St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR HEMIARTHROPLASTY HIP PARTIAL

Professional

Both

$4,992.23

Service Code	HCPCS 27125
Min. Negotiated Rate	$3,744.17
Max. Negotiated Rate	$3,744.17
Rate for Payer: Cash Price	$1,346.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,744.17
Rate for Payer: SOMOS Essential	$3,744.17

PR HEMICORTICAL INTERCALARY ALLOGRAFT PARTIAL

Professional

Both

$3,046.12

Service Code	HCPCS 20933
Min. Negotiated Rate	$2,284.59
Max. Negotiated Rate	$2,284.59
Rate for Payer: Cash Price	$812.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,284.59
Rate for Payer: SOMOS Essential	$2,284.59

PR HEMIEPIPHYSEAL ARREST

Professional

Both

$2,986.80

Service Code	HCPCS 24470
Min. Negotiated Rate	$2,240.10
Max. Negotiated Rate	$2,240.10
Rate for Payer: Cash Price	$809.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,240.10
Rate for Payer: SOMOS Essential	$2,240.10

PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE

Professional

Both

$1,114.89

Service Code	HCPCS 28160
Min. Negotiated Rate	$836.17
Max. Negotiated Rate	$836.17
Rate for Payer: Cash Price	$309.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$836.17
Rate for Payer: SOMOS Essential	$836.17

PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION

Professional

Both

$288.93

Service Code	HCPCS 90935
Min. Negotiated Rate	$216.70
Max. Negotiated Rate	$216.70
Rate for Payer: Cash Price	$78.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$216.70
Rate for Payer: SOMOS Essential	$216.70

PR HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX

Professional

Both

$407.79

Service Code	HCPCS 90937
Min. Negotiated Rate	$305.84
Max. Negotiated Rate	$305.84
Rate for Payer: Cash Price	$112.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$305.84
Rate for Payer: SOMOS Essential	$305.84

PR HEMOPERFUSION

Professional

Both

$352.56

Service Code	HCPCS 90997
Min. Negotiated Rate	$264.42
Max. Negotiated Rate	$264.42
Rate for Payer: Cash Price	$96.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$264.42
Rate for Payer: SOMOS Essential	$264.42

PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS

Professional

Both

$831.22

Service Code	HCPCS 46221
Min. Negotiated Rate	$623.42
Max. Negotiated Rate	$623.42
Rate for Payer: Cash Price	$225.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$623.42
Rate for Payer: SOMOS Essential	$623.42

PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO

Professional

Both

$2,125.80

Service Code	HCPCS 46260
Min. Negotiated Rate	$1,594.35
Max. Negotiated Rate	$1,594.35
Rate for Payer: Cash Price	$573.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,594.35
Rate for Payer: SOMOS Essential	$1,594.35

PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP

Professional

Both

$1,560.23

Service Code	HCPCS 46255
Min. Negotiated Rate	$1,170.17
Max. Negotiated Rate	$1,170.17
Rate for Payer: Cash Price	$420.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,170.17
Rate for Payer: SOMOS Essential	$1,170.17

PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP

Professional

Both

$1,401.09

Service Code	HCPCS 46250
Min. Negotiated Rate	$1,050.82
Max. Negotiated Rate	$1,050.82
Rate for Payer: Cash Price	$378.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,050.82
Rate for Payer: SOMOS Essential	$1,050.82

PR HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO

Professional

Both

$1,786.26

Service Code	HCPCS 46257
Min. Negotiated Rate	$1,339.70
Max. Negotiated Rate	$1,339.70
Rate for Payer: Cash Price	$487.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,339.70
Rate for Payer: SOMOS Essential	$1,339.70

PR HEMORRHOIDOPEXY STAPLING

Professional

Both

$1,729.04

Service Code	HCPCS 46947
Min. Negotiated Rate	$1,296.78
Max. Negotiated Rate	$1,296.78
Rate for Payer: Cash Price	$466.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,296.78
Rate for Payer: SOMOS Essential	$1,296.78

PR HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1

Professional

Both

$9,723.32

Service Code	HCPCS 47400
Min. Negotiated Rate	$7,292.49
Max. Negotiated Rate	$7,292.49
Rate for Payer: Cash Price	$2,585.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,292.49
Rate for Payer: SOMOS Essential	$7,292.49

PR HEPATECTOMY RESCJ PARTIAL LOBECTOMY

Professional

Both

$10,512.08

Service Code	HCPCS 47120
Min. Negotiated Rate	$7,884.06
Max. Negotiated Rate	$7,884.06
Rate for Payer: Cash Price	$2,799.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,884.06
Rate for Payer: SOMOS Essential	$7,884.06

PR HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY

Professional

Both

$13,863.08

Service Code	HCPCS 47125
Min. Negotiated Rate	$10,397.31
Max. Negotiated Rate	$10,397.31
Rate for Payer: Cash Price	$3,687.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,397.31
Rate for Payer: SOMOS Essential	$10,397.31

PR HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY

Professional

Both

$14,892.08

Service Code	HCPCS 47130
Min. Negotiated Rate	$11,169.06
Max. Negotiated Rate	$11,169.06
Rate for Payer: Cash Price	$3,957.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$11,169.06
Rate for Payer: SOMOS Essential	$11,169.06

PR HEPATECTOMY RESCJ TRISEGMENTECTOMY

Professional

Both

$15,391.67

Service Code	HCPCS 47122
Min. Negotiated Rate	$11,543.75
Max. Negotiated Rate	$11,543.75
Rate for Payer: Cash Price	$4,087.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$11,543.75
Rate for Payer: SOMOS Essential	$11,543.75

PR HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM

Professional

Both

$364.88

Service Code	HCPCS 90636
Min. Negotiated Rate	$273.66
Max. Negotiated Rate	$273.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$273.66
Rate for Payer: SOMOS Essential	$273.66

PR HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES

Professional

Both

$5,462.38

Service Code	HCPCS 47010
Min. Negotiated Rate	$4,096.78
Max. Negotiated Rate	$4,096.78
Rate for Payer: Cash Price	$1,458.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,096.78
Rate for Payer: SOMOS Essential	$4,096.78

PR HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE

Professional

Both

$97.79

Service Code	HCPCS 90633
Min. Negotiated Rate	$73.34
Max. Negotiated Rate	$73.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$73.34
Rate for Payer: SOMOS Essential	$73.34

PR HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE

Professional

Both

$241.99

Service Code	HCPCS 90632
Min. Negotiated Rate	$181.49
Max. Negotiated Rate	$181.49
Rate for Payer: Cash Price	$70.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$181.49
Rate for Payer: SOMOS Essential	$181.49

PR HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM

Professional

Both

$160.25

Service Code	HCPCS 90743
Min. Negotiated Rate	$120.19
Max. Negotiated Rate	$120.19
Rate for Payer: Cash Price	$75.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$120.19
Rate for Payer: SOMOS Essential	$120.19

PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE

Professional

Both

$162.86

Service Code	HCPCS 90746
Min. Negotiated Rate	$122.14
Max. Negotiated Rate	$122.14
Rate for Payer: Cash Price	$70.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$122.14
Rate for Payer: SOMOS Essential	$122.14

PR HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM

Professional

Both

$100.00

Service Code	HCPCS 90747
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Cash Price	$140.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$75.00
Rate for Payer: SOMOS Essential	$75.00

Know your out-of-pocket cost for care.

All Charges