St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PLATE BONE LOCKING 175MML 10HOLE

Facility

$2,507.50

Service Code	HCPCS C1713
Hospital Charge Code	64905650
Hospital Revenue Code	278
Min. Negotiated Rate	$1,253.75
Max. Negotiated Rate	$1,253.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,253.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,253.75

PLATE BONE LOCKING 175MML 10HOLE

Facility

$2,507.50

Service Code	HCPCS C1713
Hospital Charge Code	64905650
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,632.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,379.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,504.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,253.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,441.81
Rate for Payer: EmblemHealth Commercial	$1,253.75
Rate for Payer: Fidelis Medicare Advantage	$2,632.88
Rate for Payer: Group Health Inc Commercial	$1,253.75
Rate for Payer: Group Health Inc Medicare	$877.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,253.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,253.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,629.88

PLATE BONE LOCKING M 1.5 7HOLE

Facility

$1,056.25

Service Code	HCPCS C1713
Hospital Charge Code	64905651
Hospital Revenue Code	278
Min. Negotiated Rate	$528.12
Max. Negotiated Rate	$528.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$528.12
Rate for Payer: Hamaspik Choice Inc Medicare	$528.12

PLATE BONE LOCKING M 1.5 7HOLE

Facility

$1,056.25

Service Code	HCPCS C1713
Hospital Charge Code	64905651
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,109.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$580.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$633.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$528.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$607.34
Rate for Payer: EmblemHealth Commercial	$528.12
Rate for Payer: Fidelis Medicare Advantage	$1,109.06
Rate for Payer: Group Health Inc Commercial	$528.12
Rate for Payer: Group Health Inc Medicare	$369.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$528.12
Rate for Payer: Hamaspik Choice Inc Medicare	$528.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$686.56

PLATE BONE LOC MED 57MML HOLEX

Facility

$1,334.13

Service Code	HCPCS C1713
Hospital Charge Code	64902631
Hospital Revenue Code	278
Min. Negotiated Rate	$667.06
Max. Negotiated Rate	$667.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$667.06
Rate for Payer: Hamaspik Choice Inc Medicare	$667.06

PLATE BONE LOC MED 57MML HOLEX

Facility

$1,334.13

Service Code	HCPCS C1713
Hospital Charge Code	64902631
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,400.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$733.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$800.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$667.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$767.12
Rate for Payer: EmblemHealth Commercial	$667.06
Rate for Payer: Fidelis Medicare Advantage	$1,400.84
Rate for Payer: Group Health Inc Commercial	$667.06
Rate for Payer: Group Health Inc Medicare	$466.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$667.06
Rate for Payer: Hamaspik Choice Inc Medicare	$667.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$867.18

PLATE BONE LOC MED 64MML HOLEX

Facility

$1,776.13

Service Code	HCPCS C1713
Hospital Charge Code	64902741
Hospital Revenue Code	278
Min. Negotiated Rate	$888.06
Max. Negotiated Rate	$888.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$888.06
Rate for Payer: Hamaspik Choice Inc Medicare	$888.06

PLATE BONE LOC MED 64MML HOLEX

Facility

$1,776.13

Service Code	HCPCS C1713
Hospital Charge Code	64902741
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,864.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$976.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,065.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$888.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,021.27
Rate for Payer: EmblemHealth Commercial	$888.06
Rate for Payer: Fidelis Medicare Advantage	$1,864.94
Rate for Payer: Group Health Inc Commercial	$888.06
Rate for Payer: Group Health Inc Medicare	$621.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$888.06
Rate for Payer: Hamaspik Choice Inc Medicare	$888.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,154.48

PLATE BONE LOC MESH MED 69MML

Facility

$1,776.13

Service Code	HCPCS C1713
Hospital Charge Code	64901899
Hospital Revenue Code	278
Min. Negotiated Rate	$888.06
Max. Negotiated Rate	$888.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$888.06
Rate for Payer: Hamaspik Choice Inc Medicare	$888.06

PLATE BONE LOC MESH MED 69MML

Facility

$1,776.13

Service Code	HCPCS C1713
Hospital Charge Code	64901899
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,864.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$976.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,065.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$888.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,021.27
Rate for Payer: EmblemHealth Commercial	$888.06
Rate for Payer: Fidelis Medicare Advantage	$1,864.94
Rate for Payer: Group Health Inc Commercial	$888.06
Rate for Payer: Group Health Inc Medicare	$621.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$888.06
Rate for Payer: Hamaspik Choice Inc Medicare	$888.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,154.48

PLATE BONE LOC MESH SM 53MML H

Facility

$1,776.13

Service Code	HCPCS C1781
Hospital Charge Code	64901897
Hospital Revenue Code	278
Min. Negotiated Rate	$888.06
Max. Negotiated Rate	$888.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$888.06
Rate for Payer: Hamaspik Choice Inc Medicare	$888.06

PLATE BONE LOC MESH SM 53MML H

Facility

$1,776.13

Service Code	HCPCS C1781
Hospital Charge Code	64901897
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,864.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$976.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$1,065.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$888.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,021.27
Rate for Payer: EmblemHealth Commercial	$888.06
Rate for Payer: Fidelis Medicare Advantage	$1,864.94
Rate for Payer: Group Health Inc Commercial	$888.06
Rate for Payer: Group Health Inc Medicare	$621.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$888.06
Rate for Payer: Hamaspik Choice Inc Medicare	$888.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,154.48

PLATE BONE LOC SHORT 48MML HOL

Facility

$1,278.88

Service Code	HCPCS C1713
Hospital Charge Code	64902806
Hospital Revenue Code	278
Min. Negotiated Rate	$639.44
Max. Negotiated Rate	$639.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$639.44
Rate for Payer: Hamaspik Choice Inc Medicare	$639.44

