St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR REPLANTATION HAND COMPLETE AMPUTATION

Professional

Both

$17,308.10

Service Code	HCPCS 20808
Min. Negotiated Rate	$12,981.08
Max. Negotiated Rate	$12,981.08
Rate for Payer: Cash Price	$4,648.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$12,981.08
Rate for Payer: SOMOS Essential	$12,981.08

PR REPLANTATION PENIS COMP AMPUTATION W/URETH REP

Professional

Both

$5,571.37

Service Code	HCPCS 54438
Min. Negotiated Rate	$4,178.53
Max. Negotiated Rate	$4,178.53
Rate for Payer: Cash Price	$1,522.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,178.53
Rate for Payer: SOMOS Essential	$4,178.53

PR REPOSITIONING IO LENS PROSTHESIS REQ INC SPX

Professional

Both

$3,474.94

Service Code	HCPCS 66825
Min. Negotiated Rate	$2,606.20
Max. Negotiated Rate	$2,606.20
Rate for Payer: Cash Price	$951.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,606.20
Rate for Payer: SOMOS Essential	$2,606.20

PR REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ

Professional

Both

$724.26

Service Code	HCPCS 33993
Min. Negotiated Rate	$543.20
Max. Negotiated Rate	$543.20
Rate for Payer: Cash Price	$192.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$543.20
Rate for Payer: SOMOS Essential	$543.20

PR REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO

Professional

Both

$452.45

Service Code	HCPCS 43761
Min. Negotiated Rate	$339.34
Max. Negotiated Rate	$339.34
Rate for Payer: Cash Price	$120.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$339.34
Rate for Payer: SOMOS Essential	$339.34

PR REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB

Professional

Both

$1,766.77

Service Code	HCPCS 33273
Min. Negotiated Rate	$1,325.08
Max. Negotiated Rate	$1,325.08
Rate for Payer: Cash Price	$473.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,325.08
Rate for Payer: SOMOS Essential	$1,325.08

PR REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT

Professional

Both

$166.60

Service Code	HCPCS 62252 TC
Min. Negotiated Rate	$124.95
Max. Negotiated Rate	$124.95
Rate for Payer: Cash Price	$48.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$124.95
Rate for Payer: SOMOS Essential	$124.95

PR REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT

Professional

Both

$218.30

Service Code	HCPCS 62252 26
Min. Negotiated Rate	$163.72
Max. Negotiated Rate	$163.72
Rate for Payer: Cash Price	$56.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$163.72
Rate for Payer: SOMOS Essential	$163.72

PR REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT

Professional

Both

$384.93

Service Code	HCPCS 62252
Min. Negotiated Rate	$288.70
Max. Negotiated Rate	$288.70
Rate for Payer: Cash Price	$105.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$288.70
Rate for Payer: SOMOS Essential	$288.70

PR REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I

Professional

Both

$1,532.37

Service Code	HCPCS 37192
Min. Negotiated Rate	$1,149.28
Max. Negotiated Rate	$1,149.28
Rate for Payer: Cash Price	$404.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,149.28
Rate for Payer: SOMOS Essential	$1,149.28

PR RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ

Professional

Both

$9,099.09

Service Code	HCPCS 32504
Min. Negotiated Rate	$6,824.32
Max. Negotiated Rate	$6,824.32
Rate for Payer: Cash Price	$2,420.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,824.32
Rate for Payer: SOMOS Essential	$6,824.32

PR RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ

Professional

Both

$7,990.61

Service Code	HCPCS 32503
Min. Negotiated Rate	$5,992.96
Max. Negotiated Rate	$5,992.96
Rate for Payer: Cash Price	$2,124.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,992.96
Rate for Payer: SOMOS Essential	$5,992.96

PR RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY

Professional

Both

$1,082.24

Service Code	HCPCS 32501
Min. Negotiated Rate	$811.68
Max. Negotiated Rate	$811.68
Rate for Payer: Cash Price	$287.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$811.68
Rate for Payer: SOMOS Essential	$811.68

