St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD

Professional

Both

$5,473.09

Service Code	HCPCS 27269
Min. Negotiated Rate	$4,104.82
Max. Negotiated Rate	$4,104.82
Rate for Payer: Cash Price	$1,472.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,104.82
Rate for Payer: SOMOS Essential	$4,104.82

PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN

Professional

Both

$4,399.26

Service Code	HCPCS 27511
Min. Negotiated Rate	$3,299.44
Max. Negotiated Rate	$3,299.44
Rate for Payer: Cash Price	$1,183.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,299.44
Rate for Payer: SOMOS Essential	$3,299.44

PR OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN

Professional

Both

$5,456.54

Service Code	HCPCS 27513
Min. Negotiated Rate	$4,092.40
Max. Negotiated Rate	$4,092.40
Rate for Payer: Cash Price	$1,464.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,092.40
Rate for Payer: SOMOS Essential	$4,092.40

PR OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES

Professional

Both

$2,108.16

Service Code	HCPCS 28505
Min. Negotiated Rate	$1,581.12
Max. Negotiated Rate	$1,581.12
Rate for Payer: Cash Price	$579.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,581.12
Rate for Payer: SOMOS Essential	$1,581.12

PR OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE

Professional

Both

$1,728.16

Service Code	HCPCS 28525
Min. Negotiated Rate	$1,296.12
Max. Negotiated Rate	$1,296.12
Rate for Payer: Cash Price	$478.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,296.12
Rate for Payer: SOMOS Essential	$1,296.12

PR OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT

Professional

Both

$3,950.66

Service Code	HCPCS 21408
Min. Negotiated Rate	$2,963.00
Max. Negotiated Rate	$2,963.00
Rate for Payer: Cash Price	$1,063.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,963.00
Rate for Payer: SOMOS Essential	$2,963.00

PR OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT

Professional

Both

$2,760.00

Service Code	HCPCS 21407
Min. Negotiated Rate	$2,070.00
Max. Negotiated Rate	$2,070.00
Rate for Payer: Cash Price	$746.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,070.00
Rate for Payer: SOMOS Essential	$2,070.00

PR OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT

Professional

Both

$2,552.62

Service Code	HCPCS 21406
Min. Negotiated Rate	$1,914.46
Max. Negotiated Rate	$1,914.46
Rate for Payer: Cash Price	$691.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,914.46
Rate for Payer: SOMOS Essential	$1,914.46

PR OPEN TX HUMERAL EPICONDYLAR FRACTURE

Professional

Both

$3,241.35

Service Code	HCPCS 24575
Min. Negotiated Rate	$2,431.01
Max. Negotiated Rate	$2,431.01
Rate for Payer: Cash Price	$879.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,431.01
Rate for Payer: SOMOS Essential	$2,431.01

PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN

Professional

Both

$4,094.02

Service Code	HCPCS 24545
Min. Negotiated Rate	$3,070.52
Max. Negotiated Rate	$3,070.52
Rate for Payer: Cash Price	$1,109.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,070.52
Rate for Payer: SOMOS Essential	$3,070.52

PR OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN

Professional

Both

$4,576.85

Service Code	HCPCS 24546
Min. Negotiated Rate	$3,432.64
Max. Negotiated Rate	$3,432.64
Rate for Payer: Cash Price	$1,236.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,432.64
Rate for Payer: SOMOS Essential	$3,432.64

PR OPEN TX ILIAC SPINE UNI/BIL

Professional

Both

$3,203.20

Service Code	HCPCS G0412
Min. Negotiated Rate	$2,402.40
Max. Negotiated Rate	$2,402.40
Rate for Payer: Cash Price	$865.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,402.40
Rate for Payer: SOMOS Essential	$2,402.40

PR OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE

Professional

Both

$3,613.33

Service Code	HCPCS 27540
Min. Negotiated Rate	$2,710.00
Max. Negotiated Rate	$2,710.00
Rate for Payer: Cash Price	$973.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,710.00
Rate for Payer: SOMOS Essential	$2,710.00

