St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP

Professional

Both

$169.79

Service Code	HCPCS 95991
Min. Negotiated Rate	$127.34
Max. Negotiated Rate	$127.34
Rate for Payer: Cash Price	$45.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$127.34
Rate for Payer: SOMOS Essential	$127.34

PR RF SPECTRSC R-T INTRAOP MRGN ASSMT TM PRTL MAST

Professional

Both

$208.85

Service Code	HCPCS 0546T
Min. Negotiated Rate	$156.64
Max. Negotiated Rate	$156.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$156.64
Rate for Payer: SOMOS Essential	$156.64

PR RHINECTOMY PARTIAL

Professional

Both

$3,515.82

Service Code	HCPCS 30150
Min. Negotiated Rate	$2,636.86
Max. Negotiated Rate	$2,636.86
Rate for Payer: Cash Price	$942.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,636.86
Rate for Payer: SOMOS Essential	$2,636.86

PR RHINECTOMY TOTAL

Professional

Both

$3,544.73

Service Code	HCPCS 30160
Min. Negotiated Rate	$2,658.55
Max. Negotiated Rate	$2,658.55
Rate for Payer: Cash Price	$958.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,658.55
Rate for Payer: SOMOS Essential	$2,658.55

PR RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR

Professional

Both

$6,333.08

Service Code	HCPCS 30420
Min. Negotiated Rate	$4,749.81
Max. Negotiated Rate	$4,749.81
Rate for Payer: Cash Price	$1,704.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,749.81
Rate for Payer: SOMOS Essential	$4,749.81

PR RHINOPLASTY SECONDARY INTERMEDIATE REVISION

Professional

Both

$5,895.23

Service Code	HCPCS 30435
Min. Negotiated Rate	$4,421.42
Max. Negotiated Rate	$4,421.42
Rate for Payer: Cash Price	$1,583.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,421.42
Rate for Payer: SOMOS Essential	$4,421.42

PR RHINOPLASTY SECONDARY MAJOR REVISION

Professional

Both

$7,698.78

Service Code	HCPCS 30450
Min. Negotiated Rate	$5,774.08
Max. Negotiated Rate	$5,774.08
Rate for Payer: Cash Price	$2,065.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,774.08
Rate for Payer: SOMOS Essential	$5,774.08

PR RHINOPLASTY SECONDARY MINOR REVISION

Professional

Both

$4,735.78

Service Code	HCPCS 30430
Min. Negotiated Rate	$3,551.84
Max. Negotiated Rate	$3,551.84
Rate for Payer: Cash Price	$1,272.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,551.84
Rate for Payer: SOMOS Essential	$3,551.84

PR RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT

Professional

Both

$7,008.86

Service Code	HCPCS 30462
Min. Negotiated Rate	$5,256.64
Max. Negotiated Rate	$5,256.64
Rate for Payer: Cash Price	$1,880.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,256.64
Rate for Payer: SOMOS Essential	$5,256.64

PR RHINP DFRM W/COLUM LNGTH TIP ONLY

Professional

Both

$3,648.54

Service Code	HCPCS 30460
Min. Negotiated Rate	$2,736.40
Max. Negotiated Rate	$2,736.40
Rate for Payer: Cash Price	$978.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,736.40
Rate for Payer: SOMOS Essential	$2,736.40

PR RHINP PRIM COMPLETE XTRNL PARTS

Professional

Both

$6,223.74

Service Code	HCPCS 30410
Min. Negotiated Rate	$4,667.80
Max. Negotiated Rate	$4,667.80
Rate for Payer: Cash Price	$1,672.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,667.80
Rate for Payer: SOMOS Essential	$4,667.80

PR RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI

Professional

Both

$5,412.61

Service Code	HCPCS 30400
Min. Negotiated Rate	$4,059.46
Max. Negotiated Rate	$4,059.46
Rate for Payer: Cash Price	$1,454.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,059.46
Rate for Payer: SOMOS Essential	$4,059.46

