St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR RMVL PRM EPICAR PM&ELTRDS THORCOM 1 LEAD SYS

Professional

Both

$3,462.13

Service Code	HCPCS 33236
Min. Negotiated Rate	$2,596.60
Max. Negotiated Rate	$2,596.60
Rate for Payer: Cash Price	$923.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,596.60
Rate for Payer: SOMOS Essential	$2,596.60

PR RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY

Professional

Both

$3,711.37

Service Code	HCPCS 33237
Min. Negotiated Rate	$2,783.53
Max. Negotiated Rate	$2,783.53
Rate for Payer: Cash Price	$991.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,783.53
Rate for Payer: SOMOS Essential	$2,783.53

PR RMVL PRM TRANSVENOUS ELECTRODE THORACOTOMY

Professional

Both

$4,200.81

Service Code	HCPCS 33238
Min. Negotiated Rate	$3,150.61
Max. Negotiated Rate	$3,150.61
Rate for Payer: Cash Price	$1,122.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,150.61
Rate for Payer: SOMOS Essential	$3,150.61

PR RMVL PROSTC MATRL/MESH ABDL WALL FOR INFECTION

Professional

Both

$1,224.83

Service Code	HCPCS 11008
Min. Negotiated Rate	$918.62
Max. Negotiated Rate	$918.62
Rate for Payer: Cash Price	$324.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$918.62
Rate for Payer: SOMOS Essential	$918.62

PR RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER

Professional

Both

$5,297.88

Service Code	HCPCS 27488
Min. Negotiated Rate	$3,973.41
Max. Negotiated Rate	$3,973.41
Rate for Payer: Cash Price	$1,429.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,973.41
Rate for Payer: SOMOS Essential	$3,973.41

PR RMVL/REVJ SLING MALE URINARY INCONTINENCE

Professional

Both

$3,294.62

Service Code	HCPCS 53442
Min. Negotiated Rate	$2,470.96
Max. Negotiated Rate	$2,470.96
Rate for Payer: Cash Price	$903.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,470.96
Rate for Payer: SOMOS Essential	$2,470.96

PR RMVL/REVJ SLING STRESS INCONTINENCE

Professional

Both

$3,205.27

Service Code	HCPCS 57287
Min. Negotiated Rate	$2,403.95
Max. Negotiated Rate	$2,403.95
Rate for Payer: Cash Price	$870.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,403.95
Rate for Payer: SOMOS Essential	$2,403.95

PR RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS

Professional

Both

$3,614.21

Service Code	HCPCS 54410
Min. Negotiated Rate	$2,710.66
Max. Negotiated Rate	$2,710.66
Rate for Payer: Cash Price	$990.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,710.66
Rate for Payer: SOMOS Essential	$2,710.66

PR RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ

Professional

Both

$1,032.29

Service Code	HCPCS 50382
Min. Negotiated Rate	$774.22
Max. Negotiated Rate	$774.22
Rate for Payer: Cash Price	$277.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$774.22
Rate for Payer: SOMOS Essential	$774.22

PR RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD

Professional

Both

$5,323.57

Service Code	HCPCS 53448
Min. Negotiated Rate	$3,992.68
Max. Negotiated Rate	$3,992.68
Rate for Payer: Cash Price	$1,452.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,992.68
Rate for Payer: SOMOS Essential	$3,992.68

PR RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL

Professional

Both

$4,317.22

Service Code	HCPCS 54411
Min. Negotiated Rate	$3,237.92
Max. Negotiated Rate	$3,237.92
Rate for Payer: Cash Price	$1,177.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,237.92
Rate for Payer: SOMOS Essential	$3,237.92

PR RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC

Professional

Both

$3,375.09

Service Code	HCPCS 53447
Min. Negotiated Rate	$2,531.32
Max. Negotiated Rate	$2,531.32
Rate for Payer: Cash Price	$923.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,531.32
Rate for Payer: SOMOS Essential	$2,531.32

