St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD

Professional

Both

$1,647.03

Service Code	HCPCS 33262
Min. Negotiated Rate	$1,235.27
Max. Negotiated Rate	$1,235.27
Rate for Payer: Cash Price	$436.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,235.27
Rate for Payer: SOMOS Essential	$1,235.27

PR RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD

Professional

Both

$1,708.91

Service Code	HCPCS 33263
Min. Negotiated Rate	$1,281.68
Max. Negotiated Rate	$1,281.68
Rate for Payer: Cash Price	$454.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,281.68
Rate for Payer: SOMOS Essential	$1,281.68

PR RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD

Professional

Both

$1,780.84

Service Code	HCPCS 33264
Min. Negotiated Rate	$1,335.63
Max. Negotiated Rate	$1,335.63
Rate for Payer: Cash Price	$473.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,335.63
Rate for Payer: SOMOS Essential	$1,335.63

PR RMVL IMPLTBL GLUCOSE SENSOR SUBQ POCKET VIA INC

Professional

Both

$265.90

Service Code	HCPCS 0447T
Min. Negotiated Rate	$199.42
Max. Negotiated Rate	$199.42
Rate for Payer: Cash Price	$73.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$199.42
Rate for Payer: SOMOS Essential	$199.42

PR RMVL IMPLT MATRL POSTERIOR SEGMENT INTRAOCULAR

Professional

Both

$3,703.63

Service Code	HCPCS 67121
Min. Negotiated Rate	$2,777.72
Max. Negotiated Rate	$2,777.72
Rate for Payer: Cash Price	$1,021.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,777.72
Rate for Payer: SOMOS Essential	$2,777.72

PR RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH

Professional

Both

$3,066.49

Service Code	HCPCS 54406
Min. Negotiated Rate	$2,299.87
Max. Negotiated Rate	$2,299.87
Rate for Payer: Cash Price	$839.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,299.87
Rate for Payer: SOMOS Essential	$2,299.87

PR RMVL INSJ IMPLTBL GLUC SENSOR DIF ANATOMIC SITE

Professional

Both

$378.56

Service Code	HCPCS 0448T
Min. Negotiated Rate	$283.92
Max. Negotiated Rate	$283.92
Rate for Payer: Cash Price	$104.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$283.92
Rate for Payer: SOMOS Essential	$283.92

PR RMVL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS

Professional

Both

$2,166.40

Service Code	HCPCS 33989
Min. Negotiated Rate	$1,624.80
Max. Negotiated Rate	$1,624.80
Rate for Payer: Cash Price	$573.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,624.80
Rate for Payer: SOMOS Essential	$1,624.80

PR RMVL LENS MATERIAL ASPIR TQ 1/> STAGES

Professional

Both

$2,850.54

Service Code	HCPCS 66840
Min. Negotiated Rate	$2,137.90
Max. Negotiated Rate	$2,137.90
Rate for Payer: Cash Price	$784.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,137.90
Rate for Payer: SOMOS Essential	$2,137.90

PR RMVL LENS MATERIAL INTRACAPSULAR

Professional

Both

$3,077.80

Service Code	HCPCS 66920
Min. Negotiated Rate	$2,308.35
Max. Negotiated Rate	$2,308.35
Rate for Payer: Cash Price	$846.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,308.35
Rate for Payer: SOMOS Essential	$2,308.35

PR RMVL LENS MATERIAL PARS PLANA W/WO VITRECTOMY

Professional

Both

$3,445.16

Service Code	HCPCS 66852
Min. Negotiated Rate	$2,583.87
Max. Negotiated Rate	$2,583.87
Rate for Payer: Cash Price	$948.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,583.87
Rate for Payer: SOMOS Essential	$2,583.87

PR RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR

Professional

Both

$3,237.92

Service Code	HCPCS 66850
Min. Negotiated Rate	$2,428.44
Max. Negotiated Rate	$2,428.44
Rate for Payer: Cash Price	$891.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,428.44
Rate for Payer: SOMOS Essential	$2,428.44

