St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PLATE AVIATOR 12MM

Facility

$2,291.25

Service Code	HCPCS C1713
Hospital Charge Code	64906230
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,405.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,260.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,374.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,145.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,317.47
Rate for Payer: EmblemHealth Commercial	$1,145.62
Rate for Payer: Fidelis Medicare Advantage	$2,405.81
Rate for Payer: Group Health Inc Commercial	$1,145.62
Rate for Payer: Group Health Inc Medicare	$801.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,145.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,145.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,489.31

PLATE AVIATOR 22MM

Facility

$5,728.13

Service Code	HCPCS C1713
Hospital Charge Code	64905413
Hospital Revenue Code	278
Min. Negotiated Rate	$2,864.06
Max. Negotiated Rate	$2,864.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,864.06
Rate for Payer: Hamaspik Choice Inc Medicare	$2,864.06

PLATE AVIATOR 22MM

Facility

$5,728.13

Service Code	HCPCS C1713
Hospital Charge Code	64905413
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,014.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,150.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,436.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,864.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,293.67
Rate for Payer: EmblemHealth Commercial	$2,864.06
Rate for Payer: Fidelis Medicare Advantage	$6,014.54
Rate for Payer: Group Health Inc Commercial	$2,864.06
Rate for Payer: Group Health Inc Medicare	$2,004.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,864.06
Rate for Payer: Hamaspik Choice Inc Medicare	$2,864.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,723.28

PLATE AVIATOR 24MM

Facility

$6,159.33

Service Code	HCPCS C1713
Hospital Charge Code	64904431
Hospital Revenue Code	278
Min. Negotiated Rate	$3,079.66
Max. Negotiated Rate	$3,079.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,079.66
Rate for Payer: Hamaspik Choice Inc Medicare	$3,079.66

PLATE AVIATOR 24MM

Facility

$6,159.33

Service Code	HCPCS C1713
Hospital Charge Code	64904431
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,467.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,695.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,079.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,541.61
Rate for Payer: EmblemHealth Commercial	$3,079.66
Rate for Payer: Fidelis Medicare Advantage	$6,467.30
Rate for Payer: Group Health Inc Commercial	$3,079.66
Rate for Payer: Group Health Inc Medicare	$2,155.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,079.66
Rate for Payer: Hamaspik Choice Inc Medicare	$3,079.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,003.56

PLATE AVIATOR 26MM

Facility

$4,927.46

Service Code	HCPCS C1713
Hospital Charge Code	64906854
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,173.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,710.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,956.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,463.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,833.29
Rate for Payer: EmblemHealth Commercial	$2,463.73
Rate for Payer: Fidelis Medicare Advantage	$5,173.83
Rate for Payer: Group Health Inc Commercial	$2,463.73
Rate for Payer: Group Health Inc Medicare	$1,724.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,463.73
Rate for Payer: Hamaspik Choice Inc Medicare	$2,463.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,202.85

PLATE AVIATOR 26MM

Facility

$4,927.46

Service Code	HCPCS C1713
Hospital Charge Code	64906854
Hospital Revenue Code	278
Min. Negotiated Rate	$2,463.73
Max. Negotiated Rate	$2,463.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,463.73
Rate for Payer: Hamaspik Choice Inc Medicare	$2,463.73

PLATE AVIATOR 30MM (48811230)

Facility

$2,463.73

Service Code	HCPCS C1713
Hospital Charge Code	64906385
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,586.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,355.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,478.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,231.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,416.64
Rate for Payer: EmblemHealth Commercial	$1,231.86
Rate for Payer: Fidelis Medicare Advantage	$2,586.92
Rate for Payer: Group Health Inc Commercial	$1,231.86
Rate for Payer: Group Health Inc Medicare	$862.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,231.86
Rate for Payer: Hamaspik Choice Inc Medicare	$1,231.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,601.42

PLATE AVIATOR 30MM (48811230)

Facility

$2,463.73

Service Code	HCPCS C1713
Hospital Charge Code	64906385
Hospital Revenue Code	278
Min. Negotiated Rate	$1,231.86
Max. Negotiated Rate	$1,231.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,231.86
Rate for Payer: Hamaspik Choice Inc Medicare	$1,231.86

PLATE AVIATOR 34MM 3LVL

Facility

$5,180.58

Service Code	HCPCS C1713
Hospital Charge Code	64906765
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,439.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,849.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,108.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,590.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,978.83
Rate for Payer: EmblemHealth Commercial	$2,590.29
Rate for Payer: Fidelis Medicare Advantage	$5,439.61
Rate for Payer: Group Health Inc Commercial	$2,590.29
Rate for Payer: Group Health Inc Medicare	$1,813.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,590.29
Rate for Payer: Hamaspik Choice Inc Medicare	$2,590.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,367.38

PLATE AVIATOR 34MM 3LVL

Facility

$5,180.58

Service Code	HCPCS C1713
Hospital Charge Code	64906765
Hospital Revenue Code	278
Min. Negotiated Rate	$2,590.29
Max. Negotiated Rate	$2,590.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,590.29
Rate for Payer: Hamaspik Choice Inc Medicare	$2,590.29

PLATE AVTR SPINE LOCK

Facility

$6,159.32

Service Code	HCPCS C1713
Hospital Charge Code	64907241
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,467.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,695.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,079.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,541.61
Rate for Payer: EmblemHealth Commercial	$3,079.66
Rate for Payer: Fidelis Medicare Advantage	$6,467.29
Rate for Payer: Group Health Inc Commercial	$3,079.66
Rate for Payer: Group Health Inc Medicare	$2,155.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,079.66
Rate for Payer: Hamaspik Choice Inc Medicare	$3,079.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,003.56

