St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL

Professional

Both

$2,578.17

Service Code	HCPCS 92937
Min. Negotiated Rate	$1,933.63
Max. Negotiated Rate	$1,933.63
Rate for Payer: Cash Price	$685.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,933.63
Rate for Payer: SOMOS Essential	$1,933.63

PR PRQ TRLUML CORONARY STENT/ATH/ANGIO ADDL BRANCH

Professional

Both

$722.86

Service Code	HCPCS 92934
Min. Negotiated Rate	$542.14
Max. Negotiated Rate	$542.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$542.14
Rate for Payer: SOMOS Essential	$542.14

PR PRQ TRLUML CORONARY STENT W/ANGIO ADDL ART/BRNCH

Professional

Both

$234.00

Service Code	HCPCS 92929
Min. Negotiated Rate	$175.50
Max. Negotiated Rate	$175.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$175.50
Rate for Payer: SOMOS Essential	$175.50

PR PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH

Professional

Both

$2,580.83

Service Code	HCPCS 92928
Min. Negotiated Rate	$1,935.62
Max. Negotiated Rate	$1,935.62
Rate for Payer: Cash Price	$684.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,935.62
Rate for Payer: SOMOS Essential	$1,935.62

PR PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL

Professional

Both

$2,898.14

Service Code	HCPCS 92943
Min. Negotiated Rate	$2,173.60
Max. Negotiated Rate	$2,173.60
Rate for Payer: Cash Price	$768.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,173.60
Rate for Payer: SOMOS Essential	$2,173.60

PR PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH

Professional

Both

$2,891.46

Service Code	HCPCS 92933
Min. Negotiated Rate	$2,168.60
Max. Negotiated Rate	$2,168.60
Rate for Payer: Cash Price	$768.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,168.60
Rate for Payer: SOMOS Essential	$2,168.60

PR PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL

Professional

Both

$2,891.39

Service Code	HCPCS 92941
Min. Negotiated Rate	$2,168.54
Max. Negotiated Rate	$2,168.54
Rate for Payer: Cash Price	$768.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,168.54
Rate for Payer: SOMOS Essential	$2,168.54

PR PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX

Professional

Both

$1,193.05

Service Code	HCPCS 37188
Min. Negotiated Rate	$894.79
Max. Negotiated Rate	$894.79
Rate for Payer: Cash Price	$320.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$894.79
Rate for Payer: SOMOS Essential	$894.79

PR PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL

Professional

Both

$2,757.16

Service Code	HCPCS 92997
Min. Negotiated Rate	$2,067.87
Max. Negotiated Rate	$2,067.87
Rate for Payer: Cash Price	$729.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,067.87
Rate for Payer: SOMOS Essential	$2,067.87

PR PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL

Professional

Both

$1,385.37

Service Code	HCPCS 92998
Min. Negotiated Rate	$1,039.03
Max. Negotiated Rate	$1,039.03
Rate for Payer: Cash Price	$369.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,039.03
Rate for Payer: SOMOS Essential	$1,039.03

PR PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF

Professional

Both

$22,143.38

Service Code	HCPCS 43116
Min. Negotiated Rate	$16,607.54
Max. Negotiated Rate	$16,607.54
Rate for Payer: Cash Price	$5,867.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16,607.54
Rate for Payer: SOMOS Essential	$16,607.54

PR PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY

Professional

Both

$12,732.65

Service Code	HCPCS 43121
Min. Negotiated Rate	$9,549.49
Max. Negotiated Rate	$9,549.49
Rate for Payer: Cash Price	$3,385.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,549.49
Rate for Payer: SOMOS Essential	$9,549.49

PR PRTL ESOPH DSTL W/WO PROX GASTRC W/COLON NTRPSTJ

Professional

Both

$16,151.59

Service Code	HCPCS 43118
Min. Negotiated Rate	$12,113.69
Max. Negotiated Rate	$12,113.69
Rate for Payer: Cash Price	$4,283.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$12,113.69
Rate for Payer: SOMOS Essential	$12,113.69

