St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR

Professional

Both

$215.88

Service Code	HCPCS 93292
Min. Negotiated Rate	$161.91
Max. Negotiated Rate	$161.91
Rate for Payer: Cash Price	$58.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$161.91
Rate for Payer: SOMOS Essential	$161.91

PR INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB

Professional

Both

$146.76

Service Code	HCPCS 93295
Min. Negotiated Rate	$110.07
Max. Negotiated Rate	$110.07
Rate for Payer: Cash Price	$40.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$110.07
Rate for Payer: SOMOS Essential	$110.07

PR INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS

Professional

Both

$171.33

Service Code	HCPCS 93750
Min. Negotiated Rate	$128.50
Max. Negotiated Rate	$128.50
Rate for Payer: Cash Price	$45.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$128.50
Rate for Payer: SOMOS Essential	$128.50

PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON

Professional

Both

$83.76

Service Code	HCPCS 93290 26
Min. Negotiated Rate	$62.82
Max. Negotiated Rate	$62.82
Rate for Payer: Cash Price	$22.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$62.82
Rate for Payer: SOMOS Essential	$62.82

PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON

Professional

Both

$143.61

Service Code	HCPCS 93290 TC
Min. Negotiated Rate	$107.71
Max. Negotiated Rate	$107.71
Rate for Payer: Cash Price	$38.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$107.71
Rate for Payer: SOMOS Essential	$107.71

PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON

Professional

Both

$227.36

Service Code	HCPCS 93290
Min. Negotiated Rate	$170.52
Max. Negotiated Rate	$170.52
Rate for Payer: Cash Price	$61.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$170.52
Rate for Payer: SOMOS Essential	$170.52

PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON

Professional

Both

$237.58

Service Code	HCPCS 93288
Min. Negotiated Rate	$178.18
Max. Negotiated Rate	$178.18
Rate for Payer: Cash Price	$64.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$178.18
Rate for Payer: SOMOS Essential	$178.18

PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON

Professional

Both

$79.59

Service Code	HCPCS 93288 26
Min. Negotiated Rate	$59.69
Max. Negotiated Rate	$59.69
Rate for Payer: Cash Price	$21.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$59.69
Rate for Payer: SOMOS Essential	$59.69

PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON

Professional

Both

$157.99

Service Code	HCPCS 93288 TC
Min. Negotiated Rate	$118.49
Max. Negotiated Rate	$118.49
Rate for Payer: Cash Price	$42.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$118.49
Rate for Payer: SOMOS Essential	$118.49

PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON

Professional

Both

$70.63

Service Code	HCPCS 93291 26
Min. Negotiated Rate	$52.97
Max. Negotiated Rate	$52.97
Rate for Payer: Cash Price	$19.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$52.97
Rate for Payer: SOMOS Essential	$52.97

PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON

Professional

Both

$139.30

Service Code	HCPCS 93291 TC
Min. Negotiated Rate	$104.48
Max. Negotiated Rate	$104.48
Rate for Payer: Cash Price	$37.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$104.48
Rate for Payer: SOMOS Essential	$104.48

PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON

Professional

Both

$209.93

Service Code	HCPCS 93291
Min. Negotiated Rate	$157.45
Max. Negotiated Rate	$157.45
Rate for Payer: Cash Price	$56.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$157.45
Rate for Payer: SOMOS Essential	$157.45

PR INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON

Professional

Both

$214.55

Service Code	HCPCS 0521T
Min. Negotiated Rate	$160.91
Max. Negotiated Rate	$160.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$160.91
Rate for Payer: SOMOS Essential	$160.91

PR INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON

Professional

Both

$127.12

Service Code	HCPCS 0521T TC
Min. Negotiated Rate	$95.34
Max. Negotiated Rate	$95.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$95.34
Rate for Payer: SOMOS Essential	$95.34

PR INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON

Professional

Both

$87.40

Service Code	HCPCS 0521T 26
Min. Negotiated Rate	$65.55
Max. Negotiated Rate	$65.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$65.55
Rate for Payer: SOMOS Essential	$65.55

PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB

Professional

Both

$146.58

Service Code	HCPCS 93289 26
Min. Negotiated Rate	$109.94
Max. Negotiated Rate	$109.94
Rate for Payer: Cash Price	$39.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$109.94
Rate for Payer: SOMOS Essential	$109.94

PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB

Professional

Both

$159.43

Service Code	HCPCS 93289 TC
Min. Negotiated Rate	$119.57
Max. Negotiated Rate	$119.57
Rate for Payer: Cash Price	$43.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$119.57
Rate for Payer: SOMOS Essential	$119.57

PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB

Professional

Both

$306.01

Service Code	HCPCS 93289
Min. Negotiated Rate	$229.51
Max. Negotiated Rate	$229.51
Rate for Payer: Cash Price	$82.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$229.51
Rate for Payer: SOMOS Essential	$229.51

PR INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT

Professional

Both

$758.66

Service Code	HCPCS 49411
Min. Negotiated Rate	$569.00
Max. Negotiated Rate	$569.00
Rate for Payer: Cash Price	$205.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$569.00
Rate for Payer: SOMOS Essential	$569.00

PR INTERTHORACOSCAPULAR AMPUTATION

Professional

Both

$6,115.03

Service Code	HCPCS 23900
Min. Negotiated Rate	$4,586.27
Max. Negotiated Rate	$4,586.27
Rate for Payer: Cash Price	$1,646.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,586.27
Rate for Payer: SOMOS Essential	$4,586.27

PR INTESTINAL PLICATION SEPARATE PROCEDURE

Professional

Both

$4,879.28

Service Code	HCPCS 44680
Min. Negotiated Rate	$3,659.46
Max. Negotiated Rate	$3,659.46
Rate for Payer: Cash Price	$1,297.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,659.46
Rate for Payer: SOMOS Essential	$3,659.46

PR INT HRHC BY LIGATION 2+ HROID W/O IMG GDN

Professional

Both

$1,653.30

Service Code	HCPCS 46946
Min. Negotiated Rate	$1,239.98
Max. Negotiated Rate	$1,239.98
Rate for Payer: Cash Price	$447.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,239.98
Rate for Payer: SOMOS Essential	$1,239.98

PR INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN

Professional

Both

$1,473.15

Service Code	HCPCS 46945
Min. Negotiated Rate	$1,104.86
Max. Negotiated Rate	$1,104.86
Rate for Payer: Cash Price	$402.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,104.86
Rate for Payer: SOMOS Essential	$1,104.86

PR INT HRHC TRANSANAL HROID DARTLZJ 2+ W/US GDN

Professional

Both

$1,957.69

Service Code	HCPCS 46948
Min. Negotiated Rate	$1,468.27
Max. Negotiated Rate	$1,468.27
Rate for Payer: Cash Price	$527.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,468.27
Rate for Payer: SOMOS Essential	$1,468.27

PR INTRA-ATRIAL PACING

Professional

Both

$695.63

Service Code	HCPCS 93610 26
Min. Negotiated Rate	$521.72
Max. Negotiated Rate	$521.72
Rate for Payer: Cash Price	$183.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$521.72
Rate for Payer: SOMOS Essential	$521.72

Know your out-of-pocket cost for care.

All Charges