St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CHG RP LOCLZJ TUM SPECT 1 AREA/ACQUISJ 1 DAY IMG

Professional

Both

$197.79

Service Code	HCPCS 78803 26
Min. Negotiated Rate	$148.34
Max. Negotiated Rate	$148.34
Rate for Payer: Cash Price	$54.50
Rate for Payer: SOMOS CHP/HARP/Medicaid	$148.34
Rate for Payer: SOMOS Essential	$148.34

CHG RP LOCLZJ TUM SPECT 1 AREA/ACQUISJ 1 DAY IMG

Professional

Both

$1,320.52

Service Code	HCPCS 78803 TC
Min. Negotiated Rate	$990.39
Max. Negotiated Rate	$990.39
Rate for Payer: Cash Price	$352.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$990.39
Rate for Payer: SOMOS Essential	$990.39

CHG RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG

Professional

Both

$2,833.08

Service Code	HCPCS 78831
Min. Negotiated Rate	$2,124.81
Max. Negotiated Rate	$2,124.81
Rate for Payer: Cash Price	$763.15
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,124.81
Rate for Payer: SOMOS Essential	$2,124.81

CHG RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG

Professional

Both

$2,498.41

Service Code	HCPCS 78831 TC
Min. Negotiated Rate	$1,873.81
Max. Negotiated Rate	$1,873.81
Rate for Payer: Cash Price	$670.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,873.81
Rate for Payer: SOMOS Essential	$1,873.81

CHG RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG

Professional

Both

$334.64

Service Code	HCPCS 78831 26
Min. Negotiated Rate	$250.98
Max. Negotiated Rate	$250.98
Rate for Payer: Cash Price	$92.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$250.98
Rate for Payer: SOMOS Essential	$250.98

CHG RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG

Professional

Both

$387.77

Service Code	HCPCS 78832 26
Min. Negotiated Rate	$290.83
Max. Negotiated Rate	$290.83
Rate for Payer: Cash Price	$104.32
Rate for Payer: SOMOS CHP/HARP/Medicaid	$290.83
Rate for Payer: SOMOS Essential	$290.83

CHG RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG

Professional

Both

$3,241.60

Service Code	HCPCS 78832 TC
Min. Negotiated Rate	$2,431.20
Max. Negotiated Rate	$2,431.20
Rate for Payer: Cash Price	$859.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,431.20
Rate for Payer: SOMOS Essential	$2,431.20

CHG RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG

Professional

Both

$3,629.36

Service Code	HCPCS 78832
Min. Negotiated Rate	$2,722.02
Max. Negotiated Rate	$2,722.02
Rate for Payer: Cash Price	$964.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2,722.02
Rate for Payer: SOMOS Essential	$2,722.02

CHG RP LOCLZJ TUM SPECT W/CT 1 AREA/ACQUISJ 1DAY IMG

Professional

Both

$1,912.82

Service Code	HCPCS 78830
Min. Negotiated Rate	$1,434.62
Max. Negotiated Rate	$1,434.62
Rate for Payer: Cash Price	$508.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,434.62
Rate for Payer: SOMOS Essential	$1,434.62

CHG RP LOCLZJ TUM SPECT W/CT 1 AREA/ACQUISJ 1DAY IMG

Professional

Both

$1,645.11

Service Code	HCPCS 78830 TC
Min. Negotiated Rate	$1,233.83
Max. Negotiated Rate	$1,233.83
Rate for Payer: Cash Price	$436.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1,233.83
Rate for Payer: SOMOS Essential	$1,233.83

CHG RP LOCLZJ TUM SPECT W/CT 1 AREA/ACQUISJ 1DAY IMG

Professional

Both

$267.72

Service Code	HCPCS 78830 26
Min. Negotiated Rate	$200.79
Max. Negotiated Rate	$200.79
Rate for Payer: Cash Price	$72.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$200.79
Rate for Payer: SOMOS Essential	$200.79

CHG RP THERAPY INRACAVITARY ADMINISTRATION

Professional

Both

$302.16

Service Code	HCPCS 79200 26
Min. Negotiated Rate	$226.62
Max. Negotiated Rate	$226.62
Rate for Payer: Cash Price	$82.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$226.62
Rate for Payer: SOMOS Essential	$226.62

