St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NCB-PT LAT PROX 3H TIBIA 5H RIGHT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006987
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 RIGHT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006987
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 7H LEFT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006992
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 7H LEFT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006992
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 9H LEFT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006993
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 9H LEFT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006993
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 TIBIS 9H RIGHT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006989
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 TIBIS 9H RIGHT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006989
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 [RPX 3H TIBIA 7H RIGHT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006988
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 [RPX 3H TIBIA 7H RIGHT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006988
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 MIS INSTRUMENTS MODULE

Facility

$1,208.82

Hospital Charge Code	40006845
Hospital Revenue Code	272
Min. Negotiated Rate	$423.09
Max. Negotiated Rate	$967.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$664.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$604.41
Rate for Payer: Aetna Government	$604.41
Rate for Payer: Brighton Health Commercial	$906.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$967.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$822.00
Rate for Payer: Group Health Inc Commercial	$604.41
Rate for Payer: Group Health Inc Medicare	$423.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$604.41
Rate for Payer: Hamaspik Choice Inc Medicare	$604.41

NCB-PT SCREW MARKER

Facility

$178.00

Hospital Charge Code	40006724
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-PT SCREW RACK

Facility

$637.78

Hospital Charge Code	40006844
Hospital Revenue Code	272
Min. Negotiated Rate	$223.22
Max. Negotiated Rate	$510.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$350.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$318.89
Rate for Payer: Aetna Government	$318.89
Rate for Payer: Brighton Health Commercial	$478.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$510.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$433.69
Rate for Payer: Group Health Inc Commercial	$318.89
Rate for Payer: Group Health Inc Medicare	$223.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$318.89
Rate for Payer: Hamaspik Choice Inc Medicare	$318.89

NCB-PT SFT TS PROT SLV 10.0/8.2MM

Facility

$571.04

Hospital Charge Code	40006729
Hospital Revenue Code	272
Min. Negotiated Rate	$199.86
Max. Negotiated Rate	$456.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$314.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$285.52
Rate for Payer: Aetna Government	$285.52
Rate for Payer: Brighton Health Commercial	$428.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$456.83
Rate for Payer: Cigna LocalPlus Benefit Plan	$388.31
Rate for Payer: Group Health Inc Commercial	$285.52
Rate for Payer: Group Health Inc Medicare	$199.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$285.52
Rate for Payer: Hamaspik Choice Inc Medicare	$285.52

NCB-PT STABILIZATION BOLT

Facility

$889.92

Service Code	HCPCS C1713
Hospital Charge Code	40006728
Hospital Revenue Code	278
Min. Negotiated Rate	$444.96
Max. Negotiated Rate	$444.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$444.96
Rate for Payer: Hamaspik Choice Inc Medicare	$444.96

NCB-PT STABILIZATION BOLT

Facility

$889.92

Service Code	HCPCS C1713
Hospital Charge Code	40006728
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$934.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$489.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$533.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$444.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$511.70
Rate for Payer: EmblemHealth Commercial	$444.96
Rate for Payer: Fidelis Medicare Advantage	$934.42
Rate for Payer: Group Health Inc Commercial	$444.96
Rate for Payer: Group Health Inc Medicare	$311.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$444.96
Rate for Payer: Hamaspik Choice Inc Medicare	$444.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$578.45

NCB-PT TAP 4MM, QC

Facility

$415.30

Service Code	HCPCS C1713
Hospital Charge Code	40006713
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 TAP 4MM, QC

Facility

$415.30

Service Code	HCPCS C1713
Hospital Charge Code	40006713
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 TARGETING DEVICE LEFT

Facility

$8,928.88

Hospital Charge Code	40006726
Hospital Revenue Code	272
Min. Negotiated Rate	$3,125.11
Max. Negotiated Rate	$7,143.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,910.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,464.44
Rate for Payer: Aetna Government	$4,464.44
Rate for Payer: Brighton Health Commercial	$6,696.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7,143.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,071.64
Rate for Payer: Group Health Inc Commercial	$4,464.44
Rate for Payer: Group Health Inc Medicare	$3,125.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,464.44
Rate for Payer: Hamaspik Choice Inc Medicare	$4,464.44

NCB-PT TARGETING DEVICE RIGHT

Facility

$8,928.88

Hospital Charge Code	40006725
Hospital Revenue Code	272
Min. Negotiated Rate	$3,125.11
Max. Negotiated Rate	$7,143.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,910.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,464.44
Rate for Payer: Aetna Government	$4,464.44
Rate for Payer: Brighton Health Commercial	$6,696.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7,143.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,071.64
Rate for Payer: Group Health Inc Commercial	$4,464.44
Rate for Payer: Group Health Inc Medicare	$3,125.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,464.44
Rate for Payer: Hamaspik Choice Inc Medicare	$4,464.44

NCB-PT TROCAR

Facility

$437.56

Hospital Charge Code	40006732
Hospital Revenue Code	272
Min. Negotiated Rate	$153.15
Max. Negotiated Rate	$350.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$240.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$218.78
Rate for Payer: Aetna Government	$218.78
Rate for Payer: Brighton Health Commercial	$328.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$350.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$297.54
Rate for Payer: Group Health Inc Commercial	$218.78
Rate for Payer: Group Health Inc Medicare	$153.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$218.78
Rate for Payer: Hamaspik Choice Inc Medicare	$218.78

NCB SCREW 4.0X100MM SELF-TAPPING

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006958
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 SCREW 4.0X100MM SELF-TAPPING

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006958
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 SCREW 4.0 X 95MM SELF-TAPPING

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006957
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 SCREW 4.0 X 95MM SELF-TAPPING

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40006957
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

Know your out-of-pocket cost for care.

All Charges