St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR TTVR PERCUTANEOUS APPROACH EACH ADDL PROSTHESIS

Professional

Both

$2,049.53

Service Code	HCPCS 0570T
Min. Negotiated Rate	$1,537.15
Max. Negotiated Rate	$1,537.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,537.15
Rate for Payer: SOMOS Essential	$1,537.15

PR TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD

Professional

Both

$641.13

Service Code	HCPCS 44015
Min. Negotiated Rate	$480.85
Max. Negotiated Rate	$480.85
Rate for Payer: Cash Price	$167.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$480.85
Rate for Payer: SOMOS Essential	$480.85

PR TUBE THORACOSTOMY INCLUDES WATER SEAL

Professional

Both

$670.95

Service Code	HCPCS 32551
Min. Negotiated Rate	$503.21
Max. Negotiated Rate	$503.21
Rate for Payer: Cash Price	$179.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$503.21
Rate for Payer: SOMOS Essential	$503.21

PR TUBOTUBAL ANASTATOMOSIS

Professional

Both

$3,967.46

Service Code	HCPCS 58750
Min. Negotiated Rate	$2,975.60
Max. Negotiated Rate	$2,975.60
Rate for Payer: Cash Price	$1,069.97
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,975.60
Rate for Payer: SOMOS Essential	$2,975.60

PR TUBOUTERINE IMPLANTATION

Professional

Both

$3,957.38

Service Code	HCPCS 58752
Min. Negotiated Rate	$2,968.04
Max. Negotiated Rate	$2,968.04
Rate for Payer: Cash Price	$1,067.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,968.04
Rate for Payer: SOMOS Essential	$2,968.04

PR TWIST/BURR HOLE IMPLTJ NSTIM ELTRD CORTICAL

Professional

Both

$4,751.29

Service Code	HCPCS 61850
Min. Negotiated Rate	$3,563.47
Max. Negotiated Rate	$3,563.47
Rate for Payer: Cash Price	$1,257.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,563.47
Rate for Payer: SOMOS Essential	$3,563.47

PR TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA

Professional

Both

$4,324.36

Service Code	HCPCS 61108
Min. Negotiated Rate	$3,243.27
Max. Negotiated Rate	$3,243.27
Rate for Payer: Cash Price	$1,146.33
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,243.27
Rate for Payer: SOMOS Essential	$3,243.27

PR TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE

Professional

Both

$1,507.59

Service Code	HCPCS 61107
Min. Negotiated Rate	$1,130.69
Max. Negotiated Rate	$1,130.69
Rate for Payer: Cash Price	$395.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,130.69
Rate for Payer: SOMOS Essential	$1,130.69

PR TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE

Professional

Both

$2,218.51

Service Code	HCPCS 61105
Min. Negotiated Rate	$1,663.88
Max. Negotiated Rate	$1,663.88
Rate for Payer: Cash Price	$589.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,663.88
Rate for Payer: SOMOS Essential	$1,663.88

PR TX ADDUXOR SUBQ OPN W/OBTURATOR NEURECTOMY

Professional

Both

$2,664.13

Service Code	HCPCS 27003
Min. Negotiated Rate	$1,998.10
Max. Negotiated Rate	$1,998.10
Rate for Payer: Cash Price	$722.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,998.10
Rate for Payer: SOMOS Essential	$1,998.10

PR TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON

Professional

Both

$2,103.12

Service Code	HCPCS 46280
Min. Negotiated Rate	$1,577.34
Max. Negotiated Rate	$1,577.34
Rate for Payer: Cash Price	$568.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,577.34
Rate for Payer: SOMOS Essential	$1,577.34

PR TX ECTOPIC PREGNANCY ABDL PREGNANCY

Professional

Both

$4,416.51

Service Code	HCPCS 59130
Min. Negotiated Rate	$3,312.38
Max. Negotiated Rate	$3,312.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,312.38
Rate for Payer: SOMOS Essential	$3,312.38

PR TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR

Professional

Both

$3,795.61

Service Code	HCPCS 59120
Min. Negotiated Rate	$2,846.71
Max. Negotiated Rate	$2,846.71
Rate for Payer: Cash Price	$1,007.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,846.71
Rate for Payer: SOMOS Essential	$2,846.71

