St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

KNEE ARTHRO DIFF COMPARTMENT SK

Facility

$247.00

Service Code	HCPCS G0289
Hospital Charge Code	40010956
Hospital Revenue Code	360
Min. Negotiated Rate	$55.99
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$55.99
Rate for Payer: Aetna Government	$55.99
Rate for Payer: Brighton Health Commercial	$185.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$123.50
Rate for Payer: Group Health Inc Medicare	$86.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.50
Rate for Payer: Hamaspik Choice Inc Medicare	$123.50
Rate for Payer: United Healthcare Commercial	$1,113.00

KNEE COMP ART SURF PURP 17MM

Facility

$2,836.88

Service Code	HCPCS C1776
Hospital Charge Code	64902218
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,978.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,560.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,702.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,418.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,631.21
Rate for Payer: EmblemHealth Commercial	$1,418.44
Rate for Payer: Fidelis Medicare Advantage	$2,978.72
Rate for Payer: Group Health Inc Commercial	$1,418.44
Rate for Payer: Group Health Inc Medicare	$992.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,418.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,418.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,843.97

KNEE COMP ART SURF PURP 17MM

Facility

$2,836.88

Service Code	HCPCS C1776
Hospital Charge Code	64902218
Hospital Revenue Code	278
Min. Negotiated Rate	$1,418.44
Max. Negotiated Rate	$1,418.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,418.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,418.44

KNEE CONNECT GMRS

Facility

$14,690.62

Service Code	HCPCS C1776
Hospital Charge Code	64907298
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$15,425.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8,079.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$8,814.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7,345.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$8,447.11
Rate for Payer: EmblemHealth Commercial	$7,345.31
Rate for Payer: Fidelis Medicare Advantage	$15,425.15
Rate for Payer: Group Health Inc Commercial	$7,345.31
Rate for Payer: Group Health Inc Medicare	$5,141.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,345.31
Rate for Payer: Hamaspik Choice Inc Medicare	$7,345.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9,548.90

KNEE CONNECT GMRS

Facility

$14,690.62

Service Code	HCPCS C1776
Hospital Charge Code	64907298
Hospital Revenue Code	278
Min. Negotiated Rate	$7,345.31
Max. Negotiated Rate	$7,345.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,345.31
Rate for Payer: Hamaspik Choice Inc Medicare	$7,345.31

KNEE FEM HOW ROT HNG

Facility

$18,243.75

Service Code	HCPCS C1776
Hospital Charge Code	64907254
Hospital Revenue Code	278
Min. Negotiated Rate	$9,121.88
Max. Negotiated Rate	$9,121.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,121.88
Rate for Payer: Hamaspik Choice Inc Medicare	$9,121.88

KNEE FEM HOW ROT HNG

Facility

$18,243.75

Service Code	HCPCS C1776
Hospital Charge Code	64907254
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$19,155.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10,034.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$10,946.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9,121.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$10,490.16
Rate for Payer: EmblemHealth Commercial	$9,121.88
Rate for Payer: Fidelis Medicare Advantage	$19,155.94
Rate for Payer: Group Health Inc Commercial	$9,121.88
Rate for Payer: Group Health Inc Medicare	$6,385.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,121.88
Rate for Payer: Hamaspik Choice Inc Medicare	$9,121.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11,858.44

KNEE FEMORAL CR NEXTGEN RIGHT

Facility

$10,467.75

Service Code	HCPCS C1776
Hospital Charge Code	64905816
Hospital Revenue Code	278
Min. Negotiated Rate	$5,233.88
Max. Negotiated Rate	$5,233.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,233.88
Rate for Payer: Hamaspik Choice Inc Medicare	$5,233.88

KNEE FEMORAL CR NEXTGEN RIGHT

Facility

$10,467.75

Service Code	HCPCS C1776
Hospital Charge Code	64905816
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$10,991.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,757.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$6,280.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,233.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,018.96
Rate for Payer: EmblemHealth Commercial	$5,233.88
Rate for Payer: Fidelis Medicare Advantage	$10,991.14
Rate for Payer: Group Health Inc Commercial	$5,233.88
Rate for Payer: Group Health Inc Medicare	$3,663.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,233.88
Rate for Payer: Hamaspik Choice Inc Medicare	$5,233.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,804.04

KNEE FEMORAL HINGED SZ C RHT

Facility

$12,312.00

Service Code	HCPCS C1776
Hospital Charge Code	64906290
Hospital Revenue Code	278
Min. Negotiated Rate	$6,156.00
Max. Negotiated Rate	$6,156.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,156.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,156.00

KNEE FEMORAL HINGED SZ C RHT

Facility

$12,312.00

Service Code	HCPCS C1776
Hospital Charge Code	64906290
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$12,927.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,771.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$7,387.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,156.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,079.40
Rate for Payer: EmblemHealth Commercial	$6,156.00
Rate for Payer: Fidelis Medicare Advantage	$12,927.60
Rate for Payer: Group Health Inc Commercial	$6,156.00
Rate for Payer: Group Health Inc Medicare	$4,309.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,156.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,156.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,002.80

KNEE FEM RT 68MM MED LAT

Facility

$8,183.38

Service Code	HCPCS C1776
Hospital Charge Code	64901470
Hospital Revenue Code	278
Min. Negotiated Rate	$4,091.69
Max. Negotiated Rate	$4,091.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,091.69
Rate for Payer: Hamaspik Choice Inc Medicare	$4,091.69

