St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR LUNG TRANSPLANT 1 W/CARDIOPULMONARY BYPASS

Professional

Both

$15,601.78

Service Code	HCPCS 32852
Min. Negotiated Rate	$11,701.34
Max. Negotiated Rate	$11,701.34
Rate for Payer: Cash Price	$4,139.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$11,701.34
Rate for Payer: SOMOS Essential	$11,701.34

PR LUNG TRANSPLANT 1 W/O CARDIOPULMONARY BYPASS

Professional

Both

$14,544.57

Service Code	HCPCS 32851
Min. Negotiated Rate	$10,908.43
Max. Negotiated Rate	$10,908.43
Rate for Payer: Cash Price	$3,865.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,908.43
Rate for Payer: SOMOS Essential	$10,908.43

PR LUNG TRANSPLANT 2 W/CARDIOPULMONARY BYPASS

Professional

Both

$21,506.45

Service Code	HCPCS 32854
Min. Negotiated Rate	$16,129.84
Max. Negotiated Rate	$16,129.84
Rate for Payer: Cash Price	$5,715.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,129.84
Rate for Payer: SOMOS Essential	$16,129.84

PR LUNG TRANSPLANT 2 W/O CARDIOPULMONARY BYPASS

Professional

Both

$20,313.83

Service Code	HCPCS 32853
Min. Negotiated Rate	$15,235.37
Max. Negotiated Rate	$15,235.37
Rate for Payer: Cash Price	$5,400.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15,235.37
Rate for Payer: SOMOS Essential	$15,235.37

PR LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE

Professional

Both

$24,286.33

Service Code	HCPCS 47135
Min. Negotiated Rate	$18,214.75
Max. Negotiated Rate	$18,214.75
Rate for Payer: Cash Price	$6,481.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$18,214.75
Rate for Payer: SOMOS Essential	$18,214.75

PR LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS

Professional

Both

$2,080.61

Service Code	HCPCS 38308
Min. Negotiated Rate	$1,560.46
Max. Negotiated Rate	$1,560.46
Rate for Payer: Cash Price	$565.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,560.46
Rate for Payer: SOMOS Essential	$1,560.46

PR LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS

Professional

Both

$844.41

Service Code	HCPCS 54162
Min. Negotiated Rate	$633.31
Max. Negotiated Rate	$633.31
Rate for Payer: Cash Price	$231.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$633.31
Rate for Payer: SOMOS Essential	$633.31

PR LYSIS INTRANASAL SYNECHIA

Professional

Both

$654.50

Service Code	HCPCS 30560
Min. Negotiated Rate	$490.88
Max. Negotiated Rate	$490.88
Rate for Payer: Cash Price	$178.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$490.88
Rate for Payer: SOMOS Essential	$490.88

PR LYSIS LABIAL ADHESIONS

Professional

Both

$670.01

Service Code	HCPCS 56441
Min. Negotiated Rate	$502.51
Max. Negotiated Rate	$502.51
Rate for Payer: Cash Price	$183.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$502.51
Rate for Payer: SOMOS Essential	$502.51

PR LYSIS OF ADHESIONS SALPINX/OVARY

Professional

Both

$3,963.82

Service Code	HCPCS 58740
Min. Negotiated Rate	$2,972.86
Max. Negotiated Rate	$2,972.86
Rate for Payer: Cash Price	$1,066.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,972.86
Rate for Payer: SOMOS Essential	$2,972.86

PR MACRO EXAM/DISSECT/PREP, FOR NON-MICRO, IMPRINT/INTRAOP/FROZEN, EA

Professional

Both

$150.96

Service Code	HCPCS 88388
Min. Negotiated Rate	$113.22
Max. Negotiated Rate	$113.22
Rate for Payer: Cash Price	$40.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$113.22
Rate for Payer: SOMOS Essential	$113.22

PR MACRO EXAM/DISSECT/PREP, FOR NON-MICRO, IMPRINT/INTRAOP/FROZEN, EA

Professional

Both

$60.24

Service Code	HCPCS 88388 TC
Min. Negotiated Rate	$45.18
Max. Negotiated Rate	$45.18
Rate for Payer: Cash Price	$15.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$45.18
Rate for Payer: SOMOS Essential	$45.18

