St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PLATE 4 HOLE (626964)

Facility

$2,782.00

Service Code	HCPCS C1713
Hospital Charge Code	64906676
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,921.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,530.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,669.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,391.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,599.65
Rate for Payer: EmblemHealth Commercial	$1,391.00
Rate for Payer: Fidelis Medicare Advantage	$2,921.10
Rate for Payer: Group Health Inc Commercial	$1,391.00
Rate for Payer: Group Health Inc Medicare	$973.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,391.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,391.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,808.30

PLATE 4 HOLE (629724)

Facility

$3,700.00

Service Code	HCPCS C1713
Hospital Charge Code	64906962
Hospital Revenue Code	278
Min. Negotiated Rate	$1,850.00
Max. Negotiated Rate	$1,850.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,850.00

PLATE 4 HOLE (629724)

Facility

$3,700.00

Service Code	HCPCS C1713
Hospital Charge Code	64906962
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,885.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,035.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,220.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,850.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,127.50
Rate for Payer: EmblemHealth Commercial	$1,850.00
Rate for Payer: Fidelis Medicare Advantage	$3,885.00
Rate for Payer: Group Health Inc Commercial	$1,850.00
Rate for Payer: Group Health Inc Medicare	$1,295.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,850.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,405.00

PLATE 4 HOLE CRVD W/BAR MDFC

Facility

$281.13

Service Code	HCPCS C1713
Hospital Charge Code	64901562
Hospital Revenue Code	278
Min. Negotiated Rate	$98.40
Max. Negotiated Rate	$295.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$154.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$168.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$140.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.65
Rate for Payer: EmblemHealth Commercial	$140.56
Rate for Payer: Fidelis Medicare Advantage	$295.19
Rate for Payer: Group Health Inc Commercial	$140.56
Rate for Payer: Group Health Inc Medicare	$98.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.56
Rate for Payer: Hamaspik Choice Inc Medicare	$140.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$182.73

PLATE 4 HOLE CRVD W/BAR MDFC

Facility

$281.13

Service Code	HCPCS C1713
Hospital Charge Code	64901562
Hospital Revenue Code	278
Min. Negotiated Rate	$140.56
Max. Negotiated Rate	$140.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.56
Rate for Payer: Hamaspik Choice Inc Medicare	$140.56

PLATE 4 HOLE FRACTURE W/GAP

Facility

$739.20

Service Code	HCPCS C1713
Hospital Charge Code	64903211
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$776.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$406.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$443.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$369.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$425.04
Rate for Payer: EmblemHealth Commercial	$369.60
Rate for Payer: Fidelis Medicare Advantage	$776.16
Rate for Payer: Group Health Inc Commercial	$369.60
Rate for Payer: Group Health Inc Medicare	$258.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$369.60
Rate for Payer: Hamaspik Choice Inc Medicare	$369.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$480.48

PLATE 4 HOLE FRACTURE W/GAP

Facility

$739.20

Service Code	HCPCS C1713
Hospital Charge Code	64903211
Hospital Revenue Code	278
Min. Negotiated Rate	$369.60
Max. Negotiated Rate	$369.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$369.60
Rate for Payer: Hamaspik Choice Inc Medicare	$369.60

PLATE 4 HOLE MINI

Facility

$179.40

Service Code	HCPCS C1713
Hospital Charge Code	64903206
Hospital Revenue Code	278
Min. Negotiated Rate	$89.70
Max. Negotiated Rate	$89.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.70
Rate for Payer: Hamaspik Choice Inc Medicare	$89.70

PLATE 4 HOLE MINI

Facility

$179.40

Service Code	HCPCS C1713
Hospital Charge Code	64903206
Hospital Revenue Code	278
Min. Negotiated Rate	$62.79
Max. Negotiated Rate	$188.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$107.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$89.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$103.16
Rate for Payer: EmblemHealth Commercial	$89.70
Rate for Payer: Fidelis Medicare Advantage	$188.37
Rate for Payer: Group Health Inc Commercial	$89.70
Rate for Payer: Group Health Inc Medicare	$62.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.70
Rate for Payer: Hamaspik Choice Inc Medicare	$89.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$116.61

