rate	$7,306.37
Max. Negotiated Rate	$7,306.37
Rate for Payer: Cash Price	$2,566.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,306.37
Rate for Payer: SOMOS Essential	$7,306.37

PR EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK

Professional

Both

$1,132.88

Service Code	HCPCS 20102
Min. Negotiated Rate	$849.66
Max. Negotiated Rate	$849.66
Rate for Payer: Cash Price	$307.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$849.66
Rate for Payer: SOMOS Essential	$849.66

PR EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD

Professional

Both

$5,421.82

Service Code	HCPCS 35840
Min. Negotiated Rate	$4,066.36
Max. Negotiated Rate	$4,066.36
Rate for Payer: Cash Price	$1,448.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,066.36
Rate for Payer: SOMOS Essential	$4,066.36

PR EXPL PO HEMRRG THROMBOSIS/INFCTJ CH

Professional

Both

$8,911.81

Service Code	HCPCS 35820
Min. Negotiated Rate	$6,683.86
Max. Negotiated Rate	$6,683.86
Rate for Payer: Cash Price	$2,368.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,683.86
Rate for Payer: SOMOS Essential	$6,683.86

PR EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK

Professional

Both

$3,204.39

Service Code	HCPCS 35800
Min. Negotiated Rate	$2,403.29
Max. Negotiated Rate	$2,403.29
Rate for Payer: Cash Price	$860.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,403.29
Rate for Payer: SOMOS Essential	$2,403.29

PR EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR

Professional

Both

$3,733.87

Service Code	HCPCS 35860
Min. Negotiated Rate	$2,800.40
Max. Negotiated Rate	$2,800.40
Rate for Payer: Cash Price	$993.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,800.40
Rate for Payer: SOMOS Essential	$2,800.40

PR EXPL RETROPERITONEUM W/WO BX SPX

Professional

Both

$4,125.14

Service Code	HCPCS 49010
Min. Negotiated Rate	$3,093.86
Max. Negotiated Rate	$3,093.86
Rate for Payer: Cash Price	$1,101.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,093.86
Rate for Payer: SOMOS Essential	$3,093.86

PR EXPL RPR & PRESACRAL DRG RECTAL INJURY

Professional

Both

$5,012.07

Service Code	HCPCS 45562
Min. Negotiated Rate	$3,759.05
Max. Negotiated Rate	$3,759.05
Rate for Payer: Cash Price	$1,408.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,759.05
Rate for Payer: SOMOS Essential	$3,759.05

PR EXPL RPR & PRESACRAL DRG RECTAL INJ W/COLOSTOMY

Professional

Both

$7,493.01

Service Code	HCPCS 45563
Min. Negotiated Rate	$5,619.76
Max. Negotiated Rate	$5,619.76
Rate for Payer: Cash Price	$1,993.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,619.76
Rate for Payer: SOMOS Essential	$5,619.76

PR EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL

Professional

Both

$2,885.44

Service Code	HCPCS 54560
Min. Negotiated Rate	$2,164.08
Max. Negotiated Rate	$2,164.08
Rate for Payer: Cash Price	$789.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,164.08
Rate for Payer: SOMOS Essential	$2,164.08

PR EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA

Professional

Both

$2,065.84

Service Code	HCPCS 54550
Min. Negotiated Rate	$1,549.38
Max. Negotiated Rate	$1,549.38
Rate for Payer: Cash Price	$567.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,549.38
Rate for Payer: SOMOS Essential	$1,549.38

PR EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST

Professional

Both

$1,850.66

Service Code	HCPCS 25248
Min. Negotiated Rate	$1,388.00
Max. Negotiated Rate	$1,388.00
Rate for Payer: Cash Price	$514.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,388.00
Rate for Payer: SOMOS Essential	$1,388.00

PR EXPOS PROSTATE ANY APPROACH INSJ RADIOACT SUBST

Professional

Both

$3,662.40

Service Code	HCPCS 55860
Min. Negotiated Rate	$2,746.80
Max. Negotiated Rate	$2,746.80
Rate for Payer: Cash Price	$999.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,746.80
Rate for Payer: SOMOS Essential	$2,746.80

PR EXPOS PROSTATE INSJ RADIOAC SBST W/BI PELV LYMPH

Professional

Both

$5,562.62

Service Code	HCPCS 55865
Min. Negotiated Rate	$4,171.96
Max. Negotiated Rate	$4,171.96
Rate for Payer: Cash Price	$1,519.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,171.96
Rate for Payer: SOMOS Essential	$4,171.96

PR EXPOS PROSTATE INSJ RADIOACT SBST W/LYMPH BX

Professional

Both

$4,576.85

Service Code	HCPCS 55862
Min. Negotiated Rate	$3,432.64
Max. Negotiated Rate	$3,432.64
Rate for Payer: Cash Price	$1,248.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,432.64
Rate for Payer: SOMOS Essential	$3,432.64

PR EXPRESSION CONJUNCTIVAL FOLLICLES

Professional

Both

$189.28

Service Code	HCPCS 68040
Min. Negotiated Rate	$141.96
Max. Negotiated Rate	$141.96
Rate for Payer: Cash Price	$52.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$141.96
Rate for Payer: SOMOS Essential	$141.96

Know your out-of-pocket cost for care.

All Charges