St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC

Professional

Both

$5,090.65

Service Code	HCPCS 63020
Min. Negotiated Rate	$3,817.99
Max. Negotiated Rate	$3,817.99
Rate for Payer: Cash Price	$1,360.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,817.99
Rate for Payer: SOMOS Essential	$3,817.99

PR LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR

Professional

Both

$4,226.32

Service Code	HCPCS 63030
Min. Negotiated Rate	$3,169.74
Max. Negotiated Rate	$3,169.74
Rate for Payer: Cash Price	$1,132.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,169.74
Rate for Payer: SOMOS Essential	$3,169.74

PR LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR

Professional

Both

$1,085.07

Service Code	HCPCS 63035
Min. Negotiated Rate	$813.80
Max. Negotiated Rate	$813.80
Rate for Payer: Cash Price	$285.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$813.80
Rate for Payer: SOMOS Essential	$813.80

PR LAMOP CERVICAL W/DCMPRN SPI CORD 2/> VERT SEG

Professional

Both

$6,754.27

Service Code	HCPCS 63050
Min. Negotiated Rate	$5,065.70
Max. Negotiated Rate	$5,065.70
Rate for Payer: Cash Price	$1,792.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,065.70
Rate for Payer: SOMOS Essential	$5,065.70

PR LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ

Professional

Both

$7,797.30

Service Code	HCPCS 63051
Min. Negotiated Rate	$5,847.98
Max. Negotiated Rate	$5,847.98
Rate for Payer: Cash Price	$2,074.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,847.98
Rate for Payer: SOMOS Essential	$5,847.98

PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL

Professional

Both

$6,392.86

Service Code	HCPCS 63040
Min. Negotiated Rate	$4,794.64
Max. Negotiated Rate	$4,794.64
Rate for Payer: Cash Price	$1,694.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,794.64
Rate for Payer: SOMOS Essential	$4,794.64

PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV

Professional

Both

$1,124.38

Service Code	HCPCS 63043
Min. Negotiated Rate	$843.28
Max. Negotiated Rate	$843.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$843.28
Rate for Payer: SOMOS Essential	$843.28

PR LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR

Professional

Both

$5,956.86

Service Code	HCPCS 63042
Min. Negotiated Rate	$4,467.64
Max. Negotiated Rate	$4,467.64
Rate for Payer: Cash Price	$1,591.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,467.64
Rate for Payer: SOMOS Essential	$4,467.64

PR LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR

Professional

Both

$1,197.46

Service Code	HCPCS 63044
Min. Negotiated Rate	$898.10
Max. Negotiated Rate	$898.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$898.10
Rate for Payer: SOMOS Essential	$898.10

PR LAM W/CORDOTOMY SCTJ SPINOTHALAMIC TRC 1STG THRC

Professional

Both

$8,258.46

Service Code	HCPCS 63197
Min. Negotiated Rate	$6,193.84
Max. Negotiated Rate	$6,193.84
Rate for Payer: Cash Price	$2,180.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,193.84
Rate for Payer: SOMOS Essential	$6,193.84

PR LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID

Professional

Both

$6,821.54

Service Code	HCPCS 63172
Min. Negotiated Rate	$5,116.16
Max. Negotiated Rate	$5,116.16
Rate for Payer: Cash Price	$1,800.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,116.16
Rate for Payer: SOMOS Essential	$5,116.16

PR LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL

Professional

Both

$8,327.69

Service Code	HCPCS 63173
Min. Negotiated Rate	$6,245.77
Max. Negotiated Rate	$6,245.77
Rate for Payer: Cash Price	$2,199.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,245.77
Rate for Payer: SOMOS Essential	$6,245.77

PR LAM W/MYELOTOMY CERVICAL/THORACIC/THORACOLUMBAR

Professional

Both

$7,686.91

Service Code	HCPCS 63170
Min. Negotiated Rate	$5,765.18
Max. Negotiated Rate	$5,765.18
Rate for Payer: Cash Price	$2,030.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,765.18
Rate for Payer: SOMOS Essential	$5,765.18

