St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR PREP TUMOR CAVITY IORT W/PARTIAL MASTECTOMY

Professional

Both

$740.67

Service Code	HCPCS 19294
Min. Negotiated Rate	$555.50
Max. Negotiated Rate	$555.50
Rate for Payer: Cash Price	$196.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$555.50
Rate for Payer: SOMOS Essential	$555.50

PR PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT

Professional

Both

$40.11

Service Code	HCPCS 94640
Min. Negotiated Rate	$30.08
Max. Negotiated Rate	$30.08
Rate for Payer: Cash Price	$9.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$30.08
Rate for Payer: SOMOS Essential	$30.08

PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP

Professional

Both

$122.82

Service Code	HCPCS 93279 26
Min. Negotiated Rate	$92.12
Max. Negotiated Rate	$92.12
Rate for Payer: Cash Price	$33.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$92.12
Rate for Payer: SOMOS Essential	$92.12

PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP

Professional

Both

$160.86

Service Code	HCPCS 93279 TC
Min. Negotiated Rate	$120.64
Max. Negotiated Rate	$120.64
Rate for Payer: Cash Price	$43.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$120.64
Rate for Payer: SOMOS Essential	$120.64

PR PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP

Professional

Both

$283.68

Service Code	HCPCS 93279
Min. Negotiated Rate	$212.76
Max. Negotiated Rate	$212.76
Rate for Payer: Cash Price	$76.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$212.76
Rate for Payer: SOMOS Essential	$212.76

PR PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM

Professional

Both

$167.72

Service Code	HCPCS 93260 26
Min. Negotiated Rate	$125.79
Max. Negotiated Rate	$125.79
Rate for Payer: Cash Price	$44.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$125.79
Rate for Payer: SOMOS Essential	$125.79

PR PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM

Professional

Both

$152.25

Service Code	HCPCS 93260 TC
Min. Negotiated Rate	$114.19
Max. Negotiated Rate	$114.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$114.19
Rate for Payer: SOMOS Essential	$114.19

PR PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM

Professional

Both

$319.97

Service Code	HCPCS 93260
Min. Negotiated Rate	$239.98
Max. Negotiated Rate	$239.98
Rate for Payer: Cash Price	$85.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$239.98
Rate for Payer: SOMOS Essential	$239.98

PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON

Professional

Both

$100.80

Service Code	HCPCS 93285 26
Min. Negotiated Rate	$75.60
Max. Negotiated Rate	$75.60
Rate for Payer: Cash Price	$27.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$75.60
Rate for Payer: SOMOS Essential	$75.60

PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON

Professional

Both

$255.89

Service Code	HCPCS 93285
Min. Negotiated Rate	$191.92
Max. Negotiated Rate	$191.92
Rate for Payer: Cash Price	$68.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$191.92
Rate for Payer: SOMOS Essential	$191.92

PR PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON

Professional

Both

$155.12

Service Code	HCPCS 93285 TC
Min. Negotiated Rate	$116.34
Max. Negotiated Rate	$116.34
Rate for Payer: Cash Price	$41.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$116.34
Rate for Payer: SOMOS Essential	$116.34

PR PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON

Professional

Both

$130.34

Service Code	HCPCS 0522T TC
Min. Negotiated Rate	$97.76
Max. Negotiated Rate	$97.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$97.76
Rate for Payer: SOMOS Essential	$97.76

PR PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON

Professional

Both

$181.34

Service Code	HCPCS 0522T 26
Min. Negotiated Rate	$136.00
Max. Negotiated Rate	$136.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$136.00
Rate for Payer: SOMOS Essential	$136.00

PR PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON

Professional

Both

$311.68

Service Code	HCPCS 0522T
Min. Negotiated Rate	$233.76
Max. Negotiated Rate	$233.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$233.76
Rate for Payer: SOMOS Essential	$233.76

PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB

Professional

Both

$440.48

Service Code	HCPCS 93284
Min. Negotiated Rate	$330.36
Max. Negotiated Rate	$330.36
Rate for Payer: Cash Price	$119.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$330.36
Rate for Payer: SOMOS Essential	$330.36

PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB

Professional

Both

$239.37

Service Code	HCPCS 93284 26
Min. Negotiated Rate	$179.53
Max. Negotiated Rate	$179.53
Rate for Payer: Cash Price	$64.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$179.53
Rate for Payer: SOMOS Essential	$179.53

PR PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB

Professional

Both

$201.11

Service Code	HCPCS 93284 TC
Min. Negotiated Rate	$150.83
Max. Negotiated Rate	$150.83
Rate for Payer: Cash Price	$54.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$150.83
Rate for Payer: SOMOS Essential	$150.83

PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB

Professional

Both

$188.16

Service Code	HCPCS 93283 TC
Min. Negotiated Rate	$141.12
Max. Negotiated Rate	$141.12
Rate for Payer: Cash Price	$50.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$141.12
Rate for Payer: SOMOS Essential	$141.12

PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB

Professional

Both

$409.29

Service Code	HCPCS 93283
Min. Negotiated Rate	$306.97
Max. Negotiated Rate	$306.97
Rate for Payer: Cash Price	$110.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$306.97
Rate for Payer: SOMOS Essential	$306.97

PR PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB

Professional

Both

$221.10

Service Code	HCPCS 93283 26
Min. Negotiated Rate	$165.82
Max. Negotiated Rate	$165.82
Rate for Payer: Cash Price	$59.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$165.82
Rate for Payer: SOMOS Essential	$165.82

PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB

Professional

Both

$172.38

Service Code	HCPCS 93282 TC
Min. Negotiated Rate	$129.28
Max. Negotiated Rate	$129.28
Rate for Payer: Cash Price	$46.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$129.28
Rate for Payer: SOMOS Essential	$129.28

PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB

Professional

Both

$338.63

Service Code	HCPCS 93282
Min. Negotiated Rate	$253.97
Max. Negotiated Rate	$253.97
Rate for Payer: Cash Price	$90.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$253.97
Rate for Payer: SOMOS Essential	$253.97

PR PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB

Professional

Both

$166.29

Service Code	HCPCS 93282 26
Min. Negotiated Rate	$124.72
Max. Negotiated Rate	$124.72
Rate for Payer: Cash Price	$44.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$124.72
Rate for Payer: SOMOS Essential	$124.72

PR PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS

Professional

Both

$10,958.08

Service Code	HCPCS 33031
Min. Negotiated Rate	$8,218.56
Max. Negotiated Rate	$8,218.56
Rate for Payer: Cash Price	$2,912.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,218.56
Rate for Payer: SOMOS Essential	$8,218.56

PR PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS

Professional

Both

$8,856.79

Service Code	HCPCS 33030
Min. Negotiated Rate	$6,642.59
Max. Negotiated Rate	$6,642.59
Rate for Payer: Cash Price	$2,358.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,642.59
Rate for Payer: SOMOS Essential	$6,642.59

Know your out-of-pocket cost for care.

All Charges