St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR TENDON GRAFT FROM A DISTANCE

Professional

Both

$2,215.68

Service Code	HCPCS 20924
Min. Negotiated Rate	$1,661.76
Max. Negotiated Rate	$1,661.76
Rate for Payer: Cash Price	$601.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,661.76
Rate for Payer: SOMOS Essential	$1,661.76

PR TENDON LENGTHENING UPPER ARM/ELBOW EA TENDON

Professional

Both

$2,559.34

Service Code	HCPCS 24305
Min. Negotiated Rate	$1,919.50
Max. Negotiated Rate	$1,919.50
Rate for Payer: Cash Price	$696.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,919.50
Rate for Payer: SOMOS Essential	$1,919.50

PR TENDON SHEATH INCISION

Professional

Both

$1,291.40

Service Code	HCPCS 26055
Min. Negotiated Rate	$968.55
Max. Negotiated Rate	$968.55
Rate for Payer: Cash Price	$352.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$968.55
Rate for Payer: SOMOS Essential	$968.55

PR TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT

Professional

Both

$3,850.74

Service Code	HCPCS 26483
Min. Negotiated Rate	$2,888.06
Max. Negotiated Rate	$2,888.06
Rate for Payer: Cash Price	$1,039.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,888.06
Rate for Payer: SOMOS Essential	$2,888.06

PR TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE

Professional

Both

$2,646.42

Service Code	HCPCS 24340
Min. Negotiated Rate	$1,984.82
Max. Negotiated Rate	$1,984.82
Rate for Payer: Cash Price	$714.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,984.82
Rate for Payer: SOMOS Essential	$1,984.82

PR TENODESIS DISTAL JOINT EACH

Professional

Both

$2,904.51

Service Code	HCPCS 26474
Min. Negotiated Rate	$2,178.38
Max. Negotiated Rate	$2,178.38
Rate for Payer: Cash Price	$783.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,178.38
Rate for Payer: SOMOS Essential	$2,178.38

PR TENODESIS LONG TENDON BICEPS

Professional

Both

$3,290.67

Service Code	HCPCS 23430
Min. Negotiated Rate	$2,468.00
Max. Negotiated Rate	$2,468.00
Rate for Payer: Cash Price	$891.04
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,468.00
Rate for Payer: SOMOS Essential	$2,468.00

PR TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH

Professional

Both

$2,920.75

Service Code	HCPCS 26471
Min. Negotiated Rate	$2,190.56
Max. Negotiated Rate	$2,190.56
Rate for Payer: Cash Price	$790.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,190.56
Rate for Payer: SOMOS Essential	$2,190.56

PR TENODESIS WRIST EXTENSORS FINGERS

Professional

Both

$2,846.24

Service Code	HCPCS 25301
Min. Negotiated Rate	$2,134.68
Max. Negotiated Rate	$2,134.68
Rate for Payer: Cash Price	$772.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,134.68
Rate for Payer: SOMOS Essential	$2,134.68

PR TENODESIS WRIST FLEXORS FINGERS

Professional

Both

$3,069.68

Service Code	HCPCS 25300
Min. Negotiated Rate	$2,302.26
Max. Negotiated Rate	$2,302.26
Rate for Payer: Cash Price	$831.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,302.26
Rate for Payer: SOMOS Essential	$2,302.26

PR TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA

Professional

Both

$3,083.82

Service Code	HCPCS 26449
Min. Negotiated Rate	$2,312.86
Max. Negotiated Rate	$2,312.86
Rate for Payer: Cash Price	$840.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,312.86
Rate for Payer: SOMOS Essential	$2,312.86

PR TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON

Professional

Both

$1,769.29

Service Code	HCPCS 28226
Min. Negotiated Rate	$1,326.97
Max. Negotiated Rate	$1,326.97
Rate for Payer: Cash Price	$482.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,326.97
Rate for Payer: SOMOS Essential	$1,326.97

