St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR REVJ TOT DISC ARTHRP ANT APPR LMBR EA NTRSPC

Professional

Both

$1,707.37

Service Code	HCPCS 0165T
Min. Negotiated Rate	$1,280.53
Max. Negotiated Rate	$1,280.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,280.53
Rate for Payer: SOMOS Essential	$1,280.53

PR REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT

Professional

Both

$6,455.65

Service Code	HCPCS 27137
Min. Negotiated Rate	$4,841.74
Max. Negotiated Rate	$4,841.74
Rate for Payer: Cash Price	$1,736.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,841.74
Rate for Payer: SOMOS Essential	$4,841.74

PR REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT

Professional

Both

$8,388.59

Service Code	HCPCS 27134
Min. Negotiated Rate	$6,291.44
Max. Negotiated Rate	$6,291.44
Rate for Payer: Cash Price	$2,252.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,291.44
Rate for Payer: SOMOS Essential	$6,291.44

PR REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT

Professional

Both

$6,704.74

Service Code	HCPCS 27138
Min. Negotiated Rate	$5,028.56
Max. Negotiated Rate	$5,028.56
Rate for Payer: Cash Price	$1,803.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,028.56
Rate for Payer: SOMOS Essential	$5,028.56

PR REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE

Professional

Both

$7,720.27

Service Code	HCPCS 27487
Min. Negotiated Rate	$5,790.20
Max. Negotiated Rate	$5,790.20
Rate for Payer: Cash Price	$2,077.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,790.20
Rate for Payer: SOMOS Essential	$5,790.20

PR REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT

Professional

Both

$1,527.72

Service Code	HCPCS 37183
Min. Negotiated Rate	$1,145.79
Max. Negotiated Rate	$1,145.79
Rate for Payer: Cash Price	$410.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,145.79
Rate for Payer: SOMOS Essential	$1,145.79

PR REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA

Professional

Both

$2,934.26

Service Code	HCPCS 50728
Min. Negotiated Rate	$2,200.70
Max. Negotiated Rate	$2,200.70
Rate for Payer: Cash Price	$804.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,200.70
Rate for Payer: SOMOS Essential	$2,200.70

PR REVJ URINARY-CUTANEOUS ANASTAMOSIS

Professional

Both

$2,159.40

Service Code	HCPCS 50727
Min. Negotiated Rate	$1,619.55
Max. Negotiated Rate	$1,619.55
Rate for Payer: Cash Price	$594.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,619.55
Rate for Payer: SOMOS Essential	$1,619.55

PR REVJ W/RMVL PROSTHETIC VAGINAL GRAFT ABDML APPR

Professional

Both

$4,185.13

Service Code	HCPCS 57296
Min. Negotiated Rate	$3,138.85
Max. Negotiated Rate	$3,138.85
Rate for Payer: Cash Price	$1,125.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,138.85
Rate for Payer: SOMOS Essential	$3,138.85

PR REV/REMVL CARTD SINS BARREFLX ACT DEV TOT SYSTEM

Professional

Both

$1,707.58

Service Code	HCPCS 0269T
Min. Negotiated Rate	$1,280.68
Max. Negotiated Rate	$1,280.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,280.68
Rate for Payer: SOMOS Essential	$1,280.68

PR REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA

Professional

Both

$544.36

Service Code	HCPCS 64595
Min. Negotiated Rate	$408.27
Max. Negotiated Rate	$408.27
Rate for Payer: Cash Price	$267.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$408.27
Rate for Payer: SOMOS Essential	$408.27

PR REVSC OPN/PRG FEM/POP W/ANGIOPLASTY UNI

Professional

Both

$1,946.00

Service Code	HCPCS 37224
Min. Negotiated Rate	$1,459.50
Max. Negotiated Rate	$1,459.50
Rate for Payer: Cash Price	$516.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,459.50
Rate for Payer: SOMOS Essential	$1,459.50

PR REVSC OPN/PRQ FEM/POP W/ATHRC/ANGIOP SM VSL

Professional

Both

$2,603.06

Service Code	HCPCS 37225
Min. Negotiated Rate	$1,952.30
Max. Negotiated Rate	$1,952.30
Rate for Payer: Cash Price	$691.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,952.30
Rate for Payer: SOMOS Essential	$1,952.30

