St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NCB-PT CASE, BOX

Facility

$978.92

Hospital Charge Code	40006841
Hospital Revenue Code	272
Min. Negotiated Rate	$342.62
Max. Negotiated Rate	$783.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$538.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$489.46
Rate for Payer: Aetna Government	$489.46
Rate for Payer: Brighton Health Commercial	$734.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$783.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$665.67
Rate for Payer: Group Health Inc Commercial	$489.46
Rate for Payer: Group Health Inc Medicare	$342.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$489.46
Rate for Payer: Hamaspik Choice Inc Medicare	$489.46

NCB-PT CASE LID

Facility

$734.20

Hospital Charge Code	40006840
Hospital Revenue Code	272
Min. Negotiated Rate	$256.97
Max. Negotiated Rate	$587.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$403.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$367.10
Rate for Payer: Aetna Government	$367.10
Rate for Payer: Brighton Health Commercial	$550.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$587.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$499.26
Rate for Payer: Group Health Inc Commercial	$367.10
Rate for Payer: Group Health Inc Medicare	$256.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$367.10
Rate for Payer: Hamaspik Choice Inc Medicare	$367.10

NCB-PT CONNECTION BOLT

Facility

$415.30

Service Code	HCPCS C1713
Hospital Charge Code	40006727
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-PT CONNECTION BOLT

Facility

$415.30

Service Code	HCPCS C1713
Hospital Charge Code	40006727
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-PT DEPTH GAUGE

Facility

$815.76

Hospital Charge Code	40006705
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-PT DRILL BIT 2.5MM QC

Facility

$563.62

Hospital Charge Code	40006748
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-PT DRILL BIT 3.3MM QC

Facility

$563.62

Hospital Charge Code	40204621
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-PT DRILL BIT 3.3MM QC

Facility

$563.62

Service Code	HCPCS C1713
Hospital Charge Code	40007540
Hospital Revenue Code	278
Min. Negotiated Rate	$281.81
Max. Negotiated Rate	$281.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.81
Rate for Payer: Hamaspik Choice Inc Medicare	$281.81

NCB-PT DRILL BIT 3.3MM QC

Facility

$563.62

Service Code	HCPCS C1713
Hospital Charge Code	40007540
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$591.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$338.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$281.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$324.08
Rate for Payer: EmblemHealth Commercial	$281.81
Rate for Payer: Fidelis Medicare Advantage	$591.80
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$366.35

NCB-PT DRILL_BIT 3.3MM QC

Facility

$563.62

Hospital Charge Code	40006749
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-PT DRILL BIT 4.3MM QC

Facility

$608.12

Hospital Charge Code	40006750
Hospital Revenue Code	272
Min. Negotiated Rate	$212.84
Max. Negotiated Rate	$486.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$334.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$304.06
Rate for Payer: Aetna Government	$304.06
Rate for Payer: Brighton Health Commercial	$456.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$486.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$413.52
Rate for Payer: Group Health Inc Commercial	$304.06
Rate for Payer: Group Health Inc Medicare	$212.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$304.06
Rate for Payer: Hamaspik Choice Inc Medicare	$304.06

NCB-PT DRILL GUIDE 8.2/5.2MM

Facility

$845.44

Hospital Charge Code	40006730
Hospital Revenue Code	272
Min. Negotiated Rate	$295.90
Max. Negotiated Rate	$676.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$464.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$422.72
Rate for Payer: Aetna Government	$422.72
Rate for Payer: Brighton Health Commercial	$634.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$676.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$574.90
Rate for Payer: Group Health Inc Commercial	$422.72
Rate for Payer: Group Health Inc Medicare	$295.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$422.72
Rate for Payer: Hamaspik Choice Inc Medicare	$422.72

NCB-PT IMPLANTS MODULE

Facility

$1,156.90

Hospital Charge Code	40006843
Hospital Revenue Code	272
Min. Negotiated Rate	$404.92
Max. Negotiated Rate	$925.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$636.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$578.45
Rate for Payer: Aetna Government	$578.45
Rate for Payer: Brighton Health Commercial	$867.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$925.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$786.69
Rate for Payer: Group Health Inc Commercial	$578.45
Rate for Payer: Group Health Inc Medicare	$404.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.45
Rate for Payer: Hamaspik Choice Inc Medicare	$578.45

