St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION

Professional

Both

$351.44

Service Code	HCPCS 95887
Min. Negotiated Rate	$263.58
Max. Negotiated Rate	$263.58
Rate for Payer: Cash Price	$95.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$263.58
Rate for Payer: SOMOS Essential	$263.58

PR NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION

Professional

Both

$202.69

Service Code	HCPCS 95887 TC
Min. Negotiated Rate	$152.02
Max. Negotiated Rate	$152.02
Rate for Payer: Cash Price	$55.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$152.02
Rate for Payer: SOMOS Essential	$152.02

PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12

Professional

Both

$79.14

Service Code	HCPCS 95869 26
Min. Negotiated Rate	$59.36
Max. Negotiated Rate	$59.36
Rate for Payer: Cash Price	$21.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$59.36
Rate for Payer: SOMOS Essential	$59.36

PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12

Professional

Both

$409.61

Service Code	HCPCS 95869
Min. Negotiated Rate	$307.21
Max. Negotiated Rate	$307.21
Rate for Payer: Cash Price	$111.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$307.21
Rate for Payer: SOMOS Essential	$307.21

PR NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12

Professional

Both

$330.47

Service Code	HCPCS 95869 TC
Min. Negotiated Rate	$247.85
Max. Negotiated Rate	$247.85
Rate for Payer: Cash Price	$89.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$247.85
Rate for Payer: SOMOS Essential	$247.85

PR NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER

Professional

Both

$815.33

Service Code	HCPCS 95872
Min. Negotiated Rate	$611.50
Max. Negotiated Rate	$611.50
Rate for Payer: Cash Price	$211.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$611.50
Rate for Payer: SOMOS Essential	$611.50

PR NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER

Professional

Both

$599.87

Service Code	HCPCS 95872 26
Min. Negotiated Rate	$449.90
Max. Negotiated Rate	$449.90
Rate for Payer: Cash Price	$161.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$449.90
Rate for Payer: SOMOS Essential	$449.90

PR NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER

Professional

Both

$215.50

Service Code	HCPCS 95872 TC
Min. Negotiated Rate	$161.62
Max. Negotiated Rate	$161.62
Rate for Payer: Cash Price	$50.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$161.62
Rate for Payer: SOMOS Essential	$161.62

PR NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES

Professional

Both

$58.63

Service Code	HCPCS 20560
Min. Negotiated Rate	$43.97
Max. Negotiated Rate	$43.97
Rate for Payer: Cash Price	$16.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$43.97
Rate for Payer: SOMOS Essential	$43.97

PR NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES

Professional

Both

$88.59

Service Code	HCPCS 20561
Min. Negotiated Rate	$66.44
Max. Negotiated Rate	$66.44
Rate for Payer: Cash Price	$24.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$66.44
Rate for Payer: SOMOS Essential	$66.44

PR NEGATIVE PRESSURE WOUND THERAPY DME <= 50 SQ CM

Professional

Both

$96.08

Service Code	HCPCS 97605
Min. Negotiated Rate	$72.06
Max. Negotiated Rate	$72.06
Rate for Payer: Cash Price	$26.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$72.06
Rate for Payer: SOMOS Essential	$72.06

PR NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM

Professional

Both

$103.78

Service Code	HCPCS 97606
Min. Negotiated Rate	$77.84
Max. Negotiated Rate	$77.84
Rate for Payer: Cash Price	$28.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$77.84
Rate for Payer: SOMOS Essential	$77.84

PR NEG PRESSURE WOUND THERAPY NON DME <= 50 SQ CM

Professional

Both

$94.96

Service Code	HCPCS 97607
Min. Negotiated Rate	$71.22
Max. Negotiated Rate	$71.22
Rate for Payer: Cash Price	$24.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$71.22
Rate for Payer: SOMOS Essential	$71.22

