St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR

Professional

Both

$14,638.33

Service Code	HCPCS 63252
Min. Negotiated Rate	$10,978.75
Max. Negotiated Rate	$10,978.75
Rate for Payer: Cash Price	$3,849.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,978.75
Rate for Payer: SOMOS Essential	$10,978.75

PR LAM EXC/OCCLUSION AVM SPINAL CORD CERVICAL

Professional

Both

$14,327.67

Service Code	HCPCS 63250
Min. Negotiated Rate	$10,745.75
Max. Negotiated Rate	$10,745.75
Rate for Payer: Cash Price	$3,766.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,745.75
Rate for Payer: SOMOS Essential	$10,745.75

PR LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC

Professional

Both

$14,645.05

Service Code	HCPCS 63251
Min. Negotiated Rate	$10,983.79
Max. Negotiated Rate	$10,983.79
Rate for Payer: Cash Price	$3,849.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,983.79
Rate for Payer: SOMOS Essential	$10,983.79

PR LAM FACETEC/FORAMOT DRG ARTHRD LMBR EA ADDL SGM

Professional

Both

$1,058.37

Service Code	HCPCS 63053
Min. Negotiated Rate	$793.78
Max. Negotiated Rate	$793.78
Rate for Payer: Cash Price	$281.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$793.78
Rate for Payer: SOMOS Essential	$793.78

PR LAM FACETEC/FORAMOT DRG ARTHRD LUMBAR 1 VRT SGM

Professional

Both

$1,198.23

Service Code	HCPCS 63052
Min. Negotiated Rate	$898.67
Max. Negotiated Rate	$898.67
Rate for Payer: Cash Price	$316.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$898.67
Rate for Payer: SOMOS Essential	$898.67

PR LAM FACETECTOMY&FORAMOT 1 VRT SGM EA ADDL SGM

Professional

Both

$973.35

Service Code	HCPCS 63048
Min. Negotiated Rate	$730.01
Max. Negotiated Rate	$730.01
Rate for Payer: Cash Price	$258.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$730.01
Rate for Payer: SOMOS Essential	$730.01

PR LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT CERVICAL

Professional

Both

$6,064.10

Service Code	HCPCS 63045
Min. Negotiated Rate	$4,548.08
Max. Negotiated Rate	$4,548.08
Rate for Payer: Cash Price	$1,610.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,548.08
Rate for Payer: SOMOS Essential	$4,548.08

PR LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT LUMBAR

Professional

Both

$5,130.06

Service Code	HCPCS 63047
Min. Negotiated Rate	$3,847.54
Max. Negotiated Rate	$3,847.54
Rate for Payer: Cash Price	$1,367.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,847.54
Rate for Payer: SOMOS Essential	$3,847.54

PR LAM FACETECTOMY & FORAMOTOMY 1 SEGMENT THORACIC

Professional

Both

$5,735.07

Service Code	HCPCS 63046
Min. Negotiated Rate	$4,301.30
Max. Negotiated Rate	$4,301.30
Rate for Payer: Cash Price	$1,528.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,301.30
Rate for Payer: SOMOS Essential	$4,301.30

PR LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL

Professional

Both

$3,922.10

Service Code	HCPCS 63655
Min. Negotiated Rate	$2,941.58
Max. Negotiated Rate	$2,941.58
Rate for Payer: Cash Price	$1,046.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,941.58
Rate for Payer: SOMOS Essential	$2,941.58

PR LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL

Professional

Both

$8,655.71

Service Code	HCPCS 63275
Min. Negotiated Rate	$6,491.78
Max. Negotiated Rate	$6,491.78
Rate for Payer: Cash Price	$2,269.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,491.78
Rate for Payer: SOMOS Essential	$6,491.78

PR LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR

Professional

Both

$7,392.39

Service Code	HCPCS 63277
Min. Negotiated Rate	$5,544.29
Max. Negotiated Rate	$5,544.29
Rate for Payer: Cash Price	$1,954.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,544.29
Rate for Payer: SOMOS Essential	$5,544.29