PLATE 4 HOLE ORBITAL UPPERFACE

Facility

$218.78

Service Code	HCPCS C1713
Hospital Charge Code	64901544
Hospital Revenue Code	278
Min. Negotiated Rate	$76.57
Max. Negotiated Rate	$229.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$120.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$131.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$109.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$125.80
Rate for Payer: EmblemHealth Commercial	$109.39
Rate for Payer: Fidelis Medicare Advantage	$229.72
Rate for Payer: Group Health Inc Commercial	$109.39
Rate for Payer: Group Health Inc Medicare	$76.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.39
Rate for Payer: Hamaspik Choice Inc Medicare	$109.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$142.21

PLATE 4 HOLE ORBITAL UPPERFACE

Facility

$218.78

Service Code	HCPCS C1713
Hospital Charge Code	64901544
Hospital Revenue Code	278
Min. Negotiated Rate	$109.39
Max. Negotiated Rate	$109.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.39
Rate for Payer: Hamaspik Choice Inc Medicare	$109.39

PLATE 4HOLE ORTHO

Facility

$3,950.00

Service Code	HCPCS C1713
Hospital Charge Code	64907015
Hospital Revenue Code	278
Min. Negotiated Rate	$1,975.00
Max. Negotiated Rate	$1,975.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,975.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,975.00

PLATE 4HOLE ORTHO

Facility

$3,950.00

Service Code	HCPCS C1713
Hospital Charge Code	64907015
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,147.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,172.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,370.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,975.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,271.25
Rate for Payer: EmblemHealth Commercial	$1,975.00
Rate for Payer: Fidelis Medicare Advantage	$4,147.50
Rate for Payer: Group Health Inc Commercial	$1,975.00
Rate for Payer: Group Health Inc Medicare	$1,382.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,975.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,975.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,567.50

PLATE 4 HOLE STRT W BAR

Facility

$228.38

Service Code	HCPCS C1713
Hospital Charge Code	64904110
Hospital Revenue Code	278
Min. Negotiated Rate	$79.93
Max. Negotiated Rate	$239.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$137.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.32
Rate for Payer: EmblemHealth Commercial	$114.19
Rate for Payer: Fidelis Medicare Advantage	$239.80
Rate for Payer: Group Health Inc Commercial	$114.19
Rate for Payer: Group Health Inc Medicare	$79.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.19
Rate for Payer: Hamaspik Choice Inc Medicare	$114.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.45

PLATE 4 HOLE STRT W BAR

Facility

$228.38

Service Code	HCPCS C1713
Hospital Charge Code	64904110
Hospital Revenue Code	278
Min. Negotiated Rate	$114.19
Max. Negotiated Rate	$114.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.19
Rate for Payer: Hamaspik Choice Inc Medicare	$114.19

PLATE 4 HOLE ST SAG 6MM BAR

Facility

$499.50

Service Code	HCPCS C1713
Hospital Charge Code	64903327
Hospital Revenue Code	278
Min. Negotiated Rate	$249.75
Max. Negotiated Rate	$249.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$249.75
Rate for Payer: Hamaspik Choice Inc Medicare	$249.75

PLATE 4 HOLE ST SAG 6MM BAR

Facility

$499.50

Service Code	HCPCS C1713
Hospital Charge Code	64903327
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$524.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$274.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$299.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$249.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$287.21
Rate for Payer: EmblemHealth Commercial	$249.75
Rate for Payer: Fidelis Medicare Advantage	$524.48
Rate for Payer: Group Health Inc Commercial	$249.75
Rate for Payer: Group Health Inc Medicare	$174.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$249.75
Rate for Payer: Hamaspik Choice Inc Medicare	$249.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$324.68

