St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CHG US CHEST REAL TIME W/IMAGE DOCUMENTATION

Professional

Both

$239.96

Service Code	HCPCS 76604
Min. Negotiated Rate	$179.97
Max. Negotiated Rate	$179.97
Rate for Payer: Cash Price	$65.51
Rate for Payer: SOMOS CHP/HARP/Medicaid	$179.97
Rate for Payer: SOMOS Essential	$179.97

CHG US CHEST REAL TIME W/IMAGE DOCUMENTATION

Professional

Both

$112.14

Service Code	HCPCS 76604 26
Min. Negotiated Rate	$84.10
Max. Negotiated Rate	$84.10
Rate for Payer: Cash Price	$29.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$84.10
Rate for Payer: SOMOS Essential	$84.10

CHG US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL

Professional

Both

$388.50

Service Code	HCPCS 76936 26
Min. Negotiated Rate	$291.38
Max. Negotiated Rate	$291.38
Rate for Payer: Cash Price	$104.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$291.38
Rate for Payer: SOMOS Essential	$291.38

CHG US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL

Professional

Both

$1,112.44

Service Code	HCPCS 76936
Min. Negotiated Rate	$834.33
Max. Negotiated Rate	$834.33
Rate for Payer: Cash Price	$303.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$834.33
Rate for Payer: SOMOS Essential	$834.33

CHG US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL

Professional

Both

$723.94

Service Code	HCPCS 76936 TC
Min. Negotiated Rate	$542.96
Max. Negotiated Rate	$542.96
Rate for Payer: Cash Price	$199.13
Rate for Payer: SOMOS CHP/HARP/Medicaid	$542.96
Rate for Payer: SOMOS Essential	$542.96

CHG US COMPL JOINT R-T W/IMAGE DOCUMENTATION

Professional

Both

$172.55

Service Code	HCPCS 76881 26
Min. Negotiated Rate	$129.41
Max. Negotiated Rate	$129.41
Rate for Payer: Cash Price	$47.25
Rate for Payer: SOMOS CHP/HARP/Medicaid	$129.41
Rate for Payer: SOMOS Essential	$129.41

CHG US COMPL JOINT R-T W/IMAGE DOCUMENTATION

Professional

Both

$48.72

Service Code	HCPCS 76881 TC
Min. Negotiated Rate	$36.54
Max. Negotiated Rate	$36.54
Rate for Payer: SOMOS CHP/HARP/Medicaid	$36.54
Rate for Payer: SOMOS Essential	$36.54
Rate for Payer: Cash Price	$13.20

CHG US COMPL JOINT R-T W/IMAGE DOCUMENTATION

Professional

Both

$221.27

Service Code	HCPCS 76881
Min. Negotiated Rate	$165.95
Max. Negotiated Rate	$165.95
Rate for Payer: Cash Price	$60.45
Rate for Payer: SOMOS CHP/HARP/Medicaid	$165.95
Rate for Payer: SOMOS Essential	$165.95

CHG US ENDOMYOCARDIAL BIOPSY RS&I

Professional

Both

$464.59

Service Code	HCPCS 76932
Min. Negotiated Rate	$348.44
Max. Negotiated Rate	$348.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$348.44
Rate for Payer: SOMOS Essential	$348.44

CHG US ENDOMYOCARDIAL BIOPSY RS&I

Professional

Both

$311.64

Service Code	HCPCS 76932 TC
Min. Negotiated Rate	$233.73
Max. Negotiated Rate	$233.73
Rate for Payer: SOMOS CHP/HARP/Medicaid	$233.73
Rate for Payer: SOMOS Essential	$233.73

CHG US ENDOMYOCARDIAL BIOPSY RS&I

Professional

Both

$152.95

Service Code	HCPCS 76932 26
Min. Negotiated Rate	$114.71
Max. Negotiated Rate	$114.71
Rate for Payer: Cash Price	$40.78
Rate for Payer: SOMOS CHP/HARP/Medicaid	$114.71
Rate for Payer: SOMOS Essential	$114.71

CHG US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION

Professional

Both

$265.79

Service Code	HCPCS 76813 TC
Min. Negotiated Rate	$199.34
Max. Negotiated Rate	$199.34
Rate for Payer: Cash Price	$71.35
Rate for Payer: SOMOS CHP/HARP/Medicaid	$199.34
Rate for Payer: SOMOS Essential	$199.34

