St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR TENOTOMY EXTENSOR HAND/FINGER OPEN EACH TENDON

Professional

Both

$1,990.42

Service Code	HCPCS 26460
Min. Negotiated Rate	$1,492.82
Max. Negotiated Rate	$1,492.82
Rate for Payer: Cash Price	$541.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,492.82
Rate for Payer: SOMOS Essential	$1,492.82

PR TENOTOMY FLEXOR FINGER OPEN EACH TENDON

Professional

Both

$2,052.40

Service Code	HCPCS 26455
Min. Negotiated Rate	$1,539.30
Max. Negotiated Rate	$1,539.30
Rate for Payer: Cash Price	$553.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,539.30
Rate for Payer: SOMOS Essential	$1,539.30

PR TENOTOMY FLEXOR PALM OPEN EACH TENDON

Professional

Both

$2,063.32

Service Code	HCPCS 26450
Min. Negotiated Rate	$1,547.49
Max. Negotiated Rate	$1,547.49
Rate for Payer: Cash Price	$556.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,547.49
Rate for Payer: SOMOS Essential	$1,547.49

PR TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE

Professional

Both

$3,164.88

Service Code	HCPCS 27005
Min. Negotiated Rate	$2,373.66
Max. Negotiated Rate	$2,373.66
Rate for Payer: Cash Price	$861.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,373.66
Rate for Payer: SOMOS Essential	$2,373.66

PR TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC

Professional

Both

$1,232.07

Service Code	HCPCS 28240
Min. Negotiated Rate	$924.05
Max. Negotiated Rate	$924.05
Rate for Payer: Cash Price	$340.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$924.05
Rate for Payer: SOMOS Essential	$924.05

PR TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON

Professional

Both

$2,111.59

Service Code	HCPCS 24310
Min. Negotiated Rate	$1,583.69
Max. Negotiated Rate	$1,583.69
Rate for Payer: Cash Price	$571.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,583.69
Rate for Payer: SOMOS Essential	$1,583.69

PR TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON

Professional

Both

$1,131.38

Service Code	HCPCS 28234
Min. Negotiated Rate	$848.54
Max. Negotiated Rate	$848.54
Rate for Payer: Cash Price	$314.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$848.54
Rate for Payer: SOMOS Essential	$848.54

PR TENOTOMY OPEN HAMSTRING KNEE HIP MULTIPLE BI

Professional

Both

$3,168.69

Service Code	HCPCS 27392
Min. Negotiated Rate	$2,376.52
Max. Negotiated Rate	$2,376.52
Rate for Payer: Cash Price	$858.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,376.52
Rate for Payer: SOMOS Essential	$2,376.52

PR TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON

Professional

Both

$2,006.76

Service Code	HCPCS 27390
Min. Negotiated Rate	$1,505.07
Max. Negotiated Rate	$1,505.07
Rate for Payer: Cash Price	$546.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,505.07
Rate for Payer: SOMOS Essential	$1,505.07

PR TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG

Professional

Both

$2,581.78

Service Code	HCPCS 27391
Min. Negotiated Rate	$1,936.34
Max. Negotiated Rate	$1,936.34
Rate for Payer: Cash Price	$698.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,936.34
Rate for Payer: SOMOS Essential	$1,936.34

PR TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT

Professional

Both

$1,121.40

Service Code	HCPCS 26060
Min. Negotiated Rate	$841.05
Max. Negotiated Rate	$841.05
Rate for Payer: Cash Price	$307.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$841.05
Rate for Payer: SOMOS Essential	$841.05

PR TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON

Professional

Both

$1,162.00

Service Code	HCPCS 28011
Min. Negotiated Rate	$871.50
Max. Negotiated Rate	$871.50
Rate for Payer: Cash Price	$322.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$871.50
Rate for Payer: SOMOS Essential	$871.50

