St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CHG MYOCRD IMG PET METAB EVAL SINGLE STUDY

Professional

Both

$4,826.68

Service Code	HCPCS 78459
Min. Negotiated Rate	$3,620.01
Max. Negotiated Rate	$3,620.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,620.01
Rate for Payer: SOMOS Essential	$3,620.01

CHG MYOCRD IMG PET METAB EVAL SINGLE STUDY

Professional

Both

$4,543.63

Service Code	HCPCS 78459 TC
Min. Negotiated Rate	$3,407.72
Max. Negotiated Rate	$3,407.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,407.72
Rate for Payer: SOMOS Essential	$3,407.72

CHG MYOCRD IMG PET METAB EVAL SINGLE STUDY

Professional

Both

$283.05

Service Code	HCPCS 78459 26
Min. Negotiated Rate	$212.29
Max. Negotiated Rate	$212.29
Rate for Payer: Cash Price	$78.76
Rate for Payer: SOMOS CHP/HARP/Medicaid	$212.29
Rate for Payer: SOMOS Essential	$212.29

CHG MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT

Professional

Both

$5,451.78

Service Code	HCPCS 78429
Min. Negotiated Rate	$4,088.84
Max. Negotiated Rate	$4,088.84
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,088.84
Rate for Payer: SOMOS Essential	$4,088.84

CHG MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT

Professional

Both

$311.61

Service Code	HCPCS 78429 26
Min. Negotiated Rate	$233.71
Max. Negotiated Rate	$233.71
Rate for Payer: Cash Price	$84.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$233.71
Rate for Payer: SOMOS Essential	$233.71

CHG MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT

Professional

Both

$5,140.17

Service Code	HCPCS 78429 TC
Min. Negotiated Rate	$3,855.13
Max. Negotiated Rate	$3,855.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,855.13
Rate for Payer: SOMOS Essential	$3,855.13

CHG MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT

Professional

Both

$291.97

Service Code	HCPCS 78430 26
Min. Negotiated Rate	$218.98
Max. Negotiated Rate	$218.98
Rate for Payer: Cash Price	$80.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$218.98
Rate for Payer: SOMOS Essential	$218.98

CHG MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT

Professional

Both

$5,432.14

Service Code	HCPCS 78430
Min. Negotiated Rate	$4,074.10
Max. Negotiated Rate	$4,074.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,074.10
Rate for Payer: SOMOS Essential	$4,074.10

CHG MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT

Professional

Both

$5,140.17

Service Code	HCPCS 78430 TC
Min. Negotiated Rate	$3,855.13
Max. Negotiated Rate	$3,855.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,855.13
Rate for Payer: SOMOS Essential	$3,855.13

CHG MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT

Professional

Both

$6,787.97

Service Code	HCPCS 78431 TC
Min. Negotiated Rate	$5,090.98
Max. Negotiated Rate	$5,090.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,090.98
Rate for Payer: SOMOS Essential	$5,090.98

CHG MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT

Professional

Both

$344.96

Service Code	HCPCS 78431 26
Min. Negotiated Rate	$258.72
Max. Negotiated Rate	$258.72
Rate for Payer: Cash Price	$94.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$258.72
Rate for Payer: SOMOS Essential	$258.72

CHG MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT

Professional

Both

$7,132.93

Service Code	HCPCS 78431
Min. Negotiated Rate	$5,349.70
Max. Negotiated Rate	$5,349.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,349.70
Rate for Payer: SOMOS Essential	$5,349.70

CHG MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS

Professional

Both

$5,471.17

Service Code	HCPCS 78492
Min. Negotiated Rate	$4,103.38
Max. Negotiated Rate	$4,103.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,103.38
Rate for Payer: SOMOS Essential	$4,103.38

CHG MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS

Professional

Both

$5,140.17

Service Code	HCPCS 78492 TC
Min. Negotiated Rate	$3,855.13
Max. Negotiated Rate	$3,855.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,855.13
Rate for Payer: SOMOS Essential	$3,855.13

CHG MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS

Professional

Both

$331.00

Service Code	HCPCS 78492 26
Min. Negotiated Rate	$248.25
Max. Negotiated Rate	$248.25
Rate for Payer: Cash Price	$90.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$248.25
Rate for Payer: SOMOS Essential	$248.25

CHG MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS

Professional

Both

$5,415.52

Service Code	HCPCS 78491
Min. Negotiated Rate	$4,061.64
Max. Negotiated Rate	$4,061.64
Rate for Payer: SOMOS CHP/HARP/Medicaid	$4,061.64
Rate for Payer: SOMOS Essential	$4,061.64

CHG MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS

Professional

Both

$5,140.17

Service Code	HCPCS 78491 TC
Min. Negotiated Rate	$3,855.13
Max. Negotiated Rate	$3,855.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3,855.13
Rate for Payer: SOMOS Essential	$3,855.13

CHG MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS

Professional

Both

$275.35

Service Code	HCPCS 78491 26
Min. Negotiated Rate	$206.51
Max. Negotiated Rate	$206.51
Rate for Payer: Cash Price	$77.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$206.51
Rate for Payer: SOMOS Essential	$206.51

CHG MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT

Professional

Both

$399.95

Service Code	HCPCS 78433 26
Min. Negotiated Rate	$299.96
Max. Negotiated Rate	$299.96
Rate for Payer: Cash Price	$110.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$299.96
Rate for Payer: SOMOS Essential	$299.96

CHG MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT

Professional

Both

$8,112.13

Service Code	HCPCS 78433 TC
Min. Negotiated Rate	$6,084.10
Max. Negotiated Rate	$6,084.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,084.10
Rate for Payer: SOMOS Essential	$6,084.10

CHG MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT

Professional

Both

$8,512.07

Service Code	HCPCS 78433
Min. Negotiated Rate	$6,384.05
Max. Negotiated Rate	$6,384.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,384.05
Rate for Payer: SOMOS Essential	$6,384.05

CHG MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER

Professional

Both

$7,851.45

Service Code	HCPCS 78432 TC
Min. Negotiated Rate	$5,888.59
Max. Negotiated Rate	$5,888.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$5,888.59
Rate for Payer: SOMOS Essential	$5,888.59

CHG MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER

Professional

Both

$367.54

Service Code	HCPCS 78432 26
Min. Negotiated Rate	$275.66
Max. Negotiated Rate	$275.66
Rate for Payer: Cash Price	$100.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$275.66
Rate for Payer: SOMOS Essential	$275.66

CHG MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER

Professional

Both

$8,219.02

Service Code	HCPCS 78432
Min. Negotiated Rate	$6,164.26
Max. Negotiated Rate	$6,164.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$6,164.26
Rate for Payer: SOMOS Essential	$6,164.26

CHG MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ

Professional

Both

$718.20

Service Code	HCPCS 78469 TC
Min. Negotiated Rate	$538.65
Max. Negotiated Rate	$538.65
Rate for Payer: Cash Price	$193.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$538.65
Rate for Payer: SOMOS Essential	$538.65

Know your out-of-pocket cost for care.

All Charges