St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC

Professional

Both

$5,935.20

Service Code	HCPCS 32820
Min. Negotiated Rate	$4,451.40
Max. Negotiated Rate	$4,451.40
Rate for Payer: Cash Price	$1,582.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,451.40
Rate for Payer: SOMOS Essential	$4,451.40

PR MALAR AUGMENTATION PROSTHETIC MATERIAL

Professional

Both

$3,275.41

Service Code	HCPCS 21270
Min. Negotiated Rate	$2,456.56
Max. Negotiated Rate	$2,456.56
Rate for Payer: Cash Price	$882.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,456.56
Rate for Payer: SOMOS Essential	$2,456.56

PR MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD

Professional

Both

$345.80

Service Code	HCPCS 26341
Min. Negotiated Rate	$259.35
Max. Negotiated Rate	$259.35
Rate for Payer: Cash Price	$93.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$259.35
Rate for Payer: SOMOS Essential	$259.35

PR MANIPULATION ANKLE UNDER GENERAL ANESTHESIA

Professional

Both

$708.61

Service Code	HCPCS 27860
Min. Negotiated Rate	$531.46
Max. Negotiated Rate	$531.46
Rate for Payer: Cash Price	$191.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$531.46
Rate for Payer: SOMOS Essential	$531.46

PR MANIPULATION ELBOW UNDER ANESTHESIA

Professional

Both

$1,930.36

Service Code	HCPCS 24300
Min. Negotiated Rate	$1,447.77
Max. Negotiated Rate	$1,447.77
Rate for Payer: Cash Price	$533.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,447.77
Rate for Payer: SOMOS Essential	$1,447.77

PR MANIPULATION FINGER JOINT UNDER ANES EACH JOINT

Professional

Both

$1,568.35

Service Code	HCPCS 26340
Min. Negotiated Rate	$1,176.26
Max. Negotiated Rate	$1,176.26
Rate for Payer: Cash Price	$433.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,176.26
Rate for Payer: SOMOS Essential	$1,176.26

PR MANIPULATION HIP JOINT GENERAL ANESTHESIA

Professional

Both

$810.60

Service Code	HCPCS 27275
Min. Negotiated Rate	$607.95
Max. Negotiated Rate	$607.95
Rate for Payer: Cash Price	$220.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$607.95
Rate for Payer: SOMOS Essential	$607.95

PR MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA

Professional

Both

$679.21

Service Code	HCPCS 27570
Min. Negotiated Rate	$509.41
Max. Negotiated Rate	$509.41
Rate for Payer: Cash Price	$185.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$509.41
Rate for Payer: SOMOS Essential	$509.41

PR MANIPULATION SPINE REQUIRING ANESTHESIA

Professional

Both

$572.64

Service Code	HCPCS 22505
Min. Negotiated Rate	$429.48
Max. Negotiated Rate	$429.48
Rate for Payer: Cash Price	$156.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$429.48
Rate for Payer: SOMOS Essential	$429.48

PR MANIPULATION TMJ THERAPEUTIC REQUIRE ANESTHESIA

Professional

Both

$1,022.11

Service Code	HCPCS 21073
Min. Negotiated Rate	$766.58
Max. Negotiated Rate	$766.58
Rate for Payer: Cash Price	$277.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$766.58
Rate for Payer: SOMOS Essential	$766.58

PR MANIPULATION WRIST UNDER ANESTHESIA

Professional

Both

$1,914.40

Service Code	HCPCS 25259
Min. Negotiated Rate	$1,435.80
Max. Negotiated Rate	$1,435.80
Rate for Payer: Cash Price	$524.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,435.80
Rate for Payer: SOMOS Essential	$1,435.80

PR MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ

Professional

Both

$159.29

Service Code	HCPCS 94668
Min. Negotiated Rate	$119.47
Max. Negotiated Rate	$119.47
Rate for Payer: Cash Price	$47.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$119.47
Rate for Payer: SOMOS Essential	$119.47

