St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR INSJ STABLJ DEV W/DCMPRN LUMBAR SECOND LEVEL

Professional

Both

$1,135.86

Service Code	HCPCS 22868
Min. Negotiated Rate	$851.90
Max. Negotiated Rate	$851.90
Rate for Payer: Cash Price	$297.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$851.90
Rate for Payer: SOMOS Essential	$851.90

PR INSJ STABLJ DEV W/DCMPRN LUMBAR SINGLE LEVEL

Professional

Both

$4,992.68

Service Code	HCPCS 22867
Min. Negotiated Rate	$3,744.51
Max. Negotiated Rate	$3,744.51
Rate for Payer: Cash Price	$1,319.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,744.51
Rate for Payer: SOMOS Essential	$3,744.51

PR INSJ STABLJ DEV W/O DCMPRN LUMBAR SECOND LEVEL

Professional

Both

$486.96

Service Code	HCPCS 22870
Min. Negotiated Rate	$365.22
Max. Negotiated Rate	$365.22
Rate for Payer: Cash Price	$132.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$365.22
Rate for Payer: SOMOS Essential	$365.22

PR INSJ STABLJ DEV W/O DCMPRN LUMBAR SINGLE LEVEL

Professional

Both

$1,804.11

Service Code	HCPCS 22869
Min. Negotiated Rate	$1,353.08
Max. Negotiated Rate	$1,353.08
Rate for Payer: Cash Price	$496.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,353.08
Rate for Payer: SOMOS Essential	$1,353.08

PR INSJ SUBQ EXTENSION INTRAPERITONEAL CATHETER

Professional

Both

$532.91

Service Code	HCPCS 49435
Min. Negotiated Rate	$399.68
Max. Negotiated Rate	$399.68
Rate for Payer: Cash Price	$140.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$399.68
Rate for Payer: SOMOS Essential	$399.68

PR INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH

Professional

Both

$2,453.68

Service Code	HCPCS 61215
Min. Negotiated Rate	$1,840.26
Max. Negotiated Rate	$1,840.26
Rate for Payer: Cash Price	$655.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,840.26
Rate for Payer: SOMOS Essential	$1,840.26

PR INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED

Professional

Both

$319.62

Service Code	HCPCS 51703
Min. Negotiated Rate	$239.72
Max. Negotiated Rate	$239.72
Rate for Payer: Cash Price	$86.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$239.72
Rate for Payer: SOMOS Essential	$239.72

PR INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE

Professional

Both

$104.93

Service Code	HCPCS 51702
Min. Negotiated Rate	$78.70
Max. Negotiated Rate	$78.70
Rate for Payer: Cash Price	$28.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$78.70
Rate for Payer: SOMOS Essential	$78.70

PR INSJ TESTICULAR PROSTH SEPARATE PROCEDURE

Professional

Both

$1,508.89

Service Code	HCPCS 54660
Min. Negotiated Rate	$1,131.67
Max. Negotiated Rate	$1,131.67
Rate for Payer: Cash Price	$415.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,131.67
Rate for Payer: SOMOS Essential	$1,131.67

PR INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT

Professional

Both

$3,322.13

Service Code	HCPCS 37182
Min. Negotiated Rate	$2,491.60
Max. Negotiated Rate	$2,491.60
Rate for Payer: Cash Price	$894.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,491.60
Rate for Payer: SOMOS Essential	$2,491.60

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

Professional

Both

$1,425.13

Service Code	HCPCS 36561
Min. Negotiated Rate	$1,068.85
Max. Negotiated Rate	$1,068.85
Rate for Payer: Cash Price	$382.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,068.85
Rate for Payer: SOMOS Essential	$1,068.85

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

Professional

Both

$1,728.58

Service Code	HCPCS 36560
Min. Negotiated Rate	$1,296.44
Max. Negotiated Rate	$1,296.44
Rate for Payer: Cash Price	$460.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,296.44
Rate for Payer: SOMOS Essential	$1,296.44

