St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NCB-PH CASE BASE

Facility

$912.18

Hospital Charge Code	40006827
Hospital Revenue Code	272
Min. Negotiated Rate	$319.26
Max. Negotiated Rate	$729.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$501.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$456.09
Rate for Payer: Aetna Government	$456.09
Rate for Payer: Brighton Health Commercial	$684.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$729.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$620.28
Rate for Payer: Group Health Inc Commercial	$456.09
Rate for Payer: Group Health Inc Medicare	$319.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.09
Rate for Payer: Hamaspik Choice Inc Medicare	$456.09

NCB-PH CASE LID

Facility

$808.36

Hospital Charge Code	40006826
Hospital Revenue Code	272
Min. Negotiated Rate	$282.93
Max. Negotiated Rate	$646.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$444.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$404.18
Rate for Payer: Aetna Government	$404.18
Rate for Payer: Brighton Health Commercial	$606.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$646.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$549.68
Rate for Payer: Group Health Inc Commercial	$404.18
Rate for Payer: Group Health Inc Medicare	$282.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$404.18
Rate for Payer: Hamaspik Choice Inc Medicare	$404.18

NCB-PH CONN SCREW FOR 02.4.220

Facility

$685.64

Service Code	HCPCS C1713
Hospital Charge Code	40006759
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$719.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$377.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$411.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$342.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$394.24
Rate for Payer: EmblemHealth Commercial	$342.82
Rate for Payer: Fidelis Medicare Advantage	$719.92
Rate for Payer: Group Health Inc Commercial	$342.82
Rate for Payer: Group Health Inc Medicare	$239.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$342.82
Rate for Payer: Hamaspik Choice Inc Medicare	$342.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$445.67

NCB-PH CONN SCREW FOR 02.4.220

Facility

$685.64

Service Code	HCPCS C1713
Hospital Charge Code	40006759
Hospital Revenue Code	278
Min. Negotiated Rate	$342.82
Max. Negotiated Rate	$342.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$342.82
Rate for Payer: Hamaspik Choice Inc Medicare	$342.82

NCB-PH CONN SCREW TARGETING DEVIC

Facility

$548.80

Service Code	HCPCS C1713
Hospital Charge Code	40006735
Hospital Revenue Code	278
Min. Negotiated Rate	$274.40
Max. Negotiated Rate	$274.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.40
Rate for Payer: Hamaspik Choice Inc Medicare	$274.40

NCB-PH CONN SCREW TARGETING DEVIC

Facility

$548.80

Service Code	HCPCS C1713
Hospital Charge Code	40006735
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$576.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$301.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$329.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$274.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$315.56
Rate for Payer: EmblemHealth Commercial	$274.40
Rate for Payer: Fidelis Medicare Advantage	$576.24
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$356.72

NCB-PH DRILL GUIDE 2.0/3.3MM

Facility

$363.40

Hospital Charge Code	40006739
Hospital Revenue Code	272
Min. Negotiated Rate	$127.19
Max. Negotiated Rate	$290.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$199.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$181.70
Rate for Payer: Aetna Government	$181.70
Rate for Payer: Brighton Health Commercial	$272.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$290.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$247.11
Rate for Payer: Group Health Inc Commercial	$181.70
Rate for Payer: Group Health Inc Medicare	$127.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$181.70
Rate for Payer: Hamaspik Choice Inc Medicare	$181.70

NCB-PH DRILL GUIDE 3.3/1.6MM

Facility

$430.14

Hospital Charge Code	40006740
Hospital Revenue Code	272
Min. Negotiated Rate	$150.55
Max. Negotiated Rate	$344.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$236.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$215.07
Rate for Payer: Aetna Government	$215.07
Rate for Payer: Brighton Health Commercial	$322.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$344.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$292.50
Rate for Payer: Group Health Inc Commercial	$215.07
Rate for Payer: Group Health Inc Medicare	$150.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$215.07
Rate for Payer: Hamaspik Choice Inc Medicare	$215.07

NCB-PH DRILL GUIDE FOR 024.220

Facility

$355.98

Hospital Charge Code	40006761
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-PH GDWIRE 1.6MMX190MM THR TIP

Facility

$44.50

Service Code	HCPCS C1769
Hospital Charge Code	40006865
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$35.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$33.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.26
Rate for Payer: Group Health Inc Commercial	$22.25
Rate for Payer: Group Health Inc Medicare	$15.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.25
Rate for Payer: Hamaspik Choice Inc Medicare	$22.25

