St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR IN-SITU VEIN BYP POP-TIBL PRONEAL

Professional

Both

$6,055.91

Service Code	HCPCS 35587
Min. Negotiated Rate	$4,541.93
Max. Negotiated Rate	$4,541.93
Rate for Payer: Cash Price	$1,570.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,541.93
Rate for Payer: SOMOS Essential	$4,541.93

PR INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB

Professional

Both

$1,643.92

Service Code	HCPCS 33216
Min. Negotiated Rate	$1,232.94
Max. Negotiated Rate	$1,232.94
Rate for Payer: Cash Price	$436.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,232.94
Rate for Payer: SOMOS Essential	$1,232.94

PR INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB

Professional

Both

$1,627.36

Service Code	HCPCS 33217
Min. Negotiated Rate	$1,220.52
Max. Negotiated Rate	$1,220.52
Rate for Payer: Cash Price	$433.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,220.52
Rate for Payer: SOMOS Essential	$1,220.52

PR INSJ ANT SEG AQUEOUS DRG DEV W/IO RSVR

Professional

Both

$1,478.30

Service Code	HCPCS 0474T
Min. Negotiated Rate	$1,108.72
Max. Negotiated Rate	$1,108.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,108.72
Rate for Payer: SOMOS Essential	$1,108.72

PR INSJ AQUEOUS DRAIN DEV W/O EO RSVR INITIAL DEV

Professional

Both

$2,956.52

Service Code	HCPCS 0449T
Min. Negotiated Rate	$2,217.39
Max. Negotiated Rate	$2,217.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,217.39
Rate for Payer: SOMOS Essential	$2,217.39

PR INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD

Professional

Both

$1,195.50

Service Code	HCPCS 22853
Min. Negotiated Rate	$896.62
Max. Negotiated Rate	$896.62
Rate for Payer: Cash Price	$314.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$896.62
Rate for Payer: SOMOS Essential	$896.62

PR INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD

Professional

Both

$1,539.69

Service Code	HCPCS 22859
Min. Negotiated Rate	$1,154.77
Max. Negotiated Rate	$1,154.77
Rate for Payer: Cash Price	$407.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,154.77
Rate for Payer: SOMOS Essential	$1,154.77

PR INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD

Professional

Both

$1,564.19

Service Code	HCPCS 22854
Min. Negotiated Rate	$1,173.14
Max. Negotiated Rate	$1,173.14
Rate for Payer: Cash Price	$412.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,173.14
Rate for Payer: SOMOS Essential	$1,173.14

PR INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL

Professional

Both

$865.62

Service Code	HCPCS 36810
Min. Negotiated Rate	$649.22
Max. Negotiated Rate	$649.22
Rate for Payer: Cash Price	$235.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$649.22
Rate for Payer: SOMOS Essential	$649.22

PR INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN

Professional

Both

$503.02

Service Code	HCPCS 36800
Min. Negotiated Rate	$377.26
Max. Negotiated Rate	$377.26
Rate for Payer: Cash Price	$135.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$377.26
Rate for Payer: SOMOS Essential	$377.26

PR INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR

Professional

Both

$606.62

Service Code	HCPCS 36815
Min. Negotiated Rate	$454.96
Max. Negotiated Rate	$454.96
Rate for Payer: Cash Price	$159.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$454.96
Rate for Payer: SOMOS Essential	$454.96

PR INSJ CNULA ISLTD XC-CIRCJ REG CHEMOTX XTR RMVL

Professional

Both

$6,337.35

Service Code	HCPCS 36823
Min. Negotiated Rate	$4,753.01
Max. Negotiated Rate	$4,753.01
Rate for Payer: Cash Price	$1,689.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,753.01
Rate for Payer: SOMOS Essential	$4,753.01

PR INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN

Professional

Both

$2,265.83

Service Code	HCPCS 33224
Min. Negotiated Rate	$1,699.37
Max. Negotiated Rate	$1,699.37
Rate for Payer: Cash Price	$596.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,699.37
Rate for Payer: SOMOS Essential	$1,699.37

