St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR SYMPHYSIOTOMY HORSESHOE KDN W/WO PLOP UNI/BI

Professional

Both

$4,780.09

Service Code	HCPCS 50540
Min. Negotiated Rate	$3,585.07
Max. Negotiated Rate	$3,585.07
Rate for Payer: Cash Price	$1,306.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,585.07
Rate for Payer: SOMOS Essential	$3,585.07

PR SYNDACTYLIZATION TOES

Professional

Both

$1,463.49

Service Code	HCPCS 28280
Min. Negotiated Rate	$1,097.62
Max. Negotiated Rate	$1,097.62
Rate for Payer: Cash Price	$399.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,097.62
Rate for Payer: SOMOS Essential	$1,097.62

PR SYNOVECTOMY CARPOMETACARPAL JOINT

Professional

Both

$2,093.21

Service Code	HCPCS 26130
Min. Negotiated Rate	$1,569.91
Max. Negotiated Rate	$1,569.91
Rate for Payer: Cash Price	$569.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,569.91
Rate for Payer: SOMOS Essential	$1,569.91

PR SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT

Professional

Both

$1,696.31

Service Code	HCPCS 25118
Min. Negotiated Rate	$1,272.23
Max. Negotiated Rate	$1,272.23
Rate for Payer: Cash Price	$463.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,272.23
Rate for Payer: SOMOS Essential	$1,272.23

PR SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH

Professional

Both

$1,377.18

Service Code	HCPCS 28072
Min. Negotiated Rate	$1,032.88
Max. Negotiated Rate	$1,032.88
Rate for Payer: Cash Price	$379.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,032.88
Rate for Payer: SOMOS Essential	$1,032.88

PR SYNOVECTOMY TENDON SHEATH FOOT EXTENSOR

Professional

Both

$1,238.16

Service Code	HCPCS 28088
Min. Negotiated Rate	$928.62
Max. Negotiated Rate	$928.62
Rate for Payer: Cash Price	$344.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$928.62
Rate for Payer: SOMOS Essential	$928.62

PR SYNOVECTOMY TENDON SHEATH FOOT FLEXOR

Professional

Both

$1,515.71

Service Code	HCPCS 28086
Min. Negotiated Rate	$1,136.78
Max. Negotiated Rate	$1,136.78
Rate for Payer: Cash Price	$410.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,136.78
Rate for Payer: SOMOS Essential	$1,136.78

PR SYNTHETIC SENTENCE IDENTIFICATION TEST

Professional

Both

$172.38

Service Code	HCPCS 92576
Min. Negotiated Rate	$129.28
Max. Negotiated Rate	$129.28
Rate for Payer: Cash Price	$50.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$129.28
Rate for Payer: SOMOS Essential	$129.28

PR SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX

Professional

Both

$1,446.48

Service Code	HCPCS 28070
Min. Negotiated Rate	$1,084.86
Max. Negotiated Rate	$1,084.86
Rate for Payer: Cash Price	$397.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,084.86
Rate for Payer: SOMOS Essential	$1,084.86

PR SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD

Professional

Both

$2,454.52

Service Code	HCPCS 26135
Min. Negotiated Rate	$1,840.89
Max. Negotiated Rate	$1,840.89
Rate for Payer: Cash Price	$665.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,840.89
Rate for Payer: SOMOS Essential	$1,840.89

PR SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT

Professional

Both

$2,245.78

Service Code	HCPCS 26140
Min. Negotiated Rate	$1,684.34
Max. Negotiated Rate	$1,684.34
Rate for Payer: Cash Price	$612.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,684.34
Rate for Payer: SOMOS Essential	$1,684.34

PR SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN

Professional

Both

$2,285.43

Service Code	HCPCS 26145
Min. Negotiated Rate	$1,714.07
Max. Negotiated Rate	$1,714.07
Rate for Payer: Cash Price	$621.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,714.07
Rate for Payer: SOMOS Essential	$1,714.07

