St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY

Professional

Both

$13,053.81

Service Code	HCPCS 48152
Min. Negotiated Rate	$9,790.36
Max. Negotiated Rate	$9,790.36
Rate for Payer: Cash Price	$3,467.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,790.36
Rate for Payer: SOMOS Essential	$9,790.36

PR PNCRTECT W/PANCREATOJEJUNOSTOMY

Professional

Both

$14,009.45

Service Code	HCPCS 48153
Min. Negotiated Rate	$10,507.09
Max. Negotiated Rate	$10,507.09
Rate for Payer: Cash Price	$3,725.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,507.09
Rate for Payer: SOMOS Essential	$10,507.09

PR PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX

Professional

Both

$5,493.67

Service Code	HCPCS 32940
Min. Negotiated Rate	$4,120.25
Max. Negotiated Rate	$4,120.25
Rate for Payer: Cash Price	$1,462.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,120.25
Rate for Payer: SOMOS Essential	$4,120.25

PR PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST

Professional

Both

$5,075.98

Service Code	HCPCS 32200
Min. Negotiated Rate	$3,806.98
Max. Negotiated Rate	$3,806.98
Rate for Payer: Cash Price	$1,356.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,806.98
Rate for Payer: SOMOS Essential	$3,806.98

PR PNEUMOTHORAX THER INTRAPLEURAL INJECTION AIR

Professional

Both

$373.28

Service Code	HCPCS 32960
Min. Negotiated Rate	$279.96
Max. Negotiated Rate	$279.96
Rate for Payer: Cash Price	$100.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$279.96
Rate for Payer: SOMOS Essential	$279.96

PR PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED

Professional

Both

$354.87

Service Code	HCPCS 55000
Min. Negotiated Rate	$266.15
Max. Negotiated Rate	$266.15
Rate for Payer: Cash Price	$97.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$266.15
Rate for Payer: SOMOS Essential	$266.15

PR POLIOVIRUS VACCINE INACTIVATED SUBQ/IM

Professional

Both

$133.00

Service Code	HCPCS 90713
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$99.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$99.75
Rate for Payer: SOMOS Essential	$99.75

PR POLLICIZATION DIGIT

Professional

Both

$7,323.96

Service Code	HCPCS 26550
Min. Negotiated Rate	$5,492.97
Max. Negotiated Rate	$5,492.97
Rate for Payer: Cash Price	$1,965.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,492.97
Rate for Payer: SOMOS Essential	$5,492.97

PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND

Professional

Both

$2,593.96

Service Code	HCPCS 95810
Min. Negotiated Rate	$1,945.47
Max. Negotiated Rate	$1,945.47
Rate for Payer: Cash Price	$730.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,945.47
Rate for Payer: SOMOS Essential	$1,945.47

PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND

Professional

Both

$2,128.42

Service Code	HCPCS 95810 TC
Min. Negotiated Rate	$1,596.32
Max. Negotiated Rate	$1,596.32
Rate for Payer: Cash Price	$602.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,596.32
Rate for Payer: SOMOS Essential	$1,596.32

PR POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND

Professional

Both

$465.54

Service Code	HCPCS 95810 26
Min. Negotiated Rate	$349.16
Max. Negotiated Rate	$349.16
Rate for Payer: Cash Price	$127.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$349.16
Rate for Payer: SOMOS Essential	$349.16

PR POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND

Professional

Both

$3,594.57

Service Code	HCPCS 95782 TC
Min. Negotiated Rate	$2,695.93
Max. Negotiated Rate	$2,695.93
Rate for Payer: Cash Price	$1,017.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,695.93
Rate for Payer: SOMOS Essential	$2,695.93

PR POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND

Professional

Both

$482.65

Service Code	HCPCS 95782 26
Min. Negotiated Rate	$361.99
Max. Negotiated Rate	$361.99
Rate for Payer: Cash Price	$133.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$361.99
Rate for Payer: SOMOS Essential	$361.99

PR POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND

Professional

Both

$4,077.26

Service Code	HCPCS 95782
Min. Negotiated Rate	$3,057.94
Max. Negotiated Rate	$3,057.94
Rate for Payer: Cash Price	$1,150.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,057.94
Rate for Payer: SOMOS Essential	$3,057.94

PR POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND

Professional

Both

$482.37

Service Code	HCPCS 95811 26
Min. Negotiated Rate	$361.78
Max. Negotiated Rate	$361.78
Rate for Payer: Cash Price	$132.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$361.78
Rate for Payer: SOMOS Essential	$361.78

PR POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND

Professional

Both

$2,716.77

Service Code	HCPCS 95811
Min. Negotiated Rate	$2,037.58
Max. Negotiated Rate	$2,037.58
Rate for Payer: Cash Price	$763.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,037.58
Rate for Payer: SOMOS Essential	$2,037.58

PR POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND

Professional

Both

$2,234.40

Service Code	HCPCS 95811 TC
Min. Negotiated Rate	$1,675.80
Max. Negotiated Rate	$1,675.80
Rate for Payer: Cash Price	$630.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,675.80
Rate for Payer: SOMOS Essential	$1,675.80

PR POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM

Professional

Both

$3,791.38

Service Code	HCPCS 95783 TC
Min. Negotiated Rate	$2,843.54
Max. Negotiated Rate	$2,843.54
Rate for Payer: Cash Price	$1,075.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,843.54
Rate for Payer: SOMOS Essential	$2,843.54

PR POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM

Professional

Both

$528.43

Service Code	HCPCS 95783 26
Min. Negotiated Rate	$396.32
Max. Negotiated Rate	$396.32
Rate for Payer: Cash Price	$145.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$396.32
Rate for Payer: SOMOS Essential	$396.32

PR POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM

Professional

Both

$4,319.81

Service Code	HCPCS 95783
Min. Negotiated Rate	$3,239.86
Max. Negotiated Rate	$3,239.86
Rate for Payer: Cash Price	$1,220.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,239.86
Rate for Payer: SOMOS Essential	$3,239.86

PR POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND

Professional

Both

$2,350.11

Service Code	HCPCS 95808
Min. Negotiated Rate	$1,762.58
Max. Negotiated Rate	$1,762.58
Rate for Payer: Cash Price	$600.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,762.58
Rate for Payer: SOMOS Essential	$1,762.58

PR POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND

Professional

Both

$2,025.21

Service Code	HCPCS 95808 TC
Min. Negotiated Rate	$1,518.91
Max. Negotiated Rate	$1,518.91
Rate for Payer: Cash Price	$511.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,518.91
Rate for Payer: SOMOS Essential	$1,518.91

PR POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND

Professional

Both

$324.91

Service Code	HCPCS 95808 26
Min. Negotiated Rate	$243.68
Max. Negotiated Rate	$243.68
Rate for Payer: Cash Price	$89.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$243.68
Rate for Payer: SOMOS Essential	$243.68

PR PORTOENETEROSTOMY

Professional

Both

$7,858.38

Service Code	HCPCS 47701
Min. Negotiated Rate	$5,893.78
Max. Negotiated Rate	$5,893.78
Rate for Payer: Cash Price	$2,090.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,893.78
Rate for Payer: SOMOS Essential	$5,893.78

PR POSITIONAL NYSTAGMUS TEST

Professional

Both

$19.99

Service Code	HCPCS 92542 TC
Min. Negotiated Rate	$14.99
Max. Negotiated Rate	$14.99
Rate for Payer: Cash Price	$5.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$14.99
Rate for Payer: SOMOS Essential	$14.99

Know your out-of-pocket cost for care.

All Charges