St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR REMOVAL TUMOR TEMPORAL BONE

Professional

Both

$9,179.03

Service Code	HCPCS 69970
Min. Negotiated Rate	$6,884.27
Max. Negotiated Rate	$6,884.27
Rate for Payer: Cash Price	$2,474.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,884.27
Rate for Payer: SOMOS Essential	$6,884.27

PR REMOVAL TUNNELED INTRAPERITONEAL CATHETER

Professional

Both

$985.74

Service Code	HCPCS 49422
Min. Negotiated Rate	$739.30
Max. Negotiated Rate	$739.30
Rate for Payer: Cash Price	$262.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$739.30
Rate for Payer: SOMOS Essential	$739.30

PR REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE

Professional

Both

$4,944.63

Service Code	HCPCS 33977
Min. Negotiated Rate	$3,708.47
Max. Negotiated Rate	$3,708.47
Rate for Payer: Cash Price	$1,314.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,708.47
Rate for Payer: SOMOS Essential	$3,708.47

PR REMOVAL VENTR ASSIST DEVICE XTRCORP BIVENTR

Professional

Both

$5,846.12

Service Code	HCPCS 33978
Min. Negotiated Rate	$4,384.59
Max. Negotiated Rate	$4,384.59
Rate for Payer: Cash Price	$1,548.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,384.59
Rate for Payer: SOMOS Essential	$4,384.59

PR REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST

Professional

Both

$3,196.41

Service Code	HCPCS 25251
Min. Negotiated Rate	$2,397.31
Max. Negotiated Rate	$2,397.31
Rate for Payer: Cash Price	$865.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,397.31
Rate for Payer: SOMOS Essential	$2,397.31

PR REMOVAL WRIST PROSTHESIS SEPARATE PROCEDURE

Professional

Both

$2,373.21

Service Code	HCPCS 25250
Min. Negotiated Rate	$1,779.91
Max. Negotiated Rate	$1,779.91
Rate for Payer: Cash Price	$645.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,779.91
Rate for Payer: SOMOS Essential	$1,779.91

PR REMOVE DRUG IMPLANT

Professional

Both

$443.91

Service Code	HCPCS G0517
Min. Negotiated Rate	$332.93
Max. Negotiated Rate	$332.93
Rate for Payer: Cash Price	$122.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$332.93
Rate for Payer: SOMOS Essential	$332.93

PR REMOVE INT DWELL URETERAL STENT TRANSURETHRAL

Professional

Both

$671.69

Service Code	HCPCS 50386
Min. Negotiated Rate	$503.77
Max. Negotiated Rate	$503.77
Rate for Payer: Cash Price	$183.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$503.77
Rate for Payer: SOMOS Essential	$503.77

PR REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL

Professional

Both

$893.45

Service Code	HCPCS 50385
Min. Negotiated Rate	$670.09
Max. Negotiated Rate	$670.09
Rate for Payer: Cash Price	$240.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$670.09
Rate for Payer: SOMOS Essential	$670.09

PR REMOVE W INSERT DRUG IMPLANT

Professional

Both

$727.93

Service Code	HCPCS G0518
Min. Negotiated Rate	$545.95
Max. Negotiated Rate	$545.95
Rate for Payer: Cash Price	$199.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$545.95
Rate for Payer: SOMOS Essential	$545.95

PR REM THER MNTR DEV SPLY W/REC MUSCSKEL SYS EA 30D

Professional

Both

$214.06

Service Code	HCPCS 98977
Min. Negotiated Rate	$160.54
Max. Negotiated Rate	$160.54
Rate for Payer: Cash Price	$56.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$160.54
Rate for Payer: SOMOS Essential	$160.54

PR REM THER MNTR DEV SUPPLY W/REC RESPIR SYS EA 30D

Professional

Both

$214.06

Service Code	HCPCS 98976
Min. Negotiated Rate	$160.54
Max. Negotiated Rate	$160.54
Rate for Payer: Cash Price	$56.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$160.54
Rate for Payer: SOMOS Essential	$160.54

