St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR INTRA-ATRIAL PACING

Professional

Both

$279.76

Service Code	HCPCS 93610 TC
Min. Negotiated Rate	$209.82
Max. Negotiated Rate	$209.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$209.82
Rate for Payer: SOMOS Essential	$209.82

PR INTRA-ATRIAL PACING

Professional

Both

$975.38

Service Code	HCPCS 93610
Min. Negotiated Rate	$731.54
Max. Negotiated Rate	$731.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$731.54
Rate for Payer: SOMOS Essential	$731.54

PR INTRA-ATRIAL RECORDING

Professional

Both

$490.39

Service Code	HCPCS 93602 26
Min. Negotiated Rate	$367.79
Max. Negotiated Rate	$367.79
Rate for Payer: Cash Price	$129.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$367.79
Rate for Payer: SOMOS Essential	$367.79

PR INTRA-ATRIAL RECORDING

Professional

Both

$226.84

Service Code	HCPCS 93602 TC
Min. Negotiated Rate	$170.13
Max. Negotiated Rate	$170.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$170.13
Rate for Payer: SOMOS Essential	$170.13

PR INTRA-ATRIAL RECORDING

Professional

Both

$717.22

Service Code	HCPCS 93602
Min. Negotiated Rate	$537.92
Max. Negotiated Rate	$537.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$537.92
Rate for Payer: SOMOS Essential	$537.92

PR INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I

Professional

Both

$289.07

Service Code	HCPCS 93662 26
Min. Negotiated Rate	$216.80
Max. Negotiated Rate	$216.80
Rate for Payer: Cash Price	$75.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$216.80
Rate for Payer: SOMOS Essential	$216.80

PR INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I

Professional

Both

$633.33

Service Code	HCPCS 93662 TC
Min. Negotiated Rate	$475.00
Max. Negotiated Rate	$475.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$475.00
Rate for Payer: SOMOS Essential	$475.00

PR INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I

Professional

Both

$922.39

Service Code	HCPCS 93662
Min. Negotiated Rate	$691.79
Max. Negotiated Rate	$691.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$691.79
Rate for Payer: SOMOS Essential	$691.79

PR INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING

Professional

Both

$1,288.84

Service Code	HCPCS 93613
Min. Negotiated Rate	$966.63
Max. Negotiated Rate	$966.63
Rate for Payer: Cash Price	$339.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$966.63
Rate for Payer: SOMOS Essential	$966.63

PR INTRACRANIAL ARVEN MALFRMJ DURAL CMPL

Professional

Both

$17,630.76

Service Code	HCPCS 61692
Min. Negotiated Rate	$13,223.07
Max. Negotiated Rate	$13,223.07
Rate for Payer: Cash Price	$4,629.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$13,223.07
Rate for Payer: SOMOS Essential	$13,223.07

PR INTRACRANIAL ARVEN MALFRMJ DURAL SMPL

Professional

Both

$10,522.89

Service Code	HCPCS 61690
Min. Negotiated Rate	$7,892.17
Max. Negotiated Rate	$7,892.17
Rate for Payer: Cash Price	$2,775.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,892.17
Rate for Payer: SOMOS Essential	$7,892.17

PR INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL

Professional

Both

$21,696.50

Service Code	HCPCS 61686
Min. Negotiated Rate	$16,272.38
Max. Negotiated Rate	$16,272.38
Rate for Payer: Cash Price	$5,695.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,272.38
Rate for Payer: SOMOS Essential	$16,272.38

PR INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL

Professional

Both

$13,728.47

Service Code	HCPCS 61684
Min. Negotiated Rate	$10,296.35
Max. Negotiated Rate	$10,296.35
Rate for Payer: Cash Price	$3,611.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,296.35
Rate for Payer: SOMOS Essential	$10,296.35

PR INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL

Professional

Both

$20,052.34

Service Code	HCPCS 61682
Min. Negotiated Rate	$15,039.26
Max. Negotiated Rate	$15,039.26
Rate for Payer: Cash Price	$5,292.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15,039.26
Rate for Payer: SOMOS Essential	$15,039.26

PR INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL

Professional

Both

$10,722.71

Service Code	HCPCS 61680
Min. Negotiated Rate	$8,042.03
Max. Negotiated Rate	$8,042.03
Rate for Payer: Cash Price	$2,886.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,042.03
Rate for Payer: SOMOS Essential	$8,042.03

PR INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS

Professional

Both

$5.43

Service Code	HCPCS 95024
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$4.07
Rate for Payer: Cash Price	$1.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4.07
Rate for Payer: SOMOS Essential	$4.07

PR INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE

Professional

Both

$22.68

Service Code	HCPCS 95027
Min. Negotiated Rate	$17.01
Max. Negotiated Rate	$17.01
Rate for Payer: Cash Price	$6.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$17.01
Rate for Payer: SOMOS Essential	$17.01

PR INTRAFRACTION TRACK MOTION

Professional

Both

$82.50

Service Code	HCPCS G6017
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$61.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$61.88
Rate for Payer: SOMOS Essential	$61.88

PR INTRAOP EPICAR& ENDOCAR PACG& MAPG

Professional

Both

$1,713.53

Service Code	HCPCS 93631 26
Min. Negotiated Rate	$1,285.15
Max. Negotiated Rate	$1,285.15
Rate for Payer: Cash Price	$453.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,285.15
Rate for Payer: SOMOS Essential	$1,285.15

PR INTRAOP EPICAR& ENDOCAR PACG& MAPG

Professional

Both

$1,156.58

Service Code	HCPCS 93631 TC
Min. Negotiated Rate	$867.44
Max. Negotiated Rate	$867.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$867.44
Rate for Payer: SOMOS Essential	$867.44

PR INTRAOP EPICAR& ENDOCAR PACG& MAPG

Professional

Both

$2,870.11

Service Code	HCPCS 93631
Min. Negotiated Rate	$2,152.58
Max. Negotiated Rate	$2,152.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,152.58
Rate for Payer: SOMOS Essential	$2,152.58

PR INTRAOPERATIVE COLONIC LAVAGE

Professional

Both

$765.56

Service Code	HCPCS 44701
Min. Negotiated Rate	$574.17
Max. Negotiated Rate	$574.17
Rate for Payer: Cash Price	$202.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$574.17
Rate for Payer: SOMOS Essential	$574.17

PR INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION

Professional

Both

$612.71

Service Code	HCPCS 38900
Min. Negotiated Rate	$459.53
Max. Negotiated Rate	$459.53
Rate for Payer: Cash Price	$163.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$459.53
Rate for Payer: SOMOS Essential	$459.53

PR INTRAORAL I&D TONGUE/FLOOR LINGUAL

Professional

Both

$452.66

Service Code	HCPCS 41000
Min. Negotiated Rate	$339.50
Max. Negotiated Rate	$339.50
Rate for Payer: Cash Price	$120.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$339.50
Rate for Payer: SOMOS Essential	$339.50

PR INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE

Professional

Both

$1,206.49

Service Code	HCPCS 41009
Min. Negotiated Rate	$904.87
Max. Negotiated Rate	$904.87
Rate for Payer: Cash Price	$331.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$904.87
Rate for Payer: SOMOS Essential	$904.87

Know your out-of-pocket cost for care.

All Charges