PR LAM W/O FACETEC FORAMOT/DSKC 1/2 VRT SEG CRV

Professional

Both

$5,845.18

Service Code	HCPCS 63001
Min. Negotiated Rate	$4,383.88
Max. Negotiated Rate	$4,383.88
Rate for Payer: Cash Price	$1,542.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,383.88
Rate for Payer: SOMOS Essential	$4,383.88

PR LAPAROSCOPIC APPENDECTOMY

Professional

Both

$2,718.66

Service Code	HCPCS 44970
Min. Negotiated Rate	$2,039.00
Max. Negotiated Rate	$2,039.00
Rate for Payer: Cash Price	$727.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,039.00
Rate for Payer: SOMOS Essential	$2,039.00

PR LAPAROSCOPIC SURGICAL SPLENECTOMY

Professional

Both

$4,771.10

Service Code	HCPCS 38120
Min. Negotiated Rate	$3,578.32
Max. Negotiated Rate	$3,578.32
Rate for Payer: Cash Price	$1,275.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,578.32
Rate for Payer: SOMOS Essential	$3,578.32

PR LAPAROSCOPY ADRENALECTOMY PRTL/COMPL TABDL

Professional

Both

$5,263.48

Service Code	HCPCS 60650
Min. Negotiated Rate	$3,947.61
Max. Negotiated Rate	$3,947.61
Rate for Payer: Cash Price	$1,414.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,947.61
Rate for Payer: SOMOS Essential	$3,947.61

PR LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS

Professional

Both

$6,797.60

Service Code	HCPCS 44204
Min. Negotiated Rate	$5,098.20
Max. Negotiated Rate	$5,098.20
Rate for Payer: Cash Price	$1,816.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,098.20
Rate for Payer: SOMOS Essential	$5,098.20

PR LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX

Professional

Both

$4,206.97

Service Code	HCPCS 57425
Min. Negotiated Rate	$3,155.23
Max. Negotiated Rate	$3,155.23
Rate for Payer: Cash Price	$1,136.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,155.23
Rate for Payer: SOMOS Essential	$3,155.23

PR LAPAROSCOPY DONOR NEPHRECTOMY LIVING DONOR

Professional

Both

$7,214.52

Service Code	HCPCS 50547
Min. Negotiated Rate	$5,410.89
Max. Negotiated Rate	$5,410.89
Rate for Payer: Cash Price	$1,938.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,410.89
Rate for Payer: SOMOS Essential	$5,410.89

PR LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE

Professional

Both

$4,138.86

Service Code	HCPCS 44180
Min. Negotiated Rate	$3,104.14
Max. Negotiated Rate	$3,104.14
Rate for Payer: Cash Price	$1,104.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,104.14
Rate for Payer: SOMOS Essential	$3,104.14

PR LAPAROSCOPY FIMBRIOPLASTY

Professional

Both

$3,188.75

Service Code	HCPCS 58672
Min. Negotiated Rate	$2,391.56
Max. Negotiated Rate	$2,391.56
Rate for Payer: Cash Price	$858.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,391.56
Rate for Payer: SOMOS Essential	$2,391.56

PR LAPAROSCOPY FULGURATION OVIDUCTS

Professional

Both

$1,623.76

Service Code	HCPCS 58670
Min. Negotiated Rate	$1,217.82
Max. Negotiated Rate	$1,217.82
Rate for Payer: Cash Price	$439.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,217.82
Rate for Payer: SOMOS Essential	$1,217.82

PR LAPAROSCOPY ISLET CELL TRANS

Professional

Both

$3,410.75

Service Code	HCPCS G0342
Min. Negotiated Rate	$2,558.06
Max. Negotiated Rate	$2,558.06
Rate for Payer: Cash Price	$910.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,558.06
Rate for Payer: SOMOS Essential	$2,558.06

PR LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT

Professional

Both

$5,061.28

Service Code	HCPCS 50546
Min. Negotiated Rate	$3,795.96
Max. Negotiated Rate	$3,795.96
Rate for Payer: Cash Price	$1,378.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,795.96
Rate for Payer: SOMOS Essential	$3,795.96

Know your out-of-pocket cost for care.

All Charges