St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR RMVL THIERSCH WIRE/SUTURE ANAL CANAL

Professional

Both

$1,035.58

Service Code	HCPCS 46754
Min. Negotiated Rate	$776.68
Max. Negotiated Rate	$776.68
Rate for Payer: Cash Price	$284.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$776.68
Rate for Payer: SOMOS Essential	$776.68

PR RMVL TRANSPLANTED PANCREATIC ALLOGRAFT

Professional

Both

$5,812.07

Service Code	HCPCS 48556
Min. Negotiated Rate	$4,359.05
Max. Negotiated Rate	$4,359.05
Rate for Payer: Cash Price	$1,557.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,359.05
Rate for Payer: SOMOS Essential	$4,359.05

PR RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR

Professional

Both

$2,137.70

Service Code	HCPCS 33234
Min. Negotiated Rate	$1,603.28
Max. Negotiated Rate	$1,603.28
Rate for Payer: Cash Price	$567.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,603.28
Rate for Payer: SOMOS Essential	$1,603.28

PR RMVL TRANSVNS PM ELTRD DUAL LEAD SYS

Professional

Both

$2,817.57

Service Code	HCPCS 33235
Min. Negotiated Rate	$2,113.18
Max. Negotiated Rate	$2,113.18
Rate for Payer: Cash Price	$746.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,113.18
Rate for Payer: SOMOS Essential	$2,113.18

PR RMVL TRNSPLED INTESTINAL ALLOGRAFT COMPL

Professional

Both

$5,541.52

Service Code	HCPCS 44137
Min. Negotiated Rate	$4,156.14
Max. Negotiated Rate	$4,156.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,156.14
Rate for Payer: SOMOS Essential	$4,156.14

PR RMVL TRNSPLED RENAL ALLOGRAFT

Professional

Both

$5,440.09

Service Code	HCPCS 50370
Min. Negotiated Rate	$4,080.07
Max. Negotiated Rate	$4,080.07
Rate for Payer: Cash Price	$1,462.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,080.07
Rate for Payer: SOMOS Essential	$4,080.07

PR RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ

Professional

Both

$820.65

Service Code	HCPCS 36590
Min. Negotiated Rate	$615.49
Max. Negotiated Rate	$615.49
Rate for Payer: Cash Price	$219.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$615.49
Rate for Payer: SOMOS Essential	$615.49

PR RMVL TUN CVC W/O SUBQ PORT/PMP

Professional

Both

$582.72

Service Code	HCPCS 36589
Min. Negotiated Rate	$437.04
Max. Negotiated Rate	$437.04
Rate for Payer: Cash Price	$156.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$437.04
Rate for Payer: SOMOS Essential	$437.04

PR RMVL VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC

Professional

Both

$7,868.00

Service Code	HCPCS 33980
Min. Negotiated Rate	$5,901.00
Max. Negotiated Rate	$5,901.00
Rate for Payer: Cash Price	$2,092.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,901.00
Rate for Payer: SOMOS Essential	$5,901.00

PR RMVL VITREOUS ANT APPR PARTIAL REMOVAL

Professional

Both

$1,960.67

Service Code	HCPCS 67005
Min. Negotiated Rate	$1,470.50
Max. Negotiated Rate	$1,470.50
Rate for Payer: Cash Price	$542.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,470.50
Rate for Payer: SOMOS Essential	$1,470.50

PR RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT

Professional

Both

$2,245.11

Service Code	HCPCS 67010
Min. Negotiated Rate	$1,683.83
Max. Negotiated Rate	$1,683.83
Rate for Payer: Cash Price	$619.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,683.83
Rate for Payer: SOMOS Essential	$1,683.83

PR RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT

Professional

Both

$451.57

Service Code	HCPCS 11983
Min. Negotiated Rate	$338.68
Max. Negotiated Rate	$338.68
Rate for Payer: Cash Price	$120.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$338.68
Rate for Payer: SOMOS Essential	$338.68