PR MACRO EXAM/DISSECT/PREP, FOR NON-MICRO, IMPRINT/INTRAOP/FROZEN, EA

Professional

Both

$90.72

Service Code	HCPCS 88388 26
Min. Negotiated Rate	$68.04
Max. Negotiated Rate	$68.04
Rate for Payer: Cash Price	$24.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$68.04
Rate for Payer: SOMOS Essential	$68.04

PR MACRO EXAM/DISSECT/PREP FOR NON-MICRO STUDY, EA

Professional

Both

$101.96

Service Code	HCPCS 88387 26
Min. Negotiated Rate	$76.47
Max. Negotiated Rate	$76.47
Rate for Payer: Cash Price	$27.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$76.47
Rate for Payer: SOMOS Essential	$76.47

PR MACRO EXAM/DISSECT/PREP FOR NON-MICRO STUDY, EA

Professional

Both

$34.37

Service Code	HCPCS 88387 TC
Min. Negotiated Rate	$25.78
Max. Negotiated Rate	$25.78
Rate for Payer: Cash Price	$8.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25.78
Rate for Payer: SOMOS Essential	$25.78

PR MACRO EXAM/DISSECT/PREP FOR NON-MICRO STUDY, EA

Professional

Both

$136.33

Service Code	HCPCS 88387
Min. Negotiated Rate	$102.25
Max. Negotiated Rate	$102.25
Rate for Payer: Cash Price	$36.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$102.25
Rate for Payer: SOMOS Essential	$102.25

PR MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY

Professional

Both

$10,194.52

Service Code	HCPCS 95965 TC
Min. Negotiated Rate	$7,645.89
Max. Negotiated Rate	$7,645.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,645.89
Rate for Payer: SOMOS Essential	$7,645.89

PR MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY

Professional

Both

$1,632.68

Service Code	HCPCS 95965 26
Min. Negotiated Rate	$1,224.51
Max. Negotiated Rate	$1,224.51
Rate for Payer: Cash Price	$447.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,224.51
Rate for Payer: SOMOS Essential	$1,224.51

PR MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY

Professional

Both

$11,827.20

Service Code	HCPCS 95965
Min. Negotiated Rate	$8,870.40
Max. Negotiated Rate	$8,870.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,870.40
Rate for Payer: SOMOS Essential	$8,870.40

PR MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY

Professional

Both

$7,365.23

Service Code	HCPCS 95966
Min. Negotiated Rate	$5,523.92
Max. Negotiated Rate	$5,523.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,523.92
Rate for Payer: SOMOS Essential	$5,523.92

PR MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY

Professional

Both

$6,530.16

Service Code	HCPCS 95966 TC
Min. Negotiated Rate	$4,897.62
Max. Negotiated Rate	$4,897.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,897.62
Rate for Payer: SOMOS Essential	$4,897.62

PR MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY

Professional

Both

$835.07

Service Code	HCPCS 95966 26
Min. Negotiated Rate	$626.30
Max. Negotiated Rate	$626.30
Rate for Payer: Cash Price	$217.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$626.30
Rate for Payer: SOMOS Essential	$626.30

PR MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL

Professional

Both

$733.74

Service Code	HCPCS 95967 26
Min. Negotiated Rate	$550.30
Max. Negotiated Rate	$550.30
Rate for Payer: Cash Price	$188.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$550.30
Rate for Payer: SOMOS Essential	$550.30

PR MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL

Professional

Both

$4,097.94

Service Code	HCPCS 95967 TC
Min. Negotiated Rate	$3,073.46
Max. Negotiated Rate	$3,073.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,073.46
Rate for Payer: SOMOS Essential	$3,073.46

PR MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL

Professional

Both

$4,831.68

Service Code	HCPCS 95967
Min. Negotiated Rate	$3,623.76
Max. Negotiated Rate	$3,623.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,623.76
Rate for Payer: SOMOS Essential	$3,623.76

Know your out-of-pocket cost for care.

All Charges