St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD

Professional

Both

$559.16

Service Code	HCPCS 93888
Min. Negotiated Rate	$419.37
Max. Negotiated Rate	$419.37
Rate for Payer: Cash Price	$187.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$419.37
Rate for Payer: SOMOS Essential	$419.37

PR TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD

Professional

Both

$456.86

Service Code	HCPCS 93888 TC
Min. Negotiated Rate	$342.64
Max. Negotiated Rate	$342.64
Rate for Payer: Cash Price	$160.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$342.64
Rate for Payer: SOMOS Essential	$342.64

PR TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS

Professional

Both

$5,745.92

Service Code	HCPCS 47460
Min. Negotiated Rate	$4,309.44
Max. Negotiated Rate	$4,309.44
Rate for Payer: Cash Price	$1,529.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,309.44
Rate for Payer: SOMOS Essential	$4,309.44

PR TRANSECTION/AVULSION FACIAL NRV DIFFERENT/CMPL

Professional

Both

$2,048.03

Service Code	HCPCS 64742
Min. Negotiated Rate	$1,536.02
Max. Negotiated Rate	$1,536.02
Rate for Payer: Cash Price	$564.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,536.02
Rate for Payer: SOMOS Essential	$1,536.02

PR TRANSECTION/AVULSION GREATER OCCIPITAL NERVE

Professional

Both

$2,404.89

Service Code	HCPCS 64744
Min. Negotiated Rate	$1,803.67
Max. Negotiated Rate	$1,803.67
Rate for Payer: Cash Price	$641.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,803.67
Rate for Payer: SOMOS Essential	$1,803.67

PR TRANSECTION/AVULSION INF ALVEOLAR NRV W/OSTEO

Professional

Both

$1,903.06

Service Code	HCPCS 64738
Min. Negotiated Rate	$1,427.30
Max. Negotiated Rate	$1,427.30
Rate for Payer: Cash Price	$517.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,427.30
Rate for Payer: SOMOS Essential	$1,427.30

PR TRANSECTION/AVULSION INFRAORBITAL NERVE

Professional

Both

$2,431.87

Service Code	HCPCS 64734
Min. Negotiated Rate	$1,823.90
Max. Negotiated Rate	$1,823.90
Rate for Payer: Cash Price	$649.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,823.90
Rate for Payer: SOMOS Essential	$1,823.90

PR TRANSECTION/AVULSION LINGUAL NERVE

Professional

Both

$1,950.34

Service Code	HCPCS 64740
Min. Negotiated Rate	$1,462.76
Max. Negotiated Rate	$1,462.76
Rate for Payer: Cash Price	$528.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,462.76
Rate for Payer: SOMOS Essential	$1,462.76

PR TRANSECTION/AVULSION MENTAL NERVE

Professional

Both

$1,389.85

Service Code	HCPCS 64736
Min. Negotiated Rate	$1,042.39
Max. Negotiated Rate	$1,042.39
Rate for Payer: Cash Price	$380.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,042.39
Rate for Payer: SOMOS Essential	$1,042.39

PR TRANSECTION/AVULSION OTH CRANIAL NRV XDRL

Professional

Both

$2,528.09

Service Code	HCPCS 64771
Min. Negotiated Rate	$1,896.07
Max. Negotiated Rate	$1,896.07
Rate for Payer: Cash Price	$688.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,896.07
Rate for Payer: SOMOS Essential	$1,896.07

PR TRANSECTION/AVULSION OTH SPINAL NRV XDRL

Professional

Both

$2,477.13

Service Code	HCPCS 64772
Min. Negotiated Rate	$1,857.85
Max. Negotiated Rate	$1,857.85
Rate for Payer: Cash Price	$665.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,857.85
Rate for Payer: SOMOS Essential	$1,857.85

PR TRANSECTION/AVULSION PHRENIC NERVE

Professional

Both

$1,932.60

Service Code	HCPCS 64746
Min. Negotiated Rate	$1,449.45
Max. Negotiated Rate	$1,449.45
Rate for Payer: Cash Price	$518.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,449.45
Rate for Payer: SOMOS Essential	$1,449.45

PR TRANSECTION/AVULSION SUPRAORBITAL NERVE

Professional

Both

$2,147.67

Service Code	HCPCS 64732
Min. Negotiated Rate	$1,610.75
Max. Negotiated Rate	$1,610.75
Rate for Payer: Cash Price	$575.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,610.75
Rate for Payer: SOMOS Essential	$1,610.75