PR TX ECTOPIC PREGNANCY CERVICAL W/EVACUATION

Professional

Both

$1,931.37

Service Code	HCPCS 59140
Min. Negotiated Rate	$1,448.53
Max. Negotiated Rate	$1,448.53
Rate for Payer: Cash Price	$514.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,448.53
Rate for Payer: SOMOS Essential	$1,448.53

PR TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER

Professional

Both

$4,185.34

Service Code	HCPCS 59136
Min. Negotiated Rate	$3,139.00
Max. Negotiated Rate	$3,139.00
Rate for Payer: Cash Price	$1,109.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,139.00
Rate for Payer: SOMOS Essential	$3,139.00

PR TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY

Professional

Both

$3,794.32

Service Code	HCPCS 59121
Min. Negotiated Rate	$2,845.74
Max. Negotiated Rate	$2,845.74
Rate for Payer: Cash Price	$1,007.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,845.74
Rate for Payer: SOMOS Essential	$2,845.74

PR TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE

Professional

Both

$3,804.68

Service Code	HCPCS 24516
Min. Negotiated Rate	$2,853.51
Max. Negotiated Rate	$2,853.51
Rate for Payer: Cash Price	$1,026.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,853.51
Rate for Payer: SOMOS Essential	$2,853.51

PR TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL

Professional

Both

$1,419.25

Service Code	HCPCS 59812
Min. Negotiated Rate	$1,064.44
Max. Negotiated Rate	$1,064.44
Rate for Payer: Cash Price	$379.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,064.44
Rate for Payer: SOMOS Essential	$1,064.44

PR TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW

Professional

Both

$5,405.33

Service Code	HCPCS 27245
Min. Negotiated Rate	$4,054.00
Max. Negotiated Rate	$4,054.00
Rate for Payer: Cash Price	$1,457.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,054.00
Rate for Payer: SOMOS Essential	$4,054.00

PR TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT

Professional

Both

$5,414.99

Service Code	HCPCS 27244
Min. Negotiated Rate	$4,061.24
Max. Negotiated Rate	$4,061.24
Rate for Payer: Cash Price	$1,460.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,061.24
Rate for Payer: SOMOS Essential	$4,061.24

PR TX MISSED ABORTION FIRST TRIMESTER SURGICAL

Professional

Both

$1,775.03

Service Code	HCPCS 59820
Min. Negotiated Rate	$1,331.27
Max. Negotiated Rate	$1,331.27
Rate for Payer: Cash Price	$475.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,331.27
Rate for Payer: SOMOS Essential	$1,331.27

PR TX MISSED ABORTION SECOND TRIMESTER SURGICAL

Professional

Both

$1,744.72

Service Code	HCPCS 59821
Min. Negotiated Rate	$1,308.54
Max. Negotiated Rate	$1,308.54
Rate for Payer: Cash Price	$465.69
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,308.54
Rate for Payer: SOMOS Essential	$1,308.54

PR TX OPEN TENDON FLEXOR TOE 1 TENDON SPX

Professional

Both

$1,003.28

Service Code	HCPCS 28232
Min. Negotiated Rate	$752.46
Max. Negotiated Rate	$752.46
Rate for Payer: Cash Price	$279.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$752.46
Rate for Payer: SOMOS Essential	$752.46

PR TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX

Professional

Both

$1,195.74

Service Code	HCPCS 28230
Min. Negotiated Rate	$896.80
Max. Negotiated Rate	$896.80
Rate for Payer: Cash Price	$329.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$896.80
Rate for Payer: SOMOS Essential	$896.80

PR TX SEPTIC ABORTION SURGICAL

Professional

Both

$2,150.72

Service Code	HCPCS 59830
Min. Negotiated Rate	$1,613.04
Max. Negotiated Rate	$1,613.04
Rate for Payer: Cash Price	$572.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,613.04
Rate for Payer: SOMOS Essential	$1,613.04

Know your out-of-pocket cost for care.

All Charges