St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PIN STEINMAN 5.0X175

Facility

$208.00

Service Code	HCPCS C1713
Hospital Charge Code	40209886
Hospital Revenue Code	278
Min. Negotiated Rate	$72.80
Max. Negotiated Rate	$218.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$114.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$124.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$104.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$119.60
Rate for Payer: EmblemHealth Commercial	$104.00
Rate for Payer: Fidelis Medicare Advantage	$218.40
Rate for Payer: Group Health Inc Commercial	$104.00
Rate for Payer: Group Health Inc Medicare	$72.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.00
Rate for Payer: Hamaspik Choice Inc Medicare	$104.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$135.20

PIN STEINMAN 5.0X175

Facility

$208.00

Service Code	HCPCS C1713
Hospital Charge Code	40209886
Hospital Revenue Code	278
Min. Negotiated Rate	$104.00
Max. Negotiated Rate	$104.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.00
Rate for Payer: Hamaspik Choice Inc Medicare	$104.00

PIN STEINMAN THRD TIP

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64906974
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$409.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$234.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$195.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.25
Rate for Payer: EmblemHealth Commercial	$195.00
Rate for Payer: Fidelis Medicare Advantage	$409.50
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$253.50

PIN STEINMAN THRD TIP

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64906974
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00

PIN STL APX S/D 5X150X40 HF

Facility

$257.14

Service Code	HCPCS C1713
Hospital Charge Code	64906946
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$270.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$141.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$154.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$128.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$147.86
Rate for Payer: EmblemHealth Commercial	$128.57
Rate for Payer: Fidelis Medicare Advantage	$270.00
Rate for Payer: Group Health Inc Commercial	$128.57
Rate for Payer: Group Health Inc Medicare	$90.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.57
Rate for Payer: Hamaspik Choice Inc Medicare	$128.57
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$167.14

PIN STL APX S/D 5X150X40 HF

Facility

$257.14

Service Code	HCPCS C1713
Hospital Charge Code	64906946
Hospital Revenue Code	278
Min. Negotiated Rate	$128.57
Max. Negotiated Rate	$128.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.57
Rate for Payer: Hamaspik Choice Inc Medicare	$128.57

PIN STRINMAN

Facility

$49.00

Service Code	HCPCS C1713
Hospital Charge Code	40200159
Hospital Revenue Code	278
Min. Negotiated Rate	$17.15
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$29.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.18
Rate for Payer: EmblemHealth Commercial	$24.50
Rate for Payer: Fidelis Medicare Advantage	$51.45
Rate for Payer: Group Health Inc Commercial	$24.50
Rate for Payer: Group Health Inc Medicare	$17.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.50
Rate for Payer: Hamaspik Choice Inc Medicare	$24.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$31.85

PIN STRINMAN

Facility

$49.00

Service Code	HCPCS C1713
Hospital Charge Code	40200159
Hospital Revenue Code	278
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$24.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.50
Rate for Payer: Hamaspik Choice Inc Medicare	$24.50

PIN TEMP FIXATION

Facility

$594.15

Hospital Charge Code	64906099
Hospital Revenue Code	270
Min. Negotiated Rate	$207.95
Max. Negotiated Rate	$475.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$326.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$297.08
Rate for Payer: Aetna Government	$297.08
Rate for Payer: Brighton Health Commercial	$445.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$475.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$404.02
Rate for Payer: Group Health Inc Commercial	$297.08
Rate for Payer: Group Health Inc Medicare	$207.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$297.08
Rate for Payer: Hamaspik Choice Inc Medicare	$297.08

PIN TITANIUM SCHANTE

Facility

$264.00

Service Code	HCPCS C1713
Hospital Charge Code	40209887
Hospital Revenue Code	278
Min. Negotiated Rate	$132.00
Max. Negotiated Rate	$132.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$132.00
Rate for Payer: Hamaspik Choice Inc Medicare	$132.00

PIN TITANIUM SCHANTE

Facility

$264.00

Service Code	HCPCS C1713
Hospital Charge Code	40209887
Hospital Revenue Code	278
Min. Negotiated Rate	$92.40
Max. Negotiated Rate	$277.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$145.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$158.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$132.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$151.80
Rate for Payer: EmblemHealth Commercial	$132.00
Rate for Payer: Fidelis Medicare Advantage	$277.20
Rate for Payer: Group Health Inc Commercial	$132.00
Rate for Payer: Group Health Inc Medicare	$92.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$132.00
Rate for Payer: Hamaspik Choice Inc Medicare	$132.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$171.60

PIN TO ROD COUPLING

Facility

$628.60

Service Code	HCPCS C1713
Hospital Charge Code	40201264
Hospital Revenue Code	278
Min. Negotiated Rate	$314.30
Max. Negotiated Rate	$314.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$314.30
Rate for Payer: Hamaspik Choice Inc Medicare	$314.30

PIN TO ROD COUPLING

Facility

$628.60

Service Code	HCPCS C1713
Hospital Charge Code	40201264
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$660.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$345.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$377.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$314.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$361.44
Rate for Payer: EmblemHealth Commercial	$314.30
Rate for Payer: Fidelis Medicare Advantage	$660.03
Rate for Payer: Group Health Inc Commercial	$314.30
Rate for Payer: Group Health Inc Medicare	$220.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$314.30
Rate for Payer: Hamaspik Choice Inc Medicare	$314.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$408.59

