St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

KNEE PSN ASF PS 11MM VE L 6-9 GH

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40204651
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 PSN ASF PS 11MM VE L 6-9 GH

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40204651
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 SPACER COPAL

Facility

$11,250.00

Service Code	HCPCS C1889
Hospital Charge Code	64907509
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$5,625.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,625.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,625.00

KNEE SPACER COPAL

Facility

$11,250.00

Service Code	HCPCS C1889
Hospital Charge Code	64907509
Hospital Revenue Code	278
Min. Negotiated Rate	$3,937.50
Max. Negotiated Rate	$11,812.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,187.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,625.00
Rate for Payer: Aetna Government	$5,625.00
Rate for Payer: Brighton Health Commercial	$6,750.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,625.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,468.75
Rate for Payer: EmblemHealth Commercial	$5,625.00
Rate for Payer: Fidelis Medicare Advantage	$11,812.50
Rate for Payer: Group Health Inc Commercial	$5,625.00
Rate for Payer: Group Health Inc Medicare	$3,937.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,625.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,625.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,312.50

KNEE STRAPPING

Facility

$330.23

Service Code	HCPCS 29530
Hospital Charge Code	30101322
Hospital Revenue Code	450
Min. Negotiated Rate	$103.40
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$147.72
Rate for Payer: Aetna Government	$147.72
Rate for Payer: Affinity Essential Plan 1&2	$103.40
Rate for Payer: Affinity Essential Plan 3&4	$103.40
Rate for Payer: Affinity Medicaid/CHP/HARP	$103.40
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$147.72
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$147.72
Rate for Payer: Cash Price	$147.72
Rate for Payer: Cash Price	$147.72
Rate for Payer: Cash Price	$147.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$147.72
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: Elderplan Medicare Advantage	$147.72
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis Essential Plan Aliesa	$125.56
Rate for Payer: Fidelis Essential Plan QHP	$131.47
Rate for Payer: Fidelis Medicare Advantage	$147.72
Rate for Payer: Fidelis Qualified Health Plan	$131.47
Rate for Payer: Group Health Inc Commercial	$525.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.12
Rate for Payer: Hamaspik Choice Inc Medicare	$147.72
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$147.72
Rate for Payer: Humana Medicare	$150.67
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$147.72
Rate for Payer: Senior Whole Health Medicare Advantage	$147.72
Rate for Payer: United Healthcare Commercial	$569.00
Rate for Payer: United Healthcare Medicare Advantage	$147.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$147.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$118.18
Rate for Payer: Wellcare Medicare	$140.33

KNEE STRAPPING

Facility

$330.23

Service Code	HCPCS 29530
Hospital Charge Code	30101322
Hospital Revenue Code	450
Rate for Payer: Cash Price	$147.72

KNEE SYSTEM VANG FEM L

Facility

$8,622.50

Service Code	HCPCS C1776
Hospital Charge Code	64903851
Hospital Revenue Code	278
Min. Negotiated Rate	$4,311.25
Max. Negotiated Rate	$4,311.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,311.25
Rate for Payer: Hamaspik Choice Inc Medicare	$4,311.25

KNEE SYSTEM VANG FEM L

Facility

$8,622.50

Service Code	HCPCS C1776
Hospital Charge Code	64903851
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,053.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,742.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,173.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,311.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,957.94
Rate for Payer: EmblemHealth Commercial	$4,311.25
Rate for Payer: Fidelis Medicare Advantage	$9,053.62
Rate for Payer: Group Health Inc Commercial	$4,311.25
Rate for Payer: Group Health Inc Medicare	$3,017.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,311.25
Rate for Payer: Hamaspik Choice Inc Medicare	$4,311.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,604.62

KNEE TIBIAL HINGED SZ 2

Facility

$6,104.00

Service Code	HCPCS C1776
Hospital Charge Code	64906289
Hospital Revenue Code	278
Min. Negotiated Rate	$3,052.00
Max. Negotiated Rate	$3,052.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,052.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,052.00

