St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I

Professional

Both

$614.01

Service Code	HCPCS 36907
Min. Negotiated Rate	$460.51
Max. Negotiated Rate	$460.51
Rate for Payer: Cash Price	$164.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$460.51
Rate for Payer: SOMOS Essential	$460.51

PR TRLUML DILAT AQUEOUS O/F CAN WO RETENTION DEV/ST

Professional

Both

$2,573.59

Service Code	HCPCS 66174
Min. Negotiated Rate	$1,930.19
Max. Negotiated Rate	$1,930.19
Rate for Payer: Cash Price	$709.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,930.19
Rate for Payer: SOMOS Essential	$1,930.19

PR TRLUML DILAT AQUEOUS O/F CAN W/RETENTION DEV/ST

Professional

Both

$2,985.43

Service Code	HCPCS 66175
Min. Negotiated Rate	$2,239.07
Max. Negotiated Rate	$2,239.07
Rate for Payer: Cash Price	$823.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,239.07
Rate for Payer: SOMOS Essential	$2,239.07

PR TRLUML PERIPH ATHRC W/RS&I ABDOM AORTA

Professional

Both

$51,140.60

Service Code	HCPCS 0236T
Min. Negotiated Rate	$38,355.45
Max. Negotiated Rate	$38,355.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$38,355.45
Rate for Payer: SOMOS Essential	$38,355.45

PR TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL

Professional

Both

$51,140.60

Service Code	HCPCS 0237T
Min. Negotiated Rate	$38,355.45
Max. Negotiated Rate	$38,355.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$38,355.45
Rate for Payer: SOMOS Essential	$38,355.45

PR TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA

Professional

Both

$51,140.60

Service Code	HCPCS 0238T
Min. Negotiated Rate	$38,355.45
Max. Negotiated Rate	$38,355.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$38,355.45
Rate for Payer: SOMOS Essential	$38,355.45

PR TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL

Professional

Both

$14,077.77

Service Code	HCPCS 61597
Min. Negotiated Rate	$10,558.33
Max. Negotiated Rate	$10,558.33
Rate for Payer: Cash Price	$3,727.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,558.33
Rate for Payer: SOMOS Essential	$10,558.33

PR TRNSCUT ELECT MODLATION PAIN REPROCES EA TX SESS

Professional

Both

$62.76

Service Code	HCPCS 0278T
Min. Negotiated Rate	$47.07
Max. Negotiated Rate	$47.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$47.07
Rate for Payer: SOMOS Essential	$47.07

PR TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR

Professional

Both

$976.08

Service Code	HCPCS 38240
Min. Negotiated Rate	$732.06
Max. Negotiated Rate	$732.06
Rate for Payer: Cash Price	$269.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$732.06
Rate for Payer: SOMOS Essential	$732.06

PR TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR

Professional

Both

$719.53

Service Code	HCPCS 38241
Min. Negotiated Rate	$539.65
Max. Negotiated Rate	$539.65
Rate for Payer: Cash Price	$199.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$539.65
Rate for Payer: SOMOS Essential	$539.65

PR TRNSPLJ HEMATOPOIETIC CELL BOOST

Professional

Both

$499.14

Service Code	HCPCS 38243
Min. Negotiated Rate	$374.36
Max. Negotiated Rate	$374.36
Rate for Payer: Cash Price	$138.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$374.36
Rate for Payer: SOMOS Essential	$374.36

PR TRNSRAL SKULL BSE/BR STEM/CORD BX/DCOMPR/EXC LES

Professional

Both

$12,102.93

Service Code	HCPCS 61575
Min. Negotiated Rate	$9,077.20
Max. Negotiated Rate	$9,077.20
Rate for Payer: Cash Price	$3,183.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,077.20
Rate for Payer: SOMOS Essential	$9,077.20

PR TRNSRL SKUL BSE/BR STM/CORD BX/DCMP/ SPLT TONGUE

Professional

Both

$19,979.54

Service Code	HCPCS 61576
Min. Negotiated Rate	$14,984.66
Max. Negotiated Rate	$14,984.66
Rate for Payer: Cash Price	$5,262.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$14,984.66
Rate for Payer: SOMOS Essential	$14,984.66

