St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR RPR NON/MAL FEMUR DSTL H/N W/O GRF

Professional

Both

$5,215.49

Service Code	HCPCS 27470
Min. Negotiated Rate	$3,911.62
Max. Negotiated Rate	$3,911.62
Rate for Payer: Cash Price	$1,407.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,911.62
Rate for Payer: SOMOS Essential	$3,911.62

PR RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH

Professional

Both

$5,366.48

Service Code	HCPCS 27725
Min. Negotiated Rate	$4,024.86
Max. Negotiated Rate	$4,024.86
Rate for Payer: Cash Price	$1,450.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,024.86
Rate for Payer: SOMOS Essential	$4,024.86

PR RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT

Professional

Both

$5,541.69

Service Code	HCPCS 27724
Min. Negotiated Rate	$4,156.27
Max. Negotiated Rate	$4,156.27
Rate for Payer: Cash Price	$1,489.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,156.27
Rate for Payer: SOMOS Essential	$4,156.27

PR RPR NON/MALUNION METARSAL W/WO BONE GRAFT

Professional

Both

$2,501.03

Service Code	HCPCS 28322
Min. Negotiated Rate	$1,875.77
Max. Negotiated Rate	$1,875.77
Rate for Payer: Cash Price	$681.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,875.77
Rate for Payer: SOMOS Essential	$1,875.77

PR RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS

Professional

Both

$7,331.45

Service Code	HCPCS 33496
Min. Negotiated Rate	$5,498.59
Max. Negotiated Rate	$5,498.59
Rate for Payer: Cash Price	$1,948.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,498.59
Rate for Payer: SOMOS Essential	$5,498.59

PR RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT

Professional

Both

$5,150.18

Service Code	HCPCS 25420
Min. Negotiated Rate	$3,862.64
Max. Negotiated Rate	$3,862.64
Rate for Payer: Cash Price	$1,390.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,862.64
Rate for Payer: SOMOS Essential	$3,862.64

PR RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT

Professional

Both

$4,563.30

Service Code	HCPCS 25405
Min. Negotiated Rate	$3,422.48
Max. Negotiated Rate	$3,422.48
Rate for Payer: Cash Price	$1,232.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,422.48
Rate for Payer: SOMOS Essential	$3,422.48

PR RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF

Professional

Both

$4,287.54

Service Code	HCPCS 25415
Min. Negotiated Rate	$3,215.66
Max. Negotiated Rate	$3,215.66
Rate for Payer: Cash Price	$1,156.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,215.66
Rate for Payer: SOMOS Essential	$3,215.66

PR RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT

Professional

Both

$3,549.25

Service Code	HCPCS 25400
Min. Negotiated Rate	$2,661.94
Max. Negotiated Rate	$2,661.94
Rate for Payer: Cash Price	$957.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,661.94
Rate for Payer: SOMOS Essential	$2,661.94

PR RPR NON-UNION MTCRPL/PHALANX

Professional

Both

$4,587.35

Service Code	HCPCS 26546
Min. Negotiated Rate	$3,440.51
Max. Negotiated Rate	$3,440.51
Rate for Payer: Cash Price	$1,238.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,440.51
Rate for Payer: SOMOS Essential	$3,440.51

PR RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC

Professional

Both

$3,386.18

Service Code	HCPCS 25440
Min. Negotiated Rate	$2,539.64
Max. Negotiated Rate	$2,539.64
Rate for Payer: Cash Price	$918.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,539.64
Rate for Payer: SOMOS Essential	$2,539.64

PR RPR NSL VLV COLLAPSE LW NRG SUBQ/SBMCSL RMDLG

Professional

Both

$644.32

Service Code	HCPCS 30469
Min. Negotiated Rate	$483.24
Max. Negotiated Rate	$483.24
Rate for Payer: Cash Price	$174.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$483.24
Rate for Payer: SOMOS Essential	$483.24

PR RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT

Professional

Both

$726.08

Service Code	HCPCS 30468
Min. Negotiated Rate	$544.56
Max. Negotiated Rate	$544.56
Rate for Payer: Cash Price	$195.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$544.56
Rate for Payer: SOMOS Essential	$544.56

