St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY

Professional

Both

$5,591.92

Service Code	HCPCS 50548
Min. Negotiated Rate	$4,193.94
Max. Negotiated Rate	$4,193.94
Rate for Payer: Cash Price	$1,525.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,193.94
Rate for Payer: SOMOS Essential	$4,193.94

PR LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS

Professional

Both

$3,160.22

Service Code	HCPCS 54692
Min. Negotiated Rate	$2,370.16
Max. Negotiated Rate	$2,370.16
Rate for Payer: Cash Price	$863.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,370.16
Rate for Payer: SOMOS Essential	$2,370.16

PR LAPAROSCOPY PROCTOPEXY PROLAPSE

Professional

Both

$4,880.40

Service Code	HCPCS 45400
Min. Negotiated Rate	$3,660.30
Max. Negotiated Rate	$3,660.30
Rate for Payer: Cash Price	$1,317.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,660.30
Rate for Payer: SOMOS Essential	$3,660.30

PR LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ

Professional

Both

$6,598.62

Service Code	HCPCS 45402
Min. Negotiated Rate	$4,948.96
Max. Negotiated Rate	$4,948.96
Rate for Payer: Cash Price	$1,771.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,948.96
Rate for Payer: SOMOS Essential	$4,948.96

PR LAPAROSCOPY RADICAL NEPHRECTOMY

Professional

Both

$5,563.39

Service Code	HCPCS 50545
Min. Negotiated Rate	$4,172.54
Max. Negotiated Rate	$4,172.54
Rate for Payer: Cash Price	$1,518.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,172.54
Rate for Payer: SOMOS Essential	$4,172.54

PR LAPAROSCOPY SALPINGOSTOMY

Professional

Both

$3,461.33

Service Code	HCPCS 58673
Min. Negotiated Rate	$2,596.00
Max. Negotiated Rate	$2,596.00
Rate for Payer: Cash Price	$931.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,596.00
Rate for Payer: SOMOS Essential	$2,596.00

PR LAPAROSCOPY SLING OPERATION STRESS INCONT

Professional

Both

$3,576.62

Service Code	HCPCS 51992
Min. Negotiated Rate	$2,682.46
Max. Negotiated Rate	$2,682.46
Rate for Payer: Cash Price	$973.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,682.46
Rate for Payer: SOMOS Essential	$2,682.46

PR LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS

Professional

Both

$1,084.76

Service Code	HCPCS 44203
Min. Negotiated Rate	$813.57
Max. Negotiated Rate	$813.57
Rate for Payer: Cash Price	$284.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$813.57
Rate for Payer: SOMOS Essential	$813.57

PR LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<

Professional

Both

$3,166.31

Service Code	HCPCS 58541
Min. Negotiated Rate	$2,374.73
Max. Negotiated Rate	$2,374.73
Rate for Payer: Cash Price	$857.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,374.73
Rate for Payer: SOMOS Essential	$2,374.73

PR LAPAROSCOPY SURG ABLATION RENAL CYSTS

Professional

Both

$3,839.57

Service Code	HCPCS 50541
Min. Negotiated Rate	$2,879.68
Max. Negotiated Rate	$2,879.68
Rate for Payer: Cash Price	$1,046.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,879.68
Rate for Payer: SOMOS Essential	$2,879.68

PR LAPAROSCOPY SURG CHOLECYSTECTOMY

Professional

Both

$2,979.24

Service Code	HCPCS 47562
Min. Negotiated Rate	$2,234.43
Max. Negotiated Rate	$2,234.43
Rate for Payer: Cash Price	$797.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,234.43
Rate for Payer: SOMOS Essential	$2,234.43

PR LAPAROSCOPY SURG CHOLECYSTOENETEROSTOMY

Professional

Both

$3,522.93

Service Code	HCPCS 47570
Min. Negotiated Rate	$2,642.20
Max. Negotiated Rate	$2,642.20
Rate for Payer: Cash Price	$937.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,642.20
Rate for Payer: SOMOS Essential	$2,642.20

PR LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY

Professional

Both

$5,379.22

Service Code	HCPCS 44188
Min. Negotiated Rate	$4,034.42
Max. Negotiated Rate	$4,034.42
Rate for Payer: Cash Price	$1,437.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,034.42
Rate for Payer: SOMOS Essential	$4,034.42