PR LAMINECTOMY BX/EXC ISPI NEO XDRL SACRAL

Professional

Both

$7,691.88

Service Code	HCPCS 63278
Min. Negotiated Rate	$5,768.91
Max. Negotiated Rate	$5,768.91
Rate for Payer: Cash Price	$2,031.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,768.91
Rate for Payer: SOMOS Essential	$5,768.91

PR LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC

Professional

Both

$8,530.48

Service Code	HCPCS 63276
Min. Negotiated Rate	$6,397.86
Max. Negotiated Rate	$6,397.86
Rate for Payer: Cash Price	$2,256.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,397.86
Rate for Payer: SOMOS Essential	$6,397.86

PR LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR

Professional

Both

$7,261.07

Service Code	HCPCS 63200
Min. Negotiated Rate	$5,445.80
Max. Negotiated Rate	$5,445.80
Rate for Payer: Cash Price	$1,942.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,445.80
Rate for Payer: SOMOS Essential	$5,445.80

PR LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR

Professional

Both

$5,658.07

Service Code	HCPCS 63005
Min. Negotiated Rate	$4,243.55
Max. Negotiated Rate	$4,243.55
Rate for Payer: Cash Price	$1,506.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,243.55
Rate for Payer: SOMOS Essential	$4,243.55

PR LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL

Professional

Both

$4,974.97

Service Code	HCPCS 63011
Min. Negotiated Rate	$3,731.23
Max. Negotiated Rate	$3,731.23
Rate for Payer: Cash Price	$1,324.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,731.23
Rate for Payer: SOMOS Essential	$3,731.23

PR LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC

Professional

Both

$5,824.74

Service Code	HCPCS 63003
Min. Negotiated Rate	$4,368.56
Max. Negotiated Rate	$4,368.56
Rate for Payer: Cash Price	$1,546.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,368.56
Rate for Payer: SOMOS Essential	$4,368.56

PR LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL

Professional

Both

$7,030.49

Service Code	HCPCS 63015
Min. Negotiated Rate	$5,272.87
Max. Negotiated Rate	$5,272.87
Rate for Payer: Cash Price	$1,864.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,272.87
Rate for Payer: SOMOS Essential	$5,272.87

PR LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR

Professional

Both

$6,009.85

Service Code	HCPCS 63017
Min. Negotiated Rate	$4,507.39
Max. Negotiated Rate	$4,507.39
Rate for Payer: Cash Price	$1,593.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,507.39
Rate for Payer: SOMOS Essential	$4,507.39

PR LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC

Professional

Both

$7,238.74

Service Code	HCPCS 63016
Min. Negotiated Rate	$5,429.06
Max. Negotiated Rate	$5,429.06
Rate for Payer: Cash Price	$1,912.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,429.06
Rate for Payer: SOMOS Essential	$5,429.06

PR LAMINECTOMY W/RHIZOTOMY 1/2 SEGMENTS

Professional

Both

$5,233.13

Service Code	HCPCS 63185
Min. Negotiated Rate	$3,924.85
Max. Negotiated Rate	$3,924.85
Rate for Payer: Cash Price	$1,565.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,924.85
Rate for Payer: SOMOS Essential	$3,924.85

PR LAMINECTOMY W/RHIZOTOMY > 2 SEGMENTS

Professional

Both

$5,473.09

Service Code	HCPCS 63190
Min. Negotiated Rate	$4,104.82
Max. Negotiated Rate	$4,104.82
Rate for Payer: Cash Price	$1,475.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,104.82
Rate for Payer: SOMOS Essential	$4,104.82

PR LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR

Professional

Both

$5,606.93

Service Code	HCPCS 63012
Min. Negotiated Rate	$4,205.20
Max. Negotiated Rate	$4,205.20
Rate for Payer: Cash Price	$1,485.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,205.20
Rate for Payer: SOMOS Essential	$4,205.20

PR LAMINECTOMY W/SECTION SPINAL ACCESSORY NERVE

Professional

Both

$6,659.38

Service Code	HCPCS 63191
Min. Negotiated Rate	$4,994.54
Max. Negotiated Rate	$4,994.54
Rate for Payer: Cash Price	$1,760.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,994.54
Rate for Payer: SOMOS Essential	$4,994.54

Know your out-of-pocket cost for care.

All Charges