NCB-PH GRAPHIC CASE, MODCREW RACK

Facility

$563.62

Hospital Charge Code	40006836
Hospital Revenue Code	272
Min. Negotiated Rate	$197.27
Max. Negotiated Rate	$450.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$281.81
Rate for Payer: Aetna Government	$281.81
Rate for Payer: Brighton Health Commercial	$422.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$450.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$383.26
Rate for Payer: Group Health Inc Commercial	$281.81
Rate for Payer: Group Health Inc Medicare	$197.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.81
Rate for Payer: Hamaspik Choice Inc Medicare	$281.81

NCB-PH GRAPHIC_CASE,MODCREW RACK

Facility

$578.46

Hospital Charge Code	40006839
Hospital Revenue Code	272
Min. Negotiated Rate	$202.46
Max. Negotiated Rate	$462.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$318.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$289.23
Rate for Payer: Aetna Government	$289.23
Rate for Payer: Brighton Health Commercial	$433.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$462.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$393.35
Rate for Payer: Group Health Inc Commercial	$289.23
Rate for Payer: Group Health Inc Medicare	$202.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$289.23
Rate for Payer: Hamaspik Choice Inc Medicare	$289.23

NCB-PH GRAPHIC CASE,MODMPLANTS

Facility

$1,290.40

Hospital Charge Code	40006835
Hospital Revenue Code	272
Min. Negotiated Rate	$451.64
Max. Negotiated Rate	$1,032.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$709.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$645.20
Rate for Payer: Aetna Government	$645.20
Rate for Payer: Brighton Health Commercial	$967.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,032.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$877.47
Rate for Payer: Group Health Inc Commercial	$645.20
Rate for Payer: Group Health Inc Medicare	$451.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$645.20
Rate for Payer: Hamaspik Choice Inc Medicare	$645.20

NCB-PH GRAPHIC CASE, MODTR EMPTY

Facility

$726.78

Hospital Charge Code	40006837
Hospital Revenue Code	272
Min. Negotiated Rate	$254.37
Max. Negotiated Rate	$581.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$399.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$363.39
Rate for Payer: Aetna Government	$363.39
Rate for Payer: Brighton Health Commercial	$545.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$581.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$494.21
Rate for Payer: Group Health Inc Commercial	$363.39
Rate for Payer: Group Health Inc Medicare	$254.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$363.39
Rate for Payer: Hamaspik Choice Inc Medicare	$363.39

NCB-PH GUIDE FIXATION SCREW

Facility

$237.32

Service Code	HCPCS C1713
Hospital Charge Code	40006736
Hospital Revenue Code	278
Min. Negotiated Rate	$118.66
Max. Negotiated Rate	$118.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.66
Rate for Payer: Hamaspik Choice Inc Medicare	$118.66

NCB-PH GUIDE FIXATION SCREW

Facility

$237.32

Service Code	HCPCS C1713
Hospital Charge Code	40006736
Hospital Revenue Code	278
Min. Negotiated Rate	$83.06
Max. Negotiated Rate	$249.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$142.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$118.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.46
Rate for Payer: EmblemHealth Commercial	$118.66
Rate for Payer: Fidelis Medicare Advantage	$249.19
Rate for Payer: Group Health Inc Commercial	$118.66
Rate for Payer: Group Health Inc Medicare	$83.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.66
Rate for Payer: Hamaspik Choice Inc Medicare	$118.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$154.26

NCB-PH HANDLE FOR TARGETING DEVIC

Facility

$1,883.68

Hospital Charge Code	40006733
Hospital Revenue Code	272
Min. Negotiated Rate	$659.29
Max. Negotiated Rate	$1,506.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,036.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$941.84
Rate for Payer: Aetna Government	$941.84
Rate for Payer: Brighton Health Commercial	$1,412.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,506.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,280.90
Rate for Payer: Group Health Inc Commercial	$941.84
Rate for Payer: Group Health Inc Medicare	$659.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$941.84
Rate for Payer: Hamaspik Choice Inc Medicare	$941.84

NCB-PH INSERT TRAY-EMPTY

Facility

$667.44

Hospital Charge Code	40006831
Hospital Revenue Code	272
Min. Negotiated Rate	$233.60
Max. Negotiated Rate	$533.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$367.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$333.72
Rate for Payer: Aetna Government	$333.72
Rate for Payer: Brighton Health Commercial	$500.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$533.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$453.86
Rate for Payer: Group Health Inc Commercial	$333.72
Rate for Payer: Group Health Inc Medicare	$233.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.72
Rate for Payer: Hamaspik Choice Inc Medicare	$333.72