NCB-PT INSTRUMENTS MODULE

Facility

$1,401.64

Hospital Charge Code	40006842
Hospital Revenue Code	272
Min. Negotiated Rate	$490.57
Max. Negotiated Rate	$1,121.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$770.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$700.82
Rate for Payer: Aetna Government	$700.82
Rate for Payer: Brighton Health Commercial	$1,051.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,121.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$953.12
Rate for Payer: Group Health Inc Commercial	$700.82
Rate for Payer: Group Health Inc Medicare	$490.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$700.82
Rate for Payer: Hamaspik Choice Inc Medicare	$700.82

NCB-PT K-WIRE GUIDE X 5.2/.2MM

Facility

$682.28

Service Code	HCPCS C1769
Hospital Charge Code	40006731
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$545.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$375.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$511.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$545.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$463.95
Rate for Payer: Group Health Inc Commercial	$341.14
Rate for Payer: Group Health Inc Medicare	$238.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$341.14
Rate for Payer: Hamaspik Choice Inc Medicare	$341.14

NCB-PT LAT PROX 3H TIBIA 13H LEFT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40204624
Hospital Revenue Code	278
Min. Negotiated Rate	$1,446.12
Max. Negotiated Rate	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12

NCB-PT LAT PROX 3H TIBIA 13H LEFT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40204624
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,036.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,590.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,735.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,446.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,663.04
Rate for Payer: EmblemHealth Commercial	$1,446.12
Rate for Payer: Fidelis Medicare Advantage	$3,036.85
Rate for Payer: Group Health Inc Commercial	$1,446.12
Rate for Payer: Group Health Inc Medicare	$1,012.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,879.96

NCB-PT LAT PROX 3H TIBIA 13H LEFT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006994
Hospital Revenue Code	278
Min. Negotiated Rate	$1,446.12
Max. Negotiated Rate	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12

NCB-PT LAT PROX 3H TIBIA 13H LEFT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006994
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,036.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,590.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,735.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,446.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,663.04
Rate for Payer: EmblemHealth Commercial	$1,446.12
Rate for Payer: Fidelis Medicare Advantage	$3,036.85
Rate for Payer: Group Health Inc Commercial	$1,446.12
Rate for Payer: Group Health Inc Medicare	$1,012.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,879.96

NCB-PT LAT PROX 3H TIBIA, 13H, LT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40007543
Hospital Revenue Code	278
Min. Negotiated Rate	$1,446.12
Max. Negotiated Rate	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12

NCB-PT LAT PROX 3H TIBIA, 13H, LT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40007543
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,036.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,590.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,735.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,446.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,663.04
Rate for Payer: EmblemHealth Commercial	$1,446.12
Rate for Payer: Fidelis Medicare Advantage	$3,036.85
Rate for Payer: Group Health Inc Commercial	$1,446.12
Rate for Payer: Group Health Inc Medicare	$1,012.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,879.96

NCB-PT LAT PROX 3H TIBIA 13H RT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006990
Hospital Revenue Code	278
Min. Negotiated Rate	$1,446.12
Max. Negotiated Rate	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12

NCB-PT LAT PROX 3H TIBIA 13H RT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006990
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,036.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,590.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,735.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,446.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,663.04
Rate for Payer: EmblemHealth Commercial	$1,446.12
Rate for Payer: Fidelis Medicare Advantage	$3,036.85
Rate for Payer: Group Health Inc Commercial	$1,446.12
Rate for Payer: Group Health Inc Medicare	$1,012.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,879.96

NCB-PT LAT PROX 3H TIBIA 5H LEFT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006991
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,036.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,590.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,735.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,446.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,663.04
Rate for Payer: EmblemHealth Commercial	$1,446.12
Rate for Payer: Fidelis Medicare Advantage	$3,036.85
Rate for Payer: Group Health Inc Commercial	$1,446.12
Rate for Payer: Group Health Inc Medicare	$1,012.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,879.96

NCB-PT LAT PROX 3H TIBIA 5H LEFT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006991
Hospital Revenue Code	278
Min. Negotiated Rate	$1,446.12
Max. Negotiated Rate	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12

Know your out-of-pocket cost for care.

All Charges