St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

KNEE NEXGEN C-H 10MM

Facility

$4,250.00

Service Code	HCPCS C1776
Hospital Charge Code	64906994
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,462.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,337.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,550.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,125.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,443.75
Rate for Payer: EmblemHealth Commercial	$2,125.00
Rate for Payer: Fidelis Medicare Advantage	$4,462.50
Rate for Payer: Group Health Inc Commercial	$2,125.00
Rate for Payer: Group Health Inc Medicare	$1,487.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,125.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,762.50

KNEE NEXGEN C-H 10MM

Facility

$4,250.00

Service Code	HCPCS C1776
Hospital Charge Code	64906994
Hospital Revenue Code	278
Min. Negotiated Rate	$2,125.00
Max. Negotiated Rate	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,125.00

KNEE NEXGEN FEM LFT F REV

Facility

$16,406.40

Service Code	HCPCS C1776
Hospital Charge Code	64906991
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$17,226.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,023.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$9,843.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8,203.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,433.68
Rate for Payer: EmblemHealth Commercial	$8,203.20
Rate for Payer: Fidelis Medicare Advantage	$17,226.72
Rate for Payer: Group Health Inc Commercial	$8,203.20
Rate for Payer: Group Health Inc Medicare	$5,742.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,203.20
Rate for Payer: Hamaspik Choice Inc Medicare	$8,203.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10,664.16

KNEE NEXGEN FEM LFT F REV

Facility

$16,406.40

Service Code	HCPCS C1776
Hospital Charge Code	64906991
Hospital Revenue Code	278
Min. Negotiated Rate	$8,203.20
Max. Negotiated Rate	$8,203.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,203.20
Rate for Payer: Hamaspik Choice Inc Medicare	$8,203.20

KNEE NEXGEN FEM LT 68MM

Facility

$6,907.10

Service Code	HCPCS C1776
Hospital Charge Code	40205052
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,252.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,798.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,144.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,453.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,971.58
Rate for Payer: EmblemHealth Commercial	$3,453.55
Rate for Payer: Fidelis Medicare Advantage	$7,252.46
Rate for Payer: Group Health Inc Commercial	$3,453.55
Rate for Payer: Group Health Inc Medicare	$2,417.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,453.55
Rate for Payer: Hamaspik Choice Inc Medicare	$3,453.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,489.62

KNEE NEXGEN FEM LT 68MM

Facility

$6,907.10

Service Code	HCPCS C1776
Hospital Charge Code	40205052
Hospital Revenue Code	278
Min. Negotiated Rate	$3,453.55
Max. Negotiated Rate	$3,453.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,453.55
Rate for Payer: Hamaspik Choice Inc Medicare	$3,453.55

KNEE NEXGEN FEM LT 68MM

Facility

$8,183.38

Service Code	HCPCS C1776
Hospital Charge Code	64901469
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 NEXGEN FEM LT 68MM

Facility

$8,183.38

Service Code	HCPCS C1776
Hospital Charge Code	64901469
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 NEXGEN FEM RGT SZ-E

Facility

$6,561.56

Service Code	HCPCS C1776
Hospital Charge Code	64906494
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,889.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,608.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,936.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,280.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,772.90
Rate for Payer: EmblemHealth Commercial	$3,280.78
Rate for Payer: Fidelis Medicare Advantage	$6,889.64
Rate for Payer: Group Health Inc Commercial	$3,280.78
Rate for Payer: Group Health Inc Medicare	$2,296.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,280.78
Rate for Payer: Hamaspik Choice Inc Medicare	$3,280.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,265.01

KNEE NEXGEN FEM RGT SZ-E

Facility

$6,561.56

Service Code	HCPCS C1776
Hospital Charge Code	64906494
Hospital Revenue Code	278
Min. Negotiated Rate	$3,280.78
Max. Negotiated Rate	$3,280.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,280.78
Rate for Payer: Hamaspik Choice Inc Medicare	$3,280.78

KNEE NEXGEN POR FEM SZ E,LT

Facility

$10,467.75

Service Code	HCPCS C1776
Hospital Charge Code	64901351
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 NEXGEN POR FEM SZ E,LT

Facility

$10,467.75

Service Code	HCPCS C1776
Hospital Charge Code	64901351
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 NEXGEN POR PAT 10X32MM

Facility

$3,964.00

Service Code	HCPCS C1776
Hospital Charge Code	64901465
Hospital Revenue Code	278
Min. Negotiated Rate	$1,982.00
Max. Negotiated Rate	$1,982.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,982.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,982.00

