St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE

Professional

Both

$1,075.31

Service Code	HCPCS 57267
Min. Negotiated Rate	$806.48
Max. Negotiated Rate	$806.48
Rate for Payer: Cash Price	$289.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$806.48
Rate for Payer: SOMOS Essential	$806.48

PR INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH

Professional

Both

$3,384.47

Service Code	HCPCS 54405
Min. Negotiated Rate	$2,538.35
Max. Negotiated Rate	$2,538.35
Rate for Payer: Cash Price	$924.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,538.35
Rate for Payer: SOMOS Essential	$2,538.35

PR INSJ NON-NDWELLG BLADDER CATHETER

Professional

Both

$107.66

Service Code	HCPCS 51701
Min. Negotiated Rate	$80.74
Max. Negotiated Rate	$80.74
Rate for Payer: Cash Price	$29.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$80.74
Rate for Payer: SOMOS Essential	$80.74

PR INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y

Professional

Both

$344.30

Service Code	HCPCS 36555
Min. Negotiated Rate	$258.22
Max. Negotiated Rate	$258.22
Rate for Payer: Cash Price	$92.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$258.22
Rate for Payer: SOMOS Essential	$258.22

PR INSJ OC IMPLT AFTER ENCL MUSC ATTACHED

Professional

Both

$3,898.90

Service Code	HCPCS 65140
Min. Negotiated Rate	$2,924.18
Max. Negotiated Rate	$2,924.18
Rate for Payer: Cash Price	$1,066.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,924.18
Rate for Payer: SOMOS Essential	$2,924.18

PR INSJ OC IMPLT AFTER ENCL MUSC X ATTACHED

Professional

Both

$3,633.91

Service Code	HCPCS 65135
Min. Negotiated Rate	$2,725.43
Max. Negotiated Rate	$2,725.43
Rate for Payer: Cash Price	$993.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,725.43
Rate for Payer: SOMOS Essential	$2,725.43

PR INSJ OC IMPLT SEC AFTER EVSC SCLL SHELL

Professional

Both

$3,592.79

Service Code	HCPCS 65130
Min. Negotiated Rate	$2,694.59
Max. Negotiated Rate	$2,694.59
Rate for Payer: Cash Price	$981.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,694.59
Rate for Payer: SOMOS Essential	$2,694.59

PR INSJ OC TLSCP PROSTH RMVL CRYSTALLINE/IO LENS

Professional

Both

$4,522.21

Service Code	HCPCS 0308T
Min. Negotiated Rate	$3,391.66
Max. Negotiated Rate	$3,391.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,391.66
Rate for Payer: SOMOS Essential	$3,391.66

PR INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE

Professional

Both

$1,998.33

Service Code	HCPCS 33271
Min. Negotiated Rate	$1,498.75
Max. Negotiated Rate	$1,498.75
Rate for Payer: Cash Price	$534.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,498.75
Rate for Payer: SOMOS Essential	$1,498.75

PR INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID

Professional

Both

$2,235.80

Service Code	HCPCS 54400
Min. Negotiated Rate	$1,676.85
Max. Negotiated Rate	$1,676.85
Rate for Payer: Cash Price	$612.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,676.85
Rate for Payer: SOMOS Essential	$1,676.85

PR INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED

Professional

Both

$2,798.18

Service Code	HCPCS 54401
Min. Negotiated Rate	$2,098.64
Max. Negotiated Rate	$2,098.64
Rate for Payer: Cash Price	$769.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,098.64
Rate for Payer: SOMOS Essential	$2,098.64

PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY

Professional

Both

$1,586.34

Service Code	HCPCS 33990
Min. Negotiated Rate	$1,189.76
Max. Negotiated Rate	$1,189.76
Rate for Payer: Cash Price	$420.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,189.76
Rate for Payer: SOMOS Essential	$1,189.76

