St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG

Professional

Both

$1,230.15

Service Code	HCPCS 63082
Min. Negotiated Rate	$922.61
Max. Negotiated Rate	$922.61
Rate for Payer: Cash Price	$327.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$922.61
Rate for Payer: SOMOS Essential	$922.61

PR VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG

Professional

Both

$8,967.53

Service Code	HCPCS 63085
Min. Negotiated Rate	$6,725.65
Max. Negotiated Rate	$6,725.65
Rate for Payer: Cash Price	$2,410.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,725.65
Rate for Payer: SOMOS Essential	$6,725.65

PR VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG

Professional

Both

$869.79

Service Code	HCPCS 63086
Min. Negotiated Rate	$652.34
Max. Negotiated Rate	$652.34
Rate for Payer: Cash Price	$235.49
Rate for Payer: SOMOS CHP/HARP/Medicaid	$652.34
Rate for Payer: SOMOS Essential	$652.34

PR VERTEBRAL CORPECTOMY EXC INDRL LES EACH SEG

Professional

Both

$1,502.87

Service Code	HCPCS 63308
Min. Negotiated Rate	$1,127.15
Max. Negotiated Rate	$1,127.15
Rate for Payer: Cash Price	$397.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,127.15
Rate for Payer: SOMOS Essential	$1,127.15

PR VERTEBRAL CORPECTOMY EXC LES 1 SEG IDRL CERVICAL

Professional

Both

$11,347.67

Service Code	HCPCS 63304
Min. Negotiated Rate	$8,510.75
Max. Negotiated Rate	$8,510.75
Rate for Payer: Cash Price	$2,988.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,510.75
Rate for Payer: SOMOS Essential	$8,510.75

PR VERTEBRAL CORPECTOMY LES 1 SEG IDRL THRC TTHRC

Professional

Both

$12,077.73

Service Code	HCPCS 63305
Min. Negotiated Rate	$9,058.30
Max. Negotiated Rate	$9,058.30
Rate for Payer: Cash Price	$3,180.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,058.30
Rate for Payer: SOMOS Essential	$9,058.30

PR VERTEBRL CORPECT LES 1 SEG IDRL THRC THORACOLMBR

Professional

Both

$11,870.01

Service Code	HCPCS 63306
Min. Negotiated Rate	$8,902.51
Max. Negotiated Rate	$8,902.51
Rate for Payer: Cash Price	$3,124.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,902.51
Rate for Payer: SOMOS Essential	$8,902.51

PR VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL

Professional

Both

$891.31

Service Code	HCPCS 22512
Min. Negotiated Rate	$668.48
Max. Negotiated Rate	$668.48
Rate for Payer: Cash Price	$239.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$668.48
Rate for Payer: SOMOS Essential	$668.48

PR VESICULECTOMY ANY APPROACH

Professional

Both

$3,013.71

Service Code	HCPCS 55650
Min. Negotiated Rate	$2,260.28
Max. Negotiated Rate	$2,260.28
Rate for Payer: Cash Price	$824.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,260.28
Rate for Payer: SOMOS Essential	$2,260.28

PR VESICULOTOMY

Professional

Both

$1,776.39

Service Code	HCPCS 55600
Min. Negotiated Rate	$1,332.29
Max. Negotiated Rate	$1,332.29
Rate for Payer: Cash Price	$488.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,332.29
Rate for Payer: SOMOS Essential	$1,332.29

PR VESICULOTOMY COMPLICATED

Professional

Both

$2,208.01

Service Code	HCPCS 55605
Min. Negotiated Rate	$1,656.01
Max. Negotiated Rate	$1,656.01
Rate for Payer: Cash Price	$605.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,656.01
Rate for Payer: SOMOS Essential	$1,656.01

PR VESTIBULAR NRV SECTION TRANSCRANIAL APPROACH

Professional

Both

$7,528.64

Service Code	HCPCS 69950
Min. Negotiated Rate	$5,646.48
Max. Negotiated Rate	$5,646.48
Rate for Payer: Cash Price	$2,030.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,646.48
Rate for Payer: SOMOS Essential	$5,646.48

PR VESTIBULAR NRV SECTION TRANSLABYRINTHINE APPR

Professional

Both

$6,494.08

Service Code	HCPCS 69915
Min. Negotiated Rate	$4,870.56
Max. Negotiated Rate	$4,870.56
Rate for Payer: Cash Price	$1,751.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,870.56
Rate for Payer: SOMOS Essential	$4,870.56

