St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PLATE, MTP 0 DEG MED RIGHT

Facility

$3,158.13

Service Code	HCPCS C1713
Hospital Charge Code	40004427
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,316.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,736.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,894.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,579.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,815.92
Rate for Payer: EmblemHealth Commercial	$1,579.06
Rate for Payer: Fidelis Medicare Advantage	$3,316.04
Rate for Payer: Group Health Inc Commercial	$1,579.06
Rate for Payer: Group Health Inc Medicare	$1,105.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,579.06
Rate for Payer: Hamaspik Choice Inc Medicare	$1,579.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,052.78

PLATE, MTP 0 DEG MED RIGHT

Facility

$3,158.13

Service Code	HCPCS C1713
Hospital Charge Code	40004427
Hospital Revenue Code	278
Min. Negotiated Rate	$1,579.06
Max. Negotiated Rate	$1,579.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,579.06
Rate for Payer: Hamaspik Choice Inc Medicare	$1,579.06

PLATE NARROW LOCKED

Facility

$2,705.00

Service Code	HCPCS C1713
Hospital Charge Code	64903743
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,840.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,487.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,623.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,352.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,555.38
Rate for Payer: EmblemHealth Commercial	$1,352.50
Rate for Payer: Fidelis Medicare Advantage	$2,840.25
Rate for Payer: Group Health Inc Commercial	$1,352.50
Rate for Payer: Group Health Inc Medicare	$946.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,352.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,352.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,758.25

PLATE NARROW LOCKED

Facility

$2,705.00

Service Code	HCPCS C1713
Hospital Charge Code	64903743
Hospital Revenue Code	278
Min. Negotiated Rate	$1,352.50
Max. Negotiated Rate	$1,352.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,352.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,352.50

PLATE NARROW TRI

Facility

$3,696.00

Service Code	HCPCS C1889
Hospital Charge Code	64907486
Hospital Revenue Code	278
Min. Negotiated Rate	$1,293.60
Max. Negotiated Rate	$3,880.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,032.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,848.00
Rate for Payer: Aetna Government	$1,848.00
Rate for Payer: Brighton Health Commercial	$2,217.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,125.20
Rate for Payer: EmblemHealth Commercial	$1,848.00
Rate for Payer: Fidelis Medicare Advantage	$3,880.80
Rate for Payer: Group Health Inc Commercial	$1,848.00
Rate for Payer: Group Health Inc Medicare	$1,293.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,848.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,402.40

PLATE NARROW TRI

Facility

$3,696.00

Service Code	HCPCS C1889
Hospital Charge Code	64907486
Hospital Revenue Code	278
Min. Negotiated Rate	$1,848.00
Max. Negotiated Rate	$1,848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,848.00

PLATE NCB PP 8 HOLE DST FEM

Facility

$1,620.00

Service Code	HCPCS C1713
Hospital Charge Code	64906412
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,701.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$891.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$972.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$810.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$931.50
Rate for Payer: EmblemHealth Commercial	$810.00
Rate for Payer: Fidelis Medicare Advantage	$1,701.00
Rate for Payer: Group Health Inc Commercial	$810.00
Rate for Payer: Group Health Inc Medicare	$567.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$810.00
Rate for Payer: Hamaspik Choice Inc Medicare	$810.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,053.00

PLATE NCB PP 8 HOLE DST FEM

Facility

$1,620.00

Service Code	HCPCS C1713
Hospital Charge Code	64906412
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$810.00
Rate for Payer: Hamaspik Choice Inc Medicare	$810.00

PLATE NCP LAT LEFT 3H, 7H, L

Facility

$3,615.30

Service Code	HCPCS C1713
Hospital Charge Code	64905483
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,796.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,988.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,169.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,807.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,078.80
Rate for Payer: EmblemHealth Commercial	$1,807.65
Rate for Payer: Fidelis Medicare Advantage	$3,796.06
Rate for Payer: Group Health Inc Commercial	$1,807.65
Rate for Payer: Group Health Inc Medicare	$1,265.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,807.65
Rate for Payer: Hamaspik Choice Inc Medicare	$1,807.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,349.94

PLATE NCP LAT LEFT 3H, 7H, L

Facility

$3,615.30

Service Code	HCPCS C1713
Hospital Charge Code	64905483
Hospital Revenue Code	278
Min. Negotiated Rate	$1,807.65
Max. Negotiated Rate	$1,807.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,807.65
Rate for Payer: Hamaspik Choice Inc Medicare	$1,807.65

PLATE NCP LAT PROX 3H TIBIA 7H LT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006600
Hospital Revenue Code	278
Min. Negotiated Rate	$1,446.12
Max. Negotiated Rate	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12

PLATE NCP LAT PROX 3H TIBIA 7H LT

Facility

$4,410.00

Service Code	HCPCS C1713
Hospital Charge Code	40204574
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,630.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,425.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,646.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,205.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,535.75
Rate for Payer: EmblemHealth Commercial	$2,205.00
Rate for Payer: Fidelis Medicare Advantage	$4,630.50
Rate for Payer: Group Health Inc Commercial	$2,205.00
Rate for Payer: Group Health Inc Medicare	$1,543.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,205.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,205.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,866.50

PLATE NCP LAT PROX 3H TIBIA 7H LT

Facility

$2,892.24

Service Code	HCPCS C1713
Hospital Charge Code	40006600
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,036.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,590.73
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,735.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,446.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,663.04
Rate for Payer: EmblemHealth Commercial	$1,446.12
Rate for Payer: Fidelis Medicare Advantage	$3,036.85
Rate for Payer: Group Health Inc Commercial	$1,446.12
Rate for Payer: Group Health Inc Medicare	$1,012.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,446.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,446.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,879.96

