St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW

Professional

Both

$2,274.41

Service Code	HCPCS 23935
Min. Negotiated Rate	$1,705.81
Max. Negotiated Rate	$1,705.81
Rate for Payer: Cash Price	$619.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,705.81
Rate for Payer: SOMOS Essential	$1,705.81

PR INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE

Professional

Both

$2,833.22

Service Code	HCPCS 27303
Min. Negotiated Rate	$2,124.92
Max. Negotiated Rate	$2,124.92
Rate for Payer: Cash Price	$770.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,124.92
Rate for Payer: SOMOS Essential	$2,124.92

PR INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT

Professional

Both

$607.39

Service Code	HCPCS 62148
Min. Negotiated Rate	$455.54
Max. Negotiated Rate	$455.54
Rate for Payer: Cash Price	$158.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$455.54
Rate for Payer: SOMOS Essential	$455.54

PR INCISIONAL BIOPSY EYELID SKIN & LID MARGIN

Professional

Both

$281.40

Service Code	HCPCS 67810
Min. Negotiated Rate	$211.05
Max. Negotiated Rate	$211.05
Rate for Payer: Cash Price	$76.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$211.05
Rate for Payer: SOMOS Essential	$211.05

PR INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION

Professional

Both

$129.92

Service Code	HCPCS 11107
Min. Negotiated Rate	$97.44
Max. Negotiated Rate	$97.44
Rate for Payer: Cash Price	$35.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$97.44
Rate for Payer: SOMOS Essential	$97.44

PR INCISIONAL BIOPSY SKIN SINGLE LESION

Professional

Both

$236.95

Service Code	HCPCS 11106
Min. Negotiated Rate	$177.71
Max. Negotiated Rate	$177.71
Rate for Payer: Cash Price	$64.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$177.71
Rate for Payer: SOMOS Essential	$177.71

PR INCISION ANAL SEPTUM INFANT

Professional

Both

$1,217.90

Service Code	HCPCS 46070
Min. Negotiated Rate	$913.42
Max. Negotiated Rate	$913.42
Rate for Payer: Cash Price	$327.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$913.42
Rate for Payer: SOMOS Essential	$913.42

PR INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN

Professional

Both

$3,558.66

Service Code	HCPCS 44900
Min. Negotiated Rate	$2,669.00
Max. Negotiated Rate	$2,669.00
Rate for Payer: Cash Price	$947.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,669.00
Rate for Payer: SOMOS Essential	$2,669.00

PR INCISION BONE CORTEX FOOT

Professional

Both

$2,384.80

Service Code	HCPCS 28005
Min. Negotiated Rate	$1,788.60
Max. Negotiated Rate	$1,788.60
Rate for Payer: Cash Price	$656.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,788.60
Rate for Payer: SOMOS Essential	$1,788.60

PR INCISION BONE CORTEX HAND/FINGER

Professional

Both

$2,440.27

Service Code	HCPCS 26034
Min. Negotiated Rate	$1,830.20
Max. Negotiated Rate	$1,830.20
Rate for Payer: Cash Price	$663.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,830.20
Rate for Payer: SOMOS Essential	$1,830.20

PR INCISION BONE CORTEX PELVIS&/HIP JOINT

Professional

Both

$4,460.75

Service Code	HCPCS 26992
Min. Negotiated Rate	$3,345.56
Max. Negotiated Rate	$3,345.56
Rate for Payer: Cash Price	$1,206.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,345.56
Rate for Payer: SOMOS Essential	$3,345.56

PR INCISION BONE CORTEX SHOULDER AREA

Professional

Both

$3,027.85

Service Code	HCPCS 23035
Min. Negotiated Rate	$2,270.89
Max. Negotiated Rate	$2,270.89
Rate for Payer: Cash Price	$812.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,270.89
Rate for Payer: SOMOS Essential	$2,270.89

PR INCISION CONJUNCTIVA DRAINAGE OF CYST

Professional

Both

$453.92

Service Code	HCPCS 68020
Min. Negotiated Rate	$340.44
Max. Negotiated Rate	$340.44
Rate for Payer: Cash Price	$124.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$340.44
Rate for Payer: SOMOS Essential	$340.44

