St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PIN EXTERNAL FX 5MM DIA 150M B

Facility

$311.20

Service Code	HCPCS C1713
Hospital Charge Code	64904078
Hospital Revenue Code	278
Min. Negotiated Rate	$108.92
Max. Negotiated Rate	$326.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$171.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$186.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$178.94
Rate for Payer: EmblemHealth Commercial	$155.60
Rate for Payer: Fidelis Medicare Advantage	$326.76
Rate for Payer: Group Health Inc Commercial	$155.60
Rate for Payer: Group Health Inc Medicare	$108.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$155.60
Rate for Payer: Hamaspik Choice Inc Medicare	$155.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$202.28

PIN EXTERNAL FX 5MM DIA 150M B

Facility

$311.20

Service Code	HCPCS C1713
Hospital Charge Code	64904078
Hospital Revenue Code	278
Min. Negotiated Rate	$155.60
Max. Negotiated Rate	$155.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$155.60
Rate for Payer: Hamaspik Choice Inc Medicare	$155.60

PIN EXTERNAL FX 5MM DIA 150M C

Facility

$630.00

Service Code	HCPCS C1713
Hospital Charge Code	64902600
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$315.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$315.00
Rate for Payer: Hamaspik Choice Inc Medicare	$315.00

PIN EXTERNAL FX 5MM DIA 150M C

Facility

$630.00

Service Code	HCPCS C1713
Hospital Charge Code	64902600
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$661.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$346.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$378.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$315.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$362.25
Rate for Payer: EmblemHealth Commercial	$315.00
Rate for Payer: Fidelis Medicare Advantage	$661.50
Rate for Payer: Group Health Inc Commercial	$315.00
Rate for Payer: Group Health Inc Medicare	$220.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$315.00
Rate for Payer: Hamaspik Choice Inc Medicare	$315.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$409.50

PIN EXTERNAL FX 5MM DIA 180

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64904698
Hospital Revenue Code	278
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.55
Rate for Payer: EmblemHealth Commercial	$166.56
Rate for Payer: Fidelis Medicare Advantage	$349.79
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.53

PIN EXTERNAL FX 5MM DIA 180

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64904698
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

PIN EXTERNAL FX 5MM DIA 250 A

Facility

$333.13

Hospital Charge Code	64904738
Hospital Revenue Code	270
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$266.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$166.56
Rate for Payer: Aetna Government	$166.56
Rate for Payer: Brighton Health Commercial	$249.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$266.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$226.53
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

PIN EXTERNAL FX 6MM DIA 150

Facility

$349.38

Service Code	HCPCS C1713
Hospital Charge Code	64904334
Hospital Revenue Code	278
Min. Negotiated Rate	$174.69
Max. Negotiated Rate	$174.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.69
Rate for Payer: Hamaspik Choice Inc Medicare	$174.69

PIN EXTERNAL FX 6MM DIA 150

Facility

$349.38

Service Code	HCPCS C1713
Hospital Charge Code	64904334
Hospital Revenue Code	278
Min. Negotiated Rate	$122.28
Max. Negotiated Rate	$366.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$192.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$209.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.89
Rate for Payer: EmblemHealth Commercial	$174.69
Rate for Payer: Fidelis Medicare Advantage	$366.85
Rate for Payer: Group Health Inc Commercial	$174.69
Rate for Payer: Group Health Inc Medicare	$122.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.69
Rate for Payer: Hamaspik Choice Inc Medicare	$174.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$227.10

PIN EXTERNAL FX 6MM DIA 200

Facility

$349.38

Service Code	HCPCS C1713
Hospital Charge Code	64904742
Hospital Revenue Code	278
Min. Negotiated Rate	$122.28
Max. Negotiated Rate	$366.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$192.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$209.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.89
Rate for Payer: EmblemHealth Commercial	$174.69
Rate for Payer: Fidelis Medicare Advantage	$366.85
Rate for Payer: Group Health Inc Commercial	$174.69
Rate for Payer: Group Health Inc Medicare	$122.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.69
Rate for Payer: Hamaspik Choice Inc Medicare	$174.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$227.10

