St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR RPLJ DGT EXCLUDING THMB SUBLIMIS TDN COMPL AMP

Professional

Both

$7,804.44

Service Code	HCPCS 20822
Min. Negotiated Rate	$5,853.33
Max. Negotiated Rate	$5,853.33
Rate for Payer: Cash Price	$2,102.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,853.33
Rate for Payer: SOMOS Essential	$5,853.33

PR RPLJ THMB CARP/MTCRPL JT MP JT COMPL AMPUTATION

Professional

Both

$9,059.96

Service Code	HCPCS 20824
Min. Negotiated Rate	$6,794.97
Max. Negotiated Rate	$6,794.97
Rate for Payer: Cash Price	$2,435.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,794.97
Rate for Payer: SOMOS Essential	$6,794.97

PR RPLJ THUMB DISTAL TIP MP JOINT COMPL AMPUTATION

Professional

Both

$8,019.52

Service Code	HCPCS 20827
Min. Negotiated Rate	$6,014.64
Max. Negotiated Rate	$6,014.64
Rate for Payer: Cash Price	$2,158.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,014.64
Rate for Payer: SOMOS Essential	$6,014.64

PR RPR 1ST FEM HERNIA ANY AGE INCARCERATED

Professional

Both

$2,864.58

Service Code	HCPCS 49553
Min. Negotiated Rate	$2,148.44
Max. Negotiated Rate	$2,148.44
Rate for Payer: Cash Price	$764.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,148.44
Rate for Payer: SOMOS Essential	$2,148.44

PR RPR 1ST FEM HRNA ANY AGE REDUCIBLE

Professional

Both

$2,618.77

Service Code	HCPCS 49550
Min. Negotiated Rate	$1,964.08
Max. Negotiated Rate	$1,964.08
Rate for Payer: Cash Price	$699.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,964.08
Rate for Payer: SOMOS Essential	$1,964.08

PR RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED

Professional

Both

$2,661.33

Service Code	HCPCS 49507
Min. Negotiated Rate	$1,996.00
Max. Negotiated Rate	$1,996.00
Rate for Payer: Cash Price	$711.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,996.00
Rate for Payer: SOMOS Essential	$1,996.00

PR RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE

Professional

Both

$2,366.88

Service Code	HCPCS 49505
Min. Negotiated Rate	$1,775.16
Max. Negotiated Rate	$1,775.16
Rate for Payer: Cash Price	$633.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,775.16
Rate for Payer: SOMOS Essential	$1,775.16

PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED

Professional

Both

$2,752.58

Service Code	HCPCS 49501
Min. Negotiated Rate	$2,064.44
Max. Negotiated Rate	$2,064.44
Rate for Payer: Cash Price	$735.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,064.44
Rate for Payer: SOMOS Essential	$2,064.44

PR RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE

Professional

Both

$1,885.35

Service Code	HCPCS 49500
Min. Negotiated Rate	$1,414.01
Max. Negotiated Rate	$1,414.01
Rate for Payer: Cash Price	$506.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,414.01
Rate for Payer: SOMOS Essential	$1,414.01

PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER

Professional

Both

$2,788.70

Service Code	HCPCS 49496
Min. Negotiated Rate	$2,091.52
Max. Negotiated Rate	$2,091.52
Rate for Payer: Cash Price	$746.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,091.52
Rate for Payer: SOMOS Essential	$2,091.52

PR RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC

Professional

Both

$1,856.02

Service Code	HCPCS 49495
Min. Negotiated Rate	$1,392.02
Max. Negotiated Rate	$1,392.02
Rate for Payer: Cash Price	$496.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,392.02
Rate for Payer: SOMOS Essential	$1,392.02

PR RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED

Professional

Both

$4,349.91

Service Code	HCPCS 49492
Min. Negotiated Rate	$3,262.43
Max. Negotiated Rate	$3,262.43
Rate for Payer: Cash Price	$1,160.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,262.43
Rate for Payer: SOMOS Essential	$3,262.43

PR RPR 1ST INGUN HRNA PRETERM INFT RDC

Professional

Both

$3,621.49

Service Code	HCPCS 49491
Min. Negotiated Rate	$2,716.12
Max. Negotiated Rate	$2,716.12
Rate for Payer: Cash Price	$966.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,716.12
Rate for Payer: SOMOS Essential	$2,716.12