KNEE TIBIAL HINGED SZ 2

Facility

$6,104.00

Service Code	HCPCS C1776
Hospital Charge Code	64906289
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,409.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,357.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,662.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,052.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,509.80
Rate for Payer: EmblemHealth Commercial	$3,052.00
Rate for Payer: Fidelis Medicare Advantage	$6,409.20
Rate for Payer: Group Health Inc Commercial	$3,052.00
Rate for Payer: Group Health Inc Medicare	$2,136.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,052.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,052.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,967.60

KNEE TIBIAL TRAY

Facility

$5,535.00

Service Code	HCPCS C1776
Hospital Charge Code	64907171
Hospital Revenue Code	278
Min. Negotiated Rate	$2,767.50
Max. Negotiated Rate	$2,767.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,767.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,767.50

KNEE TIBIAL TRAY

Facility

$5,535.00

Service Code	HCPCS C1776
Hospital Charge Code	64907171
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,811.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,044.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,321.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,767.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,182.62
Rate for Payer: EmblemHealth Commercial	$2,767.50
Rate for Payer: Fidelis Medicare Advantage	$5,811.75
Rate for Payer: Group Health Inc Commercial	$2,767.50
Rate for Payer: Group Health Inc Medicare	$1,937.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,767.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,767.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,597.75

KNEE TRIAL EXCH G

Facility

$1,250.00

Service Code	HCPCS C1889
Hospital Charge Code	64907517
Hospital Revenue Code	278
Min. Negotiated Rate	$437.50
Max. Negotiated Rate	$1,312.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$687.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$625.00
Rate for Payer: Aetna Government	$625.00
Rate for Payer: Brighton Health Commercial	$750.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$625.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$718.75
Rate for Payer: EmblemHealth Commercial	$625.00
Rate for Payer: Fidelis Medicare Advantage	$1,312.50
Rate for Payer: Group Health Inc Commercial	$625.00
Rate for Payer: Group Health Inc Medicare	$437.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$625.00
Rate for Payer: Hamaspik Choice Inc Medicare	$625.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$812.50

KNEE TRIAL EXCH G

Facility

$1,250.00

Service Code	HCPCS C1889
Hospital Charge Code	64907517
Hospital Revenue Code	278
Min. Negotiated Rate	$625.00
Max. Negotiated Rate	$625.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$625.00
Rate for Payer: Hamaspik Choice Inc Medicare	$625.00

KNIFE BAYONET DISCETOMY

Facility

$677.55

Hospital Charge Code	64906182
Hospital Revenue Code	270
Min. Negotiated Rate	$237.14
Max. Negotiated Rate	$542.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$372.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$338.78
Rate for Payer: Aetna Government	$338.78
Rate for Payer: Brighton Health Commercial	$508.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$542.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$460.73
Rate for Payer: Group Health Inc Commercial	$338.78
Rate for Payer: Group Health Inc Medicare	$237.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$338.78
Rate for Payer: Hamaspik Choice Inc Medicare	$338.78

KNIFE BEVEL CLEARCUT DUAL

Facility

$68.75

Hospital Charge Code	64904044
Hospital Revenue Code	270
Min. Negotiated Rate	$24.06
Max. Negotiated Rate	$55.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.38
Rate for Payer: Aetna Government	$34.38
Rate for Payer: Brighton Health Commercial	$51.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.75
Rate for Payer: Group Health Inc Commercial	$34.38
Rate for Payer: Group Health Inc Medicare	$24.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.38
Rate for Payer: Hamaspik Choice Inc Medicare	$34.38

KNIFE COLD SACSE STR

Facility

$84.83

Hospital Charge Code	64907064
Hospital Revenue Code	270
Min. Negotiated Rate	$29.69
Max. Negotiated Rate	$67.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$42.42
Rate for Payer: Aetna Government	$42.42
Rate for Payer: Brighton Health Commercial	$63.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$57.68
Rate for Payer: Group Health Inc Commercial	$42.42
Rate for Payer: Group Health Inc Medicare	$29.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.42
Rate for Payer: Hamaspik Choice Inc Medicare	$42.42

