St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR INITIAL TX 1ST DEGREE BURN LOCAL TX

Professional

Both

$197.23

Service Code	HCPCS 16000
Min. Negotiated Rate	$147.92
Max. Negotiated Rate	$147.92
Rate for Payer: Cash Price	$52.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$147.92
Rate for Payer: SOMOS Essential	$147.92

PR INITIAT MED ASSIST TX IN ER

Professional

Both

$268.00

Service Code	HCPCS G2213
Min. Negotiated Rate	$201.00
Max. Negotiated Rate	$201.00
Rate for Payer: Cash Price	$67.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$201.00
Rate for Payer: SOMOS Essential	$201.00

PR INITIAT SELECTIVE HEAD/BODY HYPOTHERMIA NEONATE

Professional

Both

$865.62

Service Code	HCPCS 99184
Min. Negotiated Rate	$649.22
Max. Negotiated Rate	$649.22
Rate for Payer: Cash Price	$236.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$649.22
Rate for Payer: SOMOS Essential	$649.22

PR INIT/SUB PSYCH CARE M 1ST 30

Professional

Both

$151.94

Service Code	HCPCS G2214
Min. Negotiated Rate	$113.96
Max. Negotiated Rate	$113.96
Rate for Payer: Cash Price	$42.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$113.96
Rate for Payer: SOMOS Essential	$113.96

PR INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,CERV/THORAC, 1ST LEVEL

Professional

Both

$435.33

Service Code	HCPCS 64490
Min. Negotiated Rate	$326.50
Max. Negotiated Rate	$326.50
Rate for Payer: Cash Price	$119.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$326.50
Rate for Payer: SOMOS Essential	$326.50

PR INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT

Professional

Both

$163.14

Service Code	HCPCS 49427
Min. Negotiated Rate	$122.36
Max. Negotiated Rate	$122.36
Rate for Payer: Cash Price	$43.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$122.36
Rate for Payer: SOMOS Essential	$122.36

PR INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS

Professional

Both

$165.87

Service Code	HCPCS 20550
Min. Negotiated Rate	$124.40
Max. Negotiated Rate	$124.40
Rate for Payer: Cash Price	$44.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$124.40
Rate for Payer: SOMOS Essential	$124.40

PR INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN

Professional

Both

$260.16

Service Code	HCPCS 64417
Min. Negotiated Rate	$195.12
Max. Negotiated Rate	$195.12
Rate for Payer: Cash Price	$71.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$195.12
Rate for Payer: SOMOS Essential	$195.12

PR INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN

Professional

Both

$282.52

Service Code	HCPCS 64415
Min. Negotiated Rate	$211.89
Max. Negotiated Rate	$211.89
Rate for Payer: Cash Price	$77.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$211.89
Rate for Payer: SOMOS Essential	$211.89

PR INJECTION AA&/STRD BRACH PLEX CONT NFS CATH IMG

Professional

Both

$320.85

Service Code	HCPCS 64416
Min. Negotiated Rate	$240.64
Max. Negotiated Rate	$240.64
Rate for Payer: Cash Price	$85.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$240.64
Rate for Payer: SOMOS Essential	$240.64

PR INJECTION AA&/STRD FEM NRV CONT NFS CATH IMG GDN

Professional

Both

$293.30

Service Code	HCPCS 64448
Min. Negotiated Rate	$219.98
Max. Negotiated Rate	$219.98
Rate for Payer: Cash Price	$79.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$219.98
Rate for Payer: SOMOS Essential	$219.98

PR INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN

Professional

Both

$256.87

Service Code	HCPCS 64447
Min. Negotiated Rate	$192.65
Max. Negotiated Rate	$192.65
Rate for Payer: Cash Price	$70.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$192.65
Rate for Payer: SOMOS Essential	$192.65