PR REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER

Professional

Both

$2,696.05

Service Code	HCPCS 53446
Min. Negotiated Rate	$2,022.04
Max. Negotiated Rate	$2,022.04
Rate for Payer: Cash Price	$739.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,022.04
Rate for Payer: SOMOS Essential	$2,022.04

PR REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD

Professional

Both

$1,498.07

Service Code	HCPCS 33227
Min. Negotiated Rate	$1,123.55
Max. Negotiated Rate	$1,123.55
Rate for Payer: Cash Price	$399.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,123.55
Rate for Payer: SOMOS Essential	$1,123.55

PR REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS

Professional

Both

$1,561.49

Service Code	HCPCS 33228
Min. Negotiated Rate	$1,171.12
Max. Negotiated Rate	$1,171.12
Rate for Payer: Cash Price	$416.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,171.12
Rate for Payer: SOMOS Essential	$1,171.12

PR REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD

Professional

Both

$1,651.86

Service Code	HCPCS 33229
Min. Negotiated Rate	$1,238.90
Max. Negotiated Rate	$1,238.90
Rate for Payer: Cash Price	$437.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,238.90
Rate for Payer: SOMOS Essential	$1,238.90

PR RENAL ALTRNSPLJ IMPLTJ GRF W/O RCP NEPHRECTOMY

Professional

Both

$10,931.03

Service Code	HCPCS 50360
Min. Negotiated Rate	$8,198.27
Max. Negotiated Rate	$8,198.27
Rate for Payer: Cash Price	$2,926.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,198.27
Rate for Payer: SOMOS Essential	$8,198.27

PR RENAL ALTRNSPLJ IMPLTJ GRF W/RCP NEPHRECTOMY

Professional

Both

$12,988.54

Service Code	HCPCS 50365
Min. Negotiated Rate	$9,741.40
Max. Negotiated Rate	$9,741.40
Rate for Payer: Cash Price	$3,488.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,741.40
Rate for Payer: SOMOS Essential	$9,741.40

PR RENAL AUTOTRNSPLJ REIMPLANTATION KIDNEY

Professional

Both

$9,184.98

Service Code	HCPCS 50380
Min. Negotiated Rate	$6,888.74
Max. Negotiated Rate	$6,888.74
Rate for Payer: Cash Price	$2,465.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,888.74
Rate for Payer: SOMOS Essential	$6,888.74

PR RENAL BIOPSY PRQ TROCAR/NEEDLE

Professional

Both

$519.16

Service Code	HCPCS 50200
Min. Negotiated Rate	$389.37
Max. Negotiated Rate	$389.37
Rate for Payer: Cash Price	$141.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$389.37
Rate for Payer: SOMOS Essential	$389.37

PR RENAL BIOPSY SURG EXPOSURE KIDNEY

Professional

Both

$3,384.15

Service Code	HCPCS 50205
Min. Negotiated Rate	$2,538.11
Max. Negotiated Rate	$2,538.11
Rate for Payer: Cash Price	$906.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,538.11
Rate for Payer: SOMOS Essential	$2,538.11

PR RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION

Professional

Both

$1,219.82

Service Code	HCPCS 50551
Min. Negotiated Rate	$914.86
Max. Negotiated Rate	$914.86
Rate for Payer: Cash Price	$331.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$914.86
Rate for Payer: SOMOS Essential	$914.86

PR RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY

Professional

Both

$1,412.43

Service Code	HCPCS 50555
Min. Negotiated Rate	$1,059.32
Max. Negotiated Rate	$1,059.32
Rate for Payer: Cash Price	$384.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,059.32
Rate for Payer: SOMOS Essential	$1,059.32

PR RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI

Professional

Both

$1,430.73

Service Code	HCPCS 50557
Min. Negotiated Rate	$1,073.05
Max. Negotiated Rate	$1,073.05
Rate for Payer: Cash Price	$389.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,073.05
Rate for Payer: SOMOS Essential	$1,073.05

PR RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR

Professional

Both

$2,395.23

Service Code	HCPCS 50562
Min. Negotiated Rate	$1,796.42
Max. Negotiated Rate	$1,796.42
Rate for Payer: Cash Price	$653.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,796.42
Rate for Payer: SOMOS Essential	$1,796.42

Know your out-of-pocket cost for care.

All Charges