PLATE NCP LAT PROX 3H TIBIA 7H LT

Facility

$4,410.00

Service Code	HCPCS C1713
Hospital Charge Code	40204574
Hospital Revenue Code	278
Min. Negotiated Rate	$2,205.00
Max. Negotiated Rate	$2,205.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,205.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,205.00

PLATE OCCIPITAL 24 3 3

Facility

$12,314.38

Service Code	HCPCS C1713
Hospital Charge Code	64904821
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$12,930.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,772.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$7,388.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,157.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,080.77
Rate for Payer: EmblemHealth Commercial	$6,157.19
Rate for Payer: Fidelis Medicare Advantage	$12,930.10
Rate for Payer: Group Health Inc Commercial	$6,157.19
Rate for Payer: Group Health Inc Medicare	$4,310.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,157.19
Rate for Payer: Hamaspik Choice Inc Medicare	$6,157.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,004.35

PLATE OCCIPITAL 24 3 3

Facility

$12,314.38

Service Code	HCPCS C1713
Hospital Charge Code	64904821
Hospital Revenue Code	278
Min. Negotiated Rate	$6,157.19
Max. Negotiated Rate	$6,157.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,157.19
Rate for Payer: Hamaspik Choice Inc Medicare	$6,157.19

PLATE OLECRANON FOR LEFT ULNA 3

Facility

$3,426.75

Service Code	HCPCS C1713
Hospital Charge Code	64904578
Hospital Revenue Code	278
Min. Negotiated Rate	$1,713.38
Max. Negotiated Rate	$1,713.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,713.38
Rate for Payer: Hamaspik Choice Inc Medicare	$1,713.38

PLATE OLECRANON FOR LEFT ULNA 3

Facility

$3,426.75

Service Code	HCPCS C1713
Hospital Charge Code	64904578
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,598.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,884.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,056.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,713.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,970.38
Rate for Payer: EmblemHealth Commercial	$1,713.38
Rate for Payer: Fidelis Medicare Advantage	$3,598.09
Rate for Payer: Group Health Inc Commercial	$1,713.38
Rate for Payer: Group Health Inc Medicare	$1,199.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,713.38
Rate for Payer: Hamaspik Choice Inc Medicare	$1,713.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,227.39

PLATE OMEGA3 TSP

Facility

$1,917.50

Service Code	HCPCS C1713
Hospital Charge Code	64907010
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,013.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,054.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,150.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$958.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,102.56
Rate for Payer: EmblemHealth Commercial	$958.75
Rate for Payer: Fidelis Medicare Advantage	$2,013.38
Rate for Payer: Group Health Inc Commercial	$958.75
Rate for Payer: Group Health Inc Medicare	$671.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$958.75
Rate for Payer: Hamaspik Choice Inc Medicare	$958.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,246.38

PLATE OMEGA3 TSP

Facility

$1,917.50

Service Code	HCPCS C1713
Hospital Charge Code	64907010
Hospital Revenue Code	278
Min. Negotiated Rate	$958.75
Max. Negotiated Rate	$958.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$958.75
Rate for Payer: Hamaspik Choice Inc Medicare	$958.75

PLATE ORB 3D LFT LG

Facility

$2,908.35

Service Code	HCPCS C1713
Hospital Charge Code	64906960
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,053.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,599.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,745.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,454.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,672.30
Rate for Payer: EmblemHealth Commercial	$1,454.18
Rate for Payer: Fidelis Medicare Advantage	$3,053.77
Rate for Payer: Group Health Inc Commercial	$1,454.18
Rate for Payer: Group Health Inc Medicare	$1,017.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,454.18
Rate for Payer: Hamaspik Choice Inc Medicare	$1,454.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,890.43

PLATE ORB 3D LFT LG

Facility

$2,908.35

Service Code	HCPCS C1713
Hospital Charge Code	64906960
Hospital Revenue Code	278
Min. Negotiated Rate	$1,454.18
Max. Negotiated Rate	$1,454.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,454.18
Rate for Payer: Hamaspik Choice Inc Medicare	$1,454.18

PLATE ORBTL 3D LFT SML FLR-04006

Facility

$1,367.02

Service Code	HCPCS C1713
Hospital Charge Code	64906522
Hospital Revenue Code	278
Min. Negotiated Rate	$683.51
Max. Negotiated Rate	$683.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$683.51
Rate for Payer: Hamaspik Choice Inc Medicare	$683.51

PLATE ORBTL 3D LFT SML FLR-04006

Facility

$1,367.02

Service Code	HCPCS C1713
Hospital Charge Code	64906522
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,435.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$751.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$820.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$683.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$786.04
Rate for Payer: EmblemHealth Commercial	$683.51
Rate for Payer: Fidelis Medicare Advantage	$1,435.37
Rate for Payer: Group Health Inc Commercial	$683.51
Rate for Payer: Group Health Inc Medicare	$478.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$683.51
Rate for Payer: Hamaspik Choice Inc Medicare	$683.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$888.56

PLATE ORTHO

Facility

$5,640.73

Hospital Charge Code	64907188
Hospital Revenue Code	278
Min. Negotiated Rate	$2,820.36
Max. Negotiated Rate	$2,820.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,820.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2,820.36

Know your out-of-pocket cost for care.

All Charges