PR RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE

Professional

Both

$4,283.58

Service Code	HCPCS 27409
Min. Negotiated Rate	$3,212.68
Max. Negotiated Rate	$3,212.68
Rate for Payer: Cash Price	$1,155.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,212.68
Rate for Payer: SOMOS Essential	$3,212.68

PR RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB

Professional

Both

$1,721.72

Service Code	HCPCS 33218
Min. Negotiated Rate	$1,291.29
Max. Negotiated Rate	$1,291.29
Rate for Payer: Cash Price	$457.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,291.29
Rate for Payer: SOMOS Essential	$1,291.29

PR RPR 1 VNTRC W/O/F OBSTRCJ&AORTIC ARCH HYPOPLAS

Professional

Both

$12,217.38

Service Code	HCPCS 33619
Min. Negotiated Rate	$9,163.04
Max. Negotiated Rate	$9,163.04
Rate for Payer: Cash Price	$3,249.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,163.04
Rate for Payer: SOMOS Essential	$9,163.04

PR RPR 2 OUTLET R VNTRC RPR R VENTR O/F TRC OBSTRCJ

Professional

Both

$8,904.35

Service Code	HCPCS 33612
Min. Negotiated Rate	$6,678.26
Max. Negotiated Rate	$6,678.26
Rate for Payer: Cash Price	$2,365.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,678.26
Rate for Payer: SOMOS Essential	$6,678.26

PR RPR 2 OUTLET R VNTRC W/INTRAVENTR TUNNEL RPR

Professional

Both

$8,673.18

Service Code	HCPCS 33611
Min. Negotiated Rate	$6,504.88
Max. Negotiated Rate	$6,504.88
Rate for Payer: Cash Price	$2,303.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,504.88
Rate for Payer: SOMOS Essential	$6,504.88

PR RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB

Professional

Both

$1,663.62

Service Code	HCPCS 33220
Min. Negotiated Rate	$1,247.72
Max. Negotiated Rate	$1,247.72
Rate for Payer: Cash Price	$448.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,247.72
Rate for Payer: SOMOS Essential	$1,247.72

PR RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED

Professional

Both

$4,611.67

Service Code	HCPCS 49596
Min. Negotiated Rate	$3,458.75
Max. Negotiated Rate	$3,458.75
Rate for Payer: Cash Price	$1,225.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,458.75
Rate for Payer: SOMOS Essential	$3,458.75

PR RPR AA HERNIA 1ST > 10 CM REDUCIBLE

Professional

Both

$3,476.48

Service Code	HCPCS 49595
Min. Negotiated Rate	$2,607.36
Max. Negotiated Rate	$2,607.36
Rate for Payer: Cash Price	$925.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,607.36
Rate for Payer: SOMOS Essential	$2,607.36

PR RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED

Professional

Both

$3,376.66

Service Code	HCPCS 49594
Min. Negotiated Rate	$2,532.50
Max. Negotiated Rate	$2,532.50
Rate for Payer: Cash Price	$896.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,532.50
Rate for Payer: SOMOS Essential	$2,532.50

PR RPR AA HERNIA 1ST 3-10 CM REDUCIBLE

Professional

Both

$2,588.92

Service Code	HCPCS 49593
Min. Negotiated Rate	$1,941.69
Max. Negotiated Rate	$1,941.69
Rate for Payer: Cash Price	$688.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,941.69
Rate for Payer: SOMOS Essential	$1,941.69

PR RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED

Professional

Both

$2,153.41

Service Code	HCPCS 49592
Min. Negotiated Rate	$1,615.06
Max. Negotiated Rate	$1,615.06
Rate for Payer: Cash Price	$571.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,615.06
Rate for Payer: SOMOS Essential	$1,615.06

PR RPR AA HERNIA 1ST < 3 CM REDUCIBLE

Professional

Both

$1,544.27

Service Code	HCPCS 49591
Min. Negotiated Rate	$1,158.20
Max. Negotiated Rate	$1,158.20
Rate for Payer: Cash Price	$411.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,158.20
Rate for Payer: SOMOS Essential	$1,158.20

Know your out-of-pocket cost for care.

All Charges