St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR VAGINAL DELIVERY ONLY W/POSTPARTUM CARE

Professional

Both

$4,864.86

Service Code	HCPCS 59410
Min. Negotiated Rate	$3,648.64
Max. Negotiated Rate	$3,648.64
Rate for Payer: Cash Price	$1,314.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,648.64
Rate for Payer: SOMOS Essential	$3,648.64

PR VAGINAL DELIVERY & POSTPARTUM CARE VBAC

Professional

Both

$5,338.69

Service Code	HCPCS 59614
Min. Negotiated Rate	$4,004.02
Max. Negotiated Rate	$4,004.02
Rate for Payer: Cash Price	$1,436.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,004.02
Rate for Payer: SOMOS Essential	$4,004.02

PR VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE

Professional

Both

$5,314.65

Service Code	HCPCS 58294
Min. Negotiated Rate	$3,985.99
Max. Negotiated Rate	$3,985.99
Rate for Payer: Cash Price	$1,428.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,985.99
Rate for Payer: SOMOS Essential	$3,985.99

PR VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE

Professional

Both

$3,905.58

Service Code	HCPCS 58270
Min. Negotiated Rate	$2,929.18
Max. Negotiated Rate	$2,929.18
Rate for Payer: Cash Price	$1,050.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,929.18
Rate for Payer: SOMOS Essential	$2,929.18

PR VAGINAL HYSTERECTOMY RADICAL SCHAUTA OPERATION

Professional

Both

$6,179.39

Service Code	HCPCS 58285
Min. Negotiated Rate	$4,634.54
Max. Negotiated Rate	$4,634.54
Rate for Payer: Cash Price	$1,674.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,634.54
Rate for Payer: SOMOS Essential	$4,634.54

PR VAGINAL HYSTERECTOMY UTERUS > 250 GM

Professional

Both

$5,023.69

Service Code	HCPCS 58290
Min. Negotiated Rate	$3,767.77
Max. Negotiated Rate	$3,767.77
Rate for Payer: Cash Price	$1,351.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,767.77
Rate for Payer: SOMOS Essential	$3,767.77

PR VAGINAL HYSTERECTOMY UTERUS 250 GM/<

Professional

Both

$3,661.98

Service Code	HCPCS 58260
Min. Negotiated Rate	$2,746.48
Max. Negotiated Rate	$2,746.48
Rate for Payer: Cash Price	$987.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,746.48
Rate for Payer: SOMOS Essential	$2,746.48

PR VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY

Professional

Both

$4,297.86

Service Code	HCPCS 58275
Min. Negotiated Rate	$3,223.40
Max. Negotiated Rate	$3,223.40
Rate for Payer: Cash Price	$1,162.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,223.40
Rate for Payer: SOMOS Essential	$3,223.40

PR VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL

Professional

Both

$3,934.14

Service Code	HCPCS 57110
Min. Negotiated Rate	$2,950.60
Max. Negotiated Rate	$2,950.60
Rate for Payer: Cash Price	$1,060.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,950.60
Rate for Payer: SOMOS Essential	$2,950.60

PR VAGINECTOMY COMPL RMVL VAG WALL & PARAVAG TISS

Professional

Both

$7,512.89

Service Code	HCPCS 57111
Min. Negotiated Rate	$5,634.67
Max. Negotiated Rate	$5,634.67
Rate for Payer: Cash Price	$2,039.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,634.67
Rate for Payer: SOMOS Essential	$5,634.67

PR VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL

Professional

Both

$2,337.20

Service Code	HCPCS 57106
Min. Negotiated Rate	$1,752.90
Max. Negotiated Rate	$1,752.90
Rate for Payer: Cash Price	$635.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,752.90
Rate for Payer: SOMOS Essential	$1,752.90

PR VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T

Professional

Both

$6,316.70

Service Code	HCPCS 57107
Min. Negotiated Rate	$4,737.52
Max. Negotiated Rate	$4,737.52
Rate for Payer: Cash Price	$1,712.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,737.52
Rate for Payer: SOMOS Essential	$4,737.52

PR VAGINOPLASTY INTERSEX STATE

Professional

Both

$5,139.72

Service Code	HCPCS 57335
Min. Negotiated Rate	$3,854.79
Max. Negotiated Rate	$3,854.79
Rate for Payer: Cash Price	$1,384.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,854.79
Rate for Payer: SOMOS Essential	$3,854.79

