St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ

Professional

Both

$6,447.42

Service Code	HCPCS 27147
Min. Negotiated Rate	$4,835.56
Max. Negotiated Rate	$4,835.56
Rate for Payer: Cash Price	$1,737.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,835.56
Rate for Payer: SOMOS Essential	$4,835.56

PR OSTEOTOMY MANDIBLE SEGMENTAL

Professional

Both

$4,352.95

Service Code	HCPCS 21198
Min. Negotiated Rate	$3,264.71
Max. Negotiated Rate	$3,264.71
Rate for Payer: Cash Price	$1,161.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,264.71
Rate for Payer: SOMOS Essential	$3,264.71

PR OSTEOTOMY MANDIBLE SGMTL W/GENIOGLOSSUS ADVMNT

Professional

Both

$4,264.40

Service Code	HCPCS 21199
Min. Negotiated Rate	$3,198.30
Max. Negotiated Rate	$3,198.30
Rate for Payer: Cash Price	$1,157.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,198.30
Rate for Payer: SOMOS Essential	$3,198.30

PR OSTEOTOMY MAXILLA SEGMENTAL

Professional

Both

$4,073.23

Service Code	HCPCS 21206
Min. Negotiated Rate	$3,054.92
Max. Negotiated Rate	$3,054.92
Rate for Payer: Cash Price	$1,106.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,054.92
Rate for Payer: SOMOS Essential	$3,054.92

PR OSTEOTOMY METACARPAL EACH

Professional

Both

$3,164.81

Service Code	HCPCS 26565
Min. Negotiated Rate	$2,373.61
Max. Negotiated Rate	$2,373.61
Rate for Payer: Cash Price	$849.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,373.61
Rate for Payer: SOMOS Essential	$2,373.61

PR OSTEOTOMY PELVIS BILATERAL

Professional

Both

$6,170.36

Service Code	HCPCS 27158
Min. Negotiated Rate	$4,627.77
Max. Negotiated Rate	$4,627.77
Rate for Payer: Cash Price	$1,662.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,627.77
Rate for Payer: SOMOS Essential	$4,627.77

PR OSTEOTOMY PHALANX FINGER EACH

Professional

Both

$3,187.77

Service Code	HCPCS 26567
Min. Negotiated Rate	$2,390.83
Max. Negotiated Rate	$2,390.83
Rate for Payer: Cash Price	$859.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,390.83
Rate for Payer: SOMOS Essential	$2,390.83

PR OSTEOTOMY RADIUS DISTAL THIRD

Professional

Both

$2,983.79

Service Code	HCPCS 25350
Min. Negotiated Rate	$2,237.84
Max. Negotiated Rate	$2,237.84
Rate for Payer: Cash Price	$807.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,237.84
Rate for Payer: SOMOS Essential	$2,237.84

PR OSTEOTOMY RADIUS MIDDLE/PROXIMAL THIRD

Professional

Both

$3,392.76

Service Code	HCPCS 25355
Min. Negotiated Rate	$2,544.57
Max. Negotiated Rate	$2,544.57
Rate for Payer: Cash Price	$918.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,544.57
Rate for Payer: SOMOS Essential	$2,544.57

PR OSTEOTOMY RADIUS & ULNA

Professional

Both

$4,067.60

Service Code	HCPCS 25365
Min. Negotiated Rate	$3,050.70
Max. Negotiated Rate	$3,050.70
Rate for Payer: Cash Price	$1,097.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,050.70
Rate for Payer: SOMOS Essential	$3,050.70

PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM

Professional

Both

$2,731.54

Service Code	HCPCS 22208
Min. Negotiated Rate	$2,048.66
Max. Negotiated Rate	$2,048.66
Rate for Payer: Cash Price	$724.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,048.66
Rate for Payer: SOMOS Essential	$2,048.66

PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR

Professional

Both

$11,010.51

Service Code	HCPCS 22207
Min. Negotiated Rate	$8,257.88
Max. Negotiated Rate	$8,257.88
Rate for Payer: Cash Price	$2,938.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,257.88
Rate for Payer: SOMOS Essential	$8,257.88

