St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NCB-DF DEPTH GAUGE LARGE <110MM

Facility

$815.76

Hospital Charge Code	40006704
Hospital Revenue Code	272
Min. Negotiated Rate	$285.52
Max. Negotiated Rate	$652.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$448.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$407.88
Rate for Payer: Aetna Government	$407.88
Rate for Payer: Brighton Health Commercial	$611.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$652.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$554.72
Rate for Payer: Group Health Inc Commercial	$407.88
Rate for Payer: Group Health Inc Medicare	$285.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$407.88
Rate for Payer: Hamaspik Choice Inc Medicare	$407.88

NCB-DF DRILL BIT 4.3MM X 300MM

Facility

$252.16

Hospital Charge Code	40006702
Hospital Revenue Code	272
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$201.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$126.08
Rate for Payer: Aetna Government	$126.08
Rate for Payer: Brighton Health Commercial	$189.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$201.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$171.47
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

NCB-DF DRILL GUIDE 8.2/4.3MM

Facility

$548.80

Hospital Charge Code	40006717
Hospital Revenue Code	272
Min. Negotiated Rate	$192.08
Max. Negotiated Rate	$439.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$301.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$274.40
Rate for Payer: Aetna Government	$274.40
Rate for Payer: Brighton Health Commercial	$411.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$439.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$373.18
Rate for Payer: Group Health Inc Commercial	$274.40
Rate for Payer: Group Health Inc Medicare	$192.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.40
Rate for Payer: Hamaspik Choice Inc Medicare	$274.40

NCB-DF INSTRUMENTS INSERT

Facility

$1,030.84

Hospital Charge Code	40006822
Hospital Revenue Code	272
Min. Negotiated Rate	$360.79
Max. Negotiated Rate	$824.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$566.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$515.42
Rate for Payer: Aetna Government	$515.42
Rate for Payer: Brighton Health Commercial	$773.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$824.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$700.97
Rate for Payer: Group Health Inc Commercial	$515.42
Rate for Payer: Group Health Inc Medicare	$360.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$515.42
Rate for Payer: Hamaspik Choice Inc Medicare	$515.42

NCB-DF MIS INSTRUMENT TRAY

Facility

$1,193.98

Hospital Charge Code	40006825
Hospital Revenue Code	272
Min. Negotiated Rate	$417.89
Max. Negotiated Rate	$955.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$656.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$596.99
Rate for Payer: Aetna Government	$596.99
Rate for Payer: Brighton Health Commercial	$895.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$955.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$811.91
Rate for Payer: Group Health Inc Commercial	$596.99
Rate for Payer: Group Health Inc Medicare	$417.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$596.99
Rate for Payer: Hamaspik Choice Inc Medicare	$596.99

NCB-DF MIS SCREWDRIVER

Facility

$541.38

Hospital Charge Code	40006710
Hospital Revenue Code	272
Min. Negotiated Rate	$189.48
Max. Negotiated Rate	$433.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$297.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$270.69
Rate for Payer: Aetna Government	$270.69
Rate for Payer: Brighton Health Commercial	$406.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$433.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$368.14
Rate for Payer: Group Health Inc Commercial	$270.69
Rate for Payer: Group Health Inc Medicare	$189.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$270.69
Rate for Payer: Hamaspik Choice Inc Medicare	$270.69

NCB-DF PLATES INSERT

Facility

$1,498.04

Service Code	HCPCS C1713
Hospital Charge Code	40006823
Hospital Revenue Code	278
Min. Negotiated Rate	$749.02
Max. Negotiated Rate	$749.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$749.02
Rate for Payer: Hamaspik Choice Inc Medicare	$749.02

NCB-DF PLATES INSERT

Facility

$1,498.04

Service Code	HCPCS C1713
Hospital Charge Code	40006823
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,572.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$823.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$898.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$749.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$861.37
Rate for Payer: EmblemHealth Commercial	$749.02
Rate for Payer: Fidelis Medicare Advantage	$1,572.94
Rate for Payer: Group Health Inc Commercial	$749.02
Rate for Payer: Group Health Inc Medicare	$524.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$749.02
Rate for Payer: Hamaspik Choice Inc Medicare	$749.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$973.73

