St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR NASAL/SINUS NDSC SURG MEDIAL/INF ORB WALL DCMPRN

Professional

Both

$4,287.99

Service Code	HCPCS 31292
Min. Negotiated Rate	$3,215.99
Max. Negotiated Rate	$3,215.99
Rate for Payer: Cash Price	$1,148.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,215.99
Rate for Payer: SOMOS Essential	$3,215.99

PR NASAL/SINUS NDSC SURG W/BX POLYPC/DBRDMT SPX

Professional

Both

$684.18

Service Code	HCPCS 31237
Min. Negotiated Rate	$513.13
Max. Negotiated Rate	$513.13
Rate for Payer: Cash Price	$185.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$513.13
Rate for Payer: SOMOS Essential	$513.13

PR NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION

Professional

Both

$679.70

Service Code	HCPCS 31240
Min. Negotiated Rate	$509.77
Max. Negotiated Rate	$509.77
Rate for Payer: Cash Price	$184.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$509.77
Rate for Payer: SOMOS Essential	$509.77

PR NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMORRHAGE

Professional

Both

$713.09

Service Code	HCPCS 31238
Min. Negotiated Rate	$534.82
Max. Negotiated Rate	$534.82
Rate for Payer: Cash Price	$194.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$534.82
Rate for Payer: SOMOS Essential	$534.82

PR NASAL/SINUS NDSC SURG W/DACRYOCYSTORHINOSTOMY

Professional

Both

$2,556.40

Service Code	HCPCS 31239
Min. Negotiated Rate	$1,917.30
Max. Negotiated Rate	$1,917.30
Rate for Payer: Cash Price	$697.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,917.30
Rate for Payer: SOMOS Essential	$1,917.30

PR NASAL/SINUS NDSC SURG W/DILATION FRNT&SPHN SINUS

Professional

Both

$1,096.52

Service Code	HCPCS 31298
Min. Negotiated Rate	$822.39
Max. Negotiated Rate	$822.39
Rate for Payer: Cash Price	$295.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$822.39
Rate for Payer: SOMOS Essential	$822.39

PR NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS

Professional

Both

$767.41

Service Code	HCPCS 31296
Min. Negotiated Rate	$575.56
Max. Negotiated Rate	$575.56
Rate for Payer: Cash Price	$206.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$575.56
Rate for Payer: SOMOS Essential	$575.56

PR NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS

Professional

Both

$672.28

Service Code	HCPCS 31295
Min. Negotiated Rate	$504.21
Max. Negotiated Rate	$504.21
Rate for Payer: Cash Price	$182.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$504.21
Rate for Payer: SOMOS Essential	$504.21

PR NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS

Professional

Both

$615.55

Service Code	HCPCS 31297
Min. Negotiated Rate	$461.66
Max. Negotiated Rate	$461.66
Rate for Payer: Cash Price	$166.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$461.66
Rate for Payer: SOMOS Essential	$461.66

PR NASAL/SINUS NDSC SURG W/LIG SPHENOPALATINE ART

Professional

Both

$1,897.67

Service Code	HCPCS 31241
Min. Negotiated Rate	$1,423.25
Max. Negotiated Rate	$1,423.25
Rate for Payer: Cash Price	$513.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,423.25
Rate for Payer: SOMOS Essential	$1,423.25

PR NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN

Professional

Both

$5,285.35

Service Code	HCPCS 31294
Min. Negotiated Rate	$3,964.01
Max. Negotiated Rate	$3,964.01
Rate for Payer: Cash Price	$1,424.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,964.01
Rate for Payer: SOMOS Essential	$3,964.01

PR NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY

Professional

Both

$1,903.41

Service Code	HCPCS 31257
Min. Negotiated Rate	$1,427.56
Max. Negotiated Rate	$1,427.56
Rate for Payer: Cash Price	$513.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,427.56
Rate for Payer: SOMOS Essential	$1,427.56

