Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

PR RADIATION TREATMENT DELIVERY

Professional

Both

$557.62

Service Code	HCPCS G6005
Min. Negotiated Rate	$418.22
Max. Negotiated Rate	$418.22
Rate for Payer: Cash Price	$149.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$418.22
Rate for Payer: SOMOS Essential	$418.22

PR RADIATION TREATMENT DELIVERY

Professional

Both

$1,013.15

Service Code	HCPCS G6012
Min. Negotiated Rate	$759.86
Max. Negotiated Rate	$759.86
Rate for Payer: Cash Price	$271.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$759.86
Rate for Payer: SOMOS Essential	$759.86

PR RADIATION TREATMENT DELIVERY

Professional

Both

$1,024.80

Service Code	HCPCS G6007
Min. Negotiated Rate	$768.60
Max. Negotiated Rate	$768.60
Rate for Payer: Cash Price	$271.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$768.60
Rate for Payer: SOMOS Essential	$768.60

PR RADIATION TREATMENT DELIVERY

Professional

Both

$768.78

Service Code	HCPCS G6008
Min. Negotiated Rate	$576.58
Max. Negotiated Rate	$576.58
Rate for Payer: Cash Price	$205.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$576.58
Rate for Payer: SOMOS Essential	$576.58

PR RADIATION TREATMENT DELIVERY

Professional

Both

$554.75

Service Code	HCPCS G6006
Min. Negotiated Rate	$416.06
Max. Negotiated Rate	$416.06
Rate for Payer: Cash Price	$148.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$416.06
Rate for Payer: SOMOS Essential	$416.06

PR RADIATION TREATMENT DELIVERY

Professional

Both

$765.91

Service Code	HCPCS G6009
Min. Negotiated Rate	$574.43
Max. Negotiated Rate	$574.43
Rate for Payer: Cash Price	$205.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$574.43
Rate for Payer: SOMOS Essential	$574.43

PR RADIATION TREATMENT DELIVERY

Professional

Both

$658.25

Service Code	HCPCS G6003
Min. Negotiated Rate	$493.69
Max. Negotiated Rate	$493.69
Rate for Payer: Cash Price	$181.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$493.69
Rate for Payer: SOMOS Essential	$493.69

PR RADIATION TREATMENT DELIVERY

Professional

Both

$1,024.66

Service Code	HCPCS G6011
Min. Negotiated Rate	$768.50
Max. Negotiated Rate	$768.50
Rate for Payer: Cash Price	$270.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$768.50
Rate for Payer: SOMOS Essential	$768.50

PR RADIATION TREATMENT DELIVERY

Professional

Both

$1,010.28

Service Code	HCPCS G6014
Min. Negotiated Rate	$757.71
Max. Negotiated Rate	$757.71
Rate for Payer: Cash Price	$270.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$757.71
Rate for Payer: SOMOS Essential	$757.71

PR RADIATION TREATMENT DELIVERY

Professional

Both

$556.19

Service Code	HCPCS G6004
Min. Negotiated Rate	$417.14
Max. Negotiated Rate	$417.14
Rate for Payer: Cash Price	$149.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$417.14
Rate for Payer: SOMOS Essential	$417.14

PR RADIATION TREATMENT DELIVERY

Professional

Both

$761.60

Service Code	HCPCS G6010
Min. Negotiated Rate	$571.20
Max. Negotiated Rate	$571.20
Rate for Payer: Cash Price	$204.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$571.20
Rate for Payer: SOMOS Essential	$571.20

PR RADIATION TREATMENT DELIVERY

Professional

Both

$1,016.02

Service Code	HCPCS G6013
Min. Negotiated Rate	$762.02
Max. Negotiated Rate	$762.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$762.02
Rate for Payer: SOMOS Essential	$762.02

PR RADIATION TX DELIVERY IMRT

Professional

Both

$1,553.37

Service Code	HCPCS G6015
Min. Negotiated Rate	$1,165.03
Max. Negotiated Rate	$1,165.03
Rate for Payer: Cash Price	$421.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,165.03
Rate for Payer: SOMOS Essential	$1,165.03

