St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR INSERTION PICC W/RS&I 5 YR/>

Professional

Both

$346.99

Service Code	HCPCS 36573
Min. Negotiated Rate	$260.24
Max. Negotiated Rate	$260.24
Rate for Payer: Cash Price	$92.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$260.24
Rate for Payer: SOMOS Essential	$260.24

PR INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP

Professional

Both

$373.42

Service Code	HCPCS 95830
Min. Negotiated Rate	$280.06
Max. Negotiated Rate	$280.06
Rate for Payer: Cash Price	$102.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$280.06
Rate for Payer: SOMOS Essential	$280.06

PR INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG

Professional

Both

$389.45

Service Code	HCPCS 33285
Min. Negotiated Rate	$292.09
Max. Negotiated Rate	$292.09
Rate for Payer: Cash Price	$102.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$292.09
Rate for Payer: SOMOS Essential	$292.09

PR INSERTION TANDEM CUFF

Professional

Both

$3,316.64

Service Code	HCPCS 53444
Min. Negotiated Rate	$2,487.48
Max. Negotiated Rate	$2,487.48
Rate for Payer: Cash Price	$908.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,487.48
Rate for Payer: SOMOS Essential	$2,487.48

PR INSERTION THOMAS SHUNT SEPARATE PROCEDURE

Professional

Both

$2,153.31

Service Code	HCPCS 36835
Min. Negotiated Rate	$1,614.98
Max. Negotiated Rate	$1,614.98
Rate for Payer: Cash Price	$575.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,614.98
Rate for Payer: SOMOS Essential	$1,614.98

PR INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ

Professional

Both

$4,408.92

Service Code	HCPCS 11960
Min. Negotiated Rate	$3,306.69
Max. Negotiated Rate	$3,306.69
Rate for Payer: Cash Price	$1,198.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,306.69
Rate for Payer: SOMOS Essential	$3,306.69

PR INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN

Professional

Both

$1,012.52

Service Code	HCPCS 49421
Min. Negotiated Rate	$759.39
Max. Negotiated Rate	$759.39
Rate for Payer: Cash Price	$269.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$759.39
Rate for Payer: SOMOS Essential	$759.39

PR INSERTION TUNNEL INTRAPERITONEAL CATH SUBQ PORT

Professional

Both

$1,858.08

Service Code	HCPCS 49419
Min. Negotiated Rate	$1,393.56
Max. Negotiated Rate	$1,393.56
Rate for Payer: Cash Price	$494.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,393.56
Rate for Payer: SOMOS Essential	$1,393.56

PR INSERTION UTERINE TANDEM&/VAGINAL OVOIDS

Professional

Both

$1,175.09

Service Code	HCPCS 57155
Min. Negotiated Rate	$881.32
Max. Negotiated Rate	$881.32
Rate for Payer: Cash Price	$320.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$881.32
Rate for Payer: SOMOS Essential	$881.32

PR INSERTION VAGINAL RADIATION DEVICE

Professional

Both

$627.10

Service Code	HCPCS 57156
Min. Negotiated Rate	$470.32
Max. Negotiated Rate	$470.32
Rate for Payer: Cash Price	$170.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$470.32
Rate for Payer: SOMOS Essential	$470.32

PR INSERTION VASCULAR PEDICLE CARPAL BONE

Professional

Both

$3,251.75

Service Code	HCPCS 25430
Min. Negotiated Rate	$2,438.81
Max. Negotiated Rate	$2,438.81
Rate for Payer: Cash Price	$880.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,438.81
Rate for Payer: SOMOS Essential	$2,438.81

PR INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX

Professional

Both

$707.63

Service Code	HCPCS 20650
Min. Negotiated Rate	$530.72
Max. Negotiated Rate	$530.72
Rate for Payer: Cash Price	$197.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$530.72
Rate for Payer: SOMOS Essential	$530.72

PR INSERTION WRLS CAR STIMULATOR LV PACG BTH COMPNT

Professional

Both

$1,545.78

Service Code	HCPCS 0517T
Min. Negotiated Rate	$1,159.34
Max. Negotiated Rate	$1,159.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,159.34
Rate for Payer: SOMOS Essential	$1,159.34

