St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CHG TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE

Professional

Both

$423.92

Service Code	HCPCS 77333 TC
Min. Negotiated Rate	$317.94
Max. Negotiated Rate	$317.94
Rate for Payer: Cash Price	$115.75
Rate for Payer: SOMOS CHP/HARP/Medicaid	$317.94
Rate for Payer: SOMOS Essential	$317.94

CHG TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE

Professional

Both

$160.93

Service Code	HCPCS 77333 26
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$120.70
Rate for Payer: Cash Price	$43.36
Rate for Payer: SOMOS CHP/HARP/Medicaid	$120.70
Rate for Payer: SOMOS Essential	$120.70

CHG TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE

Professional

Both

$584.85

Service Code	HCPCS 77333
Min. Negotiated Rate	$438.64
Max. Negotiated Rate	$438.64
Rate for Payer: Cash Price	$159.11
Rate for Payer: SOMOS CHP/HARP/Medicaid	$438.64
Rate for Payer: SOMOS Essential	$438.64

CHG TX DEVICES DESIGN & CONSTRUCTION SIMPLE

Professional

Both

$96.32

Service Code	HCPCS 77332 26
Min. Negotiated Rate	$72.24
Max. Negotiated Rate	$72.24
Rate for Payer: Cash Price	$26.37
Rate for Payer: SOMOS CHP/HARP/Medicaid	$72.24
Rate for Payer: SOMOS Essential	$72.24

CHG TX DEVICES DESIGN & CONSTRUCTION SIMPLE

Professional

Both

$63.11

Service Code	HCPCS 77332 TC
Min. Negotiated Rate	$47.33
Max. Negotiated Rate	$47.33
Rate for Payer: Cash Price	$18.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$47.33
Rate for Payer: SOMOS Essential	$47.33

CHG TX DEVICES DESIGN & CONSTRUCTION SIMPLE

Professional

Both

$159.46

Service Code	HCPCS 77332
Min. Negotiated Rate	$119.60
Max. Negotiated Rate	$119.60
Rate for Payer: Cash Price	$45.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$119.60
Rate for Payer: SOMOS Essential	$119.60

CHG ULTRASONIC GUIDANCE INTRAOPERATIVE

Professional

Both

$794.64

Service Code	HCPCS 76998
Min. Negotiated Rate	$595.98
Max. Negotiated Rate	$595.98
Rate for Payer: SOMOS CHP/HARP/Medicaid	$595.98
Rate for Payer: SOMOS Essential	$595.98

CHG ULTRASONIC GUIDANCE INTRAOPERATIVE

Professional

Both

$530.67

Service Code	HCPCS 76998 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 ULTRASONIC GUIDANCE INTRAOPERATIVE

Professional

Both

$263.97

Service Code	HCPCS 76998 26
Min. Negotiated Rate	$197.98
Max. Negotiated Rate	$197.98
Rate for Payer: Cash Price	$53.93
Rate for Payer: SOMOS CHP/HARP/Medicaid	$197.98
Rate for Payer: SOMOS Essential	$197.98

CHG ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION

Professional

Both

$157.99

Service Code	HCPCS 76983 TC
Min. Negotiated Rate	$118.49
Max. Negotiated Rate	$118.49
Rate for Payer: Cash Price	$43.85
Rate for Payer: SOMOS CHP/HARP/Medicaid	$118.49
Rate for Payer: SOMOS Essential	$118.49

CHG ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION

Professional

Both

$102.31

Service Code	HCPCS 76983 26
Min. Negotiated Rate	$76.73
Max. Negotiated Rate	$76.73
Rate for Payer: Cash Price	$27.57
Rate for Payer: SOMOS CHP/HARP/Medicaid	$76.73
Rate for Payer: SOMOS Essential	$76.73

CHG ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION

Professional

Both

$260.30

Service Code	HCPCS 76983
Min. Negotiated Rate	$195.22
Max. Negotiated Rate	$195.22
Rate for Payer: Cash Price	$71.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$195.22
Rate for Payer: SOMOS Essential	$195.22

CHG ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION

Professional

Both

$283.05

Service Code	HCPCS 76982 TC
Min. Negotiated Rate	$212.29
Max. Negotiated Rate	$212.29
Rate for Payer: Cash Price	$77.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$212.29
Rate for Payer: SOMOS Essential	$212.29