NCBDF/PT TRQ SCDRV6MM,3.5HX,280MM

Facility

$2,491.78

Hospital Charge Code	40006708
Hospital Revenue Code	272
Min. Negotiated Rate	$872.12
Max. Negotiated Rate	$1,993.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,370.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,245.89
Rate for Payer: Aetna Government	$1,245.89
Rate for Payer: Brighton Health Commercial	$1,868.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,993.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,694.41
Rate for Payer: Group Health Inc Commercial	$1,245.89
Rate for Payer: Group Health Inc Medicare	$872.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,245.89
Rate for Payer: Hamaspik Choice Inc Medicare	$1,245.89

NCB-DF SAFETY LOCK PIN

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006723
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB-DF SAFETY LOCK PIN

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006723
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$111.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24

NCB-DF SCREW CADDY

Facility

$630.36

Hospital Charge Code	40006824
Hospital Revenue Code	272
Min. Negotiated Rate	$220.63
Max. Negotiated Rate	$504.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$346.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$315.18
Rate for Payer: Aetna Government	$315.18
Rate for Payer: Brighton Health Commercial	$472.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$504.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$428.64
Rate for Payer: Group Health Inc Commercial	$315.18
Rate for Payer: Group Health Inc Medicare	$220.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$315.18
Rate for Payer: Hamaspik Choice Inc Medicare	$315.18

NCB-DF SCREWDRIVER SHAFT QC

Facility

$355.98

Hospital Charge Code	40006711
Hospital Revenue Code	272
Min. Negotiated Rate	$124.59
Max. Negotiated Rate	$284.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$195.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$177.99
Rate for Payer: Aetna Government	$177.99
Rate for Payer: Brighton Health Commercial	$266.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$284.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$242.07
Rate for Payer: Group Health Inc Commercial	$177.99
Rate for Payer: Group Health Inc Medicare	$124.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.99
Rate for Payer: Hamaspik Choice Inc Medicare	$177.99

NCB-DF SOFT TISSUE SLEEVE10/8.2MM

Facility

$415.30

Hospital Charge Code	40006716
Hospital Revenue Code	272
Min. Negotiated Rate	$145.36
Max. Negotiated Rate	$332.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$228.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$207.65
Rate for Payer: Aetna Government	$207.65
Rate for Payer: Brighton Health Commercial	$311.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$332.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$282.40
Rate for Payer: Group Health Inc Commercial	$207.65
Rate for Payer: Group Health Inc Medicare	$145.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.65
Rate for Payer: Hamaspik Choice Inc Medicare	$207.65

NCB-DF STABILIZATION BOLT

Facility

$964.08

Service Code	HCPCS C1713
Hospital Charge Code	40006722
Hospital Revenue Code	278
Min. Negotiated Rate	$482.04
Max. Negotiated Rate	$482.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$482.04
Rate for Payer: Hamaspik Choice Inc Medicare	$482.04

NCB-DF STABILIZATION BOLT

Facility

$964.08

Service Code	HCPCS C1713
Hospital Charge Code	40006722
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,012.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$530.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$578.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$482.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$554.35
Rate for Payer: EmblemHealth Commercial	$482.04
Rate for Payer: Fidelis Medicare Advantage	$1,012.28
Rate for Payer: Group Health Inc Commercial	$482.04
Rate for Payer: Group Health Inc Medicare	$337.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$482.04
Rate for Payer: Hamaspik Choice Inc Medicare	$482.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$626.65

NCB-DF TAP 5.0MM X 250MM

Facility

$415.30

Service Code	HCPCS C1713
Hospital Charge Code	40006715
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$436.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$228.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$249.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$207.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$238.80
Rate for Payer: EmblemHealth Commercial	$207.65
Rate for Payer: Fidelis Medicare Advantage	$436.06
Rate for Payer: Group Health Inc Commercial	$207.65
Rate for Payer: Group Health Inc Medicare	$145.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.65
Rate for Payer: Hamaspik Choice Inc Medicare	$207.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$269.94