PIN TRANS FIX

Facility

$200.00

Service Code	HCPCS C1713
Hospital Charge Code	40201397
Hospital Revenue Code	278
Min. Negotiated Rate	$100.00
Max. Negotiated Rate	$100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

PIN TRANS FIX

Facility

$200.00

Service Code	HCPCS C1713
Hospital Charge Code	40201397
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$210.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.00
Rate for Payer: EmblemHealth Commercial	$100.00
Rate for Payer: Fidelis Medicare Advantage	$210.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$130.00

PIN TRANSFIX AX5/6 40X300

Facility

$123.50

Service Code	HCPCS C1713
Hospital Charge Code	64906459
Hospital Revenue Code	278
Min. Negotiated Rate	$61.75
Max. Negotiated Rate	$61.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.75
Rate for Payer: Hamaspik Choice Inc Medicare	$61.75

PIN TRANSFIX AX5/6 40X300

Facility

$123.50

Service Code	HCPCS C1713
Hospital Charge Code	64906459
Hospital Revenue Code	278
Min. Negotiated Rate	$43.22
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$67.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$74.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$61.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.01
Rate for Payer: EmblemHealth Commercial	$61.75
Rate for Payer: Fidelis Medicare Advantage	$129.68
Rate for Payer: Group Health Inc Commercial	$61.75
Rate for Payer: Group Health Inc Medicare	$43.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.75
Rate for Payer: Hamaspik Choice Inc Medicare	$61.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.28

PIOGLITAZONE 15 MG TAB

Facility

$11.59

Hospital Charge Code	41642383
Hospital Revenue Code	250
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$9.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.80
Rate for Payer: Aetna Government	$5.80
Rate for Payer: Brighton Health Commercial	$8.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.88
Rate for Payer: Group Health Inc Commercial	$5.80
Rate for Payer: Group Health Inc Medicare	$4.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.80
Rate for Payer: Hamaspik Choice Inc Medicare	$5.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.53

PIOGLITAZONE 15 MG TAB

Facility

$11.59

Hospital Charge Code	41652383
Hospital Revenue Code	250
Min. Negotiated Rate	$4.06
Max. Negotiated Rate	$9.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.80
Rate for Payer: Aetna Government	$5.80
Rate for Payer: Brighton Health Commercial	$8.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.88
Rate for Payer: Group Health Inc Commercial	$5.80
Rate for Payer: Group Health Inc Medicare	$4.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.80
Rate for Payer: Hamaspik Choice Inc Medicare	$5.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.53

PIOGLITAZONE 30 MG TAB

Facility

$17.72

Hospital Charge Code	41652511
Hospital Revenue Code	250
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$14.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.86
Rate for Payer: Aetna Government	$8.86
Rate for Payer: Brighton Health Commercial	$13.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.05
Rate for Payer: Group Health Inc Commercial	$8.86
Rate for Payer: Group Health Inc Medicare	$6.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.86
Rate for Payer: Hamaspik Choice Inc Medicare	$8.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.52

PIOGLITAZONE 30 MG TAB

Facility

$17.72

Hospital Charge Code	41642511
Hospital Revenue Code	250
Min. Negotiated Rate	$6.20
Max. Negotiated Rate	$14.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.86
Rate for Payer: Aetna Government	$8.86
Rate for Payer: Brighton Health Commercial	$13.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.05
Rate for Payer: Group Health Inc Commercial	$8.86
Rate for Payer: Group Health Inc Medicare	$6.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.86
Rate for Payer: Hamaspik Choice Inc Medicare	$8.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.52

PIOGLITAZONE 45 MG TAB

Facility

$19.19

Hospital Charge Code	41643002
Hospital Revenue Code	250
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$15.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.60
Rate for Payer: Aetna Government	$9.60
Rate for Payer: Brighton Health Commercial	$14.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.05
Rate for Payer: Group Health Inc Commercial	$9.60
Rate for Payer: Group Health Inc Medicare	$6.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.60
Rate for Payer: Hamaspik Choice Inc Medicare	$9.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.47

PIOGLITAZONE 45 MG TAB

Facility

$19.19

Hospital Charge Code	41653002
Hospital Revenue Code	250
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$15.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.60
Rate for Payer: Aetna Government	$9.60
Rate for Payer: Brighton Health Commercial	$14.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.05
Rate for Payer: Group Health Inc Commercial	$9.60
Rate for Payer: Group Health Inc Medicare	$6.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.60
Rate for Payer: Hamaspik Choice Inc Medicare	$9.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.47

PIOGLITAZONE HCL 15 MG PO TABS [25528]

Facility

$1.56

Service Code	NDC 00904709061
Hospital Charge Code	00904709061
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$1.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.78
Rate for Payer: Aetna Government	$0.78
Rate for Payer: Brighton Health Commercial	$1.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.06
Rate for Payer: Group Health Inc Commercial	$0.78
Rate for Payer: Group Health Inc Medicare	$0.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.78
Rate for Payer: Hamaspik Choice Inc Medicare	$0.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.02

PIOGLITAZONE HCL 15 MG PO TABS [25528]

Facility

$7.01

Service Code	NDC 57237021930
Hospital Charge Code	57237021930
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Brighton Health Commercial	$5.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

Know your out-of-pocket cost for care.

All Charges