PLATE 4 HOLE W/ SPAA

Facility

$281.83

Service Code	HCPCS C1713
Hospital Charge Code	64904937
Hospital Revenue Code	278
Min. Negotiated Rate	$140.92
Max. Negotiated Rate	$140.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.92
Rate for Payer: Hamaspik Choice Inc Medicare	$140.92

PLATE 4 HOLE W/ SPAA

Facility

$281.83

Service Code	HCPCS C1713
Hospital Charge Code	64904937
Hospital Revenue Code	278
Min. Negotiated Rate	$98.64
Max. Negotiated Rate	$295.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$155.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$169.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$140.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$162.05
Rate for Payer: EmblemHealth Commercial	$140.92
Rate for Payer: Fidelis Medicare Advantage	$295.92
Rate for Payer: Group Health Inc Commercial	$140.92
Rate for Payer: Group Health Inc Medicare	$98.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.92
Rate for Payer: Hamaspik Choice Inc Medicare	$140.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$183.19

PLATE 4HOLE X UN3 (53-34630)

Facility

$233.36

Service Code	HCPCS C1713
Hospital Charge Code	64906510
Hospital Revenue Code	278
Min. Negotiated Rate	$81.68
Max. Negotiated Rate	$245.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$128.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$140.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$116.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$134.18
Rate for Payer: EmblemHealth Commercial	$116.68
Rate for Payer: Fidelis Medicare Advantage	$245.03
Rate for Payer: Group Health Inc Commercial	$116.68
Rate for Payer: Group Health Inc Medicare	$81.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$116.68
Rate for Payer: Hamaspik Choice Inc Medicare	$116.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$151.68

PLATE 4HOLE X UN3 (53-34630)

Facility

$233.36

Service Code	HCPCS C1713
Hospital Charge Code	64906510
Hospital Revenue Code	278
Min. Negotiated Rate	$116.68
Max. Negotiated Rate	$116.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$116.68
Rate for Payer: Hamaspik Choice Inc Medicare	$116.68

PLATE 4H ST LNG BAR MAND

Facility

$269.35

Service Code	HCPCS C1713
Hospital Charge Code	64901382
Hospital Revenue Code	278
Min. Negotiated Rate	$94.27
Max. Negotiated Rate	$282.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$148.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$161.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$134.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$154.88
Rate for Payer: EmblemHealth Commercial	$134.68
Rate for Payer: Fidelis Medicare Advantage	$282.82
Rate for Payer: Group Health Inc Commercial	$134.68
Rate for Payer: Group Health Inc Medicare	$94.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$134.68
Rate for Payer: Hamaspik Choice Inc Medicare	$134.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$175.08

PLATE 4H ST LNG BAR MAND

Facility

$269.35

Service Code	HCPCS C1713
Hospital Charge Code	64901382
Hospital Revenue Code	278
Min. Negotiated Rate	$134.68
Max. Negotiated Rate	$134.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$134.68
Rate for Payer: Hamaspik Choice Inc Medicare	$134.68

PLATE 500-999

Facility

$1,419.03

Service Code	HCPCS C1713
Hospital Charge Code	40203087
Hospital Revenue Code	278
Min. Negotiated Rate	$709.52
Max. Negotiated Rate	$709.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$709.52
Rate for Payer: Hamaspik Choice Inc Medicare	$709.52

PLATE 500-999

Facility

$1,419.03

Service Code	HCPCS C1713
Hospital Charge Code	40203087
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,489.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$851.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$709.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$815.94
Rate for Payer: EmblemHealth Commercial	$709.52
Rate for Payer: Fidelis Medicare Advantage	$1,489.98
Rate for Payer: Group Health Inc Commercial	$709.52
Rate for Payer: Group Health Inc Medicare	$496.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$709.52
Rate for Payer: Hamaspik Choice Inc Medicare	$709.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$922.37

Know your out-of-pocket cost for care.

All Charges