St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR REMOVAL LENS MATERIAL EXTRACAPSULAR

Professional

Both

$3,224.17

Service Code	HCPCS 66940
Min. Negotiated Rate	$2,418.13
Max. Negotiated Rate	$2,418.13
Rate for Payer: Cash Price	$888.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,418.13
Rate for Payer: SOMOS Essential	$2,418.13

PR REMOVAL LENS MATRL INTRACAPSULAR DISLOCATED LENS

Professional

Both

$3,521.84

Service Code	HCPCS 66930
Min. Negotiated Rate	$2,641.38
Max. Negotiated Rate	$2,641.38
Rate for Payer: Cash Price	$969.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,641.38
Rate for Payer: SOMOS Essential	$2,641.38

PR REMOVAL LUNG PNEUMONECTOMY EXTRAPLEURAL

Professional

Both

$15,700.48

Service Code	HCPCS 32445
Min. Negotiated Rate	$11,775.36
Max. Negotiated Rate	$11,775.36
Rate for Payer: Cash Price	$4,173.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$11,775.36
Rate for Payer: SOMOS Essential	$11,775.36

PR REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA

Professional

Both

$13,592.78

Service Code	HCPCS 32442
Min. Negotiated Rate	$10,194.58
Max. Negotiated Rate	$10,194.58
Rate for Payer: Cash Price	$3,605.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,194.58
Rate for Payer: SOMOS Essential	$10,194.58

PR REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT

Professional

Both

$323.93

Service Code	HCPCS 11982
Min. Negotiated Rate	$242.95
Max. Negotiated Rate	$242.95
Rate for Payer: Cash Price	$85.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$242.95
Rate for Payer: SOMOS Essential	$242.95

PR REMOVAL OCULAR IMPLANT

Professional

Both

$3,290.63

Service Code	HCPCS 65175
Min. Negotiated Rate	$2,467.97
Max. Negotiated Rate	$2,467.97
Rate for Payer: Cash Price	$896.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,467.97
Rate for Payer: SOMOS Essential	$2,467.97

PR REMOVAL OF IMPACTED WAX MD

Professional

Both

$145.46

Service Code	HCPCS G0268
Min. Negotiated Rate	$109.10
Max. Negotiated Rate	$109.10
Rate for Payer: Cash Price	$38.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$109.10
Rate for Payer: SOMOS Essential	$109.10

PR REMOVAL OF LUNG PNEUMONECTOMY

Professional

Both

$6,972.04

Service Code	HCPCS 32440
Min. Negotiated Rate	$5,229.03
Max. Negotiated Rate	$5,229.03
Rate for Payer: Cash Price	$1,858.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,229.03
Rate for Payer: SOMOS Essential	$5,229.03

PR REMOVAL PANCREATIC CALCULUS

Professional

Both

$5,343.24

Service Code	HCPCS 48020
Min. Negotiated Rate	$4,007.43
Max. Negotiated Rate	$4,007.43
Rate for Payer: Cash Price	$1,423.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,007.43
Rate for Payer: SOMOS Essential	$4,007.43

PR REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY

Professional

Both

$3,840.27

Service Code	HCPCS 49402
Min. Negotiated Rate	$2,880.20
Max. Negotiated Rate	$2,880.20
Rate for Payer: Cash Price	$1,026.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,880.20
Rate for Payer: SOMOS Essential	$2,880.20

PR REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY

Professional

Both

$1,031.73

Service Code	HCPCS 33233
Min. Negotiated Rate	$773.80
Max. Negotiated Rate	$773.80
Rate for Payer: Cash Price	$274.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$773.80
Rate for Payer: SOMOS Essential	$773.80

PR REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ

Professional

Both

$823.24

Service Code	HCPCS 33992
Min. Negotiated Rate	$617.43
Max. Negotiated Rate	$617.43
Rate for Payer: Cash Price	$219.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$617.43
Rate for Payer: SOMOS Essential	$617.43

