St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CHG RADEX FINGR MINIMUM 2 VIEWS

Professional

Both

$136.43

Service Code	HCPCS 73140 TC
Min. Negotiated Rate	$102.32
Max. Negotiated Rate	$102.32
Rate for Payer: Cash Price	$37.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$102.32
Rate for Payer: SOMOS Essential	$102.32

CHG RADEX FINGR MINIMUM 2 VIEWS

Professional

Both

$27.65

Service Code	HCPCS 73140 26
Min. Negotiated Rate	$20.74
Max. Negotiated Rate	$20.74
Rate for Payer: Cash Price	$7.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$20.74
Rate for Payer: SOMOS Essential	$20.74

CHG RADEX FOOT COMPLETE MINIMUM 3 VIEWS

Professional

Both

$147.53

Service Code	HCPCS 73630
Min. Negotiated Rate	$110.65
Max. Negotiated Rate	$110.65
Rate for Payer: Cash Price	$40.19
Rate for Payer: SOMOS CHP/HARP/Medicaid	$110.65
Rate for Payer: SOMOS Essential	$110.65

CHG RADEX FOOT COMPLETE MINIMUM 3 VIEWS

Professional

Both

$114.87

Service Code	HCPCS 73630 TC
Min. Negotiated Rate	$86.15
Max. Negotiated Rate	$86.15
Rate for Payer: Cash Price	$31.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$86.15
Rate for Payer: SOMOS Essential	$86.15

CHG RADEX FOOT COMPLETE MINIMUM 3 VIEWS

Professional

Both

$32.66

Service Code	HCPCS 73630 26
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$24.50
Rate for Payer: Cash Price	$8.91
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24.50
Rate for Payer: SOMOS Essential	$24.50

CHG RADEX FOREARM 2 VIEWS

Professional

Both

$31.40

Service Code	HCPCS 73090 26
Min. Negotiated Rate	$23.55
Max. Negotiated Rate	$23.55
Rate for Payer: Cash Price	$8.56
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23.55
Rate for Payer: SOMOS Essential	$23.55

CHG RADEX FOREARM 2 VIEWS

Professional

Both

$94.75

Service Code	HCPCS 73090 TC
Min. Negotiated Rate	$71.06
Max. Negotiated Rate	$71.06
Rate for Payer: Cash Price	$25.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$71.06
Rate for Payer: SOMOS Essential	$71.06

CHG RADEX FOREARM 2 VIEWS

Professional

Both

$126.14

Service Code	HCPCS 73090
Min. Negotiated Rate	$94.60
Max. Negotiated Rate	$94.60
Rate for Payer: Cash Price	$34.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$94.60
Rate for Payer: SOMOS Essential	$94.60

CHG RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD

Professional

Both

$35.35

Service Code	HCPCS 76010 26
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$26.51
Rate for Payer: Cash Price	$9.26
Rate for Payer: SOMOS CHP/HARP/Medicaid	$26.51
Rate for Payer: SOMOS Essential	$26.51

CHG RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD

Professional

Both

$128.63

Service Code	HCPCS 76010
Min. Negotiated Rate	$96.47
Max. Negotiated Rate	$96.47
Rate for Payer: Cash Price	$34.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$96.47
Rate for Payer: SOMOS Essential	$96.47

CHG RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD

Professional

Both

$93.31

Service Code	HCPCS 76010 TC
Min. Negotiated Rate	$69.98
Max. Negotiated Rate	$69.98
Rate for Payer: Cash Price	$24.99
Rate for Payer: SOMOS CHP/HARP/Medicaid	$69.98
Rate for Payer: SOMOS Essential	$69.98

CHG RADEX HAND 2 VIEWS

Professional

Both

$134.75

Service Code	HCPCS 73120
Min. Negotiated Rate	$101.06
Max. Negotiated Rate	$101.06
Rate for Payer: Cash Price	$37.09
Rate for Payer: SOMOS CHP/HARP/Medicaid	$101.06
Rate for Payer: SOMOS Essential	$101.06

CHG RADEX HAND 2 VIEWS

Professional

Both

$32.83

Service Code	HCPCS 73120 26
Min. Negotiated Rate	$24.62
Max. Negotiated Rate	$24.62
Rate for Payer: Cash Price	$8.96
Rate for Payer: SOMOS CHP/HARP/Medicaid	$24.62
Rate for Payer: SOMOS Essential	$24.62

