St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB

Professional

Both

$11.87

Service Code	HCPCS 95905 26
Min. Negotiated Rate	$8.90
Max. Negotiated Rate	$8.90
Rate for Payer: Cash Price	$3.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.90
Rate for Payer: SOMOS Essential	$8.90

PR M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL

Professional

Both

$597.10

Service Code	HCPCS 88368
Min. Negotiated Rate	$447.82
Max. Negotiated Rate	$447.82
Rate for Payer: Cash Price	$171.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$447.82
Rate for Payer: SOMOS Essential	$447.82

PR M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL

Professional

Both

$158.97

Service Code	HCPCS 88368 26
Min. Negotiated Rate	$119.23
Max. Negotiated Rate	$119.23
Rate for Payer: Cash Price	$44.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$119.23
Rate for Payer: SOMOS Essential	$119.23

PR M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL

Professional

Both

$438.17

Service Code	HCPCS 88368 TC
Min. Negotiated Rate	$328.63
Max. Negotiated Rate	$328.63
Rate for Payer: Cash Price	$126.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$328.63
Rate for Payer: SOMOS Essential	$328.63

PR M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN

Professional

Both

$476.39

Service Code	HCPCS 88367
Min. Negotiated Rate	$357.29
Max. Negotiated Rate	$357.29
Rate for Payer: Cash Price	$128.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$357.29
Rate for Payer: SOMOS Essential	$357.29

PR M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN

Professional

Both

$127.23

Service Code	HCPCS 88367 26
Min. Negotiated Rate	$95.42
Max. Negotiated Rate	$95.42
Rate for Payer: Cash Price	$34.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$95.42
Rate for Payer: SOMOS Essential	$95.42

PR M/PHMTRC ALYS ISH CPTR-ASST TECH 1ST PROBE STAIN

Professional

Both

$349.16

Service Code	HCPCS 88367 TC
Min. Negotiated Rate	$261.87
Max. Negotiated Rate	$261.87
Rate for Payer: Cash Price	$94.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$261.87
Rate for Payer: SOMOS Essential	$261.87

PR M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST

Professional

Both

$491.02

Service Code	HCPCS 88361
Min. Negotiated Rate	$368.26
Max. Negotiated Rate	$368.26
Rate for Payer: Cash Price	$136.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$368.26
Rate for Payer: SOMOS Essential	$368.26

PR M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST

Professional

Both

$324.73

Service Code	HCPCS 88361 TC
Min. Negotiated Rate	$243.55
Max. Negotiated Rate	$243.55
Rate for Payer: Cash Price	$91.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$243.55
Rate for Payer: SOMOS Essential	$243.55

PR M/PHMTRC ALYS TUMOR IMHCHEM EA ANTBDY CMPTR ASST

Professional

Both

$166.29

Service Code	HCPCS 88361 26
Min. Negotiated Rate	$124.72
Max. Negotiated Rate	$124.72
Rate for Payer: Cash Price	$45.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$124.72
Rate for Payer: SOMOS Essential	$124.72

PR M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL

Professional

Both

$492.87

Service Code	HCPCS 88360
Min. Negotiated Rate	$369.65
Max. Negotiated Rate	$369.65
Rate for Payer: Cash Price	$138.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$369.65
Rate for Payer: SOMOS Essential	$369.65

PR M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL

Professional

Both

$333.38

Service Code	HCPCS 88360 TC
Min. Negotiated Rate	$250.04
Max. Negotiated Rate	$250.04
Rate for Payer: Cash Price	$94.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$250.04
Rate for Payer: SOMOS Essential	$250.04

PR M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL

Professional

Both

$159.50

Service Code	HCPCS 88360 26
Min. Negotiated Rate	$119.62
Max. Negotiated Rate	$119.62
Rate for Payer: Cash Price	$43.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$119.62
Rate for Payer: SOMOS Essential	$119.62