PR REMOVAL PERQ R HEART VAD VENOUS CANNULA SEP INSJ

Professional

Both

$694.33

Service Code	HCPCS 33997
Min. Negotiated Rate	$520.75
Max. Negotiated Rate	$520.75
Rate for Payer: Cash Price	$188.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$520.75
Rate for Payer: SOMOS Essential	$520.75

PR REMOVAL PG WCS LV PACG BATTERY COMPONENT ONLY

Professional

Both

$1,099.63

Service Code	HCPCS 0518T
Min. Negotiated Rate	$824.72
Max. Negotiated Rate	$824.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$824.72
Rate for Payer: SOMOS Essential	$824.72

PR REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION

Professional

Both

$3,379.11

Service Code	HCPCS 22850
Min. Negotiated Rate	$2,534.33
Max. Negotiated Rate	$2,534.33
Rate for Payer: Cash Price	$905.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,534.33
Rate for Payer: SOMOS Essential	$2,534.33

PR REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION

Professional

Both

$3,248.67

Service Code	HCPCS 22852
Min. Negotiated Rate	$2,436.50
Max. Negotiated Rate	$2,436.50
Rate for Payer: Cash Price	$872.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,436.50
Rate for Payer: SOMOS Essential	$2,436.50

PR REMOVAL&RPLCMT PG WCS LV PACG BOTH COMPONENTS

Professional

Both

$4,028.12

Service Code	HCPCS 0519T
Min. Negotiated Rate	$3,021.09
Max. Negotiated Rate	$3,021.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,021.09
Rate for Payer: SOMOS Essential	$3,021.09

PR REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM

Professional

Both

$2,101.89

Service Code	HCPCS 23333
Min. Negotiated Rate	$1,576.42
Max. Negotiated Rate	$1,576.42
Rate for Payer: Cash Price	$571.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,576.42
Rate for Payer: SOMOS Essential	$1,576.42

PR REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR

Professional

Both

$382.97

Service Code	HCPCS 33286
Min. Negotiated Rate	$287.23
Max. Negotiated Rate	$287.23
Rate for Payer: Cash Price	$100.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$287.23
Rate for Payer: SOMOS Essential	$287.23

PR REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN

Professional

Both

$1,558.38

Service Code	HCPCS 23000
Min. Negotiated Rate	$1,168.78
Max. Negotiated Rate	$1,168.78
Rate for Payer: Cash Price	$428.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,168.78
Rate for Payer: SOMOS Essential	$1,168.78

PR REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA

Professional

Both

$71.61

Service Code	HCPCS 15854
Min. Negotiated Rate	$53.71
Max. Negotiated Rate	$53.71
Rate for Payer: Cash Price	$19.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$53.71
Rate for Payer: SOMOS Essential	$53.71

PR REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA

Professional

Both

$50.19

Service Code	HCPCS 15853
Min. Negotiated Rate	$37.64
Max. Negotiated Rate	$37.64
Rate for Payer: Cash Price	$13.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$37.64
Rate for Payer: SOMOS Essential	$37.64

PR REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA

Professional

Both

$272.69

Service Code	HCPCS 15851
Min. Negotiated Rate	$204.52
Max. Negotiated Rate	$204.52
Rate for Payer: Cash Price	$74.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$204.52
Rate for Payer: SOMOS Essential	$204.52

PR REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT

Professional

Both

$2,409.93

Service Code	HCPCS 11971
Min. Negotiated Rate	$1,807.45
Max. Negotiated Rate	$1,807.45
Rate for Payer: Cash Price	$655.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,807.45
Rate for Payer: SOMOS Essential	$1,807.45

PR REMOVAL TONGS/HALO APPLIED BY ANOTHER INDIVIDUAL

Professional

Both

$407.44

Service Code	HCPCS 20665
Min. Negotiated Rate	$305.58
Max. Negotiated Rate	$305.58
Rate for Payer: Cash Price	$112.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$305.58
Rate for Payer: SOMOS Essential	$305.58

Know your out-of-pocket cost for care.

All Charges