PR OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC

Professional

Both

$11,299.61

Service Code	HCPCS 22206
Min. Negotiated Rate	$8,474.71
Max. Negotiated Rate	$8,474.71
Rate for Payer: Cash Price	$3,020.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,474.71
Rate for Payer: SOMOS Essential	$8,474.71

PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV

Professional

Both

$8,231.93

Service Code	HCPCS 22210
Min. Negotiated Rate	$6,173.95
Max. Negotiated Rate	$6,173.95
Rate for Payer: Cash Price	$2,205.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,173.95
Rate for Payer: SOMOS Essential	$6,173.95

PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR

Professional

Both

$6,938.44

Service Code	HCPCS 22214
Min. Negotiated Rate	$5,203.83
Max. Negotiated Rate	$5,203.83
Rate for Payer: Cash Price	$1,856.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,203.83
Rate for Payer: SOMOS Essential	$5,203.83

PR OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC

Professional

Both

$6,934.97

Service Code	HCPCS 22212
Min. Negotiated Rate	$5,201.23
Max. Negotiated Rate	$5,201.23
Rate for Payer: Cash Price	$1,855.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,201.23
Rate for Payer: SOMOS Essential	$5,201.23

PR OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM CRV

Professional

Both

$7,430.01

Service Code	HCPCS 22220
Min. Negotiated Rate	$5,572.51
Max. Negotiated Rate	$5,572.51
Rate for Payer: Cash Price	$1,983.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,572.51
Rate for Payer: SOMOS Essential	$5,572.51

PR OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM LMBR

Professional

Both

$7,117.22

Service Code	HCPCS 22224
Min. Negotiated Rate	$5,337.92
Max. Negotiated Rate	$5,337.92
Rate for Payer: Cash Price	$1,908.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,337.92
Rate for Payer: SOMOS Essential	$5,337.92

PR OSTEOTOMY SPINE W/DSKC ANT APPR 1 VRT SGM THRC

Professional

Both

$8,433.11

Service Code	HCPCS 22222
Min. Negotiated Rate	$6,324.83
Max. Negotiated Rate	$6,324.83
Rate for Payer: Cash Price	$2,236.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,324.83
Rate for Payer: SOMOS Essential	$6,324.83

PR OSTEOTOMY TALUS

Professional

Both

$3,177.90

Service Code	HCPCS 28302
Min. Negotiated Rate	$2,383.42
Max. Negotiated Rate	$2,383.42
Rate for Payer: Cash Price	$859.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,383.42
Rate for Payer: SOMOS Essential	$2,383.42

PR OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS

Professional

Both

$2,642.19

Service Code	HCPCS 28304
Min. Negotiated Rate	$1,981.64
Max. Negotiated Rate	$1,981.64
Rate for Payer: Cash Price	$720.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,981.64
Rate for Payer: SOMOS Essential	$1,981.64

PR OSTEOTOMY TIBIA

Professional

Both

$3,312.26

Service Code	HCPCS 27705
Min. Negotiated Rate	$2,484.20
Max. Negotiated Rate	$2,484.20
Rate for Payer: Cash Price	$890.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,484.20
Rate for Payer: SOMOS Essential	$2,484.20

PR OSTEOTOMY TIBIA & FIBULA

Professional

Both

$4,969.86

Service Code	HCPCS 27709
Min. Negotiated Rate	$3,727.40
Max. Negotiated Rate	$3,727.40
Rate for Payer: Cash Price	$1,357.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,727.40
Rate for Payer: SOMOS Essential	$3,727.40

PR OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX

Professional

Both

$3,967.18

Service Code	HCPCS 27140
Min. Negotiated Rate	$2,975.38
Max. Negotiated Rate	$2,975.38
Rate for Payer: Cash Price	$1,072.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,975.38
Rate for Payer: SOMOS Essential	$2,975.38

PR OSTEOTOMY ULNA

Professional

Both

$2,904.44

Service Code	HCPCS 25360
Min. Negotiated Rate	$2,178.33
Max. Negotiated Rate	$2,178.33
Rate for Payer: Cash Price	$788.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,178.33
Rate for Payer: SOMOS Essential	$2,178.33

Know your out-of-pocket cost for care.

All Charges