KNEE FEM RT 68MM MED LAT

Facility

$8,183.38

Service Code	HCPCS C1776
Hospital Charge Code	64901470
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,592.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,500.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,910.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,091.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,705.44
Rate for Payer: EmblemHealth Commercial	$4,091.69
Rate for Payer: Fidelis Medicare Advantage	$8,592.55
Rate for Payer: Group Health Inc Commercial	$4,091.69
Rate for Payer: Group Health Inc Medicare	$2,864.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,091.69
Rate for Payer: Hamaspik Choice Inc Medicare	$4,091.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,319.20

KNEE IMMOBILIZER

Facility

$65.56

Service Code	HCPCS 99070
Hospital Charge Code	40203421
Hospital Revenue Code	278
Min. Negotiated Rate	$32.78
Max. Negotiated Rate	$32.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.78
Rate for Payer: Hamaspik Choice Inc Medicare	$32.78

KNEE IMMOBILIZER

Facility

$65.56

Service Code	HCPCS 99070
Hospital Charge Code	40203421
Hospital Revenue Code	278
Min. Negotiated Rate	$10.26
Max. Negotiated Rate	$68.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.26
Rate for Payer: Aetna Government	$10.26
Rate for Payer: Brighton Health Commercial	$39.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.70
Rate for Payer: EmblemHealth Commercial	$32.78
Rate for Payer: Fidelis Medicare Advantage	$68.84
Rate for Payer: Group Health Inc Commercial	$32.78
Rate for Payer: Group Health Inc Medicare	$22.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.78
Rate for Payer: Hamaspik Choice Inc Medicare	$32.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$42.61

KNEE MEXGEN 17MM C-H

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	64906949
Hospital Revenue Code	278
Min. Negotiated Rate	$1,700.00
Max. Negotiated Rate	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00

KNEE MEXGEN 17MM C-H

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	64906949
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,570.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,870.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,040.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,955.00
Rate for Payer: EmblemHealth Commercial	$1,700.00
Rate for Payer: Fidelis Medicare Advantage	$3,570.00
Rate for Payer: Group Health Inc Commercial	$1,700.00
Rate for Payer: Group Health Inc Medicare	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,210.00

KNEE NEX CD3-4/YELLOW 20MM

Facility

$8,560.00

Service Code	HCPCS C1776
Hospital Charge Code	64905876
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,988.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,708.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,136.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,280.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,922.00
Rate for Payer: EmblemHealth Commercial	$4,280.00
Rate for Payer: Fidelis Medicare Advantage	$8,988.00
Rate for Payer: Group Health Inc Commercial	$4,280.00
Rate for Payer: Group Health Inc Medicare	$2,996.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,280.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,280.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,564.00

KNEE NEX CD3-4/YELLOW 20MM

Facility

$8,560.00

Service Code	HCPCS C1776
Hospital Charge Code	64905876
Hospital Revenue Code	278
Min. Negotiated Rate	$4,280.00
Max. Negotiated Rate	$4,280.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,280.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,280.00

KNEE NEXG EF 5-6/GREEN 23MM

Facility

$8,560.00

Service Code	HCPCS C1776
Hospital Charge Code	64905881
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,988.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,708.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,136.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,280.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,922.00
Rate for Payer: EmblemHealth Commercial	$4,280.00
Rate for Payer: Fidelis Medicare Advantage	$8,988.00
Rate for Payer: Group Health Inc Commercial	$4,280.00
Rate for Payer: Group Health Inc Medicare	$2,996.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,280.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,280.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,564.00

KNEE NEXG EF 5-6/GREEN 23MM

Facility

$8,560.00

Service Code	HCPCS C1776
Hospital Charge Code	64905881
Hospital Revenue Code	278
Min. Negotiated Rate	$4,280.00
Max. Negotiated Rate	$4,280.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,280.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,280.00

KNEE NEXGEN 12MM PATELA REV

Facility

$5,705.70

Service Code	HCPCS C1776
Hospital Charge Code	64906989
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,990.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,138.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,423.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,852.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,280.78
Rate for Payer: EmblemHealth Commercial	$2,852.85
Rate for Payer: Fidelis Medicare Advantage	$5,990.98
Rate for Payer: Group Health Inc Commercial	$2,852.85
Rate for Payer: Group Health Inc Medicare	$1,997.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,852.85
Rate for Payer: Hamaspik Choice Inc Medicare	$2,852.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,708.70

KNEE NEXGEN 12MM PATELA REV

Facility

$5,705.70

Service Code	HCPCS C1776
Hospital Charge Code	64906989
Hospital Revenue Code	278
Min. Negotiated Rate	$2,852.85
Max. Negotiated Rate	$2,852.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,852.85
Rate for Payer: Hamaspik Choice Inc Medicare	$2,852.85

KNEE NEXGEN ARTCLR 20MM E,F

Facility

$2,282.28

Service Code	HCPCS C1776
Hospital Charge Code	64906495
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,396.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,255.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,369.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,141.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,312.31
Rate for Payer: EmblemHealth Commercial	$1,141.14
Rate for Payer: Fidelis Medicare Advantage	$2,396.39
Rate for Payer: Group Health Inc Commercial	$1,141.14
Rate for Payer: Group Health Inc Medicare	$798.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,141.14
Rate for Payer: Hamaspik Choice Inc Medicare	$1,141.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,483.48

KNEE NEXGEN ARTCLR 20MM E,F

Facility

$2,282.28

Service Code	HCPCS C1776
Hospital Charge Code	64906495
Hospital Revenue Code	278
Min. Negotiated Rate	$1,141.14
Max. Negotiated Rate	$1,141.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,141.14
Rate for Payer: Hamaspik Choice Inc Medicare	$1,141.14

Know your out-of-pocket cost for care.

All Charges