St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CHG PARATHYROID PLANAR IMAGING W/WO SUBTRACTION

Professional

Both

$1,172.43

Service Code	HCPCS 78071 TC
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$879.32
Rate for Payer: Cash Price	$313.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$879.32
Rate for Payer: SOMOS Essential	$879.32

CHG PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1ST SPEC

Professional

Both

$178.12

Service Code	HCPCS 88331 TC
Min. Negotiated Rate	$133.59
Max. Negotiated Rate	$133.59
Rate for Payer: Cash Price	$48.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$133.59
Rate for Payer: SOMOS Essential	$133.59

CHG PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1ST SPEC

Professional

Both

$239.33

Service Code	HCPCS 88331 26
Min. Negotiated Rate	$179.50
Max. Negotiated Rate	$179.50
Rate for Payer: Cash Price	$65.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$179.50
Rate for Payer: SOMOS Essential	$179.50

CHG PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1ST SPEC

Professional

Both

$417.45

Service Code	HCPCS 88331
Min. Negotiated Rate	$313.09
Max. Negotiated Rate	$313.09
Rate for Payer: Cash Price	$114.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$313.09
Rate for Payer: SOMOS Essential	$313.09

CHG PATH CONSLTJ SURG CYTOLOGIC EXAM EACH ADDL SITE

Professional

Both

$83.37

Service Code	HCPCS 88334 TC
Min. Negotiated Rate	$62.53
Max. Negotiated Rate	$62.53
Rate for Payer: Cash Price	$22.79
Rate for Payer: SOMOS CHP/HARP/Medicaid	$62.53
Rate for Payer: SOMOS Essential	$62.53

CHG PATH CONSLTJ SURG CYTOLOGIC EXAM EACH ADDL SITE

Professional

Both

$227.85

Service Code	HCPCS 88334
Min. Negotiated Rate	$170.89
Max. Negotiated Rate	$170.89
Rate for Payer: SOMOS CHP/HARP/Medicaid	$170.89
Rate for Payer: SOMOS Essential	$170.89

CHG PATH CONSLTJ SURG CYTOLOGIC EXAM EACH ADDL SITE

Professional

Both

$144.48

Service Code	HCPCS 88334 26
Min. Negotiated Rate	$108.36
Max. Negotiated Rate	$108.36
Rate for Payer: Cash Price	$39.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$108.36
Rate for Payer: SOMOS Essential	$108.36

CHG PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE

Professional

Both

$239.16

Service Code	HCPCS 88333 26
Min. Negotiated Rate	$179.37
Max. Negotiated Rate	$179.37
Rate for Payer: Cash Price	$65.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$179.37
Rate for Payer: SOMOS Essential	$179.37

CHG PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE

Professional

Both

$139.30

Service Code	HCPCS 88333 TC
Min. Negotiated Rate	$104.48
Max. Negotiated Rate	$104.48
Rate for Payer: Cash Price	$37.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$104.48
Rate for Payer: SOMOS Essential	$104.48

CHG PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE

Professional

Both

$378.46

Service Code	HCPCS 88333
Min. Negotiated Rate	$283.84
Max. Negotiated Rate	$283.84
Rate for Payer: Cash Price	$103.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$283.84
Rate for Payer: SOMOS Essential	$283.84

CHG PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION

Professional

Both

$226.00

Service Code	HCPCS 88332
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$169.50
Rate for Payer: Cash Price	$61.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$169.50
Rate for Payer: SOMOS Essential	$169.50

CHG PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION

Professional

Both

$107.66

Service Code	HCPCS 88332 TC
Min. Negotiated Rate	$80.74
Max. Negotiated Rate	$80.74
Rate for Payer: Cash Price	$29.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$80.74
Rate for Payer: SOMOS Essential	$80.74

CHG PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION

Professional

Both

$118.34

Service Code	HCPCS 88332 26
Min. Negotiated Rate	$88.76
Max. Negotiated Rate	$88.76
Rate for Payer: Cash Price	$32.20
Rate for Payer: SOMOS CHP/HARP/Medicaid	$88.76
Rate for Payer: SOMOS Essential	$88.76