PR RPR OMPHALOCELE GROSS TYP OPRATION 1ST STG

Professional

Both

$3,149.72

Service Code	HCPCS 49610
Min. Negotiated Rate	$2,362.29
Max. Negotiated Rate	$2,362.29
Rate for Payer: Cash Price	$840.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,362.29
Rate for Payer: SOMOS Essential	$2,362.29

PR RPR OMPHALOCELE GROSS TYP OPRATION 2ND STG

Professional

Both

$2,773.05

Service Code	HCPCS 49611
Min. Negotiated Rate	$2,079.79
Max. Negotiated Rate	$2,079.79
Rate for Payer: Cash Price	$740.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,079.79
Rate for Payer: SOMOS Essential	$2,079.79

PR RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/MESH

Professional

Both

$6,887.06

Service Code	HCPCS 43337
Min. Negotiated Rate	$5,165.30
Max. Negotiated Rate	$5,165.30
Rate for Payer: Cash Price	$1,829.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,165.30
Rate for Payer: SOMOS Essential	$5,165.30

PR RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH

Professional

Both

$6,461.46

Service Code	HCPCS 43336
Min. Negotiated Rate	$4,846.10
Max. Negotiated Rate	$4,846.10
Rate for Payer: Cash Price	$1,717.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,846.10
Rate for Payer: SOMOS Essential	$4,846.10

PR RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH

Professional

Both

$5,158.76

Service Code	HCPCS 43332
Min. Negotiated Rate	$3,869.07
Max. Negotiated Rate	$3,869.07
Rate for Payer: Cash Price	$1,376.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,869.07
Rate for Payer: SOMOS Essential	$3,869.07

PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH

Professional

Both

$5,949.62

Service Code	HCPCS 43335
Min. Negotiated Rate	$4,462.22
Max. Negotiated Rate	$4,462.22
Rate for Payer: Cash Price	$1,582.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,462.22
Rate for Payer: SOMOS Essential	$4,462.22

PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH

Professional

Both

$5,540.57

Service Code	HCPCS 43334
Min. Negotiated Rate	$4,155.43
Max. Negotiated Rate	$4,155.43
Rate for Payer: Cash Price	$1,470.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,155.43
Rate for Payer: SOMOS Essential	$4,155.43

PR RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE

Professional

Both

$3,305.33

Service Code	HCPCS 49621
Min. Negotiated Rate	$2,479.00
Max. Negotiated Rate	$2,479.00
Rate for Payer: Cash Price	$882.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,479.00
Rate for Payer: SOMOS Essential	$2,479.00

PR RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED

Professional

Both

$4,074.67

Service Code	HCPCS 49622
Min. Negotiated Rate	$3,056.00
Max. Negotiated Rate	$3,056.00
Rate for Payer: Cash Price	$1,086.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,056.00
Rate for Payer: SOMOS Essential	$3,056.00

PR RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/BYPASS

Professional

Both

$10,737.23

Service Code	HCPCS 33926
Min. Negotiated Rate	$8,052.92
Max. Negotiated Rate	$8,052.92
Rate for Payer: Cash Price	$2,849.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,052.92
Rate for Payer: SOMOS Essential	$8,052.92

PR RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS

Professional

Both

$7,636.48

Service Code	HCPCS 33925
Min. Negotiated Rate	$5,727.36
Max. Negotiated Rate	$5,727.36
Rate for Payer: Cash Price	$2,026.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,727.36
Rate for Payer: SOMOS Essential	$5,727.36

PR RPR PATENT DUXUS ARTERIOSUS DIV 18 YR & OLDER

Professional

Both

$5,264.98

Service Code	HCPCS 33824
Min. Negotiated Rate	$3,948.74
Max. Negotiated Rate	$3,948.74
Rate for Payer: Cash Price	$1,403.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,948.74
Rate for Payer: SOMOS Essential	$3,948.74

Know your out-of-pocket cost for care.

All Charges