St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CHG CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST

Professional

Both

$768.64

Service Code	HCPCS 74175 TC
Min. Negotiated Rate	$576.48
Max. Negotiated Rate	$576.48
Rate for Payer: Cash Price	$270.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$576.48
Rate for Payer: SOMOS Essential	$576.48

CHG CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST

Professional

Both

$1,115.94

Service Code	HCPCS 74175
Min. Negotiated Rate	$836.96
Max. Negotiated Rate	$836.96
Rate for Payer: Cash Price	$364.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$836.96
Rate for Payer: SOMOS Essential	$836.96

CHG CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST

Professional

Both

$347.31

Service Code	HCPCS 74175 26
Min. Negotiated Rate	$260.48
Max. Negotiated Rate	$260.48
Rate for Payer: Cash Price	$94.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$260.48
Rate for Payer: SOMOS Essential	$260.48

CHG CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST

Professional

Both

$348.74

Service Code	HCPCS 71275 26
Min. Negotiated Rate	$261.56
Max. Negotiated Rate	$261.56
Rate for Payer: Cash Price	$94.48
Rate for Payer: SOMOS CHP/HARP/Medicaid	$261.56
Rate for Payer: SOMOS Essential	$261.56

CHG CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST

Professional

Both

$1,117.41

Service Code	HCPCS 71275
Min. Negotiated Rate	$838.06
Max. Negotiated Rate	$838.06
Rate for Payer: Cash Price	$335.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$838.06
Rate for Payer: SOMOS Essential	$838.06

CHG CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST

Professional

Both

$768.64

Service Code	HCPCS 71275 TC
Min. Negotiated Rate	$576.48
Max. Negotiated Rate	$576.48
Rate for Payer: Cash Price	$240.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$576.48
Rate for Payer: SOMOS Essential	$576.48

CHG CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST

Professional

Both

$768.64

Service Code	HCPCS 70496 TC
Min. Negotiated Rate	$576.48
Max. Negotiated Rate	$576.48
Rate for Payer: Cash Price	$238.03
Rate for Payer: SOMOS CHP/HARP/Medicaid	$576.48
Rate for Payer: SOMOS Essential	$576.48

CHG CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST

Professional

Both

$337.12

Service Code	HCPCS 70496 26
Min. Negotiated Rate	$252.84
Max. Negotiated Rate	$252.84
Rate for Payer: Cash Price	$90.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$252.84
Rate for Payer: SOMOS Essential	$252.84

CHG CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST

Professional

Both

$1,105.76

Service Code	HCPCS 70496
Min. Negotiated Rate	$829.32
Max. Negotiated Rate	$829.32
Rate for Payer: Cash Price	$328.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$829.32
Rate for Payer: SOMOS Essential	$829.32

CHG CT ANGIOGRAPHY LOWER EXTREMITY

Professional

Both

$768.64

Service Code	HCPCS 73706 TC
Min. Negotiated Rate	$576.48
Max. Negotiated Rate	$576.48
Rate for Payer: Cash Price	$287.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$576.48
Rate for Payer: SOMOS Essential	$576.48

CHG CT ANGIOGRAPHY LOWER EXTREMITY

Professional

Both

$360.22

Service Code	HCPCS 73706 26
Min. Negotiated Rate	$270.16
Max. Negotiated Rate	$270.16
Rate for Payer: Cash Price	$97.66
Rate for Payer: SOMOS CHP/HARP/Medicaid	$270.16
Rate for Payer: SOMOS Essential	$270.16

CHG CT ANGIOGRAPHY LOWER EXTREMITY

Professional

Both

$1,128.86

Service Code	HCPCS 73706
Min. Negotiated Rate	$846.64
Max. Negotiated Rate	$846.64
Rate for Payer: Cash Price	$385.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$846.64
Rate for Payer: SOMOS Essential	$846.64