PR INCISION DEEP BONE CORTEX FOREARM&/WRIST

Professional

Both

$2,596.90

Service Code	HCPCS 25035
Min. Negotiated Rate	$1,947.68
Max. Negotiated Rate	$1,947.68
Rate for Payer: Cash Price	$711.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,947.68
Rate for Payer: SOMOS Essential	$1,947.68

PR INCISION DEEP OPENING BONE CORTEX THORAX

Professional

Both

$2,029.34

Service Code	HCPCS 21510
Min. Negotiated Rate	$1,522.00
Max. Negotiated Rate	$1,522.00
Rate for Payer: Cash Price	$545.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,522.00
Rate for Payer: SOMOS Essential	$1,522.00

PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE

Professional

Both

$779.94

Service Code	HCPCS 10061
Min. Negotiated Rate	$584.96
Max. Negotiated Rate	$584.96
Rate for Payer: Cash Price	$215.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$584.96
Rate for Payer: SOMOS Essential	$584.96

PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE

Professional

Both

$444.40

Service Code	HCPCS 10060
Min. Negotiated Rate	$333.30
Max. Negotiated Rate	$333.30
Rate for Payer: Cash Price	$124.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$333.30
Rate for Payer: SOMOS Essential	$333.30

PR INCISION&DRAINAGE BURSA FOOT

Professional

Both

$396.06

Service Code	HCPCS 28001
Min. Negotiated Rate	$297.04
Max. Negotiated Rate	$297.04
Rate for Payer: Cash Price	$107.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$297.04
Rate for Payer: SOMOS Essential	$297.04

PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION

Professional

Both

$791.32

Service Code	HCPCS 10180
Min. Negotiated Rate	$593.49
Max. Negotiated Rate	$593.49
Rate for Payer: Cash Price	$213.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$593.49
Rate for Payer: SOMOS Essential	$593.49

PR INCISION & DRAINAGE FOREARM&/WRIST BURSA

Professional

Both

$1,641.57

Service Code	HCPCS 25031
Min. Negotiated Rate	$1,231.18
Max. Negotiated Rate	$1,231.18
Rate for Payer: Cash Price	$447.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,231.18
Rate for Payer: SOMOS Essential	$1,231.18

PR INCISION DRAINAGE LACRIMAL GLAND

Professional

Both

$540.86

Service Code	HCPCS 68400
Min. Negotiated Rate	$405.64
Max. Negotiated Rate	$405.64
Rate for Payer: Cash Price	$149.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$405.64
Rate for Payer: SOMOS Essential	$405.64

PR INCISION DRAINAGE LACRIMAL SAC

Professional

Both

$684.15

Service Code	HCPCS 68420
Min. Negotiated Rate	$513.11
Max. Negotiated Rate	$513.11
Rate for Payer: Cash Price	$188.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$513.11
Rate for Payer: SOMOS Essential	$513.11

PR INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA

Professional

Both

$1,721.13

Service Code	HCPCS 27603
Min. Negotiated Rate	$1,290.85
Max. Negotiated Rate	$1,290.85
Rate for Payer: Cash Price	$463.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,290.85
Rate for Payer: SOMOS Essential	$1,290.85

PR INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA

Professional

Both

$1,394.75

Service Code	HCPCS 27604
Min. Negotiated Rate	$1,046.06
Max. Negotiated Rate	$1,046.06
Rate for Payer: Cash Price	$381.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,046.06
Rate for Payer: SOMOS Essential	$1,046.06

PR INCISION & DRAINAGE PILONIDAL CYST COMPLICATED

Professional

Both

$744.00

Service Code	HCPCS 10081
Min. Negotiated Rate	$558.00
Max. Negotiated Rate	$558.00
Rate for Payer: Cash Price	$202.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$558.00
Rate for Payer: SOMOS Essential	$558.00

Know your out-of-pocket cost for care.

All Charges