PR NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM

Professional

Both

$112.28

Service Code	HCPCS 97608
Min. Negotiated Rate	$84.21
Max. Negotiated Rate	$84.21
Rate for Payer: Cash Price	$29.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$84.21
Rate for Payer: SOMOS Essential	$84.21

PR NEPHRECTOMY PARTIAL

Professional

Both

$5,548.20

Service Code	HCPCS 50240
Min. Negotiated Rate	$4,161.15
Max. Negotiated Rate	$4,161.15
Rate for Payer: Cash Price	$1,518.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,161.15
Rate for Payer: SOMOS Essential	$4,161.15

PR NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN

Professional

Both

$6,109.32

Service Code	HCPCS 50236
Min. Negotiated Rate	$4,581.99
Max. Negotiated Rate	$4,581.99
Rate for Payer: Cash Price	$1,665.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,581.99
Rate for Payer: SOMOS Essential	$4,581.99

PR NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ

Professional

Both

$4,500.72

Service Code	HCPCS 50220
Min. Negotiated Rate	$3,375.54
Max. Negotiated Rate	$3,375.54
Rate for Payer: Cash Price	$1,219.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,375.54
Rate for Payer: SOMOS Essential	$3,375.54

PR NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD

Professional

Both

$5,375.55

Service Code	HCPCS 50230
Min. Negotiated Rate	$4,031.66
Max. Negotiated Rate	$4,031.66
Rate for Payer: Cash Price	$1,463.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,031.66
Rate for Payer: SOMOS Essential	$4,031.66

PR NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL

Professional

Both

$5,104.79

Service Code	HCPCS 50225
Min. Negotiated Rate	$3,828.59
Max. Negotiated Rate	$3,828.59
Rate for Payer: Cash Price	$1,396.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,828.59
Rate for Payer: SOMOS Essential	$3,828.59

PR NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC

Professional

Both

$5,469.10

Service Code	HCPCS 50234
Min. Negotiated Rate	$4,101.82
Max. Negotiated Rate	$4,101.82
Rate for Payer: Cash Price	$1,483.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,101.82
Rate for Payer: SOMOS Essential	$4,101.82

PR NEPHROLITHOTOMY COMP CGEN KDN ABNORMALITY

Professional

Both

$4,941.48

Service Code	HCPCS 50070
Min. Negotiated Rate	$3,706.11
Max. Negotiated Rate	$3,706.11
Rate for Payer: Cash Price	$1,349.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,706.11
Rate for Payer: SOMOS Essential	$3,706.11

PR NEPHROLITHOTOMY REMOVAL STAGE 1

Professional

Both

$4,748.63

Service Code	HCPCS 50060
Min. Negotiated Rate	$3,561.47
Max. Negotiated Rate	$3,561.47
Rate for Payer: Cash Price	$1,298.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,561.47
Rate for Payer: SOMOS Essential	$3,561.47

PR NEPHROLITHOTOMY RMVL LG STAGHORN STAGE 1

Professional

Both

$6,066.55

Service Code	HCPCS 50075
Min. Negotiated Rate	$4,549.91
Max. Negotiated Rate	$4,549.91
Rate for Payer: Cash Price	$1,656.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,549.91
Rate for Payer: SOMOS Essential	$4,549.91

PR NEPHROLITHOTOMY SECONDARY FOR CALCULUS

Professional

Both

$5,038.32

Service Code	HCPCS 50065
Min. Negotiated Rate	$3,778.74
Max. Negotiated Rate	$3,778.74
Rate for Payer: Cash Price	$1,374.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,778.74
Rate for Payer: SOMOS Essential	$3,778.74

PR NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY

Professional

Both

$5,555.31

Service Code	HCPCS 50500
Min. Negotiated Rate	$4,166.48
Max. Negotiated Rate	$4,166.48
Rate for Payer: Cash Price	$1,553.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,166.48
Rate for Payer: SOMOS Essential	$4,166.48

Know your out-of-pocket cost for care.

All Charges