PR TENOTOMY PERCUTANEOUS TOE SINGLE TENDON

Professional

Both

$867.34

Service Code	HCPCS 28010
Min. Negotiated Rate	$650.50
Max. Negotiated Rate	$650.50
Rate for Payer: Cash Price	$241.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$650.50
Rate for Payer: SOMOS Essential	$650.50

PR TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES

Professional

Both

$1,171.59

Service Code	HCPCS 27606
Min. Negotiated Rate	$878.69
Max. Negotiated Rate	$878.69
Rate for Payer: Cash Price	$316.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$878.69
Rate for Payer: SOMOS Essential	$878.69

PR TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES

Professional

Both

$765.91

Service Code	HCPCS 27605
Min. Negotiated Rate	$574.43
Max. Negotiated Rate	$574.43
Rate for Payer: Cash Price	$210.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$574.43
Rate for Payer: SOMOS Essential	$574.43

PR TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX

Professional

Both

$1,429.26

Service Code	HCPCS 27306
Min. Negotiated Rate	$1,071.94
Max. Negotiated Rate	$1,071.94
Rate for Payer: Cash Price	$402.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,071.94
Rate for Payer: SOMOS Essential	$1,071.94

PR TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON

Professional

Both

$1,743.28

Service Code	HCPCS 27307
Min. Negotiated Rate	$1,307.46
Max. Negotiated Rate	$1,307.46
Rate for Payer: Cash Price	$476.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,307.46
Rate for Payer: SOMOS Essential	$1,307.46

PR TENOTOMY SHOULDER AREA 1 TENDON

Professional

Both

$2,714.29

Service Code	HCPCS 23405
Min. Negotiated Rate	$2,035.72
Max. Negotiated Rate	$2,035.72
Rate for Payer: Cash Price	$733.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,035.72
Rate for Payer: SOMOS Essential	$2,035.72

PR TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION

Professional

Both

$3,257.38

Service Code	HCPCS 23406
Min. Negotiated Rate	$2,443.04
Max. Negotiated Rate	$2,443.04
Rate for Payer: Cash Price	$860.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,443.04
Rate for Payer: SOMOS Essential	$2,443.04

PR TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION

Professional

Both

$518.84

Service Code	HCPCS 95923
Min. Negotiated Rate	$389.13
Max. Negotiated Rate	$389.13
Rate for Payer: Cash Price	$141.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$389.13
Rate for Payer: SOMOS Essential	$389.13

PR TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION

Professional

Both

$341.99

Service Code	HCPCS 95923 TC
Min. Negotiated Rate	$256.49
Max. Negotiated Rate	$256.49
Rate for Payer: Cash Price	$92.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$256.49
Rate for Payer: SOMOS Essential	$256.49

PR TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION

Professional

Both

$176.86

Service Code	HCPCS 95923 26
Min. Negotiated Rate	$132.64
Max. Negotiated Rate	$132.64
Rate for Payer: Cash Price	$48.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$132.64
Rate for Payer: SOMOS Essential	$132.64

PR TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP

Professional

Both

$626.05

Service Code	HCPCS 96020 26
Min. Negotiated Rate	$469.54
Max. Negotiated Rate	$469.54
Rate for Payer: Cash Price	$169.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$469.54
Rate for Payer: SOMOS Essential	$469.54

PR THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN

Professional

Both

$152.71

Service Code	HCPCS 97530
Min. Negotiated Rate	$114.53
Max. Negotiated Rate	$114.53
Rate for Payer: Cash Price	$41.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$114.53
Rate for Payer: SOMOS Essential	$114.53

PR THERAPEUTIC APHERESIS PLASMA PHERESIS

Professional

Both

$378.56

Service Code	HCPCS 36514
Min. Negotiated Rate	$283.92
Max. Negotiated Rate	$283.92
Rate for Payer: Cash Price	$103.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$283.92
Rate for Payer: SOMOS Essential	$283.92

Know your out-of-pocket cost for care.

All Charges