PR TRNSXJ/AVLSN OBTURAT NRV INPELV W/WO TENOTOMY

Professional

Both

$2,880.92

Service Code	HCPCS 64766
Min. Negotiated Rate	$2,160.69
Max. Negotiated Rate	$2,160.69
Rate for Payer: Cash Price	$770.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,160.69
Rate for Payer: SOMOS Essential	$2,160.69

PR TRNSXJ/AVLSN OBTURAT NRV XPELV W/WO TENOTOMY

Professional

Both

$2,336.29

Service Code	HCPCS 64763
Min. Negotiated Rate	$1,752.22
Max. Negotiated Rate	$1,752.22
Rate for Payer: Cash Price	$624.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,752.22
Rate for Payer: SOMOS Essential	$1,752.22

PR TRNSXJ/LIG CAROTID ARTERY PETROUS CANAL W/O RPR

Professional

Both

$2,262.12

Service Code	HCPCS 61611
Min. Negotiated Rate	$1,696.59
Max. Negotiated Rate	$1,696.59
Rate for Payer: Cash Price	$590.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,696.59
Rate for Payer: SOMOS Essential	$1,696.59

PR TRNSXJ/REPOSITIONING ABERRANT RENAL VESSEL SPX

Professional

Both

$4,894.96

Service Code	HCPCS 50100
Min. Negotiated Rate	$3,671.22
Max. Negotiated Rate	$3,671.22
Rate for Payer: Cash Price	$1,305.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,671.22
Rate for Payer: SOMOS Essential	$3,671.22

PR TR PARASPI MUSC HIP FASC/TDN XTN GRF

Professional

Both

$3,857.77

Service Code	HCPCS 27105
Min. Negotiated Rate	$2,893.33
Max. Negotiated Rate	$2,893.33
Rate for Payer: Cash Price	$1,042.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,893.33
Rate for Payer: SOMOS Essential	$2,893.33

PR TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART

Professional

Both

$4,566.63

Service Code	HCPCS 35695
Min. Negotiated Rate	$3,424.97
Max. Negotiated Rate	$3,424.97
Rate for Payer: Cash Price	$1,209.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,424.97
Rate for Payer: SOMOS Essential	$3,424.97

PR TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART

Professional

Both

$4,396.95

Service Code	HCPCS 35694
Min. Negotiated Rate	$3,297.71
Max. Negotiated Rate	$3,297.71
Rate for Payer: Cash Price	$1,165.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,297.71
Rate for Payer: SOMOS Essential	$3,297.71

PR TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART

Professional

Both

$4,213.13

Service Code	HCPCS 35691
Min. Negotiated Rate	$3,159.85
Max. Negotiated Rate	$3,159.85
Rate for Payer: Cash Price	$1,115.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,159.85
Rate for Payer: SOMOS Essential	$3,159.85

PR TRPOS&/RIMPLTJ VERTEBRAL SUBCLAVIAN ART

Professional

Both

$3,712.98

Service Code	HCPCS 35693
Min. Negotiated Rate	$2,784.74
Max. Negotiated Rate	$2,784.74
Rate for Payer: Cash Price	$988.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,784.74
Rate for Payer: SOMOS Essential	$2,784.74

PR TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS

Professional

Both

$5,238.94

Service Code	HCPCS 26498
Min. Negotiated Rate	$3,929.20
Max. Negotiated Rate	$3,929.20
Rate for Payer: Cash Price	$1,407.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,929.20
Rate for Payer: SOMOS Essential	$3,929.20

PR TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR

Professional

Both

$4,031.27

Service Code	HCPCS 26497
Min. Negotiated Rate	$3,023.45
Max. Negotiated Rate	$3,023.45
Rate for Payer: Cash Price	$1,084.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,023.45
Rate for Payer: SOMOS Essential	$3,023.45

PR TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND

Professional

Both

$14,544.39

Service Code	HCPCS 26551
Min. Negotiated Rate	$10,908.29
Max. Negotiated Rate	$10,908.29
Rate for Payer: Cash Price	$3,903.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,908.29
Rate for Payer: SOMOS Essential	$10,908.29

Know your out-of-pocket cost for care.

All Charges