St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

K-WIRE OLIVE 150163

Facility

$9.00

Service Code	HCPCS C1713
Hospital Charge Code	64906318
Hospital Revenue Code	278
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$5.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.18
Rate for Payer: EmblemHealth Commercial	$4.50
Rate for Payer: Fidelis Medicare Advantage	$9.45
Rate for Payer: Group Health Inc Commercial	$4.50
Rate for Payer: Group Health Inc Medicare	$3.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.85

K-WIRE PERI-LOC 2.0X228MM T

Facility

$374.40

Service Code	HCPCS C1713
Hospital Charge Code	64904456
Hospital Revenue Code	278
Min. Negotiated Rate	$187.20
Max. Negotiated Rate	$187.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.20
Rate for Payer: Hamaspik Choice Inc Medicare	$187.20

K-WIRE PERI-LOC 2.0X228MM T

Facility

$374.40

Service Code	HCPCS C1713
Hospital Charge Code	64904456
Hospital Revenue Code	278
Min. Negotiated Rate	$131.04
Max. Negotiated Rate	$393.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$205.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$224.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$187.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$215.28
Rate for Payer: EmblemHealth Commercial	$187.20
Rate for Payer: Fidelis Medicare Advantage	$393.12
Rate for Payer: Group Health Inc Commercial	$187.20
Rate for Payer: Group Health Inc Medicare	$131.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.20
Rate for Payer: Hamaspik Choice Inc Medicare	$187.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$243.36

KWIRE RECON

Facility

$810.00

Service Code	HCPCS C1713
Hospital Charge Code	64907112
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$850.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$445.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$486.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$405.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$465.75
Rate for Payer: EmblemHealth Commercial	$405.00
Rate for Payer: Fidelis Medicare Advantage	$850.50
Rate for Payer: Group Health Inc Commercial	$405.00
Rate for Payer: Group Health Inc Medicare	$283.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$405.00
Rate for Payer: Hamaspik Choice Inc Medicare	$405.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$526.50

KWIRE RECON

Facility

$810.00

Service Code	HCPCS C1713
Hospital Charge Code	64907112
Hospital Revenue Code	278
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$405.00
Rate for Payer: Hamaspik Choice Inc Medicare	$405.00

KWIRE STD 1.5 X 127MM

Facility

$64.00

Service Code	HCPCS C1769
Hospital Charge Code	64906910
Hospital Revenue Code	278
Min. Negotiated Rate	$32.00
Max. Negotiated Rate	$32.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.00
Rate for Payer: Hamaspik Choice Inc Medicare	$32.00

KWIRE STD 1.5 X 127MM

Facility

$64.00

Service Code	HCPCS C1769
Hospital Charge Code	64906910
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$67.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$38.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.80
Rate for Payer: EmblemHealth Commercial	$32.00
Rate for Payer: Fidelis Medicare Advantage	$67.20
Rate for Payer: Group Health Inc Commercial	$32.00
Rate for Payer: Group Health Inc Medicare	$22.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.00
Rate for Payer: Hamaspik Choice Inc Medicare	$32.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$41.60

K-WIRE STEP

Facility

$26.00

Service Code	HCPCS C1713
Hospital Charge Code	64904537
Hospital Revenue Code	278
Min. Negotiated Rate	$13.00
Max. Negotiated Rate	$13.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.00
Rate for Payer: Hamaspik Choice Inc Medicare	$13.00

K-WIRE STEP

Facility

$26.00

Service Code	HCPCS C1713
Hospital Charge Code	64904537
Hospital Revenue Code	278
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$15.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.95
Rate for Payer: EmblemHealth Commercial	$13.00
Rate for Payer: Fidelis Medicare Advantage	$27.30
Rate for Payer: Group Health Inc Commercial	$13.00
Rate for Payer: Group Health Inc Medicare	$9.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.00
Rate for Payer: Hamaspik Choice Inc Medicare	$13.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$16.90

K-WIRE TROCAR POINT-10 PACK

Facility

$60.00

Service Code	HCPCS C1713
Hospital Charge Code	40200523
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00

K-WIRE TROCAR POINT-10 PACK

Facility

$60.00

Service Code	HCPCS C1713
Hospital Charge Code	40200523
Hospital Revenue Code	278
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$36.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.50
Rate for Payer: EmblemHealth Commercial	$30.00
Rate for Payer: Fidelis Medicare Advantage	$63.00
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$39.00

K WIRE TROC PT 2 ENDS 9X.045

Facility

$26.60

Service Code	HCPCS C1713
Hospital Charge Code	40200780
Hospital Revenue Code	278
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$15.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.30
Rate for Payer: EmblemHealth Commercial	$13.30
Rate for Payer: Fidelis Medicare Advantage	$27.93
Rate for Payer: Group Health Inc Commercial	$13.30
Rate for Payer: Group Health Inc Medicare	$9.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.30
Rate for Payer: Hamaspik Choice Inc Medicare	$13.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.29

K WIRE TROC PT 2 ENDS 9X.045

Facility

$26.60

Service Code	HCPCS C1713
Hospital Charge Code	40200780
Hospital Revenue Code	278
Min. Negotiated Rate	$13.30
Max. Negotiated Rate	$13.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.30
Rate for Payer: Hamaspik Choice Inc Medicare	$13.30

K WIRE TROC PT 2 ENDS 9X.045

Facility

$26.60

Service Code	HCPCS C1713
Hospital Charge Code	40205208
Hospital Revenue Code	278
Min. Negotiated Rate	$13.30
Max. Negotiated Rate	$13.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.30
Rate for Payer: Hamaspik Choice Inc Medicare	$13.30

