St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR OPEN TREATMENT ULNAR STYLOID FRACTURE

Professional

Both

$2,764.72

Service Code	HCPCS 25652
Min. Negotiated Rate	$2,073.54
Max. Negotiated Rate	$2,073.54
Rate for Payer: Cash Price	$750.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,073.54
Rate for Payer: SOMOS Essential	$2,073.54

PR OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC

Professional

Both

$2,537.64

Service Code	HCPCS 23550
Min. Negotiated Rate	$1,903.23
Max. Negotiated Rate	$1,903.23
Rate for Payer: Cash Price	$688.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,903.23
Rate for Payer: SOMOS Essential	$1,903.23

PR OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION

Professional

Both

$3,165.30

Service Code	HCPCS 24615
Min. Negotiated Rate	$2,373.98
Max. Negotiated Rate	$2,373.98
Rate for Payer: Cash Price	$855.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,373.98
Rate for Payer: SOMOS Essential	$2,373.98

PR OPEN TX ACUTE SHOULDER DISLOCATION

Professional

Both

$2,607.36

Service Code	HCPCS 23660
Min. Negotiated Rate	$1,955.52
Max. Negotiated Rate	$1,955.52
Rate for Payer: Cash Price	$704.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,955.52
Rate for Payer: SOMOS Essential	$1,955.52

PR OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA

Professional

Both

$3,275.16

Service Code	HCPCS 26746
Min. Negotiated Rate	$2,456.37
Max. Negotiated Rate	$2,456.37
Rate for Payer: Cash Price	$887.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,456.37
Rate for Payer: SOMOS Essential	$2,456.37

PR OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA

Professional

Both

$2,548.70

Service Code	HCPCS 25645
Min. Negotiated Rate	$1,911.52
Max. Negotiated Rate	$1,911.52
Rate for Payer: Cash Price	$690.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,911.52
Rate for Payer: SOMOS Essential	$1,911.52

PR OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE

Professional

Both

$3,174.50

Service Code	HCPCS 25628
Min. Negotiated Rate	$2,380.88
Max. Negotiated Rate	$2,380.88
Rate for Payer: Cash Price	$860.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,380.88
Rate for Payer: SOMOS Essential	$2,380.88

PR OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB

Professional

Both

$2,544.89

Service Code	HCPCS 26685
Min. Negotiated Rate	$1,908.67
Max. Negotiated Rate	$1,908.67
Rate for Payer: Cash Price	$690.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,908.67
Rate for Payer: SOMOS Essential	$1,908.67

PR OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB

Professional

Both

$2,750.02

Service Code	HCPCS 26665
Min. Negotiated Rate	$2,062.52
Max. Negotiated Rate	$2,062.52
Rate for Payer: Cash Price	$749.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,062.52
Rate for Payer: SOMOS Essential	$2,062.52

PR OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION

Professional

Both

$3,195.33

Service Code	HCPCS 23515
Min. Negotiated Rate	$2,396.50
Max. Negotiated Rate	$2,396.50
Rate for Payer: Cash Price	$863.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,396.50
Rate for Payer: SOMOS Essential	$2,396.50

PR OPEN TX COMP FRACTURE MALAR AREA W/BONE GRAFT

Professional

Both

$5,577.85

Service Code	HCPCS 21366
Min. Negotiated Rate	$4,183.39
Max. Negotiated Rate	$4,183.39
Rate for Payer: Cash Price	$1,502.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,183.39
Rate for Payer: SOMOS Essential	$4,183.39

PR OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG

Professional

Both

$4,660.04

Service Code	HCPCS 21365
Min. Negotiated Rate	$3,495.03
Max. Negotiated Rate	$3,495.03
Rate for Payer: Cash Price	$1,256.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,495.03
Rate for Payer: SOMOS Essential	$3,495.03

PR OPEN TX COMPLICATED FRONTAL SINUS FRACTURE

Professional

Both

$6,012.79

Service Code	HCPCS 21344
Min. Negotiated Rate	$4,509.59
Max. Negotiated Rate	$4,509.59
Rate for Payer: Cash Price	$1,622.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,509.59
Rate for Payer: SOMOS Essential	$4,509.59