PR INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN

Professional

Both

$2,051.07

Service Code	HCPCS 33225
Min. Negotiated Rate	$1,538.30
Max. Negotiated Rate	$1,538.30
Rate for Payer: Cash Price	$538.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,538.30
Rate for Payer: SOMOS Essential	$1,538.30

PR INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS

Professional

Both

$8,227.91

Service Code	HCPCS 33335
Min. Negotiated Rate	$6,170.93
Max. Negotiated Rate	$6,170.93
Rate for Payer: Cash Price	$2,184.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,170.93
Rate for Payer: SOMOS Essential	$6,170.93

PR INSJ GRAFT AORTA/GREAT VESSEL W/O SHUNT/BYPASS

Professional

Both

$6,274.03

Service Code	HCPCS 33330
Min. Negotiated Rate	$4,705.52
Max. Negotiated Rate	$4,705.52
Rate for Payer: Cash Price	$1,669.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,705.52
Rate for Payer: SOMOS Essential	$4,705.52

PR INSJ I-AORT BALO ASSIST DEV VIA ASCENDING AORTA

Professional

Both

$2,208.36

Service Code	HCPCS 33973
Min. Negotiated Rate	$1,656.27
Max. Negotiated Rate	$1,656.27
Rate for Payer: Cash Price	$582.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,656.27
Rate for Payer: SOMOS Essential	$1,656.27

PR INSJ IMPLANTABLE INTRA-ARTERIAL INFUSION PUM

Professional

Both

$2,961.98

Service Code	HCPCS 36260
Min. Negotiated Rate	$2,221.48
Max. Negotiated Rate	$2,221.48
Rate for Payer: Cash Price	$793.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,221.48
Rate for Payer: SOMOS Essential	$2,221.48

PR INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD

Professional

Both

$1,618.33

Service Code	HCPCS 33240
Min. Negotiated Rate	$1,213.75
Max. Negotiated Rate	$1,213.75
Rate for Payer: Cash Price	$432.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,213.75
Rate for Payer: SOMOS Essential	$1,213.75

PR INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS

Professional

Both

$1,689.24

Service Code	HCPCS 33230
Min. Negotiated Rate	$1,266.93
Max. Negotiated Rate	$1,266.93
Rate for Payer: Cash Price	$439.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,266.93
Rate for Payer: SOMOS Essential	$1,266.93

PR INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS

Professional

Both

$1,759.73

Service Code	HCPCS 33231
Min. Negotiated Rate	$1,319.80
Max. Negotiated Rate	$1,319.80
Rate for Payer: Cash Price	$470.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,319.80
Rate for Payer: SOMOS Essential	$1,319.80

PR INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER

Professional

Both

$3,175.03

Service Code	HCPCS 53445
Min. Negotiated Rate	$2,381.27
Max. Negotiated Rate	$2,381.27
Rate for Payer: Cash Price	$869.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,381.27
Rate for Payer: SOMOS Essential	$2,381.27

PR INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN

Professional

Both

$1,559.08

Service Code	HCPCS 33970
Min. Negotiated Rate	$1,169.31
Max. Negotiated Rate	$1,169.31
Rate for Payer: Cash Price	$411.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,169.31
Rate for Payer: SOMOS Essential	$1,169.31

PR INSJ INTRAPERITONEAL CATHETER W/IMG GUID

Professional

Both

$829.26

Service Code	HCPCS 49418
Min. Negotiated Rate	$621.94
Max. Negotiated Rate	$621.94
Rate for Payer: Cash Price	$222.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$621.94
Rate for Payer: SOMOS Essential	$621.94

PR INSJ IO LENS PROSTHESIS NOT W/CONCURRENT RMVL

Professional

Both

$3,162.92

Service Code	HCPCS 66985
Min. Negotiated Rate	$2,372.19
Max. Negotiated Rate	$2,372.19
Rate for Payer: Cash Price	$871.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,372.19
Rate for Payer: SOMOS Essential	$2,372.19

Know your out-of-pocket cost for care.

All Charges