PR INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG

Professional

Both

$337.93

Service Code	HCPCS 64454
Min. Negotiated Rate	$253.45
Max. Negotiated Rate	$253.45
Rate for Payer: Cash Price	$92.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$253.45
Rate for Payer: SOMOS Essential	$253.45

PR INJECTION AA&/STRD GREATER OCCIPITAL NERVE

Professional

Both

$236.88

Service Code	HCPCS 64405
Min. Negotiated Rate	$177.66
Max. Negotiated Rate	$177.66
Rate for Payer: Cash Price	$63.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$177.66
Rate for Payer: SOMOS Essential	$177.66

PR INJECTION AA&/STRD ILIOINGUINAL IH NERVES

Professional

Both

$227.36

Service Code	HCPCS 64425
Min. Negotiated Rate	$170.52
Max. Negotiated Rate	$170.52
Rate for Payer: Cash Price	$61.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$170.52
Rate for Payer: SOMOS Essential	$170.52

PR INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL

Professional

Both

$99.44

Service Code	HCPCS 64421
Min. Negotiated Rate	$74.58
Max. Negotiated Rate	$74.58
Rate for Payer: Cash Price	$28.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$74.58
Rate for Payer: SOMOS Essential	$74.58

PR INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL

Professional

Both

$241.68

Service Code	HCPCS 64420
Min. Negotiated Rate	$181.26
Max. Negotiated Rate	$181.26
Rate for Payer: Cash Price	$65.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$181.26
Rate for Payer: SOMOS Essential	$181.26

PR INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH

Professional

Both

$255.15

Service Code	HCPCS 64449
Min. Negotiated Rate	$191.36
Max. Negotiated Rate	$191.36
Rate for Payer: Cash Price	$71.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$191.36
Rate for Payer: SOMOS Essential	$191.36

PR INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG

Professional

Both

$336.49

Service Code	HCPCS 64451
Min. Negotiated Rate	$252.37
Max. Negotiated Rate	$252.37
Rate for Payer: Cash Price	$92.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$252.37
Rate for Payer: SOMOS Essential	$252.37

PR INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH

Professional

Both

$174.76

Service Code	HCPCS 64450
Min. Negotiated Rate	$131.07
Max. Negotiated Rate	$131.07
Rate for Payer: Cash Price	$47.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$131.07
Rate for Payer: SOMOS Essential	$131.07

PR INJECTION AA&/STRD PARACERVICAL NERVE

Professional

Both

$187.15

Service Code	HCPCS 64435
Min. Negotiated Rate	$140.36
Max. Negotiated Rate	$140.36
Rate for Payer: Cash Price	$51.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$140.36
Rate for Payer: SOMOS Essential	$140.36

PR INJECTION AA&/STRD PUDENDAL NERVE

Professional

Both

$229.95

Service Code	HCPCS 64430
Min. Negotiated Rate	$172.46
Max. Negotiated Rate	$172.46
Rate for Payer: Cash Price	$62.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$172.46
Rate for Payer: SOMOS Essential	$172.46

PR INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN

Professional

Both

$308.28

Service Code	HCPCS 64445
Min. Negotiated Rate	$231.21
Max. Negotiated Rate	$231.21
Rate for Payer: Cash Price	$81.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$231.21
Rate for Payer: SOMOS Essential	$231.21

PR INJECTION AA&/STRD SCIATIC NRV CONT NFS CATH IMG

Professional

Both

$314.58

Service Code	HCPCS 64446
Min. Negotiated Rate	$235.94
Max. Negotiated Rate	$235.94
Rate for Payer: Cash Price	$83.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$235.94
Rate for Payer: SOMOS Essential	$235.94

PR INJECTION AA&/STRD SUPRASCAPULAR NERVE

Professional

Both

$232.44

Service Code	HCPCS 64418
Min. Negotiated Rate	$174.33
Max. Negotiated Rate	$174.33
Rate for Payer: Cash Price	$62.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$174.33
Rate for Payer: SOMOS Essential	$174.33

Know your out-of-pocket cost for care.

All Charges