PR SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA

Professional

Both

$2,239.62

Service Code	HCPCS 25119
Min. Negotiated Rate	$1,679.72
Max. Negotiated Rate	$1,679.72
Rate for Payer: Cash Price	$607.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,679.72
Rate for Payer: SOMOS Essential	$1,679.72

PR TALECTOMY ASTRAGALECTOMY

Professional

Both

$2,575.72

Service Code	HCPCS 28130
Min. Negotiated Rate	$1,931.79
Max. Negotiated Rate	$1,931.79
Rate for Payer: Cash Price	$720.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,931.79
Rate for Payer: SOMOS Essential	$1,931.79

PR TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION

Professional

Both

$90.16

Service Code	HCPCS 11103
Min. Negotiated Rate	$67.62
Max. Negotiated Rate	$67.62
Rate for Payer: Cash Price	$24.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$67.62
Rate for Payer: SOMOS Essential	$67.62

PR TANGENTIAL BIOPSY SKIN SINGLE LESION

Professional

Both

$157.89

Service Code	HCPCS 11102
Min. Negotiated Rate	$118.42
Max. Negotiated Rate	$118.42
Rate for Payer: Cash Price	$42.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$118.42
Rate for Payer: SOMOS Essential	$118.42

PR TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S)

Professional

Both

$320.85

Service Code	HCPCS 64489
Min. Negotiated Rate	$240.64
Max. Negotiated Rate	$240.64
Rate for Payer: Cash Price	$85.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$240.64
Rate for Payer: SOMOS Essential	$240.64

PR TAP BLOCK BILATERAL BY INJECTION(S)

Professional

Both

$276.36

Service Code	HCPCS 64488
Min. Negotiated Rate	$207.27
Max. Negotiated Rate	$207.27
Rate for Payer: Cash Price	$75.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$207.27
Rate for Payer: SOMOS Essential	$207.27

PR TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S)

Professional

Both

$257.01

Service Code	HCPCS 64487
Min. Negotiated Rate	$192.76
Max. Negotiated Rate	$192.76
Rate for Payer: Cash Price	$69.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$192.76
Rate for Payer: SOMOS Essential	$192.76

PR TAP BLOCK UNILATERAL BY INJECTION(S)

Professional

Both

$225.09

Service Code	HCPCS 64486
Min. Negotiated Rate	$168.82
Max. Negotiated Rate	$168.82
Rate for Payer: Cash Price	$60.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$168.82
Rate for Payer: SOMOS Essential	$168.82

PR TAS CONGENITAL CARDIAC ANOMALIES ANY METHOD

Professional

Both

$3,306.52

Service Code	HCPCS 33741
Min. Negotiated Rate	$2,479.89
Max. Negotiated Rate	$2,479.89
Rate for Payer: Cash Price	$877.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,479.89
Rate for Payer: SOMOS Essential	$2,479.89

PR TATTOOING INCL MICROPIGMENTATION 6.0 CM/<

Professional

Both

$469.74

Service Code	HCPCS 11920
Min. Negotiated Rate	$352.30
Max. Negotiated Rate	$352.30
Rate for Payer: Cash Price	$133.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$352.30
Rate for Payer: SOMOS Essential	$352.30

PR TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM

Professional

Both

$570.36

Service Code	HCPCS 11921
Min. Negotiated Rate	$427.77
Max. Negotiated Rate	$427.77
Rate for Payer: Cash Price	$153.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$427.77
Rate for Payer: SOMOS Essential	$427.77

PR TATTOOING INCL MICROPIGMENTATION EA 20.0 CM

Professional

Both

$128.98

Service Code	HCPCS 11922
Min. Negotiated Rate	$96.74
Max. Negotiated Rate	$96.74
Rate for Payer: Cash Price	$33.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$96.74
Rate for Payer: SOMOS Essential	$96.74

PR TC99M LABELED RBC

Professional

Both

$373.14

Service Code	HCPCS A9560
Min. Negotiated Rate	$279.86
Max. Negotiated Rate	$279.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$279.86
Rate for Payer: SOMOS Essential	$279.86

Know your out-of-pocket cost for care.

All Charges