St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU

Professional

Both

$351.86

Service Code	HCPCS 93464 26
Min. Negotiated Rate	$263.90
Max. Negotiated Rate	$263.90
Rate for Payer: Cash Price	$96.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$263.90
Rate for Payer: SOMOS Essential	$263.90

PR PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU

Professional

Both

$922.39

Service Code	HCPCS 93464
Min. Negotiated Rate	$691.79
Max. Negotiated Rate	$691.79
Rate for Payer: Cash Price	$251.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$691.79
Rate for Payer: SOMOS Essential	$691.79

PR PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION

Professional

Both

$446.11

Service Code	HCPCS 99183
Min. Negotiated Rate	$334.58
Max. Negotiated Rate	$334.58
Rate for Payer: Cash Price	$120.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$334.58
Rate for Payer: SOMOS Essential	$334.58

PR PHYS/QHP R&I CPTR MTN ALYS WALK/FUNCJL ACTV REPR

Professional

Both

$443.91

Service Code	HCPCS 96004
Min. Negotiated Rate	$332.93
Max. Negotiated Rate	$332.93
Rate for Payer: Cash Price	$119.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$332.93
Rate for Payer: SOMOS Essential	$332.93

PR PHYS/QHP SVCS OP PULM REHAB W/CONT OXIMTRY MNTR

Professional

Both

$109.83

Service Code	HCPCS 94626
Min. Negotiated Rate	$82.37
Max. Negotiated Rate	$82.37
Rate for Payer: Cash Price	$30.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$82.37
Rate for Payer: SOMOS Essential	$82.37

PR PHYS/QHP SVCS OP PULM REHAB WO CONT OXIMTRY MNTR

Professional

Both

$70.42

Service Code	HCPCS 94625
Min. Negotiated Rate	$52.82
Max. Negotiated Rate	$52.82
Rate for Payer: Cash Price	$20.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$52.82
Rate for Payer: SOMOS Essential	$52.82

PR PHYS/QHP TELEPHONE EVALUATION 11-20 MIN

Professional

Both

$269.26

Service Code	HCPCS 99442
Min. Negotiated Rate	$201.94
Max. Negotiated Rate	$201.94
Rate for Payer: Cash Price	$72.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$201.94
Rate for Payer: SOMOS Essential	$201.94

PR PHYS/QHP TELEPHONE EVALUATION 21-30 MIN

Professional

Both

$391.20

Service Code	HCPCS 99443
Min. Negotiated Rate	$293.40
Max. Negotiated Rate	$293.40
Rate for Payer: Cash Price	$108.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$293.40
Rate for Payer: SOMOS Essential	$293.40

PR PHYS/QHP TELEPHONE EVALUATION 5-10 MIN

Professional

Both

$140.32

Service Code	HCPCS 99441
Min. Negotiated Rate	$105.24
Max. Negotiated Rate	$105.24
Rate for Payer: Cash Price	$38.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$105.24
Rate for Payer: SOMOS Essential	$105.24

PR PILD/PLACEBO CONTROL CLIN TR

Professional

Both

$1,536.08

Service Code	HCPCS G0276
Min. Negotiated Rate	$1,152.06
Max. Negotiated Rate	$1,152.06
Rate for Payer: Cash Price	$416.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,152.06
Rate for Payer: SOMOS Essential	$1,152.06

PR PINCH GRAFT 1/MLT SM ULCER TIP/OTH AR UP TO 2 CM

Professional

Both

$2,010.82

Service Code	HCPCS 15050
Min. Negotiated Rate	$1,508.12
Max. Negotiated Rate	$1,508.12
Rate for Payer: Cash Price	$540.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,508.12
Rate for Payer: SOMOS Essential	$1,508.12

PR PLACE AMNIOTIC MEMBRANE OCULAR SURFACE SUTURED

Professional

Both

$597.98

Service Code	HCPCS 65779
Min. Negotiated Rate	$448.48
Max. Negotiated Rate	$448.48
Rate for Payer: Cash Price	$132.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$448.48
Rate for Payer: SOMOS Essential	$448.48

