St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NCB PP DIST FEM PLT R L.317MM STR

Facility

$3,114.72

Service Code	HCPCS C1713
Hospital Charge Code	40007017
Hospital Revenue Code	278
Min. Negotiated Rate	$1,557.36
Max. Negotiated Rate	$1,557.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,557.36
Rate for Payer: Hamaspik Choice Inc Medicare	$1,557.36

NCB PP DIST FEM PLT R L.317MM STR

Facility

$3,114.72

Service Code	HCPCS C1713
Hospital Charge Code	40007017
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,270.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,713.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,868.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,557.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,790.96
Rate for Payer: EmblemHealth Commercial	$1,557.36
Rate for Payer: Fidelis Medicare Advantage	$3,270.46
Rate for Payer: Group Health Inc Commercial	$1,557.36
Rate for Payer: Group Health Inc Medicare	$1,090.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,557.36
Rate for Payer: Hamaspik Choice Inc Medicare	$1,557.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,024.57

NCB PP DIST FEM PLT R L.355MM STR

Facility

$3,263.04

Service Code	HCPCS C1713
Hospital Charge Code	40007018
Hospital Revenue Code	278
Min. Negotiated Rate	$1,631.52
Max. Negotiated Rate	$1,631.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,631.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1,631.52

NCB PP DIST FEM PLT R L.355MM STR

Facility

$3,263.04

Service Code	HCPCS C1713
Hospital Charge Code	40007018
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,426.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,794.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,957.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,631.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,876.25
Rate for Payer: EmblemHealth Commercial	$1,631.52
Rate for Payer: Fidelis Medicare Advantage	$3,426.19
Rate for Payer: Group Health Inc Commercial	$1,631.52
Rate for Payer: Group Health Inc Medicare	$1,142.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,631.52
Rate for Payer: Hamaspik Choice Inc Medicare	$1,631.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,120.98

NCB PP DIST FEM PLT R L.393MM STR

Facility

$3,589.36

Service Code	HCPCS C1713
Hospital Charge Code	40007019
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 PP DIST FEM PLT R L.393MM STR

Facility

$3,589.36

Service Code	HCPCS C1713
Hospital Charge Code	40007019
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-PP FEM SCR/INSTDP THRD SCR CD

Facility

$830.60

Service Code	HCPCS C1713
Hospital Charge Code	40006850
Hospital Revenue Code	278
Min. Negotiated Rate	$415.30
Max. Negotiated Rate	$415.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$415.30
Rate for Payer: Hamaspik Choice Inc Medicare	$415.30

NCB-PP FEM SCR/INSTDP THRD SCR CD

Facility

$830.60

Service Code	HCPCS C1713
Hospital Charge Code	40006850
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$872.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$456.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$498.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$415.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$477.60
Rate for Payer: EmblemHealth Commercial	$415.30
Rate for Payer: Fidelis Medicare Advantage	$872.13
Rate for Payer: Group Health Inc Commercial	$415.30
Rate for Payer: Group Health Inc Medicare	$290.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$415.30
Rate for Payer: Hamaspik Choice Inc Medicare	$415.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$539.89

NCB-PP FEM SCR/INSTLCK CAPS/SPCRS

Facility

$281.82

Service Code	HCPCS C1713
Hospital Charge Code	40006852
Hospital Revenue Code	278
Min. Negotiated Rate	$98.64
Max. Negotiated Rate	$295.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$155.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$169.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$140.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$162.05
Rate for Payer: EmblemHealth Commercial	$140.91
Rate for Payer: Fidelis Medicare Advantage	$295.91
Rate for Payer: Group Health Inc Commercial	$140.91
Rate for Payer: Group Health Inc Medicare	$98.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.91
Rate for Payer: Hamaspik Choice Inc Medicare	$140.91
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$183.18

NCB-PP FEM SCR/INSTLCK CAPS/SPCRS

Facility

$281.82

Service Code	HCPCS C1713
Hospital Charge Code	40006852
Hospital Revenue Code	278
Min. Negotiated Rate	$140.91
Max. Negotiated Rate	$140.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.91
Rate for Payer: Hamaspik Choice Inc Medicare	$140.91

NCB-PP FEM SCR INSTSTNDRD SCR CAD

Facility

$1,423.88

Service Code	HCPCS C1713
Hospital Charge Code	40006849
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,495.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$783.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$854.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$711.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$818.73
Rate for Payer: EmblemHealth Commercial	$711.94
Rate for Payer: Fidelis Medicare Advantage	$1,495.07
Rate for Payer: Group Health Inc Commercial	$711.94
Rate for Payer: Group Health Inc Medicare	$498.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$711.94
Rate for Payer: Hamaspik Choice Inc Medicare	$711.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$925.52

NCB-PP FEM SCR INSTSTNDRD SCR CAD

Facility

$1,423.88

Service Code	HCPCS C1713
Hospital Charge Code	40006849
Hospital Revenue Code	278
Min. Negotiated Rate	$711.94
Max. Negotiated Rate	$711.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$711.94
Rate for Payer: Hamaspik Choice Inc Medicare	$711.94

NCB-PP FEMUR MIS DRILL 3

Facility

$237.32

Hospital Charge Code	40006871
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-PP FEMUR PLATES BASE

Facility

$3,025.74

Service Code	HCPCS C1713
Hospital Charge Code	40006846
Hospital Revenue Code	278
Min. Negotiated Rate	$1,512.87
Max. Negotiated Rate	$1,512.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,512.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,512.87