CHG RADEX HAND 2 VIEWS

Professional

Both

$101.92

Service Code	HCPCS 73120 TC
Min. Negotiated Rate	$76.44
Max. Negotiated Rate	$76.44
Rate for Payer: Cash Price	$28.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$76.44
Rate for Payer: SOMOS Essential	$76.44

CHG RADEX HAND MINIMUM 3 VIEWS

Professional

Both

$124.92

Service Code	HCPCS 73130 TC
Min. Negotiated Rate	$93.69
Max. Negotiated Rate	$93.69
Rate for Payer: Cash Price	$34.42
Rate for Payer: SOMOS CHP/HARP/Medicaid	$93.69
Rate for Payer: SOMOS Essential	$93.69

CHG RADEX HAND MINIMUM 3 VIEWS

Professional

Both

$159.01

Service Code	HCPCS 73130
Min. Negotiated Rate	$119.26
Max. Negotiated Rate	$119.26
Rate for Payer: Cash Price	$43.72
Rate for Payer: SOMOS CHP/HARP/Medicaid	$119.26
Rate for Payer: SOMOS Essential	$119.26

CHG RADEX HAND MINIMUM 3 VIEWS

Professional

Both

$34.09

Service Code	HCPCS 73130 26
Min. Negotiated Rate	$25.57
Max. Negotiated Rate	$25.57
Rate for Payer: Cash Price	$9.30
Rate for Payer: SOMOS CHP/HARP/Medicaid	$25.57
Rate for Payer: SOMOS Essential	$25.57

CHG RADEX HIP ARTHROGRAPHY RS&I

Professional

Both

$446.92

Service Code	HCPCS 73525 TC
Min. Negotiated Rate	$335.19
Max. Negotiated Rate	$335.19
Rate for Payer: Cash Price	$119.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$335.19
Rate for Payer: SOMOS Essential	$335.19

CHG RADEX HIP ARTHROGRAPHY RS&I

Professional

Both

$114.52

Service Code	HCPCS 73525 26
Min. Negotiated Rate	$85.89
Max. Negotiated Rate	$85.89
Rate for Payer: Cash Price	$31.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$85.89
Rate for Payer: SOMOS Essential	$85.89

CHG RADEX HIP ARTHROGRAPHY RS&I

Professional

Both

$561.44

Service Code	HCPCS 73525
Min. Negotiated Rate	$421.08
Max. Negotiated Rate	$421.08
Rate for Payer: Cash Price	$151.07
Rate for Payer: SOMOS CHP/HARP/Medicaid	$421.08
Rate for Payer: SOMOS Essential	$421.08

CHG RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS

Professional

Both

$176.79

Service Code	HCPCS 73521
Min. Negotiated Rate	$132.59
Max. Negotiated Rate	$132.59
Rate for Payer: Cash Price	$48.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$132.59
Rate for Payer: SOMOS Essential	$132.59

CHG RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS

Professional

Both

$43.23

Service Code	HCPCS 73521 26
Min. Negotiated Rate	$32.42
Max. Negotiated Rate	$32.42
Rate for Payer: Cash Price	$11.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$32.42
Rate for Payer: SOMOS Essential	$32.42

CHG RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS

Professional

Both

$133.56

Service Code	HCPCS 73521 TC
Min. Negotiated Rate	$100.17
Max. Negotiated Rate	$100.17
Rate for Payer: Cash Price	$36.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$100.17
Rate for Payer: SOMOS Essential	$100.17

CHG RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS

Professional

Both

$172.38

Service Code	HCPCS 73522 TC
Min. Negotiated Rate	$129.28
Max. Negotiated Rate	$129.28
Rate for Payer: Cash Price	$47.38
Rate for Payer: SOMOS CHP/HARP/Medicaid	$129.28
Rate for Payer: SOMOS Essential	$129.28

CHG RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS

Professional

Both

$56.32

Service Code	HCPCS 73522 26
Min. Negotiated Rate	$42.24
Max. Negotiated Rate	$42.24
Rate for Payer: Cash Price	$15.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$42.24
Rate for Payer: SOMOS Essential	$42.24

Know your out-of-pocket cost for care.

All Charges