CHG CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST

Professional

Both

$1,105.76

Service Code	HCPCS 70498
Min. Negotiated Rate	$829.32
Max. Negotiated Rate	$829.32
Rate for Payer: Cash Price	$328.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$829.32
Rate for Payer: SOMOS Essential	$829.32

CHG CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST

Professional

Both

$337.12

Service Code	HCPCS 70498 26
Min. Negotiated Rate	$252.84
Max. Negotiated Rate	$252.84
Rate for Payer: Cash Price	$90.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$252.84
Rate for Payer: SOMOS Essential	$252.84

CHG CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST

Professional

Both

$768.64

Service Code	HCPCS 70498 TC
Min. Negotiated Rate	$576.48
Max. Negotiated Rate	$576.48
Rate for Payer: Cash Price	$237.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$576.48
Rate for Payer: SOMOS Essential	$576.48

CHG CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST

Professional

Both

$1,111.85

Service Code	HCPCS 72191
Min. Negotiated Rate	$833.89
Max. Negotiated Rate	$833.89
Rate for Payer: Cash Price	$363.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$833.89
Rate for Payer: SOMOS Essential	$833.89

CHG CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST

Professional

Both

$343.18

Service Code	HCPCS 72191 26
Min. Negotiated Rate	$257.38
Max. Negotiated Rate	$257.38
Rate for Payer: Cash Price	$92.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$257.38
Rate for Payer: SOMOS Essential	$257.38

CHG CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST

Professional

Both

$768.64

Service Code	HCPCS 72191 TC
Min. Negotiated Rate	$576.48
Max. Negotiated Rate	$576.48
Rate for Payer: Cash Price	$270.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$576.48
Rate for Payer: SOMOS Essential	$576.48

CHG CT ANGIOGRAPHY UPPER EXTREMITY

Professional

Both

$1,111.85

Service Code	HCPCS 73206
Min. Negotiated Rate	$833.89
Max. Negotiated Rate	$833.89
Rate for Payer: Cash Price	$354.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$833.89
Rate for Payer: SOMOS Essential	$833.89

CHG CT ANGIOGRAPHY UPPER EXTREMITY

Professional

Both

$343.18

Service Code	HCPCS 73206 26
Min. Negotiated Rate	$257.38
Max. Negotiated Rate	$257.38
Rate for Payer: Cash Price	$92.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$257.38
Rate for Payer: SOMOS Essential	$257.38

CHG CT ANGIOGRAPHY UPPER EXTREMITY

Professional

Both

$768.64

Service Code	HCPCS 73206 TC
Min. Negotiated Rate	$576.48
Max. Negotiated Rate	$576.48
Rate for Payer: Cash Price	$261.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$576.48
Rate for Payer: SOMOS Essential	$576.48

CHG CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE

Professional

Both

$46.97

Service Code	HCPCS 77078 26
Min. Negotiated Rate	$35.23
Max. Negotiated Rate	$35.23
Rate for Payer: Cash Price	$12.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$35.23
Rate for Payer: SOMOS Essential	$35.23

CHG CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE

Professional

Both

$416.29

Service Code	HCPCS 77078
Min. Negotiated Rate	$312.22
Max. Negotiated Rate	$312.22
Rate for Payer: Cash Price	$121.17
Rate for Payer: SOMOS CHP/HARP/Medicaid	$312.22
Rate for Payer: SOMOS Essential	$312.22

CHG CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE

Professional

Both

$369.29

Service Code	HCPCS 77078 TC
Min. Negotiated Rate	$276.97
Max. Negotiated Rate	$276.97
Rate for Payer: Cash Price	$108.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$276.97
Rate for Payer: SOMOS Essential	$276.97

CHG CT CERVICAL SPINE W/CONTRAST MATERIAL

Professional

Both

$741.06

Service Code	HCPCS 72126
Min. Negotiated Rate	$555.80
Max. Negotiated Rate	$555.80
Rate for Payer: Cash Price	$200.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$555.80
Rate for Payer: SOMOS Essential	$555.80

Know your out-of-pocket cost for care.

All Charges