PIN EXTERNAL FX 6MM DIA 200

Facility

$349.38

Service Code	HCPCS C1713
Hospital Charge Code	64904742
Hospital Revenue Code	278
Min. Negotiated Rate	$174.69
Max. Negotiated Rate	$174.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.69
Rate for Payer: Hamaspik Choice Inc Medicare	$174.69

PIN EXTERNAL FX 6MM DIA 200M

Facility

$349.38

Hospital Charge Code	64904700
Hospital Revenue Code	270
Min. Negotiated Rate	$122.28
Max. Negotiated Rate	$279.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$192.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$174.69
Rate for Payer: Aetna Government	$174.69
Rate for Payer: Brighton Health Commercial	$262.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$279.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$237.58
Rate for Payer: Group Health Inc Commercial	$174.69
Rate for Payer: Group Health Inc Medicare	$122.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.69
Rate for Payer: Hamaspik Choice Inc Medicare	$174.69

PIN EXTERNAL FX 6MM DIA 250

Facility

$348.88

Service Code	HCPCS C1713
Hospital Charge Code	64904744
Hospital Revenue Code	278
Min. Negotiated Rate	$122.11
Max. Negotiated Rate	$366.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$209.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.61
Rate for Payer: EmblemHealth Commercial	$174.44
Rate for Payer: Fidelis Medicare Advantage	$366.32
Rate for Payer: Group Health Inc Commercial	$174.44
Rate for Payer: Group Health Inc Medicare	$122.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.44
Rate for Payer: Hamaspik Choice Inc Medicare	$174.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.77

PIN EXTERNAL FX 6MM DIA 250

Facility

$348.88

Service Code	HCPCS C1713
Hospital Charge Code	64904744
Hospital Revenue Code	278
Min. Negotiated Rate	$174.44
Max. Negotiated Rate	$174.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.44
Rate for Payer: Hamaspik Choice Inc Medicare	$174.44

PIN EXTERNAL FX T 5/6MM DIA

Facility

$346.80

Service Code	HCPCS C1713
Hospital Charge Code	64904689
Hospital Revenue Code	278
Min. Negotiated Rate	$173.40
Max. Negotiated Rate	$173.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.40
Rate for Payer: Hamaspik Choice Inc Medicare	$173.40

PIN EXTERNAL FX T 5/6MM DIA

Facility

$346.80

Service Code	HCPCS C1713
Hospital Charge Code	64904689
Hospital Revenue Code	278
Min. Negotiated Rate	$121.38
Max. Negotiated Rate	$364.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$208.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$173.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$199.41
Rate for Payer: EmblemHealth Commercial	$173.40
Rate for Payer: Fidelis Medicare Advantage	$364.14
Rate for Payer: Group Health Inc Commercial	$173.40
Rate for Payer: Group Health Inc Medicare	$121.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.40
Rate for Payer: Hamaspik Choice Inc Medicare	$173.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$225.42

PIN EXTERNAL FX T 5MM/4MM DI A

Facility

$308.75

Service Code	HCPCS C1713
Hospital Charge Code	64904064
Hospital Revenue Code	278
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$324.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$169.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$185.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$154.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$177.53
Rate for Payer: EmblemHealth Commercial	$154.38
Rate for Payer: Fidelis Medicare Advantage	$324.19
Rate for Payer: Group Health Inc Commercial	$154.38
Rate for Payer: Group Health Inc Medicare	$108.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.38
Rate for Payer: Hamaspik Choice Inc Medicare	$154.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$200.69

PIN EXTERNAL FX T 5MM/4MM DI A

Facility

$308.75

Service Code	HCPCS C1713
Hospital Charge Code	64904064
Hospital Revenue Code	278
Min. Negotiated Rate	$154.38
Max. Negotiated Rate	$154.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.38
Rate for Payer: Hamaspik Choice Inc Medicare	$154.38