KNEE NEXGEN POR PAT 10X32MM

Facility

$3,964.00

Service Code	HCPCS C1776
Hospital Charge Code	64901465
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,162.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,180.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,378.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,982.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,279.30
Rate for Payer: EmblemHealth Commercial	$1,982.00
Rate for Payer: Fidelis Medicare Advantage	$4,162.20
Rate for Payer: Group Health Inc Commercial	$1,982.00
Rate for Payer: Group Health Inc Medicare	$1,387.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,982.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,982.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,576.60

KNEE NEXGEN POR PAT 10X35MM

Facility

$3,964.00

Service Code	HCPCS C1776
Hospital Charge Code	64901991
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,162.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,180.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,378.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,982.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,279.30
Rate for Payer: EmblemHealth Commercial	$1,982.00
Rate for Payer: Fidelis Medicare Advantage	$4,162.20
Rate for Payer: Group Health Inc Commercial	$1,982.00
Rate for Payer: Group Health Inc Medicare	$1,387.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,982.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,982.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,576.60

KNEE NEXGEN POR PAT 10X35MM

Facility

$3,171.20

Service Code	HCPCS C1776
Hospital Charge Code	40205071
Hospital Revenue Code	278
Min. Negotiated Rate	$1,585.60
Max. Negotiated Rate	$1,585.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,585.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,585.60

KNEE NEXGEN POR PAT 10X35MM

Facility

$3,964.00

Service Code	HCPCS C1776
Hospital Charge Code	64901991
Hospital Revenue Code	278
Min. Negotiated Rate	$1,982.00
Max. Negotiated Rate	$1,982.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,982.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,982.00

KNEE NEXGEN POR PAT 10X35MM

Facility

$3,171.20

Service Code	HCPCS C1776
Hospital Charge Code	40205071
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,329.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,744.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,902.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,585.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,823.44
Rate for Payer: EmblemHealth Commercial	$1,585.60
Rate for Payer: Fidelis Medicare Advantage	$3,329.76
Rate for Payer: Group Health Inc Commercial	$1,585.60
Rate for Payer: Group Health Inc Medicare	$1,109.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,585.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,585.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,061.28

KNEE NEXGEN TRAB TIB SZ4 10M

Facility

$9,710.00

Service Code	HCPCS C1776
Hospital Charge Code	64901467
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$10,195.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,340.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,826.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,855.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,583.25
Rate for Payer: EmblemHealth Commercial	$4,855.00
Rate for Payer: Fidelis Medicare Advantage	$10,195.50
Rate for Payer: Group Health Inc Commercial	$4,855.00
Rate for Payer: Group Health Inc Medicare	$3,398.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,855.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,855.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,311.50

KNEE NEXGEN TRAB TIB SZ4 10M

Facility

$9,710.00

Service Code	HCPCS C1776
Hospital Charge Code	64901467
Hospital Revenue Code	278
Min. Negotiated Rate	$4,855.00
Max. Negotiated Rate	$4,855.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,855.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,855.00

KNEE NXGN 14MM TIB 4

Facility

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	64906861
Hospital Revenue Code	278
Min. Negotiated Rate	$3,884.00
Max. Negotiated Rate	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00

KNEE NXGN 14MM TIB 4

Facility

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	64906861
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,156.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,272.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,660.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,884.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,466.60
Rate for Payer: EmblemHealth Commercial	$3,884.00
Rate for Payer: Fidelis Medicare Advantage	$8,156.40
Rate for Payer: Group Health Inc Commercial	$3,884.00
Rate for Payer: Group Health Inc Medicare	$2,718.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,049.20

KNEE NXGN D35MM T10MM

Facility

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	64906895
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,156.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,272.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,660.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,884.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,466.60
Rate for Payer: EmblemHealth Commercial	$3,884.00
Rate for Payer: Fidelis Medicare Advantage	$8,156.40
Rate for Payer: Group Health Inc Commercial	$3,884.00
Rate for Payer: Group Health Inc Medicare	$2,718.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,049.20

KNEE NXGN D35MM T10MM

Facility

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	64906895
Hospital Revenue Code	278
Min. Negotiated Rate	$3,884.00
Max. Negotiated Rate	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00

KNEE ORTHOSIS

Facility

$130.00

Service Code	HCPCS L1820
Hospital Charge Code	41709519
Hospital Revenue Code	274
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$136.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$71.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$72.17
Rate for Payer: Aetna Government	$72.17
Rate for Payer: Brighton Health Commercial	$78.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$65.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$74.75
Rate for Payer: EmblemHealth Commercial	$65.00
Rate for Payer: Fidelis Medicare Advantage	$136.50
Rate for Payer: Group Health Inc Commercial	$65.00
Rate for Payer: Group Health Inc Medicare	$45.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.00
Rate for Payer: Hamaspik Choice Inc Medicare	$65.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$84.50

Know your out-of-pocket cost for care.

All Charges