PR RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY

Professional

Both

$6,373.89

Service Code	HCPCS 32484
Min. Negotiated Rate	$4,780.42
Max. Negotiated Rate	$4,780.42
Rate for Payer: Cash Price	$1,695.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,780.42
Rate for Payer: SOMOS Essential	$4,780.42

PR RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC

Professional

Both

$7,025.13

Service Code	HCPCS 32482
Min. Negotiated Rate	$5,268.85
Max. Negotiated Rate	$5,268.85
Rate for Payer: Cash Price	$1,871.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,268.85
Rate for Payer: SOMOS Essential	$5,268.85

PR RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT

Professional

Both

$6,573.35

Service Code	HCPCS 32480
Min. Negotiated Rate	$4,930.01
Max. Negotiated Rate	$4,930.01
Rate for Payer: Cash Price	$1,750.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,930.01
Rate for Payer: SOMOS Essential	$4,930.01

PR RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC

Professional

Both

$10,641.40

Service Code	HCPCS 32488
Min. Negotiated Rate	$7,981.05
Max. Negotiated Rate	$7,981.05
Rate for Payer: Cash Price	$2,828.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,981.05
Rate for Payer: SOMOS Essential	$7,981.05

PR RMVL LUNG OTH/THN PNUMEC RESXN-PLCTJ EMPHY LUNG

Professional

Both

$6,554.45

Service Code	HCPCS 32491
Min. Negotiated Rate	$4,915.84
Max. Negotiated Rate	$4,915.84
Rate for Payer: Cash Price	$1,747.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,915.84
Rate for Payer: SOMOS Essential	$4,915.84

PR RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY

Professional

Both

$10,422.37

Service Code	HCPCS 32486
Min. Negotiated Rate	$7,816.78
Max. Negotiated Rate	$7,816.78
Rate for Payer: Cash Price	$2,767.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,816.78
Rate for Payer: SOMOS Essential	$7,816.78

PR RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF

Professional

Both

$666.93

Service Code	HCPCS 32552
Min. Negotiated Rate	$500.20
Max. Negotiated Rate	$500.20
Rate for Payer: Cash Price	$180.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$500.20
Rate for Payer: SOMOS Essential	$500.20

PR RMVL NFROS TUBE REQ FLUORO GUIDANCE

Professional

Both

$218.19

Service Code	HCPCS 50389
Min. Negotiated Rate	$163.64
Max. Negotiated Rate	$163.64
Rate for Payer: Cash Price	$59.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$163.64
Rate for Payer: SOMOS Essential	$163.64

PR RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR

Professional

Both

$878.47

Service Code	HCPCS 49623
Min. Negotiated Rate	$658.85
Max. Negotiated Rate	$658.85
Rate for Payer: Cash Price	$232.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$658.85
Rate for Payer: SOMOS Essential	$658.85

PR RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT

Professional

Both

$2,234.54

Service Code	HCPCS 54415
Min. Negotiated Rate	$1,675.90
Max. Negotiated Rate	$1,675.90
Rate for Payer: Cash Price	$615.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,675.90
Rate for Payer: SOMOS Essential	$1,675.90

PR RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE

Professional

Both

$1,531.74

Service Code	HCPCS 33272
Min. Negotiated Rate	$1,148.80
Max. Negotiated Rate	$1,148.80
Rate for Payer: Cash Price	$408.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,148.80
Rate for Payer: SOMOS Essential	$1,148.80

PR RMVL PERITONEAL-VENOUS SHUNT

Professional

Both

$2,078.76

Service Code	HCPCS 49429
Min. Negotiated Rate	$1,559.07
Max. Negotiated Rate	$1,559.07
Rate for Payer: Cash Price	$551.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,559.07
Rate for Payer: SOMOS Essential	$1,559.07

PR RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH

Professional

Both

$1,228.19

Service Code	HCPCS 62355
Min. Negotiated Rate	$921.14
Max. Negotiated Rate	$921.14
Rate for Payer: Cash Price	$333.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$921.14
Rate for Payer: SOMOS Essential	$921.14

Know your out-of-pocket cost for care.

All Charges