St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3 CM/>

Professional

Both

$4,438.46

Service Code	HCPCS 28047
Min. Negotiated Rate	$3,328.84
Max. Negotiated Rate	$3,328.84
Rate for Payer: Cash Price	$1,208.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,328.84
Rate for Payer: SOMOS Essential	$3,328.84

PR RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM

Professional

Both

$2,991.77

Service Code	HCPCS 28046
Min. Negotiated Rate	$2,243.83
Max. Negotiated Rate	$2,243.83
Rate for Payer: Cash Price	$802.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,243.83
Rate for Payer: SOMOS Essential	$2,243.83

PR RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE 5 CM/>

Professional

Both

$5,633.25

Service Code	HCPCS 27616
Min. Negotiated Rate	$4,224.94
Max. Negotiated Rate	$4,224.94
Rate for Payer: Cash Price	$1,501.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,224.94
Rate for Payer: SOMOS Essential	$4,224.94

PR RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM

Professional

Both

$4,541.46

Service Code	HCPCS 27615
Min. Negotiated Rate	$3,406.10
Max. Negotiated Rate	$3,406.10
Rate for Payer: Cash Price	$1,209.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,406.10
Rate for Payer: SOMOS Essential	$3,406.10

PR RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5 CM/>

Professional

Both

$6,382.43

Service Code	HCPCS 23078
Min. Negotiated Rate	$4,786.82
Max. Negotiated Rate	$4,786.82
Rate for Payer: Cash Price	$1,712.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,786.82
Rate for Payer: SOMOS Essential	$4,786.82

PR RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM

Professional

Both

$5,066.64

Service Code	HCPCS 23077
Min. Negotiated Rate	$3,799.98
Max. Negotiated Rate	$3,799.98
Rate for Payer: Cash Price	$1,358.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,799.98
Rate for Payer: SOMOS Essential	$3,799.98

PR RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>

Professional

Both

$6,953.91

Service Code	HCPCS 27364
Min. Negotiated Rate	$5,215.43
Max. Negotiated Rate	$5,215.43
Rate for Payer: Cash Price	$1,863.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,215.43
Rate for Payer: SOMOS Essential	$5,215.43

PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM

Professional

Both

$3,934.00

Service Code	HCPCS 25077
Min. Negotiated Rate	$2,950.50
Max. Negotiated Rate	$2,950.50
Rate for Payer: Cash Price	$1,040.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,950.50
Rate for Payer: SOMOS Essential	$2,950.50

PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM

Professional

Both

$4,232.87

Service Code	HCPCS 21557
Min. Negotiated Rate	$3,174.65
Max. Negotiated Rate	$3,174.65
Rate for Payer: Cash Price	$1,143.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,174.65
Rate for Payer: SOMOS Essential	$3,174.65

PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>

Professional

Both

$5,969.81

Service Code	HCPCS 21558
Min. Negotiated Rate	$4,477.36
Max. Negotiated Rate	$4,477.36
Rate for Payer: Cash Price	$1,594.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,477.36
Rate for Payer: SOMOS Essential	$4,477.36

PR RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM

Professional

Both

$3,274.60

Service Code	HCPCS 26117
Min. Negotiated Rate	$2,455.95
Max. Negotiated Rate	$2,455.95
Rate for Payer: Cash Price	$888.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,455.95
Rate for Payer: SOMOS Essential	$2,455.95

PR RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM

Professional

Both

$5,985.46

Service Code	HCPCS 27049
Min. Negotiated Rate	$4,489.10
Max. Negotiated Rate	$4,489.10
Rate for Payer: Cash Price	$1,692.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,489.10
Rate for Payer: SOMOS Essential	$4,489.10

PR RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM

Professional

Both

$4,639.18

Service Code	HCPCS 27329
Min. Negotiated Rate	$3,479.38
Max. Negotiated Rate	$3,479.38
Rate for Payer: Cash Price	$1,247.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,479.38
Rate for Payer: SOMOS Essential	$3,479.38

