St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CHG MRI ABDOMEN W/CONTRAST MATERIAL

Professional

Both

$333.17

Service Code	HCPCS 74182 26
Min. Negotiated Rate	$249.88
Max. Negotiated Rate	$249.88
Rate for Payer: Cash Price	$89.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$249.88
Rate for Payer: SOMOS Essential	$249.88

CHG MRI ABDOMEN W/CONTRAST MATERIAL

Professional

Both

$1,018.64

Service Code	HCPCS 74182 TC
Min. Negotiated Rate	$763.98
Max. Negotiated Rate	$763.98
Rate for Payer: Cash Price	$272.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$763.98
Rate for Payer: SOMOS Essential	$763.98

CHG MRI ABDOMEN W/CONTRAST MATERIAL

Professional

Both

$1,351.81

Service Code	HCPCS 74182
Min. Negotiated Rate	$1,013.86
Max. Negotiated Rate	$1,013.86
Rate for Payer: Cash Price	$361.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,013.86
Rate for Payer: SOMOS Essential	$1,013.86

CHG MRI ABDOMEN W/O CONTRAST MATERIAL

Professional

Both

$280.95

Service Code	HCPCS 74181 26
Min. Negotiated Rate	$210.71
Max. Negotiated Rate	$210.71
Rate for Payer: Cash Price	$75.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$210.71
Rate for Payer: SOMOS Essential	$210.71

CHG MRI ABDOMEN W/O CONTRAST MATERIAL

Professional

Both

$586.22

Service Code	HCPCS 74181 TC
Min. Negotiated Rate	$439.66
Max. Negotiated Rate	$439.66
Rate for Payer: Cash Price	$157.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$439.66
Rate for Payer: SOMOS Essential	$439.66

CHG MRI ABDOMEN W/O CONTRAST MATERIAL

Professional

Both

$867.16

Service Code	HCPCS 74181
Min. Negotiated Rate	$650.37
Max. Negotiated Rate	$650.37
Rate for Payer: Cash Price	$233.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$650.37
Rate for Payer: SOMOS Essential	$650.37

CHG MRI ABDOMEN W/O & W/CONTRAST MATERIAL

Professional

Both

$1,084.76

Service Code	HCPCS 74183 TC
Min. Negotiated Rate	$813.57
Max. Negotiated Rate	$813.57
Rate for Payer: Cash Price	$289.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$813.57
Rate for Payer: SOMOS Essential	$813.57

CHG MRI ABDOMEN W/O & W/CONTRAST MATERIAL

Professional

Both

$1,503.95

Service Code	HCPCS 74183
Min. Negotiated Rate	$1,127.96
Max. Negotiated Rate	$1,127.96
Rate for Payer: Cash Price	$403.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,127.96
Rate for Payer: SOMOS Essential	$1,127.96

CHG MRI ABDOMEN W/O & W/CONTRAST MATERIAL

Professional

Both

$419.20

Service Code	HCPCS 74183 26
Min. Negotiated Rate	$314.40
Max. Negotiated Rate	$314.40
Rate for Payer: Cash Price	$113.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$314.40
Rate for Payer: SOMOS Essential	$314.40

CHG MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL

Professional

Both

$1,086.47

Service Code	HCPCS 73722 TC
Min. Negotiated Rate	$814.85
Max. Negotiated Rate	$814.85
Rate for Payer: Cash Price	$291.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$814.85
Rate for Payer: SOMOS Essential	$814.85

CHG MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL

Professional

Both

$311.05

Service Code	HCPCS 73722 26
Min. Negotiated Rate	$233.29
Max. Negotiated Rate	$233.29
Rate for Payer: Cash Price	$84.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$233.29
Rate for Payer: SOMOS Essential	$233.29

CHG MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL

Professional

Both

$1,397.52

Service Code	HCPCS 73722
Min. Negotiated Rate	$1,048.14
Max. Negotiated Rate	$1,048.14
Rate for Payer: Cash Price	$375.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,048.14
Rate for Payer: SOMOS Essential	$1,048.14

CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL

Professional

Both

$633.68

Service Code	HCPCS 73721 TC
Min. Negotiated Rate	$475.26
Max. Negotiated Rate	$475.26
Rate for Payer: Cash Price	$171.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$475.26
Rate for Payer: SOMOS Essential	$475.26

CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL

Professional

Both

$893.76

Service Code	HCPCS 73721
Min. Negotiated Rate	$670.32
Max. Negotiated Rate	$670.32
Rate for Payer: Cash Price	$241.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$670.32
Rate for Payer: SOMOS Essential	$670.32

CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL

Professional

Both

$260.12

Service Code	HCPCS 73721 26
Min. Negotiated Rate	$195.09
Max. Negotiated Rate	$195.09
Rate for Payer: Cash Price	$70.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$195.09
Rate for Payer: SOMOS Essential	$195.09

CHG MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL

Professional

Both

$1,311.87

Service Code	HCPCS 73723 TC
Min. Negotiated Rate	$983.90
Max. Negotiated Rate	$983.90
Rate for Payer: Cash Price	$349.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$983.90
Rate for Payer: SOMOS Essential	$983.90

CHG MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL

Professional

Both

$1,723.37

Service Code	HCPCS 73723
Min. Negotiated Rate	$1,292.53
Max. Negotiated Rate	$1,292.53
Rate for Payer: Cash Price	$461.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,292.53
Rate for Payer: SOMOS Essential	$1,292.53

CHG MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL

Professional

Both

$411.50

Service Code	HCPCS 73723 26
Min. Negotiated Rate	$308.62
Max. Negotiated Rate	$308.62
Rate for Payer: Cash Price	$111.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$308.62
Rate for Payer: SOMOS Essential	$308.62

CHG MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL

Professional

Both

$1,396.08

Service Code	HCPCS 73222
Min. Negotiated Rate	$1,047.06
Max. Negotiated Rate	$1,047.06
Rate for Payer: Cash Price	$375.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,047.06
Rate for Payer: SOMOS Essential	$1,047.06

CHG MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL

Professional

Both

$1,085.04

Service Code	HCPCS 73222 TC
Min. Negotiated Rate	$813.78
Max. Negotiated Rate	$813.78
Rate for Payer: Cash Price	$290.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$813.78
Rate for Payer: SOMOS Essential	$813.78

CHG MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL

Professional

Both

$311.05

Service Code	HCPCS 73222 26
Min. Negotiated Rate	$233.29
Max. Negotiated Rate	$233.29
Rate for Payer: Cash Price	$84.68
Rate for Payer: SOMOS CHP/HARP/Medicaid	$233.29
Rate for Payer: SOMOS Essential	$233.29

CHG MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL

Professional

Both

$261.56

Service Code	HCPCS 73221 26
Min. Negotiated Rate	$196.17
Max. Negotiated Rate	$196.17
Rate for Payer: Cash Price	$70.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$196.17
Rate for Payer: SOMOS Essential	$196.17

CHG MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL

Professional

Both

$633.68

Service Code	HCPCS 73221 TC
Min. Negotiated Rate	$475.26
Max. Negotiated Rate	$475.26
Rate for Payer: Cash Price	$171.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$475.26
Rate for Payer: SOMOS Essential	$475.26

CHG MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL

Professional

Both

$895.20

Service Code	HCPCS 73221
Min. Negotiated Rate	$671.40
Max. Negotiated Rate	$671.40
Rate for Payer: Cash Price	$242.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$671.40
Rate for Payer: SOMOS Essential	$671.40

CHG MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL

Professional

Both

$412.93

Service Code	HCPCS 73223 26
Min. Negotiated Rate	$309.70
Max. Negotiated Rate	$309.70
Rate for Payer: Cash Price	$112.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$309.70
Rate for Payer: SOMOS Essential	$309.70

Know your out-of-pocket cost for care.

All Charges