CHG PATHOLOGY CLINICAL CONSLTJ PROLNG SVC EA ADDL 30

Professional

Both

$172.97

Service Code	HCPCS 80506
Min. Negotiated Rate	$129.73
Max. Negotiated Rate	$129.73
Rate for Payer: Cash Price	$46.90
Rate for Payer: SOMOS CHP/HARP/Medicaid	$129.73
Rate for Payer: SOMOS Essential	$129.73

CHG PATHOLOGY CLINICAL CONSULTATION HI MDM 41-60 MIN

Professional

Both

$363.72

Service Code	HCPCS 80505
Min. Negotiated Rate	$272.79
Max. Negotiated Rate	$272.79
Rate for Payer: Cash Price	$98.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$272.79
Rate for Payer: SOMOS Essential	$272.79

CHG PATHOLOGY CLINICAL CONSULTATION MOD MDM 21-40MIN

Professional

Both

$189.60

Service Code	HCPCS 80504
Min. Negotiated Rate	$142.20
Max. Negotiated Rate	$142.20
Rate for Payer: Cash Price	$52.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$142.20
Rate for Payer: SOMOS Essential	$142.20

CHG PATHOLOGY CLINICAL CONSULTATION SF MDM 5-20 MIN

Professional

Both

$88.10

Service Code	HCPCS 80503
Min. Negotiated Rate	$66.08
Max. Negotiated Rate	$66.08
Rate for Payer: Cash Price	$24.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$66.08
Rate for Payer: SOMOS Essential	$66.08

CHG PATHOLOGY CONSULTATION DURING SURGERY

Professional

Both

$142.31

Service Code	HCPCS 88329
Min. Negotiated Rate	$106.73
Max. Negotiated Rate	$106.73
Rate for Payer: Cash Price	$38.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$106.73
Rate for Payer: SOMOS Essential	$106.73

CHG PELVIMETRY W/WOPLACENTAL LOCALIZATION

Professional

Both

$65.31

Service Code	HCPCS 74710 26
Min. Negotiated Rate	$48.98
Max. Negotiated Rate	$48.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$48.98
Rate for Payer: SOMOS Essential	$48.98

CHG PELVIMETRY W/WOPLACENTAL LOCALIZATION

Professional

Both

$104.79

Service Code	HCPCS 74710 TC
Min. Negotiated Rate	$78.59
Max. Negotiated Rate	$78.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$78.59
Rate for Payer: SOMOS Essential	$78.59

CHG PELVIMETRY W/WOPLACENTAL LOCALIZATION

Professional

Both

$170.10

Service Code	HCPCS 74710
Min. Negotiated Rate	$127.58
Max. Negotiated Rate	$127.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$127.58
Rate for Payer: SOMOS Essential	$127.58

CHG PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I

Professional

Both

$677.04

Service Code	HCPCS 74355
Min. Negotiated Rate	$507.78
Max. Negotiated Rate	$507.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$507.78
Rate for Payer: SOMOS Essential	$507.78

CHG PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I

Professional

Both

$146.37

Service Code	HCPCS 74355 26
Min. Negotiated Rate	$109.78
Max. Negotiated Rate	$109.78
Rate for Payer: Cash Price	$39.62
Rate for Payer: SOMOS CHP/HARP/Medicaid	$109.78
Rate for Payer: SOMOS Essential	$109.78

CHG PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I

Professional

Both

$530.67

Service Code	HCPCS 74355 TC
Min. Negotiated Rate	$398.00
Max. Negotiated Rate	$398.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$398.00
Rate for Payer: SOMOS Essential	$398.00

CHG PERINEOGRAM

Professional

Both

$121.66

Service Code	HCPCS 74775 26
Min. Negotiated Rate	$91.24
Max. Negotiated Rate	$91.24
Rate for Payer: Cash Price	$32.14
Rate for Payer: SOMOS CHP/HARP/Medicaid	$91.24
Rate for Payer: SOMOS Essential	$91.24

Know your out-of-pocket cost for care.

All Charges