PR RESCJ DIAPHRAGM W/COMPLEX REPAIR

Professional

Both

$5,594.37

Service Code	HCPCS 39561
Min. Negotiated Rate	$4,195.78
Max. Negotiated Rate	$4,195.78
Rate for Payer: Cash Price	$1,499.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,195.78
Rate for Payer: SOMOS Essential	$4,195.78

PR RESCJ DIAPHRAGM W/SIMPLE REPAIR

Professional

Both

$3,562.41

Service Code	HCPCS 39560
Min. Negotiated Rate	$2,671.81
Max. Negotiated Rate	$2,671.81
Rate for Payer: Cash Price	$955.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,671.81
Rate for Payer: SOMOS Essential	$2,671.81

PR RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL

Professional

Both

$9,488.85

Service Code	HCPCS 61600
Min. Negotiated Rate	$7,116.64
Max. Negotiated Rate	$7,116.64
Rate for Payer: Cash Price	$2,530.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,116.64
Rate for Payer: SOMOS Essential	$7,116.64

PR RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF

Professional

Both

$11,519.20

Service Code	HCPCS 61601
Min. Negotiated Rate	$8,639.40
Max. Negotiated Rate	$8,639.40
Rate for Payer: Cash Price	$3,044.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,639.40
Rate for Payer: SOMOS Essential	$8,639.40

PR RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL

Professional

Both

$15,759.63

Service Code	HCPCS 61616
Min. Negotiated Rate	$11,819.72
Max. Negotiated Rate	$11,819.72
Rate for Payer: Cash Price	$4,168.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$11,819.72
Rate for Payer: SOMOS Essential	$11,819.72

PR RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL

Professional

Both

$13,461.74

Service Code	HCPCS 61615
Min. Negotiated Rate	$10,096.30
Max. Negotiated Rate	$10,096.30
Rate for Payer: Cash Price	$3,544.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,096.30
Rate for Payer: SOMOS Essential	$10,096.30

PR RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL

Professional

Both

$9,465.23

Service Code	HCPCS 61605
Min. Negotiated Rate	$7,098.92
Max. Negotiated Rate	$7,098.92
Rate for Payer: Cash Price	$2,534.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,098.92
Rate for Payer: SOMOS Essential	$7,098.92

PR RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR

Professional

Both

$13,691.58

Service Code	HCPCS 61606
Min. Negotiated Rate	$10,268.68
Max. Negotiated Rate	$10,268.68
Rate for Payer: Cash Price	$3,594.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,268.68
Rate for Payer: SOMOS Essential	$10,268.68

PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL

Professional

Both

$15,705.66

Service Code	HCPCS 61608
Min. Negotiated Rate	$11,779.24
Max. Negotiated Rate	$11,779.24
Rate for Payer: Cash Price	$4,134.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$11,779.24
Rate for Payer: SOMOS Essential	$11,779.24

PR RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL

Professional

Both

$12,012.88

Service Code	HCPCS 61607
Min. Negotiated Rate	$9,009.66
Max. Negotiated Rate	$9,009.66
Rate for Payer: Cash Price	$3,835.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,009.66
Rate for Payer: SOMOS Essential	$9,009.66

PR RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR

Professional

Both

$8,025.89

Service Code	HCPCS 42892
Min. Negotiated Rate	$6,019.42
Max. Negotiated Rate	$6,019.42
Rate for Payer: Cash Price	$2,163.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,019.42
Rate for Payer: SOMOS Essential	$6,019.42

PR RESCJ LIP > ONE-FOURTH W/O RCNSTJ

Professional

Both

$1,763.06

Service Code	HCPCS 40530
Min. Negotiated Rate	$1,322.30
Max. Negotiated Rate	$1,322.30
Rate for Payer: Cash Price	$478.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,322.30
Rate for Payer: SOMOS Essential	$1,322.30

Know your out-of-pocket cost for care.

All Charges