PR PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY

Professional

Both

$14,506.87

Service Code	HCPCS 43117
Min. Negotiated Rate	$10,880.15
Max. Negotiated Rate	$10,880.15
Rate for Payer: Cash Price	$3,862.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,880.15
Rate for Payer: SOMOS Essential	$10,880.15

PR PRTL ESOPHG THORACOABD W/WO PROXGASTREC/PYLOROPL

Professional

Both

$11,400.76

Service Code	HCPCS 43122
Min. Negotiated Rate	$8,550.57
Max. Negotiated Rate	$8,550.57
Rate for Payer: Cash Price	$3,061.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,550.57
Rate for Payer: SOMOS Essential	$8,550.57

PR PRTL ESPHG THORACOABDL/ABDL APPR NTRPSTJ/RCNSTJ

Professional

Both

$20,068.69

Service Code	HCPCS 43123
Min. Negotiated Rate	$15,051.52
Max. Negotiated Rate	$15,051.52
Rate for Payer: Cash Price	$5,321.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$15,051.52
Rate for Payer: SOMOS Essential	$15,051.52

PR PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS

Professional

Both

$1,845.80

Service Code	HCPCS 28122
Min. Negotiated Rate	$1,384.35
Max. Negotiated Rate	$1,384.35
Rate for Payer: Cash Price	$509.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,384.35
Rate for Payer: SOMOS Essential	$1,384.35

PR PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA

Professional

Both

$4,001.24

Service Code	HCPCS 27360
Min. Negotiated Rate	$3,000.93
Max. Negotiated Rate	$3,000.93
Rate for Payer: Cash Price	$1,079.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,000.93
Rate for Payer: SOMOS Essential	$3,000.93

PR PRTL EXCHANGE TRANSFUSE BLOOD/PLSM/CRYST NEWBORN

Professional

Both

$393.75

Service Code	HCPCS 36456
Min. Negotiated Rate	$295.31
Max. Negotiated Rate	$295.31
Rate for Payer: Cash Price	$107.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$295.31
Rate for Payer: SOMOS Essential	$295.31

PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV

Professional

Both

$3,945.52

Service Code	HCPCS 22100
Min. Negotiated Rate	$2,959.14
Max. Negotiated Rate	$2,959.14
Rate for Payer: Cash Price	$1,195.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,959.14
Rate for Payer: SOMOS Essential	$2,959.14

PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA

Professional

Both

$611.21

Service Code	HCPCS 22103
Min. Negotiated Rate	$458.41
Max. Negotiated Rate	$458.41
Rate for Payer: Cash Price	$160.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$458.41
Rate for Payer: SOMOS Essential	$458.41

PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR

Professional

Both

$3,446.49

Service Code	HCPCS 22102
Min. Negotiated Rate	$2,584.87
Max. Negotiated Rate	$2,584.87
Rate for Payer: Cash Price	$920.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,584.87
Rate for Payer: SOMOS Essential	$2,584.87

PR PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC

Professional

Both

$3,971.35

Service Code	HCPCS 22101
Min. Negotiated Rate	$2,978.51
Max. Negotiated Rate	$2,978.51
Rate for Payer: Cash Price	$1,080.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,978.51
Rate for Payer: SOMOS Essential	$2,978.51

PR PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV

Professional

Both

$4,937.07

Service Code	HCPCS 22110
Min. Negotiated Rate	$3,702.80
Max. Negotiated Rate	$3,702.80
Rate for Payer: Cash Price	$1,313.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,702.80
Rate for Payer: SOMOS Essential	$3,702.80

PR PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA

Professional

Both

$658.21

Service Code	HCPCS 22116
Min. Negotiated Rate	$493.66
Max. Negotiated Rate	$493.66
Rate for Payer: Cash Price	$172.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$493.66
Rate for Payer: SOMOS Essential	$493.66

Know your out-of-pocket cost for care.

All Charges