St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

KLS PLATE ORBITAL FLOOR .3MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	40200374
Hospital Revenue Code	278
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$375.00
Rate for Payer: Hamaspik Choice Inc Medicare	$375.00

KLS PLATE ORBITAL FLOOR .3MM

Facility

$750.00

Service Code	HCPCS C1713
Hospital Charge Code	40200374
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$787.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$412.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$450.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$375.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$431.25
Rate for Payer: EmblemHealth Commercial	$375.00
Rate for Payer: Fidelis Medicare Advantage	$787.50
Rate for Payer: Group Health Inc Commercial	$375.00
Rate for Payer: Group Health Inc Medicare	$262.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$375.00
Rate for Payer: Hamaspik Choice Inc Medicare	$375.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$487.50

KLS PLT MINI RIGID BLUE 6H CURVED

Facility

$354.00

Service Code	HCPCS C1713
Hospital Charge Code	40205782
Hospital Revenue Code	278
Min. Negotiated Rate	$177.00
Max. Negotiated Rate	$177.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.00
Rate for Payer: Hamaspik Choice Inc Medicare	$177.00

KLS PLT MINI RIGID BLUE 6H CURVED

Facility

$354.00

Service Code	HCPCS C1713
Hospital Charge Code	40205782
Hospital Revenue Code	278
Min. Negotiated Rate	$123.90
Max. Negotiated Rate	$371.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$212.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$177.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$203.55
Rate for Payer: EmblemHealth Commercial	$177.00
Rate for Payer: Fidelis Medicare Advantage	$371.70
Rate for Payer: Group Health Inc Commercial	$177.00
Rate for Payer: Group Health Inc Medicare	$123.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.00
Rate for Payer: Hamaspik Choice Inc Medicare	$177.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$230.10

KLS P MICRO 1.5MM 4 H CROSS SHAPE

Facility

$374.00

Service Code	HCPCS C1713
Hospital Charge Code	40205408
Hospital Revenue Code	278
Min. Negotiated Rate	$187.00
Max. Negotiated Rate	$187.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.00
Rate for Payer: Hamaspik Choice Inc Medicare	$187.00

KLS P MICRO 1.5MM 4 H CROSS SHAPE

Facility

$374.00

Service Code	HCPCS C1713
Hospital Charge Code	40205408
Hospital Revenue Code	278
Min. Negotiated Rate	$130.90
Max. Negotiated Rate	$392.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$205.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$224.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$187.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$215.05
Rate for Payer: EmblemHealth Commercial	$187.00
Rate for Payer: Fidelis Medicare Advantage	$392.70
Rate for Payer: Group Health Inc Commercial	$187.00
Rate for Payer: Group Health Inc Medicare	$130.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.00
Rate for Payer: Hamaspik Choice Inc Medicare	$187.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$243.10

KLS REGULAR BONE SCREW 2.7X8 MM

Facility

$158.00

Service Code	HCPCS C1713
Hospital Charge Code	40200375
Hospital Revenue Code	278
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$79.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.00
Rate for Payer: Hamaspik Choice Inc Medicare	$79.00

KLS REGULAR BONE SCREW 2.7X8 MM

Facility

$158.00

Service Code	HCPCS C1713
Hospital Charge Code	40200375
Hospital Revenue Code	278
Min. Negotiated Rate	$55.30
Max. Negotiated Rate	$165.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$86.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$94.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$90.85
Rate for Payer: EmblemHealth Commercial	$79.00
Rate for Payer: Fidelis Medicare Advantage	$165.90
Rate for Payer: Group Health Inc Commercial	$79.00
Rate for Payer: Group Health Inc Medicare	$55.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.00
Rate for Payer: Hamaspik Choice Inc Medicare	$79.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$102.70

KLS SCREW BONE 2.0X4MM

Facility

$178.00

Service Code	HCPCS C1713
Hospital Charge Code	40209426
Hospital Revenue Code	278
Min. Negotiated Rate	$62.30
Max. Negotiated Rate	$186.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$97.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$106.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$89.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.35
Rate for Payer: EmblemHealth Commercial	$89.00
Rate for Payer: Fidelis Medicare Advantage	$186.90
Rate for Payer: Group Health Inc Commercial	$89.00
Rate for Payer: Group Health Inc Medicare	$62.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.00
Rate for Payer: Hamaspik Choice Inc Medicare	$89.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$115.70

KLS SCREW BONE 2.0X4MM

Facility

$178.00

Service Code	HCPCS C1713
Hospital Charge Code	40209426
Hospital Revenue Code	278
Min. Negotiated Rate	$89.00
Max. Negotiated Rate	$89.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.00
Rate for Payer: Hamaspik Choice Inc Medicare	$89.00

KLS SCREW BONE 2.3

Facility

$92.00

Service Code	HCPCS C1776
Hospital Charge Code	40208110
Hospital Revenue Code	278
Min. Negotiated Rate	$46.00
Max. Negotiated Rate	$46.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$46.00
Rate for Payer: Hamaspik Choice Inc Medicare	$46.00

KLS SCREW BONE 2.3

Facility

$92.00

Service Code	HCPCS C1776
Hospital Charge Code	40208110
Hospital Revenue Code	278
Min. Negotiated Rate	$32.20
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$50.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$55.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$52.90
Rate for Payer: EmblemHealth Commercial	$46.00
Rate for Payer: Fidelis Medicare Advantage	$96.60
Rate for Payer: Group Health Inc Commercial	$46.00
Rate for Payer: Group Health Inc Medicare	$32.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$46.00
Rate for Payer: Hamaspik Choice Inc Medicare	$46.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$59.80

