St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PR VTRECTOMY MCHNL PARS PLNA ENDOLASER PANRTA PC

Professional

Both

$4,245.71

Service Code	HCPCS 67040
Min. Negotiated Rate	$3,184.28
Max. Negotiated Rate	$3,184.28
Rate for Payer: Cash Price	$1,168.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,184.28
Rate for Payer: SOMOS Essential	$3,184.28

PR VULVECTOMY RAD COMPL BI INGUINOFEM LMPHADECTOMY

Professional

Both

$6,588.26

Service Code	HCPCS 56637
Min. Negotiated Rate	$4,941.20
Max. Negotiated Rate	$4,941.20
Rate for Payer: Cash Price	$1,790.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,941.20
Rate for Payer: SOMOS Essential	$4,941.20

PR VULVECTOMY RAD COMPL ILIAC & PELVIC LMPHADECTOMY

Professional

Both

$6,627.95

Service Code	HCPCS 56640
Min. Negotiated Rate	$4,970.96
Max. Negotiated Rate	$4,970.96
Rate for Payer: Cash Price	$1,799.81
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,970.96
Rate for Payer: SOMOS Essential	$4,970.96

PR VULVECTOMY RAD COMPL UNI INGUINOFEM LMPHADECTOMY

Professional

Both

$5,625.31

Service Code	HCPCS 56634
Min. Negotiated Rate	$4,218.98
Max. Negotiated Rate	$4,218.98
Rate for Payer: Cash Price	$1,529.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,218.98
Rate for Payer: SOMOS Essential	$4,218.98

PR VULVECTOMY RADICAL COMPLETE

Professional

Both

$5,360.95

Service Code	HCPCS 56633
Min. Negotiated Rate	$4,020.71
Max. Negotiated Rate	$4,020.71
Rate for Payer: Cash Price	$1,462.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,020.71
Rate for Payer: SOMOS Essential	$4,020.71

PR VULVECTOMY RADICAL PARTIAL

Professional

Both

$4,187.23

Service Code	HCPCS 56630
Min. Negotiated Rate	$3,140.42
Max. Negotiated Rate	$3,140.42
Rate for Payer: Cash Price	$1,135.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,140.42
Rate for Payer: SOMOS Essential	$3,140.42

PR VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADECTOMY

Professional

Both

$6,247.05

Service Code	HCPCS 56632
Min. Negotiated Rate	$4,685.29
Max. Negotiated Rate	$4,685.29
Rate for Payer: Cash Price	$1,694.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,685.29
Rate for Payer: SOMOS Essential	$4,685.29

PR VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADECTOMY

Professional

Both

$5,155.64

Service Code	HCPCS 56631
Min. Negotiated Rate	$3,866.73
Max. Negotiated Rate	$3,866.73
Rate for Payer: Cash Price	$1,400.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,866.73
Rate for Payer: SOMOS Essential	$3,866.73

PR VULVECTOMY SIMPLE COMPLETE

Professional

Both

$2,905.67

Service Code	HCPCS 56625
Min. Negotiated Rate	$2,179.25
Max. Negotiated Rate	$2,179.25
Rate for Payer: Cash Price	$791.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,179.25
Rate for Payer: SOMOS Essential	$2,179.25

PR VULVECTOMY SIMPLE PARTIAL

Professional

Both

$2,560.18

Service Code	HCPCS 56620
Min. Negotiated Rate	$1,920.14
Max. Negotiated Rate	$1,920.14
Rate for Payer: Cash Price	$696.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,920.14
Rate for Payer: SOMOS Essential	$1,920.14

PR WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG

Professional

Both

$2,834.48

Service Code	HCPCS 95958
Min. Negotiated Rate	$2,125.86
Max. Negotiated Rate	$2,125.86
Rate for Payer: Cash Price	$813.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,125.86
Rate for Payer: SOMOS Essential	$2,125.86

PR WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG

Professional

Both

$887.78

Service Code	HCPCS 95958 26
Min. Negotiated Rate	$665.84
Max. Negotiated Rate	$665.84
Rate for Payer: Cash Price	$244.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$665.84
Rate for Payer: SOMOS Essential	$665.84