KNIFE GRAFT ACL 10MM

Facility

$388.50

Service Code	HCPCS C1713
Hospital Charge Code	64902702
Hospital Revenue Code	278
Min. Negotiated Rate	$194.25
Max. Negotiated Rate	$194.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$194.25
Rate for Payer: Hamaspik Choice Inc Medicare	$194.25

KNIFE GRAFT ACL 10MM

Facility

$388.50

Service Code	HCPCS C1713
Hospital Charge Code	64902702
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$407.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$213.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$233.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$194.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$223.39
Rate for Payer: EmblemHealth Commercial	$194.25
Rate for Payer: Fidelis Medicare Advantage	$407.92
Rate for Payer: Group Health Inc Commercial	$194.25
Rate for Payer: Group Health Inc Medicare	$135.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$194.25
Rate for Payer: Hamaspik Choice Inc Medicare	$194.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$252.52

KNIFE RELAOD PROX LIN CUT

Facility

$196.96

Hospital Charge Code	64902904
Hospital Revenue Code	270
Min. Negotiated Rate	$68.94
Max. Negotiated Rate	$157.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$108.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.48
Rate for Payer: Aetna Government	$98.48
Rate for Payer: Brighton Health Commercial	$147.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$157.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$133.93
Rate for Payer: Group Health Inc Commercial	$98.48
Rate for Payer: Group Health Inc Medicare	$68.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.48
Rate for Payer: Hamaspik Choice Inc Medicare	$98.48

KNIVES MINI BLADE UNITOME

Facility

$22.40

Hospital Charge Code	64902778
Hospital Revenue Code	270
Min. Negotiated Rate	$7.84
Max. Negotiated Rate	$17.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.20
Rate for Payer: Aetna Government	$11.20
Rate for Payer: Brighton Health Commercial	$16.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.23
Rate for Payer: Group Health Inc Commercial	$11.20
Rate for Payer: Group Health Inc Medicare	$7.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.20
Rate for Payer: Hamaspik Choice Inc Medicare	$11.20

KNIVES ROSETTE ARTHROSCOPIC

Facility

$64.17

Hospital Charge Code	64904547
Hospital Revenue Code	270
Min. Negotiated Rate	$22.46
Max. Negotiated Rate	$51.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.08
Rate for Payer: Aetna Government	$32.08
Rate for Payer: Brighton Health Commercial	$48.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$51.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$43.64
Rate for Payer: Group Health Inc Commercial	$32.08
Rate for Payer: Group Health Inc Medicare	$22.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.08
Rate for Payer: Hamaspik Choice Inc Medicare	$32.08

KNOTLESS CORKSCREW

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	64907363
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,010.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$529.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$577.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$481.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$553.44
Rate for Payer: EmblemHealth Commercial	$481.25
Rate for Payer: Fidelis Medicare Advantage	$1,010.62
Rate for Payer: Group Health Inc Commercial	$481.25
Rate for Payer: Group Health Inc Medicare	$336.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$481.25
Rate for Payer: Hamaspik Choice Inc Medicare	$481.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$625.62

KNOTLESS CORKSCREW

Facility

$962.50

Service Code	HCPCS C1713
Hospital Charge Code	64907363
Hospital Revenue Code	278
Min. Negotiated Rate	$481.25
Max. Negotiated Rate	$481.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$481.25
Rate for Payer: Hamaspik Choice Inc Medicare	$481.25

KNOT PUSHER SUTURE CUTTER FOR 2

Facility

$312.50

Hospital Charge Code	64903182
Hospital Revenue Code	279
Min. Negotiated Rate	$109.38
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$171.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$156.25
Rate for Payer: Aetna Government	$156.25
Rate for Payer: Brighton Health Commercial	$234.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$212.50
Rate for Payer: Group Health Inc Commercial	$156.25
Rate for Payer: Group Health Inc Medicare	$109.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$156.25
Rate for Payer: Hamaspik Choice Inc Medicare	$156.25

Know your out-of-pocket cost for care.

All Charges