K WIRE TROC PT 2 ENDS 9X.045

Facility

$26.60

Service Code	HCPCS C1713
Hospital Charge Code	40205208
Hospital Revenue Code	278
Min. Negotiated Rate	$9.31
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$15.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.30
Rate for Payer: EmblemHealth Commercial	$13.30
Rate for Payer: Fidelis Medicare Advantage	$27.93
Rate for Payer: Group Health Inc Commercial	$13.30
Rate for Payer: Group Health Inc Medicare	$9.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.30
Rate for Payer: Hamaspik Choice Inc Medicare	$13.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.29

K-WIRE WITH DRILL TIP 2.0 X 23

Facility

$205.00

Service Code	HCPCS C1713
Hospital Charge Code	64905974
Hospital Revenue Code	278
Min. Negotiated Rate	$102.50
Max. Negotiated Rate	$102.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$102.50
Rate for Payer: Hamaspik Choice Inc Medicare	$102.50

K-WIRE WITH DRILL TIP 2.0 X 23

Facility

$205.00

Service Code	HCPCS C1713
Hospital Charge Code	64905974
Hospital Revenue Code	278
Min. Negotiated Rate	$71.75
Max. Negotiated Rate	$215.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$112.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$123.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$102.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$117.88
Rate for Payer: EmblemHealth Commercial	$102.50
Rate for Payer: Fidelis Medicare Advantage	$215.25
Rate for Payer: Group Health Inc Commercial	$102.50
Rate for Payer: Group Health Inc Medicare	$71.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$102.50
Rate for Payer: Hamaspik Choice Inc Medicare	$102.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$133.25

K-WIRE WITH STOP 2MM - FOR T10

Facility

$112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905054
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.25
Rate for Payer: Hamaspik Choice Inc Medicare	$56.25

K-WIRE WITH STOP 2MM - FOR T10

Facility

$112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905054
Hospital Revenue Code	278
Min. Negotiated Rate	$39.38
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$67.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.69
Rate for Payer: EmblemHealth Commercial	$56.25
Rate for Payer: Fidelis Medicare Advantage	$118.12
Rate for Payer: Group Health Inc Commercial	$56.25
Rate for Payer: Group Health Inc Medicare	$39.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.25
Rate for Payer: Hamaspik Choice Inc Medicare	$56.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$73.12

KYPHO KIT CEMENT C01 B

Facility

$7,850.00

Hospital Charge Code	40202372
Hospital Revenue Code	270
Min. Negotiated Rate	$2,747.50
Max. Negotiated Rate	$6,280.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,317.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,925.00
Rate for Payer: Aetna Government	$3,925.00
Rate for Payer: Brighton Health Commercial	$5,887.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,280.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,338.00
Rate for Payer: Group Health Inc Commercial	$3,925.00
Rate for Payer: Group Health Inc Medicare	$2,747.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,925.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,925.00

KYPHON

Facility

$7,850.00

Hospital Charge Code	40203090
Hospital Revenue Code	272
Min. Negotiated Rate	$2,747.50
Max. Negotiated Rate	$6,280.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,317.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,925.00
Rate for Payer: Aetna Government	$3,925.00
Rate for Payer: Brighton Health Commercial	$5,887.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,280.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,338.00
Rate for Payer: Group Health Inc Commercial	$3,925.00
Rate for Payer: Group Health Inc Medicare	$2,747.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,925.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,925.00

KYPHOPLASTY THORACIC

Facility

$18,618.83

Service Code	HCPCS 22513
Hospital Charge Code	41103929
Hospital Revenue Code	361
Rate for Payer: Cash Price	$8,273.12

KYPHOPLASTY THORACIC

Facility

$18,618.83

Service Code	HCPCS 22513
Hospital Charge Code	41103929
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$13,964.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,593.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8,273.12
Rate for Payer: Aetna Government	$8,273.12
Rate for Payer: Affinity Essential Plan 1&2	$5,791.18
Rate for Payer: Affinity Essential Plan 3&4	$5,791.18
Rate for Payer: Affinity Medicaid/CHP/HARP	$5,791.18
Rate for Payer: Brighton Health Commercial	$13,964.12
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8,273.12
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	$8,273.12
Rate for Payer: EmblemHealth Commercial	$8,273.12
Rate for Payer: Fidelis Essential Plan Aliesa	$7,032.15
Rate for Payer: Fidelis Essential Plan QHP	$7,363.08
Rate for Payer: Fidelis Medicare Advantage	$8,273.12
Rate for Payer: Fidelis Qualified Health Plan	$7,363.08
Rate for Payer: Group Health Inc Commercial	$8,273.12
Rate for Payer: Group Health Inc Medicare	$8,273.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,309.42
Rate for Payer: Hamaspik Choice Inc Medicare	$8,273.12
Rate for Payer: Healthfirst Medicare Advantage	$7,032.15
Rate for Payer: Healthfirst QHP	$8,273.12
Rate for Payer: Humana Medicare	$8,438.58
Rate for Payer: Senior Whole Health Medicare Advantage	$8,273.12
Rate for Payer: United Healthcare Commercial	$2,546.00
Rate for Payer: United Healthcare Medicare Advantage	$8,273.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,273.12
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6,618.50
Rate for Payer: Wellcare Medicare	$7,859.46

KYPHX HV-R BONE CEMENT

Facility

$420.00

Service Code	HCPCS C1713
Hospital Charge Code	40202074
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$441.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$252.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$210.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.50
Rate for Payer: EmblemHealth Commercial	$210.00
Rate for Payer: Fidelis Medicare Advantage	$441.00
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$273.00

KYPHX HV-R BONE CEMENT

Facility

$420.00

Service Code	HCPCS C1713
Hospital Charge Code	40202074
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

Know your out-of-pocket cost for care.

All Charges