PR RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP

Professional

Both

$5,932.57

Service Code	HCPCS 42844
Min. Negotiated Rate	$4,449.43
Max. Negotiated Rate	$4,449.43
Rate for Payer: Cash Price	$1,602.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,449.43
Rate for Payer: SOMOS Essential	$4,449.43

PR RADICAL RESCJ TONSIL CLOSURE W/OTHER FLAP

Professional

Both

$9,483.60

Service Code	HCPCS 42845
Min. Negotiated Rate	$7,112.70
Max. Negotiated Rate	$7,112.70
Rate for Payer: Cash Price	$2,552.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,112.70
Rate for Payer: SOMOS Essential	$7,112.70

PR RADICAL RESCTION TUMOR INNOMINATE BONE TOTAL

Professional

Both

$12,355.63

Service Code	HCPCS 27077
Min. Negotiated Rate	$9,266.72
Max. Negotiated Rate	$9,266.72
Rate for Payer: Cash Price	$3,316.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,266.72
Rate for Payer: SOMOS Essential	$9,266.72

PR RADICAL RESECTION BONE TUMOR PROXIMAL HUMERUS

Professional

Both

$8,527.02

Service Code	HCPCS 23220
Min. Negotiated Rate	$6,395.26
Max. Negotiated Rate	$6,395.26
Rate for Payer: Cash Price	$2,288.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,395.26
Rate for Payer: SOMOS Essential	$6,395.26

PR RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS

Professional

Both

$4,062.59

Service Code	HCPCS 27647
Min. Negotiated Rate	$3,046.94
Max. Negotiated Rate	$3,046.94
Rate for Payer: Cash Price	$1,117.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,046.94
Rate for Payer: SOMOS Essential	$3,046.94

PR RADICAL RESECTION OF TUMOR TIBIA

Professional

Both

$7,788.03

Service Code	HCPCS 27645
Min. Negotiated Rate	$5,841.02
Max. Negotiated Rate	$5,841.02
Rate for Payer: Cash Price	$2,094.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,841.02
Rate for Payer: SOMOS Essential	$5,841.02

PR RADICAL RESECTION STERNUM

Professional

Both

$5,743.85

Service Code	HCPCS 21630
Min. Negotiated Rate	$4,307.89
Max. Negotiated Rate	$4,307.89
Rate for Payer: Cash Price	$1,547.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,307.89
Rate for Payer: SOMOS Essential	$4,307.89

PR RADICAL RESECTION STERNUM W/MEDSTNL LMPHADEC

Professional

Both

$5,430.78

Service Code	HCPCS 21632
Min. Negotiated Rate	$4,073.08
Max. Negotiated Rate	$4,073.08
Rate for Payer: Cash Price	$1,451.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,073.08
Rate for Payer: SOMOS Essential	$4,073.08

PR RADICAL RESECTION TONSIL W/O CLOSURE

Professional

Both

$4,369.40

Service Code	HCPCS 42842
Min. Negotiated Rate	$3,277.05
Max. Negotiated Rate	$3,277.05
Rate for Payer: Cash Price	$1,180.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,277.05
Rate for Payer: SOMOS Essential	$3,277.05

PR RADICAL RESECTION TUMOR BONE FIBULA

Professional

Both

$6,765.12

Service Code	HCPCS 27646
Min. Negotiated Rate	$5,073.84
Max. Negotiated Rate	$5,073.84
Rate for Payer: Cash Price	$1,820.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,073.84
Rate for Payer: SOMOS Essential	$5,073.84

PR RADICAL RESECTION TUMOR CLAVICLE

Professional

Both

$6,637.75

Service Code	HCPCS 23200
Min. Negotiated Rate	$4,978.31
Max. Negotiated Rate	$4,978.31
Rate for Payer: Cash Price	$1,786.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,978.31
Rate for Payer: SOMOS Essential	$4,978.31

PR RADICAL RESECTION TUMOR DISTAL PHALANX FINGER

Professional

Both

$2,800.49

Service Code	HCPCS 26262
Min. Negotiated Rate	$2,100.37
Max. Negotiated Rate	$2,100.37
Rate for Payer: Cash Price	$759.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,100.37
Rate for Payer: SOMOS Essential	$2,100.37