PR VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC

Professional

Both

$7,512.89

Service Code	HCPCS 57109
Min. Negotiated Rate	$5,634.67
Max. Negotiated Rate	$5,634.67
Rate for Payer: Cash Price	$2,039.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,634.67
Rate for Payer: SOMOS Essential	$5,634.67

PR VAGOTOMY PFRMD W/PRTL DSTL GSTRCT

Professional

Both

$508.24

Service Code	HCPCS 43635
Min. Negotiated Rate	$381.18
Max. Negotiated Rate	$381.18
Rate for Payer: Cash Price	$134.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$381.18
Rate for Payer: SOMOS Essential	$381.18

PR VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP

Professional

Both

$10,556.32

Service Code	HCPCS 33460
Min. Negotiated Rate	$7,917.24
Max. Negotiated Rate	$7,917.24
Rate for Payer: Cash Price	$2,801.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,917.24
Rate for Payer: SOMOS Essential	$7,917.24

PR VALVOTOMY MITRAL VALVE CLOSED HEART

Professional

Both

$6,391.04

Service Code	HCPCS 33420
Min. Negotiated Rate	$4,793.28
Max. Negotiated Rate	$4,793.28
Rate for Payer: Cash Price	$1,700.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,793.28
Rate for Payer: SOMOS Essential	$4,793.28

PR VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS

Professional

Both

$7,329.28

Service Code	HCPCS 33422
Min. Negotiated Rate	$5,496.96
Max. Negotiated Rate	$5,496.96
Rate for Payer: Cash Price	$1,947.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,496.96
Rate for Payer: SOMOS Essential	$5,496.96

PR VALVOTOMY PULMONARY VALVE OPEN HEART W/BYPASS

Professional

Both

$9,700.46

Service Code	HCPCS 33474
Min. Negotiated Rate	$7,275.34
Max. Negotiated Rate	$7,275.34
Rate for Payer: Cash Price	$2,576.46
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,275.34
Rate for Payer: SOMOS Essential	$7,275.34

PR VALVOTOMY PULM VALVE CLSD HEART VIA PULM ARTERY

Professional

Both

$5,902.33

Service Code	HCPCS 33471
Min. Negotiated Rate	$4,426.75
Max. Negotiated Rate	$4,426.75
Rate for Payer: Cash Price	$1,571.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,426.75
Rate for Payer: SOMOS Essential	$4,426.75

PR VALVULOPLASTY AORTIC VALVE OPEN CARD BYP COMPLEX

Professional

Both

$10,090.57

Service Code	HCPCS 33391
Min. Negotiated Rate	$7,567.93
Max. Negotiated Rate	$7,567.93
Rate for Payer: Cash Price	$2,675.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,567.93
Rate for Payer: SOMOS Essential	$7,567.93

PR VALVULOPLASTY AORTIC VALVE OPEN CARD BYP SIMPLE

Professional

Both

$8,519.18

Service Code	HCPCS 33390
Min. Negotiated Rate	$6,389.38
Max. Negotiated Rate	$6,389.38
Rate for Payer: Cash Price	$2,256.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,389.38
Rate for Payer: SOMOS Essential	$6,389.38

PR VALVULOPLASTY FEMORAL VEIN

Professional

Both

$3,972.99

Service Code	HCPCS 34501
Min. Negotiated Rate	$2,979.74
Max. Negotiated Rate	$2,979.74
Rate for Payer: Cash Price	$1,057.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,979.74
Rate for Payer: SOMOS Essential	$2,979.74

PR VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS

Professional

Both

$12,085.29

Service Code	HCPCS 33425
Min. Negotiated Rate	$9,063.97
Max. Negotiated Rate	$9,063.97
Rate for Payer: Cash Price	$3,210.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,063.97
Rate for Payer: SOMOS Essential	$9,063.97

PR VALVULOPLASTY TRICUSPID VALVE W/O RING INSERTION

Professional

Both

$13,455.02

Service Code	HCPCS 33463
Min. Negotiated Rate	$10,091.26
Max. Negotiated Rate	$10,091.26
Rate for Payer: Cash Price	$3,601.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,091.26
Rate for Payer: SOMOS Essential	$10,091.26

Know your out-of-pocket cost for care.

All Charges