PR RNL EXPL X NECESSITATING OTH SPEC PX

Professional

Both

$3,250.49

Service Code	HCPCS 50010
Min. Negotiated Rate	$2,437.87
Max. Negotiated Rate	$2,437.87
Rate for Payer: Cash Price	$810.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,437.87
Rate for Payer: SOMOS Essential	$2,437.87

PR RNL NDSC NFROT FULGURATION &/INCISION W/WO BX

Professional

Both

$2,326.24

Service Code	HCPCS 50576
Min. Negotiated Rate	$1,744.68
Max. Negotiated Rate	$1,744.68
Rate for Payer: Cash Price	$633.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,744.68
Rate for Payer: SOMOS Essential	$1,744.68

PR RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY

Professional

Both

$2,948.58

Service Code	HCPCS 50575
Min. Negotiated Rate	$2,211.44
Max. Negotiated Rate	$2,211.44
Rate for Payer: Cash Price	$801.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,211.44
Rate for Payer: SOMOS Essential	$2,211.44

PR RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS

Professional

Both

$2,502.96

Service Code	HCPCS 50580
Min. Negotiated Rate	$1,877.22
Max. Negotiated Rate	$1,877.22
Rate for Payer: Cash Price	$682.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,877.22
Rate for Payer: SOMOS Essential	$1,877.22

PR RNL NDSC NFROT W/URTRL CATHJ W/WO DILAT URETER

Professional

Both

$2,189.81

Service Code	HCPCS 50572
Min. Negotiated Rate	$1,642.36
Max. Negotiated Rate	$1,642.36
Rate for Payer: Cash Price	$597.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,642.36
Rate for Payer: SOMOS Essential	$1,642.36

PR ROBOT LIN-RADSURG COM, FIRST

Professional

Both

$18,746.46

Service Code	HCPCS G0339
Min. Negotiated Rate	$14,059.84
Max. Negotiated Rate	$14,059.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$14,059.84
Rate for Payer: SOMOS Essential	$14,059.84

PR ROBT LIN-RADSURG FRACTX 2-5

Professional

Both

$14,599.17

Service Code	HCPCS G0340
Min. Negotiated Rate	$10,949.38
Max. Negotiated Rate	$10,949.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,949.38
Rate for Payer: SOMOS Essential	$10,949.38

PR ROM MEAS&REPRT EA XTR EX HAND/EA TRNK SCTJ SPI

Professional

Both

$31.40

Service Code	HCPCS 95851
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$23.55
Rate for Payer: Cash Price	$8.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23.55
Rate for Payer: SOMOS Essential	$23.55

PR ROM MEAS&REPRT HAND W/WO COMPARISON NORMAL SID

Professional

Both

$22.26

Service Code	HCPCS 95852
Min. Negotiated Rate	$16.70
Max. Negotiated Rate	$16.70
Rate for Payer: Cash Price	$6.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$16.70
Rate for Payer: SOMOS Essential	$16.70

PR ROPRTJ > 1 MO AFTER ORIGINAL OPRATION

Professional

Both

$673.05

Service Code	HCPCS 35700
Min. Negotiated Rate	$504.79
Max. Negotiated Rate	$504.79
Rate for Payer: Cash Price	$177.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$504.79
Rate for Payer: SOMOS Essential	$504.79

PR ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ

Professional

Both

$2,321.31

Service Code	HCPCS 33530
Min. Negotiated Rate	$1,740.98
Max. Negotiated Rate	$1,740.98
Rate for Payer: Cash Price	$613.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,740.98
Rate for Payer: SOMOS Essential	$1,740.98

PR ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO

Professional

Both

$702.52

Service Code	HCPCS 35390
Min. Negotiated Rate	$526.89
Max. Negotiated Rate	$526.89
Rate for Payer: Cash Price	$185.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$526.89
Rate for Payer: SOMOS Essential	$526.89

PR ROUTINE FOOTCARE PT W LOPS

Professional

Both

$85.33

Service Code	HCPCS G0247
Min. Negotiated Rate	$64.00
Max. Negotiated Rate	$64.00
Rate for Payer: Cash Price	$23.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$64.00
Rate for Payer: SOMOS Essential	$64.00

Know your out-of-pocket cost for care.

All Charges