NCB-DF TAP 5.0MM X 250MM

Facility

$415.30

Service Code	HCPCS C1713
Hospital Charge Code	40006715
Hospital Revenue Code	278
Min. Negotiated Rate	$207.65
Max. Negotiated Rate	$207.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.65
Rate for Payer: Hamaspik Choice Inc Medicare	$207.65

NCB-DF TARGETING DEVICE-LEFT

Facility

$9,625.98

Hospital Charge Code	40006720
Hospital Revenue Code	272
Min. Negotiated Rate	$3,369.09
Max. Negotiated Rate	$7,700.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,294.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,812.99
Rate for Payer: Aetna Government	$4,812.99
Rate for Payer: Brighton Health Commercial	$7,219.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7,700.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,545.67
Rate for Payer: Group Health Inc Commercial	$4,812.99
Rate for Payer: Group Health Inc Medicare	$3,369.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,812.99
Rate for Payer: Hamaspik Choice Inc Medicare	$4,812.99

NCB-DF TARGETING DEVICE-RIGHT

Facility

$9,625.98

Hospital Charge Code	40006719
Hospital Revenue Code	272
Min. Negotiated Rate	$3,369.09
Max. Negotiated Rate	$7,700.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,294.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,812.99
Rate for Payer: Aetna Government	$4,812.99
Rate for Payer: Brighton Health Commercial	$7,219.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7,700.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,545.67
Rate for Payer: Group Health Inc Commercial	$4,812.99
Rate for Payer: Group Health Inc Medicare	$3,369.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,812.99
Rate for Payer: Hamaspik Choice Inc Medicare	$4,812.99

NCB-DF TROCAR 4.3MM

Facility

$178.00

Hospital Charge Code	40006718
Hospital Revenue Code	272
Min. Negotiated Rate	$62.30
Max. Negotiated Rate	$142.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$97.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$89.00
Rate for Payer: Aetna Government	$89.00
Rate for Payer: Brighton Health Commercial	$133.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$121.04
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

NCB DIST FEM PLATE,L,L.393MM

Facility

$3,589.36

Service Code	HCPCS C1713
Hospital Charge Code	40007279
Hospital Revenue Code	278
Min. Negotiated Rate	$1,794.68
Max. Negotiated Rate	$1,794.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,794.68
Rate for Payer: Hamaspik Choice Inc Medicare	$1,794.68

NCB DIST FEM PLATE,L,L.393MM

Facility

$3,589.36

Service Code	HCPCS C1713
Hospital Charge Code	40007279
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,768.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,974.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,153.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,794.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,063.88
Rate for Payer: EmblemHealth Commercial	$1,794.68
Rate for Payer: Fidelis Medicare Advantage	$3,768.83
Rate for Payer: Group Health Inc Commercial	$1,794.68
Rate for Payer: Group Health Inc Medicare	$1,256.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,794.68
Rate for Payer: Hamaspik Choice Inc Medicare	$1,794.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,333.08

NCB DIST FEMUR PLATE LT 13H 324MM

Facility

$2,966.40

Service Code	HCPCS C1713
Hospital Charge Code	40007256
Hospital Revenue Code	278
Min. Negotiated Rate	$1,483.20
Max. Negotiated Rate	$1,483.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,483.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1,483.20

NCB DIST FEMUR PLATE LT 13H 324MM

Facility

$2,966.40

Service Code	HCPCS C1713
Hospital Charge Code	40007256
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,114.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,631.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,779.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,483.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,705.68
Rate for Payer: EmblemHealth Commercial	$1,483.20
Rate for Payer: Fidelis Medicare Advantage	$3,114.72
Rate for Payer: Group Health Inc Commercial	$1,483.20
Rate for Payer: Group Health Inc Medicare	$1,038.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,483.20
Rate for Payer: Hamaspik Choice Inc Medicare	$1,483.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,928.16

Know your out-of-pocket cost for care.

All Charges