PR OPEN TX INTERPHALANGEAL JOINT DISLOCATION

Professional

Both

$2,429.49

Service Code	HCPCS 26785
Min. Negotiated Rate	$1,822.12
Max. Negotiated Rate	$1,822.12
Rate for Payer: Cash Price	$659.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,822.12
Rate for Payer: SOMOS Essential	$1,822.12

PR OPEN TX KNEE DISLOCATION W/LIGAMENTOUS REPAIR

Professional

Both

$4,612.27

Service Code	HCPCS 27557
Min. Negotiated Rate	$3,459.20
Max. Negotiated Rate	$3,459.20
Rate for Payer: Cash Price	$1,241.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,459.20
Rate for Payer: SOMOS Essential	$3,459.20

PR OPEN TX KNEE DISLOCATION W/O LIGAMENTOUS REPAIR

Professional

Both

$3,878.77

Service Code	HCPCS 27556
Min. Negotiated Rate	$2,909.08
Max. Negotiated Rate	$2,909.08
Rate for Payer: Cash Price	$1,043.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,909.08
Rate for Payer: SOMOS Essential	$2,909.08

PR OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION

Professional

Both

$5,249.13

Service Code	HCPCS 27558
Min. Negotiated Rate	$3,936.85
Max. Negotiated Rate	$3,936.85
Rate for Payer: Cash Price	$1,410.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,936.85
Rate for Payer: SOMOS Essential	$3,936.85

PR OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION

Professional

Both

$2,044.98

Service Code	HCPCS 21454
Min. Negotiated Rate	$1,533.74
Max. Negotiated Rate	$1,533.74
Rate for Payer: Cash Price	$562.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,533.74
Rate for Payer: SOMOS Essential	$1,533.74

PR OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION

Professional

Both

$5,022.57

Service Code	HCPCS 21462
Min. Negotiated Rate	$3,766.93
Max. Negotiated Rate	$3,766.93
Rate for Payer: Cash Price	$1,352.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,766.93
Rate for Payer: SOMOS Essential	$3,766.93

PR OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION

Professional

Both

$4,556.13

Service Code	HCPCS 21461
Min. Negotiated Rate	$3,417.10
Max. Negotiated Rate	$3,417.10
Rate for Payer: Cash Price	$1,243.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,417.10
Rate for Payer: SOMOS Essential	$3,417.10

PR OPEN TX METACARPAL FRACTURE SINGLE EA BONE

Professional

Both

$2,546.18

Service Code	HCPCS 26615
Min. Negotiated Rate	$1,909.64
Max. Negotiated Rate	$1,909.64
Rate for Payer: Cash Price	$692.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,909.64
Rate for Payer: SOMOS Essential	$1,909.64

PR OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION

Professional

Both

$2,050.20

Service Code	HCPCS 28645
Min. Negotiated Rate	$1,537.65
Max. Negotiated Rate	$1,537.65
Rate for Payer: Cash Price	$567.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,537.65
Rate for Payer: SOMOS Essential	$1,537.65

PR OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW

Professional

Both

$2,998.80

Service Code	HCPCS 24635
Min. Negotiated Rate	$2,249.10
Max. Negotiated Rate	$2,249.10
Rate for Payer: Cash Price	$811.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,249.10
Rate for Payer: SOMOS Essential	$2,249.10

PR OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI

Professional

Both

$2,318.05

Service Code	HCPCS 21330
Min. Negotiated Rate	$1,738.54
Max. Negotiated Rate	$1,738.54
Rate for Payer: Cash Price	$629.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,738.54
Rate for Payer: SOMOS Essential	$1,738.54

PR OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM

Professional

Both

$3,096.73

Service Code	HCPCS 21335
Min. Negotiated Rate	$2,322.55
Max. Negotiated Rate	$2,322.55
Rate for Payer: Cash Price	$842.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,322.55
Rate for Payer: SOMOS Essential	$2,322.55

Know your out-of-pocket cost for care.

All Charges