PR VESTIBULOPLASTY ANTERIOR

Professional

Both

$2,743.90

Service Code	HCPCS 40840
Min. Negotiated Rate	$2,057.92
Max. Negotiated Rate	$2,057.92
Rate for Payer: Cash Price	$741.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,057.92
Rate for Payer: SOMOS Essential	$2,057.92

PR VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG

Professional

Both

$5,187.42

Service Code	HCPCS 40845
Min. Negotiated Rate	$3,890.56
Max. Negotiated Rate	$3,890.56
Rate for Payer: Cash Price	$1,401.80
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,890.56
Rate for Payer: SOMOS Essential	$3,890.56

PR VESTIBULOPLASTY ENTIRE ARCH

Professional

Both

$5,149.83

Service Code	HCPCS 40844
Min. Negotiated Rate	$3,862.37
Max. Negotiated Rate	$3,862.37
Rate for Payer: Cash Price	$1,389.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,862.37
Rate for Payer: SOMOS Essential	$3,862.37

PR VESTIBULOPLASTY POSTERIOR BILATERAL

Professional

Both

$3,808.18

Service Code	HCPCS 40843
Min. Negotiated Rate	$2,856.14
Max. Negotiated Rate	$2,856.14
Rate for Payer: Cash Price	$1,026.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,856.14
Rate for Payer: SOMOS Essential	$2,856.14

PR VESTIBULOPLASTY POSTERIOR UNILATERAL

Professional

Both

$2,965.97

Service Code	HCPCS 40842
Min. Negotiated Rate	$2,224.48
Max. Negotiated Rate	$2,224.48
Rate for Payer: Cash Price	$801.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,224.48
Rate for Payer: SOMOS Essential	$2,224.48

PR VGTMY W/PYLOROPLASTY W/WO GASTROST PARIETAL CELL

Professional

Both

$5,456.78

Service Code	HCPCS 43641
Min. Negotiated Rate	$4,092.58
Max. Negotiated Rate	$4,092.58
Rate for Payer: Cash Price	$1,454.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,092.58
Rate for Payer: SOMOS Essential	$4,092.58

PR VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV

Professional

Both

$5,396.13

Service Code	HCPCS 43640
Min. Negotiated Rate	$4,047.10
Max. Negotiated Rate	$4,047.10
Rate for Payer: Cash Price	$1,437.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,047.10
Rate for Payer: SOMOS Essential	$4,047.10

PR VISCER AND INFRARENAL ABDOM AORTA 1 PROSTHESIS

Professional

Both

$9,396.56

Service Code	HCPCS 34845
Min. Negotiated Rate	$7,047.42
Max. Negotiated Rate	$7,047.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$7,047.42
Rate for Payer: SOMOS Essential	$7,047.42

PR VISCER AND INFRARENAL ABDOM AORTA 2 PROSTHESIS

Professional

Both

$10,720.64

Service Code	HCPCS 34846
Min. Negotiated Rate	$8,040.48
Max. Negotiated Rate	$8,040.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$8,040.48
Rate for Payer: SOMOS Essential	$8,040.48

PR VISCER AND INFRARENAL ABDOM AORTA 3 PROSTHESIS

Professional

Both

$12,048.47

Service Code	HCPCS 34847
Min. Negotiated Rate	$9,036.35
Max. Negotiated Rate	$9,036.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9,036.35
Rate for Payer: SOMOS Essential	$9,036.35

PR VISCER AND INFRARENAL ABDOM AORTA 4+ PROSTHESIS

Professional

Both

$13,376.34

Service Code	HCPCS 34848
Min. Negotiated Rate	$10,032.26
Max. Negotiated Rate	$10,032.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$10,032.26
Rate for Payer: SOMOS Essential	$10,032.26

PR VISIT ESKETAMINE, > 56M

Professional

Both

$145.64

Service Code	HCPCS G2083
Min. Negotiated Rate	$109.23
Max. Negotiated Rate	$109.23
Rate for Payer: Cash Price	$40.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$109.23
Rate for Payer: SOMOS Essential	$109.23

Know your out-of-pocket cost for care.

All Charges