St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CHG MORPHOMETRIC ANALYSIS SKELETAL MUSCLE

Professional

Both

$571.97

Service Code	HCPCS 88355
Min. Negotiated Rate	$428.98
Max. Negotiated Rate	$428.98
Rate for Payer: Cash Price	$141.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$428.98
Rate for Payer: SOMOS Essential	$428.98

CHG MORPHOMETRIC ANALYSIS SKELETAL MUSCLE

Professional

Both

$262.78

Service Code	HCPCS 88355 TC
Min. Negotiated Rate	$197.08
Max. Negotiated Rate	$197.08
Rate for Payer: Cash Price	$62.55
Rate for Payer: SOMOS CHP/HARP/Medicaid	$197.08
Rate for Payer: SOMOS Essential	$197.08

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB

Professional

Both

$162.33

Service Code	HCPCS 88374 26
Min. Negotiated Rate	$121.75
Max. Negotiated Rate	$121.75
Rate for Payer: Cash Price	$44.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$121.75
Rate for Payer: SOMOS Essential	$121.75

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB

Professional

Both

$1,122.56

Service Code	HCPCS 88374 TC
Min. Negotiated Rate	$841.92
Max. Negotiated Rate	$841.92
Rate for Payer: Cash Price	$291.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$841.92
Rate for Payer: SOMOS Essential	$841.92

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR EACH MULTIPRB

Professional

Both

$1,284.89

Service Code	HCPCS 88374
Min. Negotiated Rate	$963.67
Max. Negotiated Rate	$963.67
Rate for Payer: Cash Price	$335.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$963.67
Rate for Payer: SOMOS Essential	$963.67

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH

Professional

Both

$94.22

Service Code	HCPCS 88373 26
Min. Negotiated Rate	$70.66
Max. Negotiated Rate	$70.66
Rate for Payer: Cash Price	$26.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$70.66
Rate for Payer: SOMOS Essential	$70.66

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH

Professional

Both

$188.30

Service Code	HCPCS 88373 TC
Min. Negotiated Rate	$141.22
Max. Negotiated Rate	$141.22
Rate for Payer: Cash Price	$51.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$141.22
Rate for Payer: SOMOS Essential	$141.22

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ CPTR PER SPEC EACH

Professional

Both

$282.52

Service Code	HCPCS 88373
Min. Negotiated Rate	$211.89
Max. Negotiated Rate	$211.89
Rate for Payer: Cash Price	$77.43
Rate for Payer: SOMOS CHP/HARP/Medicaid	$211.89
Rate for Payer: SOMOS Essential	$211.89

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB

Professional

Both

$1,675.66

Service Code	HCPCS 88377
Min. Negotiated Rate	$1,256.74
Max. Negotiated Rate	$1,256.74
Rate for Payer: Cash Price	$460.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,256.74
Rate for Payer: SOMOS Essential	$1,256.74

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB

Professional

Both

$1,434.34

Service Code	HCPCS 88377 TC
Min. Negotiated Rate	$1,075.76
Max. Negotiated Rate	$1,075.76
Rate for Payer: Cash Price	$394.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,075.76
Rate for Payer: SOMOS Essential	$1,075.76

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB

Professional

Both

$241.33

Service Code	HCPCS 88377 26
Min. Negotiated Rate	$181.00
Max. Negotiated Rate	$181.00
Rate for Payer: Cash Price	$66.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$181.00
Rate for Payer: SOMOS Essential	$181.00

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ MNL PER SPEC EACH

Professional

Both

$512.89

Service Code	HCPCS 88369
Min. Negotiated Rate	$384.67
Max. Negotiated Rate	$384.67
Rate for Payer: Cash Price	$148.65
Rate for Payer: SOMOS CHP/HARP/Medicaid	$384.67
Rate for Payer: SOMOS Essential	$384.67

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ MNL PER SPEC EACH

Professional

Both

$386.54

Service Code	HCPCS 88369 TC
Min. Negotiated Rate	$289.90
Max. Negotiated Rate	$289.90
Rate for Payer: Cash Price	$113.40
Rate for Payer: SOMOS CHP/HARP/Medicaid	$289.90
Rate for Payer: SOMOS Essential	$289.90

