St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR TOTAL DISC ARTHRP ANT SINGLE INTERSPACE LUMBAR

Professional

Both

$7,787.05

Service Code	HCPCS 22857
Min. Negotiated Rate	$5,840.29
Max. Negotiated Rate	$5,840.29
Rate for Payer: Cash Price	$2,070.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,840.29
Rate for Payer: SOMOS Essential	$5,840.29

PR TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY

Professional

Both

$15,494.15

Service Code	HCPCS 43112
Min. Negotiated Rate	$11,620.61
Max. Negotiated Rate	$11,620.61
Rate for Payer: Cash Price	$4,088.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$11,620.61
Rate for Payer: SOMOS Essential	$11,620.61

PR TOTAL FACIAL NERVE DECOMPRESSION &/REPAIR

Professional

Both

$8,493.98

Service Code	HCPCS 69955
Min. Negotiated Rate	$6,370.48
Max. Negotiated Rate	$6,370.48
Rate for Payer: Cash Price	$2,290.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,370.48
Rate for Payer: SOMOS Essential	$6,370.48

PR TOTAL LUNG LAVAGE UNILATERAL

Professional

Both

$1,356.29

Service Code	HCPCS 32997
Min. Negotiated Rate	$1,017.22
Max. Negotiated Rate	$1,017.22
Rate for Payer: Cash Price	$369.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,017.22
Rate for Payer: SOMOS Essential	$1,017.22

PR TOTAL REPAIR TRUNCUS ARTERIOSUS

Professional

Both

$10,128.27

Service Code	HCPCS 33786
Min. Negotiated Rate	$7,596.20
Max. Negotiated Rate	$7,596.20
Rate for Payer: Cash Price	$2,687.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,596.20
Rate for Payer: SOMOS Essential	$7,596.20

PR TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY

Professional

Both

$3,111.89

Service Code	HCPCS 60220
Min. Negotiated Rate	$2,333.92
Max. Negotiated Rate	$2,333.92
Rate for Payer: Cash Price	$837.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,333.92
Rate for Payer: SOMOS Essential	$2,333.92

PR TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC

Professional

Both

$4,111.21

Service Code	HCPCS 60225
Min. Negotiated Rate	$3,083.41
Max. Negotiated Rate	$3,083.41
Rate for Payer: Cash Price	$1,111.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,083.41
Rate for Payer: SOMOS Essential	$3,083.41

PR TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL

Professional

Both

$2,328.94

Service Code	HCPCS 22858
Min. Negotiated Rate	$1,746.70
Max. Negotiated Rate	$1,746.70
Rate for Payer: Cash Price	$615.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,746.70
Rate for Payer: SOMOS Essential	$1,746.70

PR TOT DISC ARTHRP ART DISC ANT APPRO 1 NTRSPC CRV

Professional

Both

$7,518.95

Service Code	HCPCS 22856
Min. Negotiated Rate	$5,639.21
Max. Negotiated Rate	$5,639.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,639.21
Rate for Payer: SOMOS Essential	$5,639.21

PR TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY

Professional

Both

$13,268.71

Service Code	HCPCS 43107
Min. Negotiated Rate	$9,951.53
Max. Negotiated Rate	$9,951.53
Rate for Payer: Cash Price	$3,534.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,951.53
Rate for Payer: SOMOS Essential	$9,951.53

PR TOT ESOPHG W/O THORCOM COLON NTRPSTJ/INT RCNSTJ

Professional

Both

$19,801.43

Service Code	HCPCS 43108
Min. Negotiated Rate	$14,851.07
Max. Negotiated Rate	$14,851.07
Rate for Payer: Cash Price	$5,248.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$14,851.07
Rate for Payer: SOMOS Essential	$14,851.07

PR TOT ESOPHG W/THORCOM W/COLON NTRPSTJ/INT RCNSTJ

Professional

Both

$19,356.61

Service Code	HCPCS 43113
Min. Negotiated Rate	$14,517.46
Max. Negotiated Rate	$14,517.46
Rate for Payer: Cash Price	$5,135.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$14,517.46
Rate for Payer: SOMOS Essential	$14,517.46