PR OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR

Professional

Both

$7,572.53

Service Code	HCPCS 21433
Min. Negotiated Rate	$5,679.40
Max. Negotiated Rate	$5,679.40
Rate for Payer: Cash Price	$2,034.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,679.40
Rate for Payer: SOMOS Essential	$5,679.40

PR OPEN TX CRANIOFACIAL SEP COMP W/INT&/XTRNL FIX

Professional

Both

$6,148.17

Service Code	HCPCS 21435
Min. Negotiated Rate	$4,611.13
Max. Negotiated Rate	$4,611.13
Rate for Payer: Cash Price	$1,656.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,611.13
Rate for Payer: SOMOS Essential	$4,611.13

PR OPEN TX CRANIOFACIAL SEP W/WIRING&/INT FIXJ

Professional

Both

$3,133.94

Service Code	HCPCS 21432
Min. Negotiated Rate	$2,350.46
Max. Negotiated Rate	$2,350.46
Rate for Payer: Cash Price	$840.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,350.46
Rate for Payer: SOMOS Essential	$2,350.46

PR OPEN TX DEPRESSED FRONTAL SINUS FRACTURE

Professional

Both

$4,700.75

Service Code	HCPCS 21343
Min. Negotiated Rate	$3,525.56
Max. Negotiated Rate	$3,525.56
Rate for Payer: Cash Price	$1,272.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,525.56
Rate for Payer: SOMOS Essential	$3,525.56

PR OPEN TX DEPRESSED MALAR FRACTURE

Professional

Both

$2,267.79

Service Code	HCPCS 21360
Min. Negotiated Rate	$1,700.84
Max. Negotiated Rate	$1,700.84
Rate for Payer: Cash Price	$618.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,700.84
Rate for Payer: SOMOS Essential	$1,700.84

PR OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE

Professional

Both

$1,764.56

Service Code	HCPCS 21356
Min. Negotiated Rate	$1,323.42
Max. Negotiated Rate	$1,323.42
Rate for Payer: Cash Price	$478.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,323.42
Rate for Payer: SOMOS Essential	$1,323.42

PR OPEN TX DISTAL FEMORAL EPIPHYSEAL SEPARATION

Professional

Both

$3,939.71

Service Code	HCPCS 27519
Min. Negotiated Rate	$2,954.78
Max. Negotiated Rate	$2,954.78
Rate for Payer: Cash Price	$1,060.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,954.78
Rate for Payer: SOMOS Essential	$2,954.78

PR OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS

Professional

Both

$2,841.83

Service Code	HCPCS 27792
Min. Negotiated Rate	$2,131.37
Max. Negotiated Rate	$2,131.37
Rate for Payer: Cash Price	$769.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,131.37
Rate for Payer: SOMOS Essential	$2,131.37

PR OPEN TX DISTAL PHALANGEAL FRACTURE EACH

Professional

Both

$2,230.94

Service Code	HCPCS 26765
Min. Negotiated Rate	$1,673.20
Max. Negotiated Rate	$1,673.20
Rate for Payer: Cash Price	$608.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,673.20
Rate for Payer: SOMOS Essential	$1,673.20

PR OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC

Professional

Both

$2,791.95

Service Code	HCPCS 25676
Min. Negotiated Rate	$2,093.96
Max. Negotiated Rate	$2,093.96
Rate for Payer: Cash Price	$757.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,093.96
Rate for Payer: SOMOS Essential	$2,093.96

PR OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION

Professional

Both

$3,112.59

Service Code	HCPCS 27829
Min. Negotiated Rate	$2,334.44
Max. Negotiated Rate	$2,334.44
Rate for Payer: Cash Price	$843.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,334.44
Rate for Payer: SOMOS Essential	$2,334.44

PR OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE

Professional

Both

$4,261.01

Service Code	HCPCS 27514
Min. Negotiated Rate	$3,195.76
Max. Negotiated Rate	$3,195.76
Rate for Payer: Cash Price	$1,147.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,195.76
Rate for Payer: SOMOS Essential	$3,195.76

Know your out-of-pocket cost for care.

All Charges