CHG M/PHMTRC ALYS ISH QUANT/SEMIQ MNL PER SPEC EACH

Professional

Both

$126.35

Service Code	HCPCS 88369 26
Min. Negotiated Rate	$94.76
Max. Negotiated Rate	$94.76
Rate for Payer: Cash Price	$35.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$94.76
Rate for Payer: SOMOS Essential	$94.76

CHG MRA ABDOMEN W/WO CONTRAST MATERIAL

Professional

Both

$1,501.43

Service Code	HCPCS 74185
Min. Negotiated Rate	$1,126.07
Max. Negotiated Rate	$1,126.07
Rate for Payer: Cash Price	$403.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,126.07
Rate for Payer: SOMOS Essential	$1,126.07

CHG MRA ABDOMEN W/WO CONTRAST MATERIAL

Professional

Both

$1,158.08

Service Code	HCPCS 74185 TC
Min. Negotiated Rate	$868.56
Max. Negotiated Rate	$868.56
Rate for Payer: Cash Price	$310.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$868.56
Rate for Payer: SOMOS Essential	$868.56

CHG MRA ABDOMEN W/WO CONTRAST MATERIAL

Professional

Both

$343.39

Service Code	HCPCS 74185 26
Min. Negotiated Rate	$257.54
Max. Negotiated Rate	$257.54
Rate for Payer: Cash Price	$92.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$257.54
Rate for Payer: SOMOS Essential	$257.54

CHG MRA CHEST W/O & W/CONTRAST MATERIAL

Professional

Both

$344.61

Service Code	HCPCS 71555 26
Min. Negotiated Rate	$258.46
Max. Negotiated Rate	$258.46
Rate for Payer: Cash Price	$92.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$258.46
Rate for Payer: SOMOS Essential	$258.46

CHG MRA CHEST W/O & W/CONTRAST MATERIAL

Professional

Both

$1,140.83

Service Code	HCPCS 71555 TC
Min. Negotiated Rate	$855.62
Max. Negotiated Rate	$855.62
Rate for Payer: Cash Price	$307.02
Rate for Payer: SOMOS CHP/HARP/Medicaid	$855.62
Rate for Payer: SOMOS Essential	$855.62

CHG MRA CHEST W/O & W/CONTRAST MATERIAL

Professional

Both

$1,485.44

Service Code	HCPCS 71555
Min. Negotiated Rate	$1,114.08
Max. Negotiated Rate	$1,114.08
Rate for Payer: Cash Price	$399.74
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,114.08
Rate for Payer: SOMOS Essential	$1,114.08

CHG MRA HEAD W/CONTRAST MATERIAL

Professional

Both

$228.52

Service Code	HCPCS 70545 26
Min. Negotiated Rate	$171.39
Max. Negotiated Rate	$171.39
Rate for Payer: Cash Price	$62.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$171.39
Rate for Payer: SOMOS Essential	$171.39

CHG MRA HEAD W/CONTRAST MATERIAL

Professional

Both

$1,011.40

Service Code	HCPCS 70545
Min. Negotiated Rate	$758.55
Max. Negotiated Rate	$758.55
Rate for Payer: Cash Price	$272.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$758.55
Rate for Payer: SOMOS Essential	$758.55

CHG MRA HEAD W/CONTRAST MATERIAL

Professional

Both

$782.88

Service Code	HCPCS 70545 TC
Min. Negotiated Rate	$587.16
Max. Negotiated Rate	$587.16
Rate for Payer: Cash Price	$210.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$587.16
Rate for Payer: SOMOS Essential	$587.16

CHG MRA HEAD W/O CONTRST MATERIAL

Professional

Both

$954.17

Service Code	HCPCS 70544
Min. Negotiated Rate	$715.63
Max. Negotiated Rate	$715.63
Rate for Payer: Cash Price	$258.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$715.63
Rate for Payer: SOMOS Essential	$715.63

CHG MRA HEAD W/O CONTRST MATERIAL

Professional

Both

$229.95

Service Code	HCPCS 70544 26
Min. Negotiated Rate	$172.46
Max. Negotiated Rate	$172.46
Rate for Payer: Cash Price	$62.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$172.46
Rate for Payer: SOMOS Essential	$172.46

Know your out-of-pocket cost for care.

All Charges