CHG RP THERAPY INRACAVITARY ADMINISTRATION

Professional

Both

$531.86

Service Code	HCPCS 79200
Min. Negotiated Rate	$398.90
Max. Negotiated Rate	$398.90
Rate for Payer: Cash Price	$145.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$398.90
Rate for Payer: SOMOS Essential	$398.90

CHG RP THERAPY INRACAVITARY ADMINISTRATION

Professional

Both

$229.71

Service Code	HCPCS 79200 TC
Min. Negotiated Rate	$172.28
Max. Negotiated Rate	$172.28
Rate for Payer: Cash Price	$62.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$172.28
Rate for Payer: SOMOS Essential	$172.28

CHG RP THERAPY INTERSTITIAL RADIOACTIVE COLLOID ADMN

Professional

Both

$1,077.44

Service Code	HCPCS 79300 TC
Min. Negotiated Rate	$808.08
Max. Negotiated Rate	$808.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$808.08
Rate for Payer: SOMOS Essential	$808.08

CHG RP THERAPY INTERSTITIAL RADIOACTIVE COLLOID ADMN

Professional

Both

$1,320.69

Service Code	HCPCS 79300
Min. Negotiated Rate	$990.52
Max. Negotiated Rate	$990.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$990.52
Rate for Payer: SOMOS Essential	$990.52

CHG RP THERAPY INTERSTITIAL RADIOACTIVE COLLOID ADMN

Professional

Both

$243.25

Service Code	HCPCS 79300 26
Min. Negotiated Rate	$182.44
Max. Negotiated Rate	$182.44
Rate for Payer: Cash Price	$66.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$182.44
Rate for Payer: SOMOS Essential	$182.44

CHG RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN

Professional

Both

$903.84

Service Code	HCPCS 79445
Min. Negotiated Rate	$677.88
Max. Negotiated Rate	$677.88
Rate for Payer: SOMOS CHP/HARP/Medicaid	$677.88
Rate for Payer: SOMOS Essential	$677.88

CHG RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN

Professional

Both

$464.31

Service Code	HCPCS 79445 TC
Min. Negotiated Rate	$348.23
Max. Negotiated Rate	$348.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$348.23
Rate for Payer: SOMOS Essential	$348.23

CHG RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN

Professional

Both

$439.53

Service Code	HCPCS 79445 26
Min. Negotiated Rate	$329.65
Max. Negotiated Rate	$329.65
Rate for Payer: Cash Price	$118.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$329.65
Rate for Payer: SOMOS Essential	$329.65

CHG RP THERAPY INTRA-ARTICULAR ADMINISTRATION

Professional

Both

$475.83

Service Code	HCPCS 79440
Min. Negotiated Rate	$356.87
Max. Negotiated Rate	$356.87
Rate for Payer: Cash Price	$130.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$356.87
Rate for Payer: SOMOS Essential	$356.87

CHG RP THERAPY INTRA-ARTICULAR ADMINISTRATION

Professional

Both

$302.16

Service Code	HCPCS 79440 26
Min. Negotiated Rate	$226.62
Max. Negotiated Rate	$226.62
Rate for Payer: Cash Price	$82.83
Rate for Payer: SOMOS CHP/HARP/Medicaid	$226.62
Rate for Payer: SOMOS Essential	$226.62

CHG RP THERAPY INTRA-ARTICULAR ADMINISTRATION

Professional

Both

$173.67

Service Code	HCPCS 79440 TC
Min. Negotiated Rate	$130.25
Max. Negotiated Rate	$130.25
Rate for Payer: Cash Price	$47.22
Rate for Payer: SOMOS CHP/HARP/Medicaid	$130.25
Rate for Payer: SOMOS Essential	$130.25

CHG RP THERAPY INTRAVENOUS ADMINISTRATION

Professional

Both

$232.61

Service Code	HCPCS 79101 TC
Min. Negotiated Rate	$174.46
Max. Negotiated Rate	$174.46
Rate for Payer: Cash Price	$63.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$174.46
Rate for Payer: SOMOS Essential	$174.46

CHG RP THERAPY INTRAVENOUS ADMINISTRATION

Professional

Both

$605.05

Service Code	HCPCS 79101
Min. Negotiated Rate	$453.79
Max. Negotiated Rate	$453.79
Rate for Payer: Cash Price	$164.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$453.79
Rate for Payer: SOMOS Essential	$453.79

Know your out-of-pocket cost for care.

All Charges