PR NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL

Professional

Both

$2,137.28

Service Code	HCPCS 31253
Min. Negotiated Rate	$1,602.96
Max. Negotiated Rate	$1,602.96
Rate for Payer: Cash Price	$575.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,602.96
Rate for Payer: SOMOS Essential	$1,602.96

PR NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL

Professional

Both

$2,014.32

Service Code	HCPCS 31259
Min. Negotiated Rate	$1,510.74
Max. Negotiated Rate	$1,510.74
Rate for Payer: Cash Price	$542.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,510.74
Rate for Payer: SOMOS Essential	$1,510.74

PR NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY

Professional

Both

$1,036.95

Service Code	HCPCS 31254
Min. Negotiated Rate	$777.71
Max. Negotiated Rate	$777.71
Rate for Payer: Cash Price	$280.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$777.71
Rate for Payer: SOMOS Essential	$777.71

PR NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS

Professional

Both

$1,614.10

Service Code	HCPCS 31276
Min. Negotiated Rate	$1,210.58
Max. Negotiated Rate	$1,210.58
Rate for Payer: Cash Price	$436.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,210.58
Rate for Payer: SOMOS Essential	$1,210.58

PR NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY

Professional

Both

$1,382.99

Service Code	HCPCS 31255
Min. Negotiated Rate	$1,037.24
Max. Negotiated Rate	$1,037.24
Rate for Payer: Cash Price	$372.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,037.24
Rate for Payer: SOMOS Essential	$1,037.24

PR NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE

Professional

Both

$169.05

Service Code	HCPCS 43752
Min. Negotiated Rate	$126.79
Max. Negotiated Rate	$126.79
Rate for Payer: Cash Price	$45.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$126.79
Rate for Payer: SOMOS Essential	$126.79

PR NASOPHARYNGOSCOPY W/ENDOSCOPE SPX

Professional

Both

$154.91

Service Code	HCPCS 92511
Min. Negotiated Rate	$116.18
Max. Negotiated Rate	$116.18
Rate for Payer: Cash Price	$42.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$116.18
Rate for Payer: SOMOS Essential	$116.18

PR NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS

Professional

Both

$270.10

Service Code	HCPCS 95860 TC
Min. Negotiated Rate	$202.57
Max. Negotiated Rate	$202.57
Rate for Payer: Cash Price	$74.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$202.57
Rate for Payer: SOMOS Essential	$202.57

PR NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS

Professional

Both

$470.30

Service Code	HCPCS 95860
Min. Negotiated Rate	$352.73
Max. Negotiated Rate	$352.73
Rate for Payer: Cash Price	$129.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$352.73
Rate for Payer: SOMOS Essential	$352.73

PR NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS

Professional

Both

$200.17

Service Code	HCPCS 95860 26
Min. Negotiated Rate	$150.13
Max. Negotiated Rate	$150.13
Rate for Payer: Cash Price	$55.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$150.13
Rate for Payer: SOMOS Essential	$150.13

PR NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS

Professional

Both

$321.30

Service Code	HCPCS 95861 26
Min. Negotiated Rate	$240.97
Max. Negotiated Rate	$240.97
Rate for Payer: Cash Price	$88.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$240.97
Rate for Payer: SOMOS Essential	$240.97

PR NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS

Professional

Both

$670.46

Service Code	HCPCS 95861
Min. Negotiated Rate	$502.85
Max. Negotiated Rate	$502.85
Rate for Payer: Cash Price	$182.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$502.85
Rate for Payer: SOMOS Essential	$502.85

PR NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS

Professional

Both

$349.16

Service Code	HCPCS 95861 TC
Min. Negotiated Rate	$261.87
Max. Negotiated Rate	$261.87
Rate for Payer: Cash Price	$94.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$261.87
Rate for Payer: SOMOS Essential	$261.87

Know your out-of-pocket cost for care.

All Charges