St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR STIMULUS EVOKED RESPONSE

Professional

Both

$948.19

Service Code	HCPCS 51792 TC
Min. Negotiated Rate	$711.14
Max. Negotiated Rate	$711.14
Rate for Payer: Cash Price	$259.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$711.14
Rate for Payer: SOMOS Essential	$711.14

PR STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY

Professional

Both

$2,239.02

Service Code	HCPCS 59525
Min. Negotiated Rate	$1,679.26
Max. Negotiated Rate	$1,679.26
Rate for Payer: Cash Price	$590.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,679.26
Rate for Payer: SOMOS Essential	$1,679.26

PR STRABISMUS ANY SUPERIOR OBLIQUE MUSCLE

Professional

Both

$2,819.81

Service Code	HCPCS 67318
Min. Negotiated Rate	$2,114.86
Max. Negotiated Rate	$2,114.86
Rate for Payer: Cash Price	$777.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,114.86
Rate for Payer: SOMOS Essential	$2,114.86

PR STRABISMUS EXPL&/RPR DETACHED EXTROCULAR MUSC

Professional

Both

$1,183.18

Service Code	HCPCS 67340
Min. Negotiated Rate	$887.38
Max. Negotiated Rate	$887.38
Rate for Payer: Cash Price	$324.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$887.38
Rate for Payer: SOMOS Essential	$887.38

PR STRABISMUS POST FIXJ SUTR TQ W/WO MUSC RECESSION

Professional

Both

$790.41

Service Code	HCPCS 67334
Min. Negotiated Rate	$592.81
Max. Negotiated Rate	$592.81
Rate for Payer: Cash Price	$173.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$592.81
Rate for Payer: SOMOS Essential	$592.81

PR STRABISMUS PREVIOUS EYE X INVOLVE EO MUSC

Professional

Both

$803.01

Service Code	HCPCS 67331
Min. Negotiated Rate	$602.26
Max. Negotiated Rate	$602.26
Rate for Payer: Cash Price	$176.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$602.26
Rate for Payer: SOMOS Essential	$602.26

PR STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC

Professional

Both

$1,872.22

Service Code	HCPCS 67311
Min. Negotiated Rate	$1,404.16
Max. Negotiated Rate	$1,404.16
Rate for Payer: Cash Price	$516.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,404.16
Rate for Payer: SOMOS Essential	$1,404.16

PR STRABISMUS RECESSION/RESCJ 1 VER MUSC

Professional

Both

$1,872.22

Service Code	HCPCS 67314
Min. Negotiated Rate	$1,404.16
Max. Negotiated Rate	$1,404.16
Rate for Payer: Cash Price	$516.92
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,404.16
Rate for Payer: SOMOS Essential	$1,404.16

PR STRABISMUS RECESSION/RESCJ 2 HRZNTL MUSC

Professional

Both

$2,725.03

Service Code	HCPCS 67312
Min. Negotiated Rate	$2,043.77
Max. Negotiated Rate	$2,043.77
Rate for Payer: Cash Price	$749.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,043.77
Rate for Payer: SOMOS Essential	$2,043.77

PR STRABISMUS RECESSION/RESCJ 2/MORE VER MUSC

Professional

Both

$2,920.51

Service Code	HCPCS 67316
Min. Negotiated Rate	$2,190.38
Max. Negotiated Rate	$2,190.38
Rate for Payer: Cash Price	$803.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,190.38
Rate for Payer: SOMOS Essential	$2,190.38

PR STRABISMUS SCARRING EO MUSC/RSTCV MYOPATHY

Professional

Both

$855.82

Service Code	HCPCS 67332
Min. Negotiated Rate	$641.86
Max. Negotiated Rate	$641.86
Rate for Payer: Cash Price	$226.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$641.86
Rate for Payer: SOMOS Essential	$641.86

PR STRAPPING ANKLE &/FOOT

Professional

Both

$72.73

Service Code	HCPCS 29540
Min. Negotiated Rate	$54.55
Max. Negotiated Rate	$54.55
Rate for Payer: Cash Price	$19.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$54.55
Rate for Payer: SOMOS Essential	$54.55