KLS SCREW BONE 2.3 X5MM

Facility

$128.00

Service Code	HCPCS C1776
Hospital Charge Code	40208009
Hospital Revenue Code	278
Min. Negotiated Rate	$44.80
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$76.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$64.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.60
Rate for Payer: EmblemHealth Commercial	$64.00
Rate for Payer: Fidelis Medicare Advantage	$134.40
Rate for Payer: Group Health Inc Commercial	$64.00
Rate for Payer: Group Health Inc Medicare	$44.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$64.00
Rate for Payer: Hamaspik Choice Inc Medicare	$64.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.20

KLS SCREW BONE 2.3 X5MM

Facility

$128.00

Service Code	HCPCS C1776
Hospital Charge Code	40208009
Hospital Revenue Code	278
Min. Negotiated Rate	$64.00
Max. Negotiated Rate	$64.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$64.00
Rate for Payer: Hamaspik Choice Inc Medicare	$64.00

KLS SCREW BONE 2.3 X7MM

Facility

$128.00

Service Code	HCPCS C1776
Hospital Charge Code	40208010
Hospital Revenue Code	278
Min. Negotiated Rate	$44.80
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$76.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$64.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.60
Rate for Payer: EmblemHealth Commercial	$64.00
Rate for Payer: Fidelis Medicare Advantage	$134.40
Rate for Payer: Group Health Inc Commercial	$64.00
Rate for Payer: Group Health Inc Medicare	$44.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$64.00
Rate for Payer: Hamaspik Choice Inc Medicare	$64.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$83.20

KLS SCREW BONE 2.3 X7MM

Facility

$128.00

Service Code	HCPCS C1776
Hospital Charge Code	40208010
Hospital Revenue Code	278
Min. Negotiated Rate	$64.00
Max. Negotiated Rate	$64.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$64.00
Rate for Payer: Hamaspik Choice Inc Medicare	$64.00

KLS SCREWS 10MM

Facility

$104.00

Service Code	HCPCS C1713
Hospital Charge Code	40202363
Hospital Revenue Code	278
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$62.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.80
Rate for Payer: EmblemHealth Commercial	$52.00
Rate for Payer: Fidelis Medicare Advantage	$109.20
Rate for Payer: Group Health Inc Commercial	$52.00
Rate for Payer: Group Health Inc Medicare	$36.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$67.60

KLS SCREWS 10MM

Facility

$104.00

Service Code	HCPCS C1713
Hospital Charge Code	40202363
Hospital Revenue Code	278
Min. Negotiated Rate	$52.00
Max. Negotiated Rate	$52.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00

KLS SCREWS 5MM

Facility

$104.00

Service Code	HCPCS C1713
Hospital Charge Code	40202364
Hospital Revenue Code	278
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$62.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.80
Rate for Payer: EmblemHealth Commercial	$52.00
Rate for Payer: Fidelis Medicare Advantage	$109.20
Rate for Payer: Group Health Inc Commercial	$52.00
Rate for Payer: Group Health Inc Medicare	$36.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$67.60

KLS SCREWS 5MM

Facility

$104.00

Service Code	HCPCS C1713
Hospital Charge Code	40202364
Hospital Revenue Code	278
Min. Negotiated Rate	$52.00
Max. Negotiated Rate	$52.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00

KLS SCRW DF CD MINI

Facility

$108.00

Service Code	HCPCS C1776
Hospital Charge Code	40205164
Hospital Revenue Code	278
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$64.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$54.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$62.10
Rate for Payer: EmblemHealth Commercial	$54.00
Rate for Payer: Fidelis Medicare Advantage	$113.40
Rate for Payer: Group Health Inc Commercial	$54.00
Rate for Payer: Group Health Inc Medicare	$37.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.00
Rate for Payer: Hamaspik Choice Inc Medicare	$54.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.20

KLS SCRW DF CD MINI

Facility

$108.00

Service Code	HCPCS C1776
Hospital Charge Code	40205164
Hospital Revenue Code	278
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.00
Rate for Payer: Hamaspik Choice Inc Medicare	$54.00

KLS TIT MESH PANEL SML GRID

Facility

$1,636.00

Service Code	HCPCS C1776
Hospital Charge Code	40205926
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,717.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$899.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$981.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$818.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$940.70
Rate for Payer: EmblemHealth Commercial	$818.00
Rate for Payer: Fidelis Medicare Advantage	$1,717.80
Rate for Payer: Group Health Inc Commercial	$818.00
Rate for Payer: Group Health Inc Medicare	$572.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$818.00
Rate for Payer: Hamaspik Choice Inc Medicare	$818.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,063.40

KLS TIT MESH PANEL SML GRID

Facility

$1,636.00

Service Code	HCPCS C1776
Hospital Charge Code	40205926
Hospital Revenue Code	278
Min. Negotiated Rate	$818.00
Max. Negotiated Rate	$818.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$818.00
Rate for Payer: Hamaspik Choice Inc Medicare	$818.00

KLS TWIST DRILL 1.9MM X70MM

Facility

$264.00

Hospital Charge Code	40205585
Hospital Revenue Code	270
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$211.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$145.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$132.00
Rate for Payer: Aetna Government	$132.00
Rate for Payer: Brighton Health Commercial	$198.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$211.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$179.52
Rate for Payer: Group Health Inc Commercial	$132.00
Rate for Payer: Group Health Inc Medicare	$92.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$132.00
Rate for Payer: Hamaspik Choice Inc Medicare	$132.00

Know your out-of-pocket cost for care.

All Charges