PR TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY

Professional

Both

$16,961.28

Service Code	HCPCS 43124
Min. Negotiated Rate	$12,720.96
Max. Negotiated Rate	$12,720.96
Rate for Payer: Cash Price	$4,504.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$12,720.96
Rate for Payer: SOMOS Essential	$12,720.96

PR TRABECULOPLASTY BY LASER SURGERY

Professional

Both

$842.63

Service Code	HCPCS 65855
Min. Negotiated Rate	$631.97
Max. Negotiated Rate	$631.97
Rate for Payer: Cash Price	$231.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$631.97
Rate for Payer: SOMOS Essential	$631.97

PR TRABECULOTOMY AB EXTERNO

Professional

Both

$3,474.28

Service Code	HCPCS 65850
Min. Negotiated Rate	$2,605.71
Max. Negotiated Rate	$2,605.71
Rate for Payer: Cash Price	$954.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,605.71
Rate for Payer: SOMOS Essential	$2,605.71

PR TRACHEAL PNXR PRQ W/TRANSTRACHEAL ASPIR&/NJX

Professional

Both

$213.68

Service Code	HCPCS 31612
Min. Negotiated Rate	$160.26
Max. Negotiated Rate	$160.26
Rate for Payer: Cash Price	$55.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$160.26
Rate for Payer: SOMOS Essential	$160.26

PR TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX

Professional

Both

$1,631.49

Service Code	HCPCS 57530
Min. Negotiated Rate	$1,223.62
Max. Negotiated Rate	$1,223.62
Rate for Payer: Cash Price	$443.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,223.62
Rate for Payer: SOMOS Essential	$1,223.62

PR TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG

Professional

Both

$1,462.55

Service Code	HCPCS 57720
Min. Negotiated Rate	$1,096.91
Max. Negotiated Rate	$1,096.91
Rate for Payer: Cash Price	$395.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,096.91
Rate for Payer: SOMOS Essential	$1,096.91

PR TRACHEOBRNCHSC THRU EST TRACHS INC

Professional

Both

$490.04

Service Code	HCPCS 31615
Min. Negotiated Rate	$367.53
Max. Negotiated Rate	$367.53
Rate for Payer: Cash Price	$133.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$367.53
Rate for Payer: SOMOS Essential	$367.53

PR TRACHEOPLASTY CERVICAL

Professional

Both

$5,892.46

Service Code	HCPCS 31750
Min. Negotiated Rate	$4,419.34
Max. Negotiated Rate	$4,419.34
Rate for Payer: Cash Price	$1,578.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,419.34
Rate for Payer: SOMOS Essential	$4,419.34

PR TRACHEOPLASTY INTRATHORACIC

Professional

Both

$6,129.69

Service Code	HCPCS 31760
Min. Negotiated Rate	$4,597.27
Max. Negotiated Rate	$4,597.27
Rate for Payer: Cash Price	$1,633.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,597.27
Rate for Payer: SOMOS Essential	$4,597.27

PR TRACHEOPLASTY TRACHEOPHARYNGEAL FSTLJ EA STG

Professional

Both

$7,504.14

Service Code	HCPCS 31755
Min. Negotiated Rate	$5,628.10
Max. Negotiated Rate	$5,628.10
Rate for Payer: Cash Price	$2,026.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,628.10
Rate for Payer: SOMOS Essential	$5,628.10

PR TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION

Professional

Both

$3,102.79

Service Code	HCPCS 31614
Min. Negotiated Rate	$2,327.09
Max. Negotiated Rate	$2,327.09
Rate for Payer: Cash Price	$836.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,327.09
Rate for Payer: SOMOS Essential	$2,327.09

PR TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION

Professional

Both

$1,854.30

Service Code	HCPCS 31613
Min. Negotiated Rate	$1,390.72
Max. Negotiated Rate	$1,390.72
Rate for Payer: Cash Price	$500.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,390.72
Rate for Payer: SOMOS Essential	$1,390.72

PR TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE

Professional

Both

$1,462.83

Service Code	HCPCS 31605
Min. Negotiated Rate	$1,097.12
Max. Negotiated Rate	$1,097.12
Rate for Payer: Cash Price	$385.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,097.12
Rate for Payer: SOMOS Essential	$1,097.12

Know your out-of-pocket cost for care.

All Charges