CHG ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION

Professional

Both

$399.53

Service Code	HCPCS 76982
Min. Negotiated Rate	$299.65
Max. Negotiated Rate	$299.65
Rate for Payer: Cash Price	$108.34
Rate for Payer: SOMOS CHP/HARP/Medicaid	$299.65
Rate for Payer: SOMOS Essential	$299.65

CHG ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION

Professional

Both

$116.48

Service Code	HCPCS 76982 26
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$87.36
Rate for Payer: Cash Price	$31.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$87.36
Rate for Payer: SOMOS Essential	$87.36

CHG ULTRASOUND ELASTOGRAPHY PARENCHYMA

Professional

Both

$116.48

Service Code	HCPCS 76981 26
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$87.36
Rate for Payer: Cash Price	$31.10
Rate for Payer: SOMOS CHP/HARP/Medicaid	$87.36
Rate for Payer: SOMOS Essential	$87.36

CHG ULTRASOUND ELASTOGRAPHY PARENCHYMA

Professional

Both

$329.04

Service Code	HCPCS 76981 TC
Min. Negotiated Rate	$246.78
Max. Negotiated Rate	$246.78
Rate for Payer: Cash Price	$90.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$246.78
Rate for Payer: SOMOS Essential	$246.78

CHG ULTRASOUND ELASTOGRAPHY PARENCHYMA

Professional

Both

$445.52

Service Code	HCPCS 76981
Min. Negotiated Rate	$334.14
Max. Negotiated Rate	$334.14
Rate for Payer: Cash Price	$121.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$334.14
Rate for Payer: SOMOS Essential	$334.14

CHG ULTRASOUND SPINAL CANAL & CONTENTS

Professional

Both

$261.21

Service Code	HCPCS 76800 26
Min. Negotiated Rate	$195.91
Max. Negotiated Rate	$195.91
Rate for Payer: Cash Price	$71.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$195.91
Rate for Payer: SOMOS Essential	$195.91

CHG ULTRASOUND SPINAL CANAL & CONTENTS

Professional

Both

$679.39

Service Code	HCPCS 76800
Min. Negotiated Rate	$509.54
Max. Negotiated Rate	$509.54
Rate for Payer: Cash Price	$203.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$509.54
Rate for Payer: SOMOS Essential	$509.54

CHG ULTRASOUND SPINAL CANAL & CONTENTS

Professional

Both

$418.18

Service Code	HCPCS 76800 TC
Min. Negotiated Rate	$313.64
Max. Negotiated Rate	$313.64
Rate for Payer: Cash Price	$131.86
Rate for Payer: SOMOS CHP/HARP/Medicaid	$313.64
Rate for Payer: SOMOS Essential	$313.64

CHG ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION

Professional

Both

$309.61

Service Code	HCPCS 76978 26
Min. Negotiated Rate	$232.21
Max. Negotiated Rate	$232.21
Rate for Payer: Cash Price	$84.29
Rate for Payer: SOMOS CHP/HARP/Medicaid	$232.21
Rate for Payer: SOMOS Essential	$232.21

CHG ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION

Professional

Both

$1,087.00

Service Code	HCPCS 76978
Min. Negotiated Rate	$815.25
Max. Negotiated Rate	$815.25
Rate for Payer: Cash Price	$256.47
Rate for Payer: SOMOS CHP/HARP/Medicaid	$815.25
Rate for Payer: SOMOS Essential	$815.25

CHG ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION

Professional

Both

$777.42

Service Code	HCPCS 76978 TC
Min. Negotiated Rate	$583.06
Max. Negotiated Rate	$583.06
Rate for Payer: Cash Price	$172.18
Rate for Payer: SOMOS CHP/HARP/Medicaid	$583.06
Rate for Payer: SOMOS Essential	$583.06

CHG ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDL LES

Professional

Both

$712.39

Service Code	HCPCS 76979
Min. Negotiated Rate	$534.29
Max. Negotiated Rate	$534.29
Rate for Payer: Cash Price	$165.58
Rate for Payer: SOMOS CHP/HARP/Medicaid	$534.29
Rate for Payer: SOMOS Essential	$534.29

Know your out-of-pocket cost for care.

All Charges