NCB-PP FEMUR PLATES BASE

Facility

$3,025.74

Service Code	HCPCS C1713
Hospital Charge Code	40006846
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,177.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,664.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,815.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,512.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,739.80
Rate for Payer: EmblemHealth Commercial	$1,512.87
Rate for Payer: Fidelis Medicare Advantage	$3,177.03
Rate for Payer: Group Health Inc Commercial	$1,512.87
Rate for Payer: Group Health Inc Medicare	$1,059.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,512.87
Rate for Payer: Hamaspik Choice Inc Medicare	$1,512.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,966.73

NCB-PP FEMUR PROVISIONALS BASE

Facility

$1,750.18

Service Code	HCPCS C1713
Hospital Charge Code	40006853
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,837.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$962.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,050.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$875.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,006.35
Rate for Payer: EmblemHealth Commercial	$875.09
Rate for Payer: Fidelis Medicare Advantage	$1,837.69
Rate for Payer: Group Health Inc Commercial	$875.09
Rate for Payer: Group Health Inc Medicare	$612.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$875.09
Rate for Payer: Hamaspik Choice Inc Medicare	$875.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,137.62

NCB-PP FEMUR PROVISIONALS BASE

Facility

$1,750.18

Service Code	HCPCS C1713
Hospital Charge Code	40006853
Hospital Revenue Code	278
Min. Negotiated Rate	$875.09
Max. Negotiated Rate	$875.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$875.09
Rate for Payer: Hamaspik Choice Inc Medicare	$875.09

NCB-PP FEMUR SCR AND INSTBASE

Facility

$2,417.62

Service Code	HCPCS C1713
Hospital Charge Code	40006848
Hospital Revenue Code	278
Min. Negotiated Rate	$1,208.81
Max. Negotiated Rate	$1,208.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,208.81
Rate for Payer: Hamaspik Choice Inc Medicare	$1,208.81

NCB-PP FEMUR SCR AND INSTBASE

Facility

$2,417.62

Service Code	HCPCS C1713
Hospital Charge Code	40006848
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,538.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,329.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,450.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,208.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,390.13
Rate for Payer: EmblemHealth Commercial	$1,208.81
Rate for Payer: Fidelis Medicare Advantage	$2,538.50
Rate for Payer: Group Health Inc Commercial	$1,208.81
Rate for Payer: Group Health Inc Medicare	$846.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,208.81
Rate for Payer: Hamaspik Choice Inc Medicare	$1,208.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,571.45

NCB-PP FEMUR SCR AND INSTTRAY

Facility

$1,186.56

Service Code	HCPCS C1713
Hospital Charge Code	40006851
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,245.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$652.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$711.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$593.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$682.27
Rate for Payer: EmblemHealth Commercial	$593.28
Rate for Payer: Fidelis Medicare Advantage	$1,245.89
Rate for Payer: Group Health Inc Commercial	$593.28
Rate for Payer: Group Health Inc Medicare	$415.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$593.28
Rate for Payer: Hamaspik Choice Inc Medicare	$593.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$771.26

NCB-PP FEMUR SCR AND INSTTRAY

Facility

$1,186.56

Service Code	HCPCS C1713
Hospital Charge Code	40006851
Hospital Revenue Code	278
Min. Negotiated Rate	$593.28
Max. Negotiated Rate	$593.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$593.28
Rate for Payer: Hamaspik Choice Inc Medicare	$593.28

NCB-PP FEMUR SCR/INSTBASE/TRAYS

Facility

$5,369.20

Service Code	HCPCS C1713
Hospital Charge Code	40006847
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,637.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,953.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,221.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,684.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,087.29
Rate for Payer: EmblemHealth Commercial	$2,684.60
Rate for Payer: Fidelis Medicare Advantage	$5,637.66
Rate for Payer: Group Health Inc Commercial	$2,684.60
Rate for Payer: Group Health Inc Medicare	$1,879.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,684.60
Rate for Payer: Hamaspik Choice Inc Medicare	$2,684.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,489.98

NCB-PP FEMUR SCR/INSTBASE/TRAYS

Facility

$5,369.20

Service Code	HCPCS C1713
Hospital Charge Code	40006847
Hospital Revenue Code	278
Min. Negotiated Rate	$2,684.60
Max. Negotiated Rate	$2,684.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,684.60
Rate for Payer: Hamaspik Choice Inc Medicare	$2,684.60

NCB PP PF PROV,LT,15/18 HL PLATES

Facility

$192.82

Service Code	HCPCS C1713
Hospital Charge Code	40006788
Hospital Revenue Code	278
Min. Negotiated Rate	$67.49
Max. Negotiated Rate	$202.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$106.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$115.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$96.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$110.87
Rate for Payer: EmblemHealth Commercial	$96.41
Rate for Payer: Fidelis Medicare Advantage	$202.46
Rate for Payer: Group Health Inc Commercial	$96.41
Rate for Payer: Group Health Inc Medicare	$67.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$96.41
Rate for Payer: Hamaspik Choice Inc Medicare	$96.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$125.33

NCB PP PF PROV,LT,15/18 HL PLATES

Facility

$192.82

Service Code	HCPCS C1713
Hospital Charge Code	40006788
Hospital Revenue Code	278
Min. Negotiated Rate	$96.41
Max. Negotiated Rate	$96.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$96.41
Rate for Payer: Hamaspik Choice Inc Medicare	$96.41

Know your out-of-pocket cost for care.

All Charges