NCB-PH INSTRUMENT TRAY

Facility

$1,053.08

Hospital Charge Code	40006828
Hospital Revenue Code	272
Min. Negotiated Rate	$368.58
Max. Negotiated Rate	$842.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$579.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$526.54
Rate for Payer: Aetna Government	$526.54
Rate for Payer: Brighton Health Commercial	$789.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$842.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$716.09
Rate for Payer: Group Health Inc Commercial	$526.54
Rate for Payer: Group Health Inc Medicare	$368.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$526.54
Rate for Payer: Hamaspik Choice Inc Medicare	$526.54

NCB-PH JIG FOR 3.5MM LOCSCREWS

Facility

$689.70

Hospital Charge Code	40006758
Hospital Revenue Code	272
Min. Negotiated Rate	$241.40
Max. Negotiated Rate	$551.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$379.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$344.85
Rate for Payer: Aetna Government	$344.85
Rate for Payer: Brighton Health Commercial	$517.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$551.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$469.00
Rate for Payer: Group Health Inc Commercial	$344.85
Rate for Payer: Group Health Inc Medicare	$241.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$344.85
Rate for Payer: Hamaspik Choice Inc Medicare	$344.85

NCB-PH MEAS DEVICE FOR CANN SCREW

Facility

$467.22

Hospital Charge Code	40006744
Hospital Revenue Code	272
Min. Negotiated Rate	$163.53
Max. Negotiated Rate	$373.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$256.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$233.61
Rate for Payer: Aetna Government	$233.61
Rate for Payer: Brighton Health Commercial	$350.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$373.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$317.71
Rate for Payer: Group Health Inc Commercial	$233.61
Rate for Payer: Group Health Inc Medicare	$163.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.61
Rate for Payer: Hamaspik Choice Inc Medicare	$233.61

NCB-PH MEASURING DEVIC=70 MM

Facility

$667.44

Hospital Charge Code	40006754
Hospital Revenue Code	272
Min. Negotiated Rate	$233.60
Max. Negotiated Rate	$533.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$367.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$333.72
Rate for Payer: Aetna Government	$333.72
Rate for Payer: Brighton Health Commercial	$500.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$533.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$453.86
Rate for Payer: Group Health Inc Commercial	$333.72
Rate for Payer: Group Health Inc Medicare	$233.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.72
Rate for Payer: Hamaspik Choice Inc Medicare	$333.72

NCB-PH MIS DRILL BIT X 3.3X230MM

Facility

$237.32

Hospital Charge Code	40006755
Hospital Revenue Code	272
Min. Negotiated Rate	$83.06
Max. Negotiated Rate	$189.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.66
Rate for Payer: Aetna Government	$118.66
Rate for Payer: Brighton Health Commercial	$177.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$189.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.38
Rate for Payer: Group Health Inc Commercial	$118.66
Rate for Payer: Group Health Inc Medicare	$83.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.66
Rate for Payer: Hamaspik Choice Inc Medicare	$118.66

NCB-PH MIS INSTRUMENT TRAY

Facility

$667.44

Hospital Charge Code	40006832
Hospital Revenue Code	272
Min. Negotiated Rate	$233.60
Max. Negotiated Rate	$533.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$367.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$333.72
Rate for Payer: Aetna Government	$333.72
Rate for Payer: Brighton Health Commercial	$500.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$533.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$453.86
Rate for Payer: Group Health Inc Commercial	$333.72
Rate for Payer: Group Health Inc Medicare	$233.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.72
Rate for Payer: Hamaspik Choice Inc Medicare	$333.72

NCB-PH MIS SCREW CADDY

Facility

$526.54

Hospital Charge Code	40006833
Hospital Revenue Code	272
Min. Negotiated Rate	$184.29
Max. Negotiated Rate	$421.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$289.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$263.27
Rate for Payer: Aetna Government	$263.27
Rate for Payer: Brighton Health Commercial	$394.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$421.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$358.05
Rate for Payer: Group Health Inc Commercial	$263.27
Rate for Payer: Group Health Inc Medicare	$184.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$263.27
Rate for Payer: Hamaspik Choice Inc Medicare	$263.27

Know your out-of-pocket cost for care.

All Charges