PR TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL

Professional

Both

$2,360.05

Service Code	HCPCS 64760
Min. Negotiated Rate	$1,770.04
Max. Negotiated Rate	$1,770.04
Rate for Payer: Cash Price	$631.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,770.04
Rate for Payer: SOMOS Essential	$1,770.04

PR TRANSECTION/AVULSION VAGUS NERVES

Professional

Both

$4,174.21

Service Code	HCPCS 64755
Min. Negotiated Rate	$3,130.66
Max. Negotiated Rate	$3,130.66
Rate for Payer: Cash Price	$1,112.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,130.66
Rate for Payer: SOMOS Essential	$3,130.66

PR TRANSECTION PULMONARY ARTERY W/CARD BYPASS

Professional

Both

$6,187.09

Service Code	HCPCS 33922
Min. Negotiated Rate	$4,640.32
Max. Negotiated Rate	$4,640.32
Rate for Payer: Cash Price	$1,649.53
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,640.32
Rate for Payer: SOMOS Essential	$4,640.32

PR TRANSESOPH DOPPL CARDIAC MON

Professional

Both

$382.31

Service Code	HCPCS G9157
Min. Negotiated Rate	$286.73
Max. Negotiated Rate	$286.73
Rate for Payer: Cash Price	$103.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$286.73
Rate for Payer: SOMOS Essential	$286.73

PR TRANSFER ADDUCTOR ISCHIUM

Professional

Both

$3,090.47

Service Code	HCPCS 27098
Min. Negotiated Rate	$2,317.85
Max. Negotiated Rate	$2,317.85
Rate for Payer: Cash Price	$835.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,317.85
Rate for Payer: SOMOS Essential	$2,317.85

PR TRANSFER ANY PEDICLE FLAP ANY LOCATION

Professional

Both

$1,757.18

Service Code	HCPCS 15650
Min. Negotiated Rate	$1,317.88
Max. Negotiated Rate	$1,317.88
Rate for Payer: Cash Price	$479.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,317.88
Rate for Payer: SOMOS Essential	$1,317.88

PR TRANSFER FREE TOE JOINT W/MVASC ANASTOMOSIS

Professional

Both

$15,022.00

Service Code	HCPCS 26556
Min. Negotiated Rate	$11,266.50
Max. Negotiated Rate	$11,266.50
Rate for Payer: Cash Price	$4,033.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$11,266.50
Rate for Payer: SOMOS Essential	$11,266.50

PR TRANSFER ILIOPSOAS FEMORAL NECK

Professional

Both

$3,999.70

Service Code	HCPCS 27111
Min. Negotiated Rate	$2,999.78
Max. Negotiated Rate	$2,999.78
Rate for Payer: Cash Price	$1,081.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,999.78
Rate for Payer: SOMOS Essential	$2,999.78

PR TRANSFER ILIOPSOAS GREATER TROCHANTER FEMUR

Professional

Both

$4,298.14

Service Code	HCPCS 27110
Min. Negotiated Rate	$3,223.60
Max. Negotiated Rate	$3,223.60
Rate for Payer: Cash Price	$1,159.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,223.60
Rate for Payer: SOMOS Essential	$3,223.60

PR TRANSFER TENDON/MUSCLE HAMSTRINGS FEMUR

Professional

Both

$3,091.73

Service Code	HCPCS 27400
Min. Negotiated Rate	$2,318.80
Max. Negotiated Rate	$2,318.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,318.80
Rate for Payer: SOMOS Essential	$2,318.80

PR TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH

Professional

Both

$4,289.32

Service Code	HCPCS 26489
Min. Negotiated Rate	$3,216.99
Max. Negotiated Rate	$3,216.99
Rate for Payer: Cash Price	$1,153.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,216.99
Rate for Payer: SOMOS Essential	$3,216.99

PR TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH

Professional

Both

$3,697.89

Service Code	HCPCS 26485
Min. Negotiated Rate	$2,773.42
Max. Negotiated Rate	$2,773.42
Rate for Payer: Cash Price	$998.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,773.42
Rate for Payer: SOMOS Essential	$2,773.42

Know your out-of-pocket cost for care.

All Charges