St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC

Professional

Both

$4,744.67

Service Code	HCPCS 31080
Min. Negotiated Rate	$3,558.50
Max. Negotiated Rate	$3,558.50
Rate for Payer: Cash Price	$1,279.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,558.50
Rate for Payer: SOMOS Essential	$3,558.50

PR SINUSOTOMY FRONTAL EXTERNAL SIMPLE

Professional

Both

$2,083.20

Service Code	HCPCS 31070
Min. Negotiated Rate	$1,562.40
Max. Negotiated Rate	$1,562.40
Rate for Payer: Cash Price	$561.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,562.40
Rate for Payer: SOMOS Essential	$1,562.40

PR SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL

Professional

Both

$3,604.76

Service Code	HCPCS 31075
Min. Negotiated Rate	$2,703.57
Max. Negotiated Rate	$2,703.57
Rate for Payer: Cash Price	$972.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,703.57
Rate for Payer: SOMOS Essential	$2,703.57

PR SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL

Professional

Both

$1,529.50

Service Code	HCPCS 31020
Min. Negotiated Rate	$1,147.12
Max. Negotiated Rate	$1,147.12
Rate for Payer: Cash Price	$399.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,147.12
Rate for Payer: SOMOS Essential	$1,147.12

PR SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS

Professional

Both

$2,188.13

Service Code	HCPCS 31030
Min. Negotiated Rate	$1,641.10
Max. Negotiated Rate	$1,641.10
Rate for Payer: Cash Price	$599.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,641.10
Rate for Payer: SOMOS Essential	$1,641.10

PR SINUSOTOMY SPHENOID W/WO BIOPSY

Professional

Both

$2,253.48

Service Code	HCPCS 31050
Min. Negotiated Rate	$1,690.11
Max. Negotiated Rate	$1,690.11
Rate for Payer: Cash Price	$608.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,690.11
Rate for Payer: SOMOS Essential	$1,690.11

PR SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP

Professional

Both

$3,028.45

Service Code	HCPCS 31051
Min. Negotiated Rate	$2,271.34
Max. Negotiated Rate	$2,271.34
Rate for Payer: Cash Price	$817.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,271.34
Rate for Payer: SOMOS Essential	$2,271.34

PR SINUSOT UNI 3/> PARANSL SINUSES

Professional

Both

$4,829.83

Service Code	HCPCS 31090
Min. Negotiated Rate	$3,622.37
Max. Negotiated Rate	$3,622.37
Rate for Payer: Cash Price	$1,303.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,622.37
Rate for Payer: SOMOS Essential	$3,622.37

PR SKIN TEST UNLISTED ANTIGEN EACH

Professional

Both

$28.60

Service Code	HCPCS 86486
Min. Negotiated Rate	$21.45
Max. Negotiated Rate	$21.45
Rate for Payer: Cash Price	$7.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$21.45
Rate for Payer: SOMOS Essential	$21.45

PR SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN

Professional

Both

$1,097.78

Service Code	HCPCS 36251
Min. Negotiated Rate	$823.34
Max. Negotiated Rate	$823.34
Rate for Payer: Cash Price	$292.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$823.34
Rate for Payer: SOMOS Essential	$823.34

PR SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL

Professional

Both

$1,558.62

Service Code	HCPCS 36252
Min. Negotiated Rate	$1,168.96
Max. Negotiated Rate	$1,168.96
Rate for Payer: Cash Price	$414.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,168.96
Rate for Payer: SOMOS Essential	$1,168.96

PR SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART

Professional

Both

$1,479.10

Service Code	HCPCS 36223
Min. Negotiated Rate	$1,109.32
Max. Negotiated Rate	$1,109.32
Rate for Payer: Cash Price	$395.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,109.32
Rate for Payer: SOMOS Essential	$1,109.32

PR SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART

Professional

Both

$1,266.27

Service Code	HCPCS 36222
Min. Negotiated Rate	$949.70
Max. Negotiated Rate	$949.70
Rate for Payer: Cash Price	$337.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$949.70
Rate for Payer: SOMOS Essential	$949.70

PR SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY

Professional

Both

$640.54

Service Code	HCPCS 36014
Min. Negotiated Rate	$480.40
Max. Negotiated Rate	$480.40
Rate for Payer: Cash Price	$171.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$480.40
Rate for Payer: SOMOS Essential	$480.40

PR SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT

Professional

Both

$1,131.24

Service Code	HCPCS 36228
Min. Negotiated Rate	$848.43
Max. Negotiated Rate	$848.43
Rate for Payer: Cash Price	$302.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$848.43
Rate for Payer: SOMOS Essential	$848.43

PR SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART

Professional

Both

$1,680.14

Service Code	HCPCS 36224
Min. Negotiated Rate	$1,260.10
Max. Negotiated Rate	$1,260.10
Rate for Payer: Cash Price	$446.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,260.10
Rate for Payer: SOMOS Essential	$1,260.10

PR SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH

Professional

Both

$1,169.28

Service Code	HCPCS 36216
Min. Negotiated Rate	$876.96
Max. Negotiated Rate	$876.96
Rate for Payer: Cash Price	$315.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$876.96
Rate for Payer: SOMOS Essential	$876.96

PR SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH

Professional

Both

$1,088.08

Service Code	HCPCS 36246
Min. Negotiated Rate	$816.06
Max. Negotiated Rate	$816.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$816.06
Rate for Payer: SOMOS Essential	$816.06

PR SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH

Professional

Both

$1,271.34

Service Code	HCPCS 36247
Min. Negotiated Rate	$953.50
Max. Negotiated Rate	$953.50
Rate for Payer: Cash Price	$338.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$953.50
Rate for Payer: SOMOS Essential	$953.50

PR SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH

Professional

Both

$1,450.16

Service Code	HCPCS 36217
Min. Negotiated Rate	$1,087.62
Max. Negotiated Rate	$1,087.62
Rate for Payer: Cash Price	$390.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,087.62
Rate for Payer: SOMOS Essential	$1,087.62

PR SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH

Professional

Both

$1,005.41

Service Code	HCPCS 36245
Min. Negotiated Rate	$754.06
Max. Negotiated Rate	$754.06
Rate for Payer: Cash Price	$269.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$754.06
Rate for Payer: SOMOS Essential	$754.06

PR SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH

Professional

Both

$889.42

Service Code	HCPCS 36215
Min. Negotiated Rate	$667.06
Max. Negotiated Rate	$667.06
Rate for Payer: Cash Price	$239.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$667.06
Rate for Payer: SOMOS Essential	$667.06

PR SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH

Professional

Both

$199.57

Service Code	HCPCS 36248
Min. Negotiated Rate	$149.68
Max. Negotiated Rate	$149.68
Rate for Payer: Cash Price	$53.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$149.68
Rate for Payer: SOMOS Essential	$149.68

PR SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH

Professional

Both

$224.49

Service Code	HCPCS 36218
Min. Negotiated Rate	$168.37
Max. Negotiated Rate	$168.37
Rate for Payer: Cash Price	$60.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$168.37
Rate for Payer: SOMOS Essential	$168.37

PR SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART

Professional

Both

$706.79

Service Code	HCPCS 36015
Min. Negotiated Rate	$530.09
Max. Negotiated Rate	$530.09
Rate for Payer: Cash Price	$190.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$530.09
Rate for Payer: SOMOS Essential	$530.09

Know your out-of-pocket cost for care.

All Charges