PR TENOLYSIS EXTENSOR FOOT SINGLE TENDON

Professional

Both

$1,114.75

Service Code	HCPCS 28225
Min. Negotiated Rate	$836.06
Max. Negotiated Rate	$836.06
Rate for Payer: Cash Price	$308.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$836.06
Rate for Payer: SOMOS Essential	$836.06

PR TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH

Professional

Both

$2,687.83

Service Code	HCPCS 26445
Min. Negotiated Rate	$2,015.87
Max. Negotiated Rate	$2,015.87
Rate for Payer: Cash Price	$721.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,015.87
Rate for Payer: SOMOS Essential	$2,015.87

PR TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS

Professional

Both

$1,529.89

Service Code	HCPCS 28222
Min. Negotiated Rate	$1,147.42
Max. Negotiated Rate	$1,147.42
Rate for Payer: Cash Price	$430.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,147.42
Rate for Payer: SOMOS Essential	$1,147.42

PR TENOLYSIS FLEXOR FOOT SINGLE TENDON

Professional

Both

$1,274.70

Service Code	HCPCS 28220
Min. Negotiated Rate	$956.02
Max. Negotiated Rate	$956.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$956.02
Rate for Payer: SOMOS Essential	$956.02

PR TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO

Professional

Both

$4,370.59

Service Code	HCPCS 26442
Min. Negotiated Rate	$3,277.94
Max. Negotiated Rate	$3,277.94
Rate for Payer: Cash Price	$1,181.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,277.94
Rate for Payer: SOMOS Essential	$3,277.94

PR TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON

Professional

Both

$2,881.48

Service Code	HCPCS 26440
Min. Negotiated Rate	$2,161.11
Max. Negotiated Rate	$2,161.11
Rate for Payer: Cash Price	$776.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,161.11
Rate for Payer: SOMOS Essential	$2,161.11

PR TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH

Professional

Both

$1,809.82

Service Code	HCPCS 27680
Min. Negotiated Rate	$1,357.36
Max. Negotiated Rate	$1,357.36
Rate for Payer: Cash Price	$497.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,357.36
Rate for Payer: SOMOS Essential	$1,357.36

PR TENOLYSIS TRICEPS

Professional

Both

$2,739.49

Service Code	HCPCS 24332
Min. Negotiated Rate	$2,054.62
Max. Negotiated Rate	$2,054.62
Rate for Payer: Cash Price	$742.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,054.62
Rate for Payer: SOMOS Essential	$2,054.62

PR TENOPLASTY ELBOW TO SHOULDER SINGLE

Professional

Both

$3,464.48

Service Code	HCPCS 24320
Min. Negotiated Rate	$2,598.36
Max. Negotiated Rate	$2,598.36
Rate for Payer: Cash Price	$935.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,598.36
Rate for Payer: SOMOS Essential	$2,598.36

PR TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX

Professional

Both

$3,094.53

Service Code	HCPCS 27006
Min. Negotiated Rate	$2,320.90
Max. Negotiated Rate	$2,320.90
Rate for Payer: Cash Price	$844.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,320.90
Rate for Payer: SOMOS Essential	$2,320.90

PR TENOTOMY ADDUCTOR HIP OPEN

Professional

Both

$2,405.20

Service Code	HCPCS 27001
Min. Negotiated Rate	$1,803.90
Max. Negotiated Rate	$1,803.90
Rate for Payer: Cash Price	$649.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,803.90
Rate for Payer: SOMOS Essential	$1,803.90

PR TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX

Professional

Both

$1,672.27

Service Code	HCPCS 27000
Min. Negotiated Rate	$1,254.20
Max. Negotiated Rate	$1,254.20
Rate for Payer: Cash Price	$454.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,254.20
Rate for Payer: SOMOS Essential	$1,254.20

PR TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS

Professional

Both

$1,801.91

Service Code	HCPCS 24357
Min. Negotiated Rate	$1,351.43
Max. Negotiated Rate	$1,351.43
Rate for Payer: Cash Price	$492.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,351.43
Rate for Payer: SOMOS Essential	$1,351.43

Know your out-of-pocket cost for care.

All Charges