St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR THERAPEUTIC APHERESIS PLATELETS

Professional

Both

$436.17

Service Code	HCPCS 36513
Min. Negotiated Rate	$327.13
Max. Negotiated Rate	$327.13
Rate for Payer: Cash Price	$118.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$327.13
Rate for Payer: SOMOS Essential	$327.13

PR THERAPEUTIC APHERESIS RED BLOOD CELLS

Professional

Both

$428.51

Service Code	HCPCS 36512
Min. Negotiated Rate	$321.38
Max. Negotiated Rate	$321.38
Rate for Payer: Cash Price	$116.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$321.38
Rate for Payer: SOMOS Essential	$321.38

PR THERAPEUTIC APHERESIS WHITE BLOOD CELLS

Professional

Both

$441.46

Service Code	HCPCS 36511
Min. Negotiated Rate	$331.10
Max. Negotiated Rate	$331.10
Rate for Payer: Cash Price	$123.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$331.10
Rate for Payer: SOMOS Essential	$331.10

PR THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG

Professional

Both

$65.59

Service Code	HCPCS 96375
Min. Negotiated Rate	$49.19
Max. Negotiated Rate	$49.19
Rate for Payer: Cash Price	$17.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$49.19
Rate for Payer: SOMOS Essential	$49.19

PR THERAPEUTIC PROCD STRG ENDUR

Professional

Both

$47.29

Service Code	HCPCS G0237
Min. Negotiated Rate	$35.47
Max. Negotiated Rate	$35.47
Rate for Payer: Cash Price	$13.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35.47
Rate for Payer: SOMOS Essential	$35.47

PR THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS

Professional

Both

$72.14

Service Code	HCPCS 97150
Min. Negotiated Rate	$54.10
Max. Negotiated Rate	$54.10
Rate for Payer: Cash Price	$20.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$54.10
Rate for Payer: SOMOS Essential	$54.10

PR THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM

Professional

Both

$58.52

Service Code	HCPCS 96372
Min. Negotiated Rate	$43.89
Max. Negotiated Rate	$43.89
Rate for Payer: Cash Price	$16.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$43.89
Rate for Payer: SOMOS Essential	$43.89

PR THERAPEUTIC PROPHYLACTIC/DX NJX INTRA-ARTERIAL

Professional

Both

$75.78

Service Code	HCPCS 96373
Min. Negotiated Rate	$56.84
Max. Negotiated Rate	$56.84
Rate for Payer: Cash Price	$21.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$56.84
Rate for Payer: SOMOS Essential	$56.84

PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES

Professional

Both

$119.46

Service Code	HCPCS 97110
Min. Negotiated Rate	$89.60
Max. Negotiated Rate	$89.60
Rate for Payer: Cash Price	$32.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$89.60
Rate for Payer: SOMOS Essential	$89.60

PR THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT

Professional

Both

$473.24

Service Code	HCPCS 62329
Min. Negotiated Rate	$354.93
Max. Negotiated Rate	$354.93
Rate for Payer: Cash Price	$119.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$354.93
Rate for Payer: SOMOS Essential	$354.93

PR THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF

Professional

Both

$414.75

Service Code	HCPCS 62272
Min. Negotiated Rate	$311.06
Max. Negotiated Rate	$311.06
Rate for Payer: Cash Price	$111.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$311.06
Rate for Payer: SOMOS Essential	$311.06

PR THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION

Professional

Both

$370.90

Service Code	HCPCS 36516
Min. Negotiated Rate	$278.18
Max. Negotiated Rate	$278.18
Rate for Payer: Cash Price	$100.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$278.18
Rate for Payer: SOMOS Essential	$278.18

PR THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG

Professional

Both

$774.94

Service Code	HCPCS 90868
Min. Negotiated Rate	$581.20
Max. Negotiated Rate	$581.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$581.20
Rate for Payer: SOMOS Essential	$581.20

PR THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES

Professional

Both

$86.91

Service Code	HCPCS 97129
Min. Negotiated Rate	$65.18
Max. Negotiated Rate	$65.18
Rate for Payer: Cash Price	$23.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$65.18
Rate for Payer: SOMOS Essential	$65.18

PR THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES

Professional

Both

$84.42

Service Code	HCPCS 97130
Min. Negotiated Rate	$63.32
Max. Negotiated Rate	$63.32
Rate for Payer: Cash Price	$22.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$63.32
Rate for Payer: SOMOS Essential	$63.32

PR THERMAL DSTRJ INTRAOSSEOUS BVN 1ST 2 LMBR/SAC

Professional

Both

$2,037.42

Service Code	HCPCS 64628
Min. Negotiated Rate	$1,528.06
Max. Negotiated Rate	$1,528.06
Rate for Payer: Cash Price	$475.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,528.06
Rate for Payer: SOMOS Essential	$1,528.06

PR THERMAL DSTRJ INTRAOSSEOUS BVN EA ADDL LMBR/SAC

Professional

Both

$949.13

Service Code	HCPCS 64629
Min. Negotiated Rate	$711.85
Max. Negotiated Rate	$711.85
Rate for Payer: Cash Price	$224.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$711.85
Rate for Payer: SOMOS Essential	$711.85

PR THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG

Professional

Both

$158.83

Service Code	HCPCS 96374
Min. Negotiated Rate	$119.12
Max. Negotiated Rate	$119.12
Rate for Payer: Cash Price	$42.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$119.12
Rate for Payer: SOMOS Essential	$119.12

PR THER PX 1/> AREAS EA 15 MIN GAIT TRAING W/STAIR

Professional

Both

$119.46

Service Code	HCPCS 97116
Min. Negotiated Rate	$89.60
Max. Negotiated Rate	$89.60
Rate for Payer: Cash Price	$32.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$89.60
Rate for Payer: SOMOS Essential	$89.60

PR THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS

Professional

Both

$150.54

Service Code	HCPCS 97113
Min. Negotiated Rate	$112.90
Max. Negotiated Rate	$112.90
Rate for Payer: Cash Price	$41.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$112.90
Rate for Payer: SOMOS Essential	$112.90

PR THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA

Professional

Both

$137.24

Service Code	HCPCS 97112
Min. Negotiated Rate	$102.93
Max. Negotiated Rate	$102.93
Rate for Payer: Cash Price	$37.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$102.93
Rate for Payer: SOMOS Essential	$102.93

PR THER PX 1/> AREAS EACH 15 MINUTES MASSAGE

Professional

Both

$124.18

Service Code	HCPCS 97124
Min. Negotiated Rate	$93.14
Max. Negotiated Rate	$93.14
Rate for Payer: Cash Price	$34.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$93.14
Rate for Payer: SOMOS Essential	$93.14

PR THER SP-GENRATJ DEV PRGRMG&MODIFICAJ

Professional

Both

$420.18

Service Code	HCPCS 92609
Min. Negotiated Rate	$315.14
Max. Negotiated Rate	$315.14
Rate for Payer: Cash Price	$116.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$315.14
Rate for Payer: SOMOS Essential	$315.14

PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING

Professional

Both

$445.41

Service Code	HCPCS 32555
Min. Negotiated Rate	$334.06
Max. Negotiated Rate	$334.06
Rate for Payer: Cash Price	$120.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$334.06
Rate for Payer: SOMOS Essential	$334.06

PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING

Professional

Both

$366.07

Service Code	HCPCS 32554
Min. Negotiated Rate	$274.55
Max. Negotiated Rate	$274.55
Rate for Payer: Cash Price	$99.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$274.55
Rate for Payer: SOMOS Essential	$274.55

Know your out-of-pocket cost for care.

All Charges