PR PLACE AMNIOTIC MEMBRA OCULAR SURFACE W/O SUTURES

Professional

Both

$209.51

Service Code	HCPCS 65778
Min. Negotiated Rate	$157.13
Max. Negotiated Rate	$157.13
Rate for Payer: Cash Price	$48.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$157.13
Rate for Payer: SOMOS Essential	$157.13

PR PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS

Professional

Both

$8,517.78

Service Code	HCPCS 48000
Min. Negotiated Rate	$6,388.34
Max. Negotiated Rate	$6,388.34
Rate for Payer: Cash Price	$2,264.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,388.34
Rate for Payer: SOMOS Essential	$6,388.34

PR PLACE DRAIN PERIPANCREATIC W/CHOLECYSTOSTOMY

Professional

Both

$10,430.60

Service Code	HCPCS 48001
Min. Negotiated Rate	$7,822.95
Max. Negotiated Rate	$7,822.95
Rate for Payer: Cash Price	$2,772.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,822.95
Rate for Payer: SOMOS Essential	$7,822.95

PR PLACEMENT ADJUSTABLE SUTURE STRABISMUS

Professional

Both

$763.32

Service Code	HCPCS 67335
Min. Negotiated Rate	$572.49
Max. Negotiated Rate	$572.49
Rate for Payer: Cash Price	$207.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$572.49
Rate for Payer: SOMOS Essential	$572.49

PR PLACEMENT CHOLEDOCHAL STENT

Professional

Both

$5,048.33

Service Code	HCPCS 47801
Min. Negotiated Rate	$3,786.25
Max. Negotiated Rate	$3,786.25
Rate for Payer: Cash Price	$1,345.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,786.25
Rate for Payer: SOMOS Essential	$3,786.25

PR PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN

Professional

Both

$3,789.35

Service Code	HCPCS 44300
Min. Negotiated Rate	$2,842.01
Max. Negotiated Rate	$2,842.01
Rate for Payer: Cash Price	$1,012.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,842.01
Rate for Payer: SOMOS Essential	$2,842.01

PR PLACEMENT INTRSTL DEV OPN W/IMG GUID 1/MLT

Professional

Both

$369.60

Service Code	HCPCS 49412
Min. Negotiated Rate	$277.20
Max. Negotiated Rate	$277.20
Rate for Payer: Cash Price	$98.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$277.20
Rate for Payer: SOMOS Essential	$277.20

PR PLACEMENT NEEDLE HEAD/NECK RADIOELEMENT APPLICAT

Professional

Both

$2,010.44

Service Code	HCPCS 41019
Min. Negotiated Rate	$1,507.83
Max. Negotiated Rate	$1,507.83
Rate for Payer: Cash Price	$549.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,507.83
Rate for Payer: SOMOS Essential	$1,507.83

PR PLACEMENT NEEDLE INTRAOSSEOUS INFUSION

Professional

Both

$259.39

Service Code	HCPCS 36680
Min. Negotiated Rate	$194.54
Max. Negotiated Rate	$194.54
Rate for Payer: Cash Price	$69.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$194.54
Rate for Payer: SOMOS Essential	$194.54

PR PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL

Professional

Both

$1,898.33

Service Code	HCPCS 55920
Min. Negotiated Rate	$1,423.75
Max. Negotiated Rate	$1,423.75
Rate for Payer: Cash Price	$518.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,423.75
Rate for Payer: SOMOS Essential	$1,423.75

PR PLACEMENT NEEDLES MUSCLE SUBSEQUENT RADIOELEMENT

Professional

Both

$1,379.04

Service Code	HCPCS 20555
Min. Negotiated Rate	$1,034.28
Max. Negotiated Rate	$1,034.28
Rate for Payer: Cash Price	$377.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,034.28
Rate for Payer: SOMOS Essential	$1,034.28

PR PLACEMENT SETON

Professional

Both

$509.85

Service Code	HCPCS 46020
Min. Negotiated Rate	$382.39
Max. Negotiated Rate	$382.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$382.39
Rate for Payer: SOMOS Essential	$382.39

PR PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR

Professional

Both

$1,429.54

Service Code	HCPCS 34709
Min. Negotiated Rate	$1,072.16
Max. Negotiated Rate	$1,072.16
Rate for Payer: Cash Price	$376.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,072.16
Rate for Payer: SOMOS Essential	$1,072.16

Know your out-of-pocket cost for care.

All Charges