PR LAPAROSCOPY SURGICAL JEJUNOSTOMY

Professional

Both

$2,935.45

Service Code	HCPCS 44186
Min. Negotiated Rate	$2,201.59
Max. Negotiated Rate	$2,201.59
Rate for Payer: Cash Price	$785.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,201.59
Rate for Payer: SOMOS Essential	$2,201.59

PR LAPAROSCOPY SURGICAL ORCHIECTOMY

Professional

Both

$2,742.85

Service Code	HCPCS 54690
Min. Negotiated Rate	$2,057.14
Max. Negotiated Rate	$2,057.14
Rate for Payer: Cash Price	$751.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,057.14
Rate for Payer: SOMOS Essential	$2,057.14

PR LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE

Professional

Both

$4,778.38

Service Code	HCPCS 44187
Min. Negotiated Rate	$3,583.78
Max. Negotiated Rate	$3,583.78
Rate for Payer: Cash Price	$1,281.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,583.78
Rate for Payer: SOMOS Essential	$3,583.78

PR LAPAROSCOPY SURG PARTIAL NEPHRECTOMY

Professional

Both

$6,213.48

Service Code	HCPCS 50543
Min. Negotiated Rate	$4,660.11
Max. Negotiated Rate	$4,660.11
Rate for Payer: Cash Price	$1,697.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,660.11
Rate for Payer: SOMOS Essential	$4,660.11

PR LAPAROSCOPY SURG PYELOPLASTY

Professional

Both

$5,173.77

Service Code	HCPCS 50544
Min. Negotiated Rate	$3,880.33
Max. Negotiated Rate	$3,880.33
Rate for Payer: Cash Price	$1,409.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,880.33
Rate for Payer: SOMOS Essential	$3,880.33

PR LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA

Professional

Both

$1,953.67

Service Code	HCPCS 49650
Min. Negotiated Rate	$1,465.25
Max. Negotiated Rate	$1,465.25
Rate for Payer: Cash Price	$524.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,465.25
Rate for Payer: SOMOS Essential	$1,465.25

PR LAPAROSCOPY SURG W/BX SINGLE/MULTIPLE

Professional

Both

$1,537.24

Service Code	HCPCS 49321
Min. Negotiated Rate	$1,152.93
Max. Negotiated Rate	$1,152.93
Rate for Payer: Cash Price	$412.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,152.93
Rate for Payer: SOMOS Essential	$1,152.93

PR LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM

Professional

Both

$4,524.77

Service Code	HCPCS 58572
Min. Negotiated Rate	$3,393.58
Max. Negotiated Rate	$3,393.58
Rate for Payer: Cash Price	$1,191.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,393.58
Rate for Payer: SOMOS Essential	$3,393.58

PR LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR

Professional

Both

$5,292.11

Service Code	HCPCS 58573
Min. Negotiated Rate	$3,969.08
Max. Negotiated Rate	$3,969.08
Rate for Payer: Cash Price	$1,433.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,969.08
Rate for Payer: SOMOS Essential	$3,969.08

PR LAPAROSCOPY URETHRAL SUSPENSION STRESS INCONT

Professional

Both

$3,122.67

Service Code	HCPCS 51990
Min. Negotiated Rate	$2,342.00
Max. Negotiated Rate	$2,342.00
Rate for Payer: Cash Price	$853.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,342.00
Rate for Payer: SOMOS Essential	$2,342.00

PR LAPAROSCOPY URTROLITHOTOMY

Professional

Both

$4,048.07

Service Code	HCPCS 50945
Min. Negotiated Rate	$3,036.05
Max. Negotiated Rate	$3,036.05
Rate for Payer: Cash Price	$1,105.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,036.05
Rate for Payer: SOMOS Essential	$3,036.05

PR LAPAROSCOPY W/LYSIS OF ADHESIONS

Professional

Both

$3,005.77

Service Code	HCPCS 58660
Min. Negotiated Rate	$2,254.33
Max. Negotiated Rate	$2,254.33
Rate for Payer: Cash Price	$812.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,254.33
Rate for Payer: SOMOS Essential	$2,254.33

Know your out-of-pocket cost for care.

All Charges