PR STRAPPING ELBOW/WRIST

Professional

Both

$79.91

Service Code	HCPCS 29260
Min. Negotiated Rate	$59.93
Max. Negotiated Rate	$59.93
Rate for Payer: Cash Price	$20.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$59.93
Rate for Payer: SOMOS Essential	$59.93

PR STRAPPING HAND/FINGER

Professional

Both

$82.78

Service Code	HCPCS 29280
Min. Negotiated Rate	$62.08
Max. Negotiated Rate	$62.08
Rate for Payer: Cash Price	$23.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$62.08
Rate for Payer: SOMOS Essential	$62.08

PR STRAPPING HIP

Professional

Both

$73.01

Service Code	HCPCS 29520
Min. Negotiated Rate	$54.76
Max. Negotiated Rate	$54.76
Rate for Payer: Cash Price	$19.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$54.76
Rate for Payer: SOMOS Essential	$54.76

PR STRAPPING KNEE

Professional

Both

$73.01

Service Code	HCPCS 29530
Min. Negotiated Rate	$54.76
Max. Negotiated Rate	$54.76
Rate for Payer: Cash Price	$19.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$54.76
Rate for Payer: SOMOS Essential	$54.76

PR STRAPPING SHOULDER

Professional

Both

$73.01

Service Code	HCPCS 29240
Min. Negotiated Rate	$54.76
Max. Negotiated Rate	$54.76
Rate for Payer: Cash Price	$19.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$54.76
Rate for Payer: SOMOS Essential	$54.76

PR STRAPPING THORAX

Professional

Both

$74.45

Service Code	HCPCS 29200
Min. Negotiated Rate	$55.84
Max. Negotiated Rate	$55.84
Rate for Payer: Cash Price	$19.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$55.84
Rate for Payer: SOMOS Essential	$55.84

PR STRAPPING TOES

Professional

Both

$45.40

Service Code	HCPCS 29550
Min. Negotiated Rate	$34.05
Max. Negotiated Rate	$34.05
Rate for Payer: Cash Price	$12.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$34.05
Rate for Payer: SOMOS Essential	$34.05

PR STRAPPING UNNA BOOT

Professional

Both

$111.06

Service Code	HCPCS 29580
Min. Negotiated Rate	$83.30
Max. Negotiated Rate	$83.30
Rate for Payer: Cash Price	$29.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$83.30
Rate for Payer: SOMOS Essential	$83.30

PR STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR

Professional

Both

$6,674.26

Service Code	HCPCS 61751
Min. Negotiated Rate	$5,005.70
Max. Negotiated Rate	$5,005.70
Rate for Payer: Cash Price	$1,765.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,005.70
Rate for Payer: SOMOS Essential	$5,005.70

PR STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL

Professional

Both

$1,141.60

Service Code	HCPCS 61781
Min. Negotiated Rate	$856.20
Max. Negotiated Rate	$856.20
Rate for Payer: Cash Price	$297.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$856.20
Rate for Payer: SOMOS Essential	$856.20

PR STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL

Professional

Both

$739.76

Service Code	HCPCS 61782
Min. Negotiated Rate	$554.82
Max. Negotiated Rate	$554.82
Rate for Payer: Cash Price	$198.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$554.82
Rate for Payer: SOMOS Essential	$554.82

PR STRTCTC IMPLTJ ELTRD CEREBRUM SEIZURE MONITORING

Professional

Both

$7,660.77

Service Code	HCPCS 61760
Min. Negotiated Rate	$5,745.58
Max. Negotiated Rate	$5,745.58
Rate for Payer: Cash Price	$2,005.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,745.58
Rate for Payer: SOMOS Essential	$5,745.58

PR STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD 1ST ARRAY

Professional

Both

$7,247.45

Service Code	HCPCS 61863
Min. Negotiated Rate	$5,435.59
Max. Negotiated Rate	$5,435.59
Rate for Payer: Cash Price	$1,917.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,435.59
Rate for Payer: SOMOS Essential	$5,435.59

Know your out-of-pocket cost for care.

All Charges