PR INSJ TUNNELED CTR VAD W/SUBQ PUMP

Professional

Both

$1,609.06

Service Code	HCPCS 36563
Min. Negotiated Rate	$1,206.80
Max. Negotiated Rate	$1,206.80
Rate for Payer: Cash Price	$423.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,206.80
Rate for Payer: SOMOS Essential	$1,206.80

PR INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>

Professional

Both

$1,099.18

Service Code	HCPCS 36558
Min. Negotiated Rate	$824.38
Max. Negotiated Rate	$824.38
Rate for Payer: Cash Price	$294.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$824.38
Rate for Payer: SOMOS Essential	$824.38

PR INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP

Professional

Both

$1,479.77

Service Code	HCPCS 36565
Min. Negotiated Rate	$1,109.83
Max. Negotiated Rate	$1,109.83
Rate for Payer: Cash Price	$395.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,109.83
Rate for Payer: SOMOS Essential	$1,109.83

PR INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT

Professional

Both

$1,544.20

Service Code	HCPCS 36566
Min. Negotiated Rate	$1,158.15
Max. Negotiated Rate	$1,158.15
Rate for Payer: Cash Price	$412.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,158.15
Rate for Payer: SOMOS Essential	$1,158.15

PR INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC

Professional

Both

$8,591.10

Service Code	HCPCS 33979
Min. Negotiated Rate	$6,443.32
Max. Negotiated Rate	$6,443.32
Rate for Payer: Cash Price	$2,277.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,443.32
Rate for Payer: SOMOS Essential	$6,443.32

PR INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR

Professional

Both

$6,958.07

Service Code	HCPCS 33976
Min. Negotiated Rate	$5,218.55
Max. Negotiated Rate	$5,218.55
Rate for Payer: Cash Price	$1,840.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,218.55
Rate for Payer: SOMOS Essential	$5,218.55

PR INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE

Professional

Both

$5,719.04

Service Code	HCPCS 33975
Min. Negotiated Rate	$4,289.28
Max. Negotiated Rate	$4,289.28
Rate for Payer: Cash Price	$1,529.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,289.28
Rate for Payer: SOMOS Essential	$4,289.28

PR INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL

Professional

Both

$2,008.09

Service Code	HCPCS 33206
Min. Negotiated Rate	$1,506.07
Max. Negotiated Rate	$1,506.07
Rate for Payer: Cash Price	$532.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,506.07
Rate for Payer: SOMOS Essential	$1,506.07

PR INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT

Professional

Both

$2,291.35

Service Code	HCPCS 33208
Min. Negotiated Rate	$1,718.51
Max. Negotiated Rate	$1,718.51
Rate for Payer: Cash Price	$606.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,718.51
Rate for Payer: SOMOS Essential	$1,718.51

PR INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR

Professional

Both

$2,112.99

Service Code	HCPCS 33207
Min. Negotiated Rate	$1,584.74
Max. Negotiated Rate	$1,584.74
Rate for Payer: Cash Price	$560.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,584.74
Rate for Payer: SOMOS Essential	$1,584.74

PR INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS

Professional

Both

$1,485.86

Service Code	HCPCS 33213
Min. Negotiated Rate	$1,114.40
Max. Negotiated Rate	$1,114.40
Rate for Payer: Cash Price	$397.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,114.40
Rate for Payer: SOMOS Essential	$1,114.40

PR INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS

Professional

Both

$1,583.96

Service Code	HCPCS 33221
Min. Negotiated Rate	$1,187.97
Max. Negotiated Rate	$1,187.97
Rate for Payer: Cash Price	$419.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,187.97
Rate for Payer: SOMOS Essential	$1,187.97

PR INS PM PLS GEN W/EXIST SINGLE LEAD

Professional

Both

$1,421.11

Service Code	HCPCS 33212
Min. Negotiated Rate	$1,065.83
Max. Negotiated Rate	$1,065.83
Rate for Payer: Cash Price	$379.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,065.83
Rate for Payer: SOMOS Essential	$1,065.83

Know your out-of-pocket cost for care.

All Charges