PLATE AVTR SPINE LOCK

Facility

$6,159.32

Service Code	HCPCS C1713
Hospital Charge Code	64907241
Hospital Revenue Code	278
Min. Negotiated Rate	$3,079.66
Max. Negotiated Rate	$3,079.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,079.66
Rate for Payer: Hamaspik Choice Inc Medicare	$3,079.66

PLATE BASE REVISION SZ 6 LEFT

Facility

$8,295.00

Service Code	HCPCS C1713
Hospital Charge Code	64903977
Hospital Revenue Code	278
Min. Negotiated Rate	$4,147.50
Max. Negotiated Rate	$4,147.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,147.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4,147.50

PLATE BASE REVISION SZ 6 LEFT

Facility

$8,295.00

Service Code	HCPCS C1713
Hospital Charge Code	64903977
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,709.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,562.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$4,977.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,147.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,769.62
Rate for Payer: EmblemHealth Commercial	$4,147.50
Rate for Payer: Fidelis Medicare Advantage	$8,709.75
Rate for Payer: Group Health Inc Commercial	$4,147.50
Rate for Payer: Group Health Inc Medicare	$2,903.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,147.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4,147.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,391.75

PLATE BONE 101MML HOLEX5 2MM T

Facility

$1,376.38

Service Code	HCPCS C1713
Hospital Charge Code	64902238
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,445.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$757.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$825.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$688.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$791.42
Rate for Payer: EmblemHealth Commercial	$688.19
Rate for Payer: Fidelis Medicare Advantage	$1,445.20
Rate for Payer: Group Health Inc Commercial	$688.19
Rate for Payer: Group Health Inc Medicare	$481.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.19
Rate for Payer: Hamaspik Choice Inc Medicare	$688.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$894.65

PLATE BONE 101MML HOLEX5 2MM T

Facility

$1,376.38

Service Code	HCPCS C1713
Hospital Charge Code	64902238
Hospital Revenue Code	278
Min. Negotiated Rate	$688.19
Max. Negotiated Rate	$688.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.19
Rate for Payer: Hamaspik Choice Inc Medicare	$688.19

PLATE BONE 103MML HOLEX8 TITAN

Facility

$162.50

Service Code	HCPCS C1713
Hospital Charge Code	64904191
Hospital Revenue Code	278
Min. Negotiated Rate	$56.88
Max. Negotiated Rate	$170.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$97.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.44
Rate for Payer: EmblemHealth Commercial	$81.25
Rate for Payer: Fidelis Medicare Advantage	$170.62
Rate for Payer: Group Health Inc Commercial	$81.25
Rate for Payer: Group Health Inc Medicare	$56.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.25
Rate for Payer: Hamaspik Choice Inc Medicare	$81.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.62

PLATE BONE 103MML HOLEX8 TITAN

Facility

$162.50

Service Code	HCPCS C1713
Hospital Charge Code	64904191
Hospital Revenue Code	278
Min. Negotiated Rate	$81.25
Max. Negotiated Rate	$81.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.25
Rate for Payer: Hamaspik Choice Inc Medicare	$81.25

PLATE BONE 10.5MMW X 154.5MML

Facility

$970.13

Service Code	HCPCS C1713
Hospital Charge Code	64903904
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,018.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$533.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$582.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$485.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$557.82
Rate for Payer: EmblemHealth Commercial	$485.06
Rate for Payer: Fidelis Medicare Advantage	$1,018.64
Rate for Payer: Group Health Inc Commercial	$485.06
Rate for Payer: Group Health Inc Medicare	$339.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$485.06
Rate for Payer: Hamaspik Choice Inc Medicare	$485.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$630.58

PLATE BONE 10.5MMW X 154.5MML

Facility

$970.13

Service Code	HCPCS C1713
Hospital Charge Code	64903904
Hospital Revenue Code	278
Min. Negotiated Rate	$485.06
Max. Negotiated Rate	$485.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$485.06
Rate for Payer: Hamaspik Choice Inc Medicare	$485.06

PLATE BONE 108MML HOLEX8 2MM T

Facility

$939.25

Service Code	HCPCS C1713
Hospital Charge Code	64902467
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$986.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$516.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$563.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$540.07
Rate for Payer: EmblemHealth Commercial	$469.62
Rate for Payer: Fidelis Medicare Advantage	$986.21
Rate for Payer: Group Health Inc Commercial	$469.62
Rate for Payer: Group Health Inc Medicare	$328.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$469.62
Rate for Payer: Hamaspik Choice Inc Medicare	$469.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$610.51

PLATE BONE 108MML HOLEX8 2MM T

Facility

$939.25

Service Code	HCPCS C1713
Hospital Charge Code	64902467
Hospital Revenue Code	278
Min. Negotiated Rate	$469.62
Max. Negotiated Rate	$469.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$469.62
Rate for Payer: Hamaspik Choice Inc Medicare	$469.62

PLATE BONE 112MML HOLEX5 STAIN

Facility

$2,437.50

Service Code	HCPCS C1713
Hospital Charge Code	64902698
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,559.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,340.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,462.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,218.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,401.56
Rate for Payer: EmblemHealth Commercial	$1,218.75
Rate for Payer: Fidelis Medicare Advantage	$2,559.38
Rate for Payer: Group Health Inc Commercial	$1,218.75
Rate for Payer: Group Health Inc Medicare	$853.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,218.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,218.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,584.38

PLATE BONE 112MML HOLEX5 STAIN

Facility

$2,437.50

Service Code	HCPCS C1713
Hospital Charge Code	64902698
Hospital Revenue Code	278
Min. Negotiated Rate	$1,218.75
Max. Negotiated Rate	$1,218.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,218.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,218.75

Know your out-of-pocket cost for care.

All Charges