CHG US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION

Professional

Both

$490.67

Service Code	HCPCS 76813
Min. Negotiated Rate	$368.00
Max. Negotiated Rate	$368.00
Rate for Payer: Cash Price	$132.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$368.00
Rate for Payer: SOMOS Essential	$368.00

CHG US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION

Professional

Both

$224.88

Service Code	HCPCS 76813 26
Min. Negotiated Rate	$168.66
Max. Negotiated Rate	$168.66
Rate for Payer: Cash Price	$60.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$168.66
Rate for Payer: SOMOS Essential	$168.66

CHG US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION

Professional

Both

$123.48

Service Code	HCPCS 76814 TC
Min. Negotiated Rate	$92.61
Max. Negotiated Rate	$92.61
Rate for Payer: Cash Price	$33.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$92.61
Rate for Payer: SOMOS Essential	$92.61

CHG US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION

Professional

Both

$307.58

Service Code	HCPCS 76814
Min. Negotiated Rate	$230.68
Max. Negotiated Rate	$230.68
Rate for Payer: Cash Price	$83.95
Rate for Payer: SOMOS CHP/HARP/Medicaid	$230.68
Rate for Payer: SOMOS Essential	$230.68

CHG US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION

Professional

Both

$184.10

Service Code	HCPCS 76814 26
Min. Negotiated Rate	$138.08
Max. Negotiated Rate	$138.08
Rate for Payer: Cash Price	$50.71
Rate for Payer: SOMOS CHP/HARP/Medicaid	$138.08
Rate for Payer: SOMOS Essential	$138.08

CHG US GUIDANCE AMNIOCENTESIS IMG S&I

Professional

Both

$71.89

Service Code	HCPCS 76946 26
Min. Negotiated Rate	$53.92
Max. Negotiated Rate	$53.92
Rate for Payer: Cash Price	$19.77
Rate for Payer: SOMOS CHP/HARP/Medicaid	$53.92
Rate for Payer: SOMOS Essential	$53.92

CHG US GUIDANCE AMNIOCENTESIS IMG S&I

Professional

Both

$136.43

Service Code	HCPCS 76946
Min. Negotiated Rate	$102.32
Max. Negotiated Rate	$102.32
Rate for Payer: Cash Price	$38.08
Rate for Payer: SOMOS CHP/HARP/Medicaid	$102.32
Rate for Payer: SOMOS Essential	$102.32

CHG US GUIDANCE AMNIOCENTESIS IMG S&I

Professional

Both

$64.54

Service Code	HCPCS 76946 TC
Min. Negotiated Rate	$48.40
Max. Negotiated Rate	$48.40
Rate for Payer: Cash Price	$18.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$48.40
Rate for Payer: SOMOS Essential	$48.40

CHG US GUIDANCE ASPIRATION OVA IMG S&I

Professional

Both

$336.63

Service Code	HCPCS 76948
Min. Negotiated Rate	$252.47
Max. Negotiated Rate	$252.47
Rate for Payer: Cash Price	$92.59
Rate for Payer: SOMOS CHP/HARP/Medicaid	$252.47
Rate for Payer: SOMOS Essential	$252.47

CHG US GUIDANCE ASPIRATION OVA IMG S&I

Professional

Both

$124.04

Service Code	HCPCS 76948 26
Min. Negotiated Rate	$93.03
Max. Negotiated Rate	$93.03
Rate for Payer: Cash Price	$34.21
Rate for Payer: SOMOS CHP/HARP/Medicaid	$93.03
Rate for Payer: SOMOS Essential	$93.03

CHG US GUIDANCE ASPIRATION OVA IMG S&I

Professional

Both

$212.63

Service Code	HCPCS 76948 TC
Min. Negotiated Rate	$159.47
Max. Negotiated Rate	$159.47
Rate for Payer: Cash Price	$58.39
Rate for Payer: SOMOS CHP/HARP/Medicaid	$159.47
Rate for Payer: SOMOS Essential	$159.47

CHG US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I

Professional

Both

$308.32

Service Code	HCPCS 76945 TC
Min. Negotiated Rate	$231.24
Max. Negotiated Rate	$231.24
Rate for Payer: SOMOS CHP/HARP/Medicaid	$231.24
Rate for Payer: SOMOS Essential	$231.24

CHG US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I

Professional

Both

$432.36

Service Code	HCPCS 76945
Min. Negotiated Rate	$324.27
Max. Negotiated Rate	$324.27
Rate for Payer: SOMOS CHP/HARP/Medicaid	$324.27
Rate for Payer: SOMOS Essential	$324.27

Know your out-of-pocket cost for care.

All Charges