PLATE BONE LOC SHORT 48MML HOL

Facility

$1,278.88

Service Code	HCPCS C1713
Hospital Charge Code	64902806
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,342.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$703.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$767.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$639.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$735.36
Rate for Payer: EmblemHealth Commercial	$639.44
Rate for Payer: Fidelis Medicare Advantage	$1,342.82
Rate for Payer: Group Health Inc Commercial	$639.44
Rate for Payer: Group Health Inc Medicare	$447.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$639.44
Rate for Payer: Hamaspik Choice Inc Medicare	$639.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$831.27

PLATE BONE LOC SIZE 1 27MML HO

Facility

$1,326.00

Hospital Charge Code	64903907
Hospital Revenue Code	270
Min. Negotiated Rate	$464.10
Max. Negotiated Rate	$1,060.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$729.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$663.00
Rate for Payer: Aetna Government	$663.00
Rate for Payer: Brighton Health Commercial	$994.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,060.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$901.68
Rate for Payer: Group Health Inc Commercial	$663.00
Rate for Payer: Group Health Inc Medicare	$464.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$663.00
Rate for Payer: Hamaspik Choice Inc Medicare	$663.00

PLATE BONE LOC SIZE 1 32MML HO

Facility

$1,345.50

Service Code	HCPCS C1713
Hospital Charge Code	64902833
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,412.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$740.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$807.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$672.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$773.66
Rate for Payer: EmblemHealth Commercial	$672.75
Rate for Payer: Fidelis Medicare Advantage	$1,412.78
Rate for Payer: Group Health Inc Commercial	$672.75
Rate for Payer: Group Health Inc Medicare	$470.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$672.75
Rate for Payer: Hamaspik Choice Inc Medicare	$672.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$874.58

PLATE BONE LOC SIZE 1 32MML HO

Facility

$1,345.50

Service Code	HCPCS C1713
Hospital Charge Code	64902833
Hospital Revenue Code	278
Min. Negotiated Rate	$672.75
Max. Negotiated Rate	$672.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$672.75
Rate for Payer: Hamaspik Choice Inc Medicare	$672.75

PLATE BONE LOC SM 34MML HOLEX2

Facility

$5,357.50

Service Code	HCPCS C1713
Hospital Charge Code	64904927
Hospital Revenue Code	278
Min. Negotiated Rate	$2,678.75
Max. Negotiated Rate	$2,678.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,678.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,678.75

PLATE BONE LOC SM 34MML HOLEX2

Facility

$5,357.50

Service Code	HCPCS C1713
Hospital Charge Code	64904927
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,625.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,946.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,214.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,678.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,080.56
Rate for Payer: EmblemHealth Commercial	$2,678.75
Rate for Payer: Fidelis Medicare Advantage	$5,625.38
Rate for Payer: Group Health Inc Commercial	$2,678.75
Rate for Payer: Group Health Inc Medicare	$1,875.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,678.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,678.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,482.38

PLATE BONE LOC SM 54MML HOLEX1

Facility

$1,776.13

Service Code	HCPCS C1713
Hospital Charge Code	64902148
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,864.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$976.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,065.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$888.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,021.27
Rate for Payer: EmblemHealth Commercial	$888.06
Rate for Payer: Fidelis Medicare Advantage	$1,864.94
Rate for Payer: Group Health Inc Commercial	$888.06
Rate for Payer: Group Health Inc Medicare	$621.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$888.06
Rate for Payer: Hamaspik Choice Inc Medicare	$888.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,154.48

PLATE BONE LOC SM 54MML HOLEX1

Facility

$1,776.13

Service Code	HCPCS C1713
Hospital Charge Code	64902148
Hospital Revenue Code	278
Min. Negotiated Rate	$888.06
Max. Negotiated Rate	$888.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$888.06
Rate for Payer: Hamaspik Choice Inc Medicare	$888.06

PLATE BONE LOC UTILITY MINI 22

Facility

$4,465.00

Service Code	HCPCS C1713
Hospital Charge Code	64904718
Hospital Revenue Code	278
Min. Negotiated Rate	$2,232.50
Max. Negotiated Rate	$2,232.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,232.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,232.50

PLATE BONE LOC UTILITY MINI 22

Facility

$4,465.00

Service Code	HCPCS C1713
Hospital Charge Code	64904718
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,688.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,455.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,679.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,232.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,567.38
Rate for Payer: EmblemHealth Commercial	$2,232.50
Rate for Payer: Fidelis Medicare Advantage	$4,688.25
Rate for Payer: Group Health Inc Commercial	$2,232.50
Rate for Payer: Group Health Inc Medicare	$1,562.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,232.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,232.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,902.25

PLATE BONE LOW-PROFILE SHORT 4

Facility

$1,381.25

Service Code	HCPCS C1713
Hospital Charge Code	64902338
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,450.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$759.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$828.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$690.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$794.22
Rate for Payer: EmblemHealth Commercial	$690.62
Rate for Payer: Fidelis Medicare Advantage	$1,450.31
Rate for Payer: Group Health Inc Commercial	$690.62
Rate for Payer: Group Health Inc Medicare	$483.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$690.62
Rate for Payer: Hamaspik Choice Inc Medicare	$690.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$897.81

PLATE BONE LOW-PROFILE SHORT 4

Facility

$1,381.25

Service Code	HCPCS C1713
Hospital Charge Code	64902338
Hospital Revenue Code	278
Min. Negotiated Rate	$690.62
Max. Negotiated Rate	$690.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$690.62
Rate for Payer: Hamaspik Choice Inc Medicare	$690.62

Know your out-of-pocket cost for care.

All Charges