PIN EXTERNAL FX T 5MM/4MM DI B

Facility

$308.75

Service Code	HCPCS C1713
Hospital Charge Code	64904066
Hospital Revenue Code	278
Min. Negotiated Rate	$108.06
Max. Negotiated Rate	$324.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$169.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$185.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$154.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$177.53
Rate for Payer: EmblemHealth Commercial	$154.38
Rate for Payer: Fidelis Medicare Advantage	$324.19
Rate for Payer: Group Health Inc Commercial	$154.38
Rate for Payer: Group Health Inc Medicare	$108.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.38
Rate for Payer: Hamaspik Choice Inc Medicare	$154.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$200.69

PIN EXTERNAL FX T 5MM/4MM DI B

Facility

$308.75

Service Code	HCPCS C1713
Hospital Charge Code	64904066
Hospital Revenue Code	278
Min. Negotiated Rate	$154.38
Max. Negotiated Rate	$154.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.38
Rate for Payer: Hamaspik Choice Inc Medicare	$154.38

PIN EXTERNAL FX T 5MM/4MM DI C

Facility

$341.25

Service Code	HCPCS C1713
Hospital Charge Code	64904136
Hospital Revenue Code	278
Min. Negotiated Rate	$119.44
Max. Negotiated Rate	$358.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$187.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$204.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$170.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$196.22
Rate for Payer: EmblemHealth Commercial	$170.62
Rate for Payer: Fidelis Medicare Advantage	$358.31
Rate for Payer: Group Health Inc Commercial	$170.62
Rate for Payer: Group Health Inc Medicare	$119.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.62
Rate for Payer: Hamaspik Choice Inc Medicare	$170.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$221.81

PIN EXTERNAL FX T 5MM/4MM DI C

Facility

$341.25

Service Code	HCPCS C1713
Hospital Charge Code	64904136
Hospital Revenue Code	278
Min. Negotiated Rate	$170.62
Max. Negotiated Rate	$170.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.62
Rate for Payer: Hamaspik Choice Inc Medicare	$170.62

PIN FINGER DISLOCATION

Facility

$8,291.05

Service Code	HCPCS 26776
Hospital Charge Code	40009455
Hospital Revenue Code	360
Rate for Payer: Cash Price	$3,743.15

PIN FINGER DISLOCATION

Facility

$8,291.05

Service Code	HCPCS 26776
Hospital Charge Code	40009455
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.00
Max. Negotiated Rate	$6,218.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,743.15
Rate for Payer: Aetna Government	$3,743.15
Rate for Payer: Affinity Essential Plan 1&2	$2,620.20
Rate for Payer: Affinity Essential Plan 3&4	$2,620.20
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,620.20
Rate for Payer: Brighton Health Commercial	$6,218.29
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,743.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$3,743.15
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,181.68
Rate for Payer: Fidelis Essential Plan QHP	$3,331.40
Rate for Payer: Fidelis Medicare Advantage	$3,743.15
Rate for Payer: Fidelis Qualified Health Plan	$3,331.40
Rate for Payer: Group Health Inc Commercial	$3,743.15
Rate for Payer: Group Health Inc Medicare	$3,743.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,145.52
Rate for Payer: Hamaspik Choice Inc Medicare	$3,743.15
Rate for Payer: Healthfirst Medicare Advantage	$3,181.68
Rate for Payer: Healthfirst QHP	$3,743.15
Rate for Payer: Humana Medicare	$3,818.01
Rate for Payer: Senior Whole Health Medicare Advantage	$3,743.15
Rate for Payer: United Healthcare Commercial	$1,468.00
Rate for Payer: United Healthcare Medicare Advantage	$3,743.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,743.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,994.52
Rate for Payer: Wellcare Medicare	$3,555.99

PIN FIXATION 5X150X50MM

Facility

$390.00

Hospital Charge Code	64906055
Hospital Revenue Code	270
Min. Negotiated Rate	$136.50
Max. Negotiated Rate	$312.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$195.00
Rate for Payer: Aetna Government	$195.00
Rate for Payer: Brighton Health Commercial	$292.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$265.20
Rate for Payer: Group Health Inc Commercial	$195.00
Rate for Payer: Group Health Inc Medicare	$136.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00

Know your out-of-pocket cost for care.

All Charges