St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER

Professional

Both

$11.38

Service Code	HCPCS 94760
Min. Negotiated Rate	$8.54
Max. Negotiated Rate	$8.54
Rate for Payer: Cash Price	$3.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8.54
Rate for Payer: SOMOS Essential	$8.54

PR NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS

Professional

Both

$91.46

Service Code	HCPCS 93923 26
Min. Negotiated Rate	$68.60
Max. Negotiated Rate	$68.60
Rate for Payer: Cash Price	$24.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$68.60
Rate for Payer: SOMOS Essential	$68.60

PR NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS

Professional

Both

$462.60

Service Code	HCPCS 93923 TC
Min. Negotiated Rate	$346.95
Max. Negotiated Rate	$346.95
Rate for Payer: Cash Price	$129.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$346.95
Rate for Payer: SOMOS Essential	$346.95

PR NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS

Professional

Both

$554.05

Service Code	HCPCS 93923
Min. Negotiated Rate	$415.54
Max. Negotiated Rate	$415.54
Rate for Payer: Cash Price	$153.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$415.54
Rate for Payer: SOMOS Essential	$415.54

PR NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL

Professional

Both

$52.33

Service Code	HCPCS 93922 26
Min. Negotiated Rate	$39.25
Max. Negotiated Rate	$39.25
Rate for Payer: Cash Price	$13.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$39.25
Rate for Payer: SOMOS Essential	$39.25

PR NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL

Professional

Both

$304.47

Service Code	HCPCS 93922 TC
Min. Negotiated Rate	$228.35
Max. Negotiated Rate	$228.35
Rate for Payer: Cash Price	$83.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$228.35
Rate for Payer: SOMOS Essential	$228.35

PR NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL

Professional

Both

$356.79

Service Code	HCPCS 93922
Min. Negotiated Rate	$267.59
Max. Negotiated Rate	$267.59
Rate for Payer: Cash Price	$97.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$267.59
Rate for Payer: SOMOS Essential	$267.59

PR NONPHYSICIAN TELEPHONE ASSESSMENT 11-20 MIN

Professional

Both

$86.80

Service Code	HCPCS 98967
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$65.10
Rate for Payer: Cash Price	$24.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$65.10
Rate for Payer: SOMOS Essential	$65.10

PR NONPHYSICIAN TELEPHONE ASSESSMENT 21-30 MIN

Professional

Both

$120.96

Service Code	HCPCS 98968
Min. Negotiated Rate	$90.72
Max. Negotiated Rate	$90.72
Rate for Payer: Cash Price	$33.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$90.72
Rate for Payer: SOMOS Essential	$90.72

PR NONPHYSICIAN TELEPHONE ASSESSMENT 5-10 MIN

Professional

Both

$44.10

Service Code	HCPCS 98966
Min. Negotiated Rate	$33.08
Max. Negotiated Rate	$33.08
Rate for Payer: Cash Price	$12.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$33.08
Rate for Payer: SOMOS Essential	$33.08

PR NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART

Professional

Both

$873.18

Service Code	HCPCS 36221
Min. Negotiated Rate	$654.88
Max. Negotiated Rate	$654.88
Rate for Payer: Cash Price	$233.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$654.88
Rate for Payer: SOMOS Essential	$654.88

PR NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS

Professional

Both

$1,133.30

Service Code	HCPCS 31267
Min. Negotiated Rate	$849.98
Max. Negotiated Rate	$849.98
Rate for Payer: Cash Price	$306.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$849.98
Rate for Payer: SOMOS Essential	$849.98

PR NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS

Professional

Both

$1,002.72

Service Code	HCPCS 31288
Min. Negotiated Rate	$752.04
Max. Negotiated Rate	$752.04
Rate for Payer: Cash Price	$270.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$752.04
Rate for Payer: SOMOS Essential	$752.04

PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN

Professional

Both

$145.78

Service Code	HCPCS 99447
Min. Negotiated Rate	$109.34
Max. Negotiated Rate	$109.34
Rate for Payer: Cash Price	$40.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$109.34
Rate for Payer: SOMOS Essential	$109.34

PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN

Professional

Both

$223.55

Service Code	HCPCS 99448
Min. Negotiated Rate	$167.66
Max. Negotiated Rate	$167.66
Rate for Payer: Cash Price	$60.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$167.66
Rate for Payer: SOMOS Essential	$167.66

PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN

Professional

Both

$293.13

Service Code	HCPCS 99449
Min. Negotiated Rate	$219.85
Max. Negotiated Rate	$219.85
Rate for Payer: Cash Price	$80.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$219.85
Rate for Payer: SOMOS Essential	$219.85

PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN

Professional

Both

$74.90

Service Code	HCPCS 99446
Min. Negotiated Rate	$56.18
Max. Negotiated Rate	$56.18
Rate for Payer: Cash Price	$19.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$56.18
Rate for Payer: SOMOS Essential	$56.18

PR NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5/> MIN

Professional

Both

$143.19

Service Code	HCPCS 99451
Min. Negotiated Rate	$107.39
Max. Negotiated Rate	$107.39
Rate for Payer: Cash Price	$38.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$107.39
Rate for Payer: SOMOS Essential	$107.39

PR NTRPROF PHONE/NTRNET/EHR REFERRAL SVC 30 MIN

Professional

Both

$133.11

Service Code	HCPCS 99452
Min. Negotiated Rate	$99.83
Max. Negotiated Rate	$99.83
Rate for Payer: Cash Price	$37.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$99.83
Rate for Payer: SOMOS Essential	$99.83

PR NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS

Professional

Both

$7,326.20

Service Code	HCPCS 62161
Min. Negotiated Rate	$5,494.65
Max. Negotiated Rate	$5,494.65
Rate for Payer: Cash Price	$1,942.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,494.65
Rate for Payer: SOMOS Essential	$5,494.65

PR NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID

Professional

Both

$7,004.90

Service Code	HCPCS 62165
Min. Negotiated Rate	$5,253.68
Max. Negotiated Rate	$5,253.68
Rate for Payer: Cash Price	$1,860.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,253.68
Rate for Payer: SOMOS Essential	$5,253.68

PR NUNDSC ICRA FENESTEXC CYST W/VENTRIC CATH DRG

Professional

Both

$9,119.92

Service Code	HCPCS 62162
Min. Negotiated Rate	$6,839.94
Max. Negotiated Rate	$6,839.94
Rate for Payer: Cash Price	$2,405.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,839.94
Rate for Payer: SOMOS Essential	$6,839.94

PR NUNDSC ICRA PLMT/RPLCMT VENTR CATH SHUNT SYS

Professional

Both

$909.65

Service Code	HCPCS 62160
Min. Negotiated Rate	$682.24
Max. Negotiated Rate	$682.24
Rate for Payer: Cash Price	$237.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$682.24
Rate for Payer: SOMOS Essential	$682.24

PR NURSING FACILITY DSCHRG MGMT 30 MIN+ TOT TIME

Professional

Both

$534.87

Service Code	HCPCS 99316
Min. Negotiated Rate	$401.15
Max. Negotiated Rate	$401.15
Rate for Payer: Cash Price	$146.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$401.15
Rate for Payer: SOMOS Essential	$401.15

PR NURSING FACILITY DSCHRG MGMT 30 MIN/< TOT TIME

Professional

Both

$331.66

Service Code	HCPCS 99315
Min. Negotiated Rate	$248.74
Max. Negotiated Rate	$248.74
Rate for Payer: Cash Price	$91.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$248.74
Rate for Payer: SOMOS Essential	$248.74

Know your out-of-pocket cost for care.

All Charges