PR MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL

Professional

Both

$103.22

Service Code	HCPCS 94667
Min. Negotiated Rate	$77.42
Max. Negotiated Rate	$77.42
Rate for Payer: Cash Price	$29.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$77.42
Rate for Payer: SOMOS Essential	$77.42

PR MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS

Professional

Both

$866.95

Service Code	HCPCS 23700
Min. Negotiated Rate	$650.21
Max. Negotiated Rate	$650.21
Rate for Payer: Cash Price	$234.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$650.21
Rate for Payer: SOMOS Essential	$650.21

PR MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH

Professional

Both

$476.18

Service Code	HCPCS 50396
Min. Negotiated Rate	$357.14
Max. Negotiated Rate	$357.14
Rate for Payer: Cash Price	$129.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$357.14
Rate for Payer: SOMOS Essential	$357.14

PR MANOMETRIC STDS THRU URTROST/NDWELLG URTRL CATH

Professional

Both

$367.75

Service Code	HCPCS 50686
Min. Negotiated Rate	$275.81
Max. Negotiated Rate	$275.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$275.81
Rate for Payer: SOMOS Essential	$275.81

PR MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV

Professional

Both

$368.13

Service Code	HCPCS 20700
Min. Negotiated Rate	$276.10
Max. Negotiated Rate	$276.10
Rate for Payer: Cash Price	$99.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$276.10
Rate for Payer: SOMOS Essential	$276.10

PR MANUAL PREP&INSJ I-ARTIC DRUG DELIVERY DEVICE

Professional

Both

$642.29

Service Code	HCPCS 20704
Min. Negotiated Rate	$481.72
Max. Negotiated Rate	$481.72
Rate for Payer: Cash Price	$175.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$481.72
Rate for Payer: SOMOS Essential	$481.72

PR MANUAL PREP&INSJ INTRAMEDULLARY DRUG DLVR DEVICE

Professional

Both

$625.45

Service Code	HCPCS 20702
Min. Negotiated Rate	$469.09
Max. Negotiated Rate	$469.09
Rate for Payer: Cash Price	$166.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$469.09
Rate for Payer: SOMOS Essential	$469.09

PR MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES

Professional

Both

$109.80

Service Code	HCPCS 97140
Min. Negotiated Rate	$82.35
Max. Negotiated Rate	$82.35
Rate for Payer: Cash Price	$30.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$82.35
Rate for Payer: SOMOS Essential	$82.35

PR MARSUPIALIZATION BARTHOLINS GLAND CYST

Professional

Both

$788.13

Service Code	HCPCS 56440
Min. Negotiated Rate	$591.10
Max. Negotiated Rate	$591.10
Rate for Payer: Cash Price	$214.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$591.10
Rate for Payer: SOMOS Essential	$591.10

PR MARSUPIALIZATION CST/ABSC LVR

Professional

Both

$5,123.16

Service Code	HCPCS 47300
Min. Negotiated Rate	$3,842.37
Max. Negotiated Rate	$3,842.37
Rate for Payer: Cash Price	$1,367.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,842.37
Rate for Payer: SOMOS Essential	$3,842.37

PR MARSUPIALIZATION PANCREATIC CYST

Professional

Both

$5,202.79

Service Code	HCPCS 48500
Min. Negotiated Rate	$3,902.09
Max. Negotiated Rate	$3,902.09
Rate for Payer: Cash Price	$1,386.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,902.09
Rate for Payer: SOMOS Essential	$3,902.09

PR MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA

Professional

Both

$1,004.08

Service Code	HCPCS 42409
Min. Negotiated Rate	$753.06
Max. Negotiated Rate	$753.06
Rate for Payer: Cash Price	$274.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$753.06
Rate for Payer: SOMOS Essential	$753.06

PR MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE

Professional

Both

$1,787.91

Service Code	HCPCS 53240
Min. Negotiated Rate	$1,340.93
Max. Negotiated Rate	$1,340.93
Rate for Payer: Cash Price	$491.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,340.93
Rate for Payer: SOMOS Essential	$1,340.93

Know your out-of-pocket cost for care.

All Charges