PR MRGFUS STEREOTACTIC ABLATION LESION INTRACRANIAL

Professional

Both

$6,925.28

Service Code	HCPCS 0398T 26
Min. Negotiated Rate	$5,193.96
Max. Negotiated Rate	$5,193.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,193.96
Rate for Payer: SOMOS Essential	$5,193.96

PR MULTIFETAL PREGNANCY REDUCTION

Professional

Both

$1,102.78

Service Code	HCPCS 59866
Min. Negotiated Rate	$827.08
Max. Negotiated Rate	$827.08
Rate for Payer: Cash Price	$292.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$827.08
Rate for Payer: SOMOS Essential	$827.08

PR MULTIFOCAL ELECTRORETINOGRAPHY W/I&R

Professional

Both

$372.26

Service Code	HCPCS 92274
Min. Negotiated Rate	$279.20
Max. Negotiated Rate	$279.20
Rate for Payer: Cash Price	$103.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$279.20
Rate for Payer: SOMOS Essential	$279.20

PR MULTIFOCAL ELECTRORETINOGRAPHY W/I&R

Professional

Both

$242.80

Service Code	HCPCS 92274 TC
Min. Negotiated Rate	$182.10
Max. Negotiated Rate	$182.10
Rate for Payer: Cash Price	$67.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$182.10
Rate for Payer: SOMOS Essential	$182.10

PR MULTIFOCAL ELECTRORETINOGRAPHY W/I&R

Professional

Both

$129.47

Service Code	HCPCS 92274 26
Min. Negotiated Rate	$97.10
Max. Negotiated Rate	$97.10
Rate for Payer: Cash Price	$35.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$97.10
Rate for Payer: SOMOS Essential	$97.10

PR MULTIPLE FAMILY GROUP PSYCHOTHERAPY

Professional

Both

$113.86

Service Code	HCPCS 90849
Min. Negotiated Rate	$85.40
Max. Negotiated Rate	$85.40
Rate for Payer: Cash Price	$32.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$85.40
Rate for Payer: SOMOS Essential	$85.40

PR MULTIPLE PUNCTURES ANTERIOR CORNEA

Professional

Both

$1,398.74

Service Code	HCPCS 65600
Min. Negotiated Rate	$1,049.06
Max. Negotiated Rate	$1,049.06
Rate for Payer: Cash Price	$388.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,049.06
Rate for Payer: SOMOS Essential	$1,049.06

PR MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE

Professional

Both

$3,339.91

Service Code	HCPCS 24301
Min. Negotiated Rate	$2,504.93
Max. Negotiated Rate	$2,504.93
Rate for Payer: Cash Price	$899.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,504.93
Rate for Payer: SOMOS Essential	$2,504.93

PR MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE

Professional

Both

$5,029.99

Service Code	HCPCS 23397
Min. Negotiated Rate	$3,772.49
Max. Negotiated Rate	$3,772.49
Rate for Payer: Cash Price	$1,360.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,772.49
Rate for Payer: SOMOS Essential	$3,772.49

PR MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE

Professional

Both

$5,639.03

Service Code	HCPCS 23395
Min. Negotiated Rate	$4,229.27
Max. Negotiated Rate	$4,229.27
Rate for Payer: Cash Price	$1,527.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,229.27
Rate for Payer: SOMOS Essential	$4,229.27

PR MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR

Professional

Both

$5,556.46

Service Code	HCPCS 15738
Min. Negotiated Rate	$4,167.34
Max. Negotiated Rate	$4,167.34
Rate for Payer: Cash Price	$1,494.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,167.34
Rate for Payer: SOMOS Essential	$4,167.34

PR MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK

Professional

Both

$6,641.43

Service Code	HCPCS 15734
Min. Negotiated Rate	$4,981.07
Max. Negotiated Rate	$4,981.07
Rate for Payer: Cash Price	$1,782.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,981.07
Rate for Payer: SOMOS Essential	$4,981.07

Know your out-of-pocket cost for care.

All Charges