PR R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ

Professional

Both

$1,140.13

Service Code	HCPCS 93594 26
Min. Negotiated Rate	$855.10
Max. Negotiated Rate	$855.10
Rate for Payer: Cash Price	$307.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$855.10
Rate for Payer: SOMOS Essential	$855.10

PR R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ

Professional

Both

$737.87

Service Code	HCPCS 93593 26
Min. Negotiated Rate	$553.40
Max. Negotiated Rate	$553.40
Rate for Payer: Cash Price	$202.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$553.40
Rate for Payer: SOMOS Essential	$553.40

PR RHYTHM ECG 1-3 LEADS INTERPRETATION & REPRT ON

Professional

Both

$27.27

Service Code	HCPCS 93042
Min. Negotiated Rate	$20.45
Max. Negotiated Rate	$20.45
Rate for Payer: Cash Price	$7.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20.45
Rate for Payer: SOMOS Essential	$20.45

PR RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R

Professional

Both

$27.16

Service Code	HCPCS 93041
Min. Negotiated Rate	$20.37
Max. Negotiated Rate	$20.37
Rate for Payer: Cash Price	$7.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20.37
Rate for Payer: SOMOS Essential	$20.37

PR RHYTHM ECG 1-3 LEADS W/INTERPRETATION & REPORT

Professional

Both

$54.46

Service Code	HCPCS 93040
Min. Negotiated Rate	$40.84
Max. Negotiated Rate	$40.84
Rate for Payer: Cash Price	$15.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$40.84
Rate for Payer: SOMOS Essential	$40.84

PR RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT

Professional

Both

$557.83

Service Code	HCPCS 93451 26
Min. Negotiated Rate	$418.37
Max. Negotiated Rate	$418.37
Rate for Payer: Cash Price	$148.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$418.37
Rate for Payer: SOMOS Essential	$418.37

PR RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT

Professional

Both

$3,195.01

Service Code	HCPCS 93451 TC
Min. Negotiated Rate	$2,396.26
Max. Negotiated Rate	$2,396.26
Rate for Payer: Cash Price	$852.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,396.26
Rate for Payer: SOMOS Essential	$2,396.26

PR RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT

Professional

Both

$3,752.84

Service Code	HCPCS 93451
Min. Negotiated Rate	$2,814.63
Max. Negotiated Rate	$2,814.63
Rate for Payer: Cash Price	$1,001.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,814.63
Rate for Payer: SOMOS Essential	$2,814.63

PR RIGHT VENTRICULAR RECORDING

Professional

Both

$834.72

Service Code	HCPCS 93603
Min. Negotiated Rate	$626.04
Max. Negotiated Rate	$626.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$626.04
Rate for Payer: SOMOS Essential	$626.04

PR RIGHT VENTRICULAR RECORDING

Professional

Both

$344.33

Service Code	HCPCS 93603 TC
Min. Negotiated Rate	$258.25
Max. Negotiated Rate	$258.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$258.25
Rate for Payer: SOMOS Essential	$258.25

PR RIGHT VENTRICULAR RECORDING

Professional

Both

$490.39

Service Code	HCPCS 93603 26
Min. Negotiated Rate	$367.79
Max. Negotiated Rate	$367.79
Rate for Payer: Cash Price	$129.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$367.79
Rate for Payer: SOMOS Essential	$367.79

PR RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART

Professional

Both

$651.81

Service Code	HCPCS 35697
Min. Negotiated Rate	$488.86
Max. Negotiated Rate	$488.86
Rate for Payer: Cash Price	$171.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$488.86
Rate for Payer: SOMOS Essential	$488.86

PR RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF

Professional

Both

$3,422.86

Service Code	HCPCS 24342
Min. Negotiated Rate	$2,567.14
Max. Negotiated Rate	$2,567.14
Rate for Payer: Cash Price	$925.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,567.14
Rate for Payer: SOMOS Essential	$2,567.14

Know your out-of-pocket cost for care.

All Charges