PR INSJ PERQ VAD W/RS&I L HRT ARTERIAL&VEN ACCESS

Professional

Both

$2,003.75

Service Code	HCPCS 33991
Min. Negotiated Rate	$1,502.81
Max. Negotiated Rate	$1,502.81
Rate for Payer: Cash Price	$528.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,502.81
Rate for Payer: SOMOS Essential	$1,502.81

PR INSJ PERQ VAD W/RS&I R HEART VENOUS ACCESS ONLY

Professional

Both

$1,541.54

Service Code	HCPCS 33995
Min. Negotiated Rate	$1,156.16
Max. Negotiated Rate	$1,156.16
Rate for Payer: Cash Price	$412.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,156.16
Rate for Payer: SOMOS Essential	$1,156.16

PR INSJ PIN-RETAINED PALATAL PROSTHESIS

Professional

Both

$680.93

Service Code	HCPCS 42281
Min. Negotiated Rate	$510.70
Max. Negotiated Rate	$510.70
Rate for Payer: Cash Price	$186.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$510.70
Rate for Payer: SOMOS Essential	$510.70

PR INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>

Professional

Both

$1,366.54

Service Code	HCPCS 36571
Min. Negotiated Rate	$1,024.90
Max. Negotiated Rate	$1,024.90
Rate for Payer: Cash Price	$367.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,024.90
Rate for Payer: SOMOS Essential	$1,024.90

PR INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR

Professional

Both

$1,493.38

Service Code	HCPCS 36570
Min. Negotiated Rate	$1,120.04
Max. Negotiated Rate	$1,120.04
Rate for Payer: Cash Price	$399.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,120.04
Rate for Payer: SOMOS Essential	$1,120.04

PR INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY

Professional

Both

$3,333.09

Service Code	HCPCS 19342
Min. Negotiated Rate	$2,499.82
Max. Negotiated Rate	$2,499.82
Rate for Payer: Cash Price	$900.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,499.82
Rate for Payer: SOMOS Essential	$2,499.82

PR INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS

Professional

Both

$4,161.08

Service Code	HCPCS 61886
Min. Negotiated Rate	$3,120.81
Max. Negotiated Rate	$3,120.81
Rate for Payer: Cash Price	$1,113.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,120.81
Rate for Payer: SOMOS Essential	$3,120.81

PR INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR

Professional

Both

$2,491.83

Service Code	HCPCS 61885
Min. Negotiated Rate	$1,868.87
Max. Negotiated Rate	$1,868.87
Rate for Payer: Cash Price	$665.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,868.87
Rate for Payer: SOMOS Essential	$1,868.87

PR INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR

Professional

Both

$4,035.05

Service Code	HCPCS 33249
Min. Negotiated Rate	$3,026.29
Max. Negotiated Rate	$3,026.29
Rate for Payer: Cash Price	$1,068.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,026.29
Rate for Payer: SOMOS Essential	$3,026.29

PR INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ

Professional

Both

$1,606.36

Service Code	HCPCS 63685
Min. Negotiated Rate	$1,204.77
Max. Negotiated Rate	$1,204.77
Rate for Payer: Cash Price	$406.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,204.77
Rate for Payer: SOMOS Essential	$1,204.77

PR INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH

Professional

Both

$708.05

Service Code	HCPCS 33210
Min. Negotiated Rate	$531.04
Max. Negotiated Rate	$531.04
Rate for Payer: Cash Price	$186.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$531.04
Rate for Payer: SOMOS Essential	$531.04

PR INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX

Professional

Both

$736.30

Service Code	HCPCS 33211
Min. Negotiated Rate	$552.22
Max. Negotiated Rate	$552.22
Rate for Payer: Cash Price	$195.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$552.22
Rate for Payer: SOMOS Essential	$552.22

PR INSJ RX ELUTING IMPLT PUNCTAL DILAT LAC CANAL EA

Professional

Both

$134.12

Service Code	HCPCS 68841
Min. Negotiated Rate	$100.59
Max. Negotiated Rate	$100.59
Rate for Payer: Cash Price	$36.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$100.59
Rate for Payer: SOMOS Essential	$100.59

Know your out-of-pocket cost for care.

All Charges