PR REVSC OPN/PRQ FEM/POP W/STNT/ANGIOP SM VSL

Professional

Both

$2,275.84

Service Code	HCPCS 37226
Min. Negotiated Rate	$1,706.88
Max. Negotiated Rate	$1,706.88
Rate for Payer: Cash Price	$601.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,706.88
Rate for Payer: SOMOS Essential	$1,706.88

PR REVSC OPN/PRQ FEM/POP W/STNT/ATHRC/ANGIOP SM VSL

Professional

Both

$3,125.75

Service Code	HCPCS 37227
Min. Negotiated Rate	$2,344.31
Max. Negotiated Rate	$2,344.31
Rate for Payer: Cash Price	$826.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,344.31
Rate for Payer: SOMOS Essential	$2,344.31

PR REVSC OPN/PRQ ILIAC ART W/STNT & ANGIOP IPSILATL

Professional

Both

$928.80

Service Code	HCPCS 37223
Min. Negotiated Rate	$696.60
Max. Negotiated Rate	$696.60
Rate for Payer: Cash Price	$246.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$696.60
Rate for Payer: SOMOS Essential	$696.60

PR REVSC OPN/PRQ ILIAC ART W/STNT PLMT & ANGIOPLSTY

Professional

Both

$2,158.77

Service Code	HCPCS 37221
Min. Negotiated Rate	$1,619.08
Max. Negotiated Rate	$1,619.08
Rate for Payer: Cash Price	$571.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,619.08
Rate for Payer: SOMOS Essential	$1,619.08

PR REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI

Professional

Both

$2,366.32

Service Code	HCPCS 37228
Min. Negotiated Rate	$1,774.74
Max. Negotiated Rate	$1,774.74
Rate for Payer: Cash Price	$625.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,774.74
Rate for Payer: SOMOS Essential	$1,774.74

PR REVSC OPN/PRQ TIB/PERO W/ANGIOPLASTY UNI EA VSL

Professional

Both

$859.46

Service Code	HCPCS 37232
Min. Negotiated Rate	$644.60
Max. Negotiated Rate	$644.60
Rate for Payer: Cash Price	$228.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$644.60
Rate for Payer: SOMOS Essential	$644.60

PR REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP SM VSL

Professional

Both

$3,002.55

Service Code	HCPCS 37229
Min. Negotiated Rate	$2,251.91
Max. Negotiated Rate	$2,251.91
Rate for Payer: Cash Price	$795.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,251.91
Rate for Payer: SOMOS Essential	$2,251.91

PR REVSC OPN/PRQ TIB/PERO W/ATHRC/ANGIOP UNI EA VSL

Professional

Both

$1,387.72

Service Code	HCPCS 37233
Min. Negotiated Rate	$1,040.79
Max. Negotiated Rate	$1,040.79
Rate for Payer: Cash Price	$368.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,040.79
Rate for Payer: SOMOS Essential	$1,040.79

PR REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP SM VSL

Professional

Both

$3,022.32

Service Code	HCPCS 37230
Min. Negotiated Rate	$2,266.74
Max. Negotiated Rate	$2,266.74
Rate for Payer: Cash Price	$801.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,266.74
Rate for Payer: SOMOS Essential	$2,266.74

PR REVSC OPN/PRQ TIB/PERO W/STNT/ANGIOP UNI EA VSL

Professional

Both

$1,218.00

Service Code	HCPCS 37234
Min. Negotiated Rate	$913.50
Max. Negotiated Rate	$913.50
Rate for Payer: Cash Price	$324.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$913.50
Rate for Payer: SOMOS Essential	$913.50

PR REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP EA VSL

Professional

Both

$1,542.98

Service Code	HCPCS 37235
Min. Negotiated Rate	$1,157.24
Max. Negotiated Rate	$1,157.24
Rate for Payer: Cash Price	$411.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,157.24
Rate for Payer: SOMOS Essential	$1,157.24

PR REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP SM VSL

Professional

Both

$3,137.58

Service Code	HCPCS 37231
Min. Negotiated Rate	$2,353.18
Max. Negotiated Rate	$2,353.18
Rate for Payer: Cash Price	$836.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,353.18
Rate for Payer: SOMOS Essential	$2,353.18

Know your out-of-pocket cost for care.

All Charges