PR RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI

Professional

Both

$3,007.97

Service Code	HCPCS 54416
Min. Negotiated Rate	$2,255.98
Max. Negotiated Rate	$2,255.98
Rate for Payer: Cash Price	$827.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,255.98
Rate for Payer: SOMOS Essential	$2,255.98

PR RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD

Professional

Both

$3,764.99

Service Code	HCPCS 54417
Min. Negotiated Rate	$2,823.74
Max. Negotiated Rate	$2,823.74
Rate for Payer: Cash Price	$1,029.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,823.74
Rate for Payer: SOMOS Essential	$2,823.74

PR RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH

Professional

Both

$340.31

Service Code	HCPCS 50387
Min. Negotiated Rate	$255.23
Max. Negotiated Rate	$255.23
Rate for Payer: Cash Price	$91.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$255.23
Rate for Payer: SOMOS Essential	$255.23

PR RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE

Professional

Both

$3,644.97

Service Code	HCPCS 69711
Min. Negotiated Rate	$2,733.73
Max. Negotiated Rate	$2,733.73
Rate for Payer: Cash Price	$983.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,733.73
Rate for Payer: SOMOS Essential	$2,733.73

PR RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS

Professional

Both

$2,837.66

Service Code	HCPCS 19330
Min. Negotiated Rate	$2,128.24
Max. Negotiated Rate	$2,128.24
Rate for Payer: Cash Price	$764.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,128.24
Rate for Payer: SOMOS Essential	$2,128.24

PR RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ

Professional

Both

$2,912.60

Service Code	HCPCS 66830
Min. Negotiated Rate	$2,184.45
Max. Negotiated Rate	$2,184.45
Rate for Payer: Cash Price	$803.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,184.45
Rate for Payer: SOMOS Essential	$2,184.45

PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY EA ADDL 10

Professional

Both

$70.28

Service Code	HCPCS 11201
Min. Negotiated Rate	$52.71
Max. Negotiated Rate	$52.71
Rate for Payer: Cash Price	$18.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$52.71
Rate for Payer: SOMOS Essential	$52.71

PR RMVL SKIN TAGS MLT FIBRQ TAGS ANY UP TO&INC 15

Professional

Both

$325.57

Service Code	HCPCS 11200
Min. Negotiated Rate	$244.18
Max. Negotiated Rate	$244.18
Rate for Payer: Cash Price	$89.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$244.18
Rate for Payer: SOMOS Essential	$244.18

PR RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR

Professional

Both

$3,970.26

Service Code	HCPCS 63662
Min. Negotiated Rate	$2,977.70
Max. Negotiated Rate	$2,977.70
Rate for Payer: Cash Price	$1,064.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,977.70
Rate for Payer: SOMOS Essential	$2,977.70

PR RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR

Professional

Both

$1,440.74

Service Code	HCPCS 63661
Min. Negotiated Rate	$1,080.56
Max. Negotiated Rate	$1,080.56
Rate for Payer: Cash Price	$392.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,080.56
Rate for Payer: SOMOS Essential	$1,080.56

PR RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS

Professional

Both

$1,332.63

Service Code	HCPCS 62365
Min. Negotiated Rate	$999.47
Max. Negotiated Rate	$999.47
Rate for Payer: Cash Price	$362.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$999.47
Rate for Payer: SOMOS Essential	$999.47

PR RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD

Professional

Both

$4,447.00

Service Code	HCPCS 26392
Min. Negotiated Rate	$3,335.25
Max. Negotiated Rate	$3,335.25
Rate for Payer: Cash Price	$1,197.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,335.25
Rate for Payer: SOMOS Essential	$3,335.25

PR RMVL SYNTH ROD & INSJ XTNSR TDN GRF H/F EA ROD

Professional

Both

$4,095.88

Service Code	HCPCS 26416
Min. Negotiated Rate	$3,071.91
Max. Negotiated Rate	$3,071.91
Rate for Payer: Cash Price	$1,102.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,071.91
Rate for Payer: SOMOS Essential	$3,071.91

Know your out-of-pocket cost for care.

All Charges