PR RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM

Professional

Both

$4,604.95

Service Code	HCPCS 24077
Min. Negotiated Rate	$3,453.71
Max. Negotiated Rate	$3,453.71
Rate for Payer: Cash Price	$1,230.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,453.71
Rate for Payer: SOMOS Essential	$3,453.71

PR RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5CM/>

Professional

Both

$5,911.29

Service Code	HCPCS 24079
Min. Negotiated Rate	$4,433.47
Max. Negotiated Rate	$4,433.47
Rate for Payer: Cash Price	$1,585.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,433.47
Rate for Payer: SOMOS Essential	$4,433.47

PR RAD TRACHELECTOMY W/BI PEL LMPHADEC

Professional

Both

$8,501.78

Service Code	HCPCS 57531
Min. Negotiated Rate	$6,376.34
Max. Negotiated Rate	$6,376.34
Rate for Payer: Cash Price	$2,251.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,376.34
Rate for Payer: SOMOS Essential	$6,376.34

PR RAPID DESENSITIZATION PROCEDURE EACH HOUR

Professional

Both

$405.90

Service Code	HCPCS 95180
Min. Negotiated Rate	$304.42
Max. Negotiated Rate	$304.42
Rate for Payer: Cash Price	$112.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$304.42
Rate for Payer: SOMOS Essential	$304.42

PR RB82 RUBIDIUM

Professional

Both

$1,864.28

Service Code	HCPCS A9555
Min. Negotiated Rate	$1,398.21
Max. Negotiated Rate	$1,398.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,398.21
Rate for Payer: SOMOS Essential	$1,398.21

PR RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ EA ADDL

Professional

Both

$334.95

Service Code	HCPCS 96935
Min. Negotiated Rate	$251.21
Max. Negotiated Rate	$251.21
Rate for Payer: Cash Price	$91.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$251.21
Rate for Payer: SOMOS Essential	$251.21

PR RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ I&R 1ST

Professional

Both

$729.12

Service Code	HCPCS 96931
Min. Negotiated Rate	$546.84
Max. Negotiated Rate	$546.84
Rate for Payer: Cash Price	$197.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$546.84
Rate for Payer: SOMOS Essential	$546.84

PR RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ I&R ADD

Professional

Both

$502.88

Service Code	HCPCS 96934
Min. Negotiated Rate	$377.16
Max. Negotiated Rate	$377.16
Rate for Payer: Cash Price	$136.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$377.16
Rate for Payer: SOMOS Essential	$377.16

PR RCM CELULR & SUBCELULR SKN IMGNG IMG ACQUISITION

Professional

Both

$551.85

Service Code	HCPCS 96932
Min. Negotiated Rate	$413.89
Max. Negotiated Rate	$413.89
Rate for Payer: Cash Price	$149.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$413.89
Rate for Payer: SOMOS Essential	$413.89

PR RCM CELULR & SUBCELULR SKN IMGNG I&R 1ST LES

Professional

Both

$177.28

Service Code	HCPCS 96933
Min. Negotiated Rate	$132.96
Max. Negotiated Rate	$132.96
Rate for Payer: Cash Price	$47.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$132.96
Rate for Payer: SOMOS Essential	$132.96

PR RCM CELULR & SUBCELULR SKN IMGNG I&R EA ADDL

Professional

Both

$167.93

Service Code	HCPCS 96936
Min. Negotiated Rate	$125.95
Max. Negotiated Rate	$125.95
Rate for Payer: Cash Price	$44.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$125.95
Rate for Payer: SOMOS Essential	$125.95

PR RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY

Professional

Both

$1,540.04

Service Code	HCPCS 28313
Min. Negotiated Rate	$1,155.03
Max. Negotiated Rate	$1,155.03
Rate for Payer: Cash Price	$424.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,155.03
Rate for Payer: SOMOS Essential	$1,155.03

Know your out-of-pocket cost for care.

All Charges