PR WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG

Professional

Both

$1,946.70

Service Code	HCPCS 95958 TC
Min. Negotiated Rate	$1,460.02
Max. Negotiated Rate	$1,460.02
Rate for Payer: Cash Price	$569.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,460.02
Rate for Payer: SOMOS Essential	$1,460.02

PR WEDGE EXCISION SKIN NAIL FOLD

Professional

Both

$384.30

Service Code	HCPCS 11765
Min. Negotiated Rate	$288.22
Max. Negotiated Rate	$288.22
Rate for Payer: Cash Price	$106.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$288.22
Rate for Payer: SOMOS Essential	$288.22

PR WEDGE RESCJ/BISCTJ OVARY UNI/BI

Professional

Both

$3,123.93

Service Code	HCPCS 58920
Min. Negotiated Rate	$2,342.95
Max. Negotiated Rate	$2,342.95
Rate for Payer: Cash Price	$841.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,342.95
Rate for Payer: SOMOS Essential	$2,342.95

PR WEDGING CAST EXCEPT CLUBFOOT CASTS

Professional

Both

$302.54

Service Code	HCPCS 29740
Min. Negotiated Rate	$226.90
Max. Negotiated Rate	$226.90
Rate for Payer: Cash Price	$81.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$226.90
Rate for Payer: SOMOS Essential	$226.90

PR WEDGING CLUBFOOT CAST

Professional

Both

$338.35

Service Code	HCPCS 29750
Min. Negotiated Rate	$253.76
Max. Negotiated Rate	$253.76
Rate for Payer: Cash Price	$90.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$253.76
Rate for Payer: SOMOS Essential	$253.76

PR WHEELCHAIR MGMT EA 15 MIN

Professional

Both

$128.98

Service Code	HCPCS 97542
Min. Negotiated Rate	$96.74
Max. Negotiated Rate	$96.74
Rate for Payer: Cash Price	$35.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$96.74
Rate for Payer: SOMOS Essential	$96.74

PR WHOLE BODY INTEGUMENTARY PHOTOGRAPHY

Professional

Both

$303.17

Service Code	HCPCS 96904
Min. Negotiated Rate	$227.38
Max. Negotiated Rate	$227.38
Rate for Payer: Cash Price	$81.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$227.38
Rate for Payer: SOMOS Essential	$227.38

PR WINDOWING CAST

Professional

Both

$191.45

Service Code	HCPCS 29730
Min. Negotiated Rate	$143.59
Max. Negotiated Rate	$143.59
Rate for Payer: Cash Price	$52.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$143.59
Rate for Payer: SOMOS Essential	$143.59

PR WOUND CLOSURE BY ADHESIVE

Professional

Both

$65.31

Service Code	HCPCS G0168
Min. Negotiated Rate	$48.98
Max. Negotiated Rate	$48.98
Rate for Payer: Cash Price	$17.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$48.98
Rate for Payer: SOMOS Essential	$48.98

PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH CPLX W/ECP

Professional

Both

$3,615.19

Service Code	HCPCS 66987
Min. Negotiated Rate	$2,711.39
Max. Negotiated Rate	$2,711.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,711.39
Rate for Payer: SOMOS Essential	$2,711.39

PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH CPLX WO ECP

Professional

Both

$3,057.04

Service Code	HCPCS 66982
Min. Negotiated Rate	$2,292.78
Max. Negotiated Rate	$2,292.78
Rate for Payer: Cash Price	$841.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,292.78
Rate for Payer: SOMOS Essential	$2,292.78

PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH INSJ 1+

Professional

Both

$2,799.86

Service Code	HCPCS 66991
Min. Negotiated Rate	$2,099.90
Max. Negotiated Rate	$2,099.90
Rate for Payer: Cash Price	$772.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,099.90
Rate for Payer: SOMOS Essential	$2,099.90

PR XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/ECP

Professional

Both

$2,905.88

Service Code	HCPCS 66988
Min. Negotiated Rate	$2,179.41
Max. Negotiated Rate	$2,179.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,179.41
Rate for Payer: SOMOS Essential	$2,179.41

Know your out-of-pocket cost for care.

All Charges