PR INSERTION WRLS CAR STIMULATOR LV PACG COMPL SYS

Professional

Both

$2,186.35

Service Code	HCPCS 0515T
Min. Negotiated Rate	$1,639.76
Max. Negotiated Rate	$1,639.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,639.76
Rate for Payer: SOMOS Essential	$1,639.76

PR INSERTION WRLS CAR STIMULATOR LV PACG ELTRD ONLY

Professional

Both

$1,761.69

Service Code	HCPCS 0516T
Min. Negotiated Rate	$1,321.27
Max. Negotiated Rate	$1,321.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,321.27
Rate for Payer: SOMOS Essential	$1,321.27

PR INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS

Professional

Both

$3,408.86

Service Code	HCPCS 33988
Min. Negotiated Rate	$2,556.64
Max. Negotiated Rate	$2,556.64
Rate for Payer: Cash Price	$901.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,556.64
Rate for Payer: SOMOS Essential	$2,556.64

PR INSERT NON-TUNNEL CV CATH

Professional

Both

$352.70

Service Code	HCPCS 36556
Min. Negotiated Rate	$264.52
Max. Negotiated Rate	$264.52
Rate for Payer: Cash Price	$95.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$264.52
Rate for Payer: SOMOS Essential	$264.52

PR INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT

Professional

Both

$339.33

Service Code	HCPCS 53855
Min. Negotiated Rate	$254.50
Max. Negotiated Rate	$254.50
Rate for Payer: Cash Price	$92.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$254.50
Rate for Payer: SOMOS Essential	$254.50

PR INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR

Professional

Both

$1,435.18

Service Code	HCPCS 36557
Min. Negotiated Rate	$1,076.38
Max. Negotiated Rate	$1,076.38
Rate for Payer: Cash Price	$384.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,076.38
Rate for Payer: SOMOS Essential	$1,076.38

PR INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I

Professional

Both

$929.22

Service Code	HCPCS 37191
Min. Negotiated Rate	$696.92
Max. Negotiated Rate	$696.92
Rate for Payer: Cash Price	$247.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$696.92
Rate for Payer: SOMOS Essential	$696.92

PR IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART

Professional

Both

$7,414.65

Service Code	HCPCS 35585
Min. Negotiated Rate	$5,560.99
Max. Negotiated Rate	$5,560.99
Rate for Payer: Cash Price	$1,963.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,560.99
Rate for Payer: SOMOS Essential	$5,560.99

PR IN SITU HYBRIDIZATION 1ST PROBE STAIN

Professional

Both

$164.71

Service Code	HCPCS 88365 26
Min. Negotiated Rate	$123.53
Max. Negotiated Rate	$123.53
Rate for Payer: Cash Price	$45.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$123.53
Rate for Payer: SOMOS Essential	$123.53

PR IN SITU HYBRIDIZATION 1ST PROBE STAIN

Professional

Both

$760.97

Service Code	HCPCS 88365
Min. Negotiated Rate	$570.73
Max. Negotiated Rate	$570.73
Rate for Payer: Cash Price	$205.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$570.73
Rate for Payer: SOMOS Essential	$570.73

PR IN SITU HYBRIDIZATION 1ST PROBE STAIN

Professional

Both

$596.30

Service Code	HCPCS 88365 TC
Min. Negotiated Rate	$447.22
Max. Negotiated Rate	$447.22
Rate for Payer: Cash Price	$160.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$447.22
Rate for Payer: SOMOS Essential	$447.22

PR IN-SITU VEIN BYPASS FEMORAL-POPLITEAL

Professional

Both

$6,416.34

Service Code	HCPCS 35583
Min. Negotiated Rate	$4,812.26
Max. Negotiated Rate	$4,812.26
Rate for Payer: Cash Price	$1,695.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,812.26
Rate for Payer: SOMOS Essential	$4,812.26

Know your out-of-pocket cost for care.

All Charges