St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PLATE ORTHO

Facility

$5,640.73

Hospital Charge Code	64907188
Hospital Revenue Code	278
Min. Negotiated Rate	$1,974.26
Max. Negotiated Rate	$5,922.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,102.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,820.36
Rate for Payer: Aetna Government	$2,820.36
Rate for Payer: Brighton Health Commercial	$3,384.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,820.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,243.42
Rate for Payer: EmblemHealth Commercial	$2,820.36
Rate for Payer: Fidelis Medicare Advantage	$5,922.77
Rate for Payer: Group Health Inc Commercial	$2,820.36
Rate for Payer: Group Health Inc Medicare	$1,974.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,820.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2,820.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,666.47

PLATE ORTHO 8HOLE

Facility

$3,450.00

Service Code	HCPCS C1713
Hospital Charge Code	64907020
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,622.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,897.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,070.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,725.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,983.75
Rate for Payer: EmblemHealth Commercial	$1,725.00
Rate for Payer: Fidelis Medicare Advantage	$3,622.50
Rate for Payer: Group Health Inc Commercial	$1,725.00
Rate for Payer: Group Health Inc Medicare	$1,207.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,725.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,242.50

PLATE ORTHO 8HOLE

Facility

$3,450.00

Service Code	HCPCS C1713
Hospital Charge Code	64907020
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$1,725.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,725.00

PLATE OZARK 42MM

Facility

$4,387.50

Service Code	HCPCS C1889
Hospital Charge Code	64907503
Hospital Revenue Code	278
Min. Negotiated Rate	$1,535.62
Max. Negotiated Rate	$4,606.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,413.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,193.75
Rate for Payer: Aetna Government	$2,193.75
Rate for Payer: Brighton Health Commercial	$2,632.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,193.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,522.81
Rate for Payer: EmblemHealth Commercial	$2,193.75
Rate for Payer: Fidelis Medicare Advantage	$4,606.88
Rate for Payer: Group Health Inc Commercial	$2,193.75
Rate for Payer: Group Health Inc Medicare	$1,535.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,193.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,851.88

PLATE OZARK 42MM

Facility

$4,387.50

Service Code	HCPCS C1889
Hospital Charge Code	64907503
Hospital Revenue Code	278
Min. Negotiated Rate	$2,193.75
Max. Negotiated Rate	$2,193.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,193.75

PLATE PELVIS II

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903201
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,300.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,300.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,600.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,000.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,450.00
Rate for Payer: EmblemHealth Commercial	$3,000.00
Rate for Payer: Fidelis Medicare Advantage	$6,300.00
Rate for Payer: Group Health Inc Commercial	$3,000.00
Rate for Payer: Group Health Inc Medicare	$2,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,000.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,900.00

PLATE PELVIS II

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903201
Hospital Revenue Code	278
Min. Negotiated Rate	$3,000.00
Max. Negotiated Rate	$3,000.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,000.00

PLATE PELV R 108MM L74.5MM 5H

Facility

$779.30

Service Code	HCPCS C1713
Hospital Charge Code	64906958
Hospital Revenue Code	278
Min. Negotiated Rate	$389.65
Max. Negotiated Rate	$389.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$389.65
Rate for Payer: Hamaspik Choice Inc Medicare	$389.65

PLATE PELV R 108MM L74.5MM 5H

Facility

$779.30

Service Code	HCPCS C1713
Hospital Charge Code	64906958
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$818.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$428.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$467.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$389.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$448.10
Rate for Payer: EmblemHealth Commercial	$389.65
Rate for Payer: Fidelis Medicare Advantage	$818.26
Rate for Payer: Group Health Inc Commercial	$389.65
Rate for Payer: Group Health Inc Medicare	$272.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$389.65
Rate for Payer: Hamaspik Choice Inc Medicare	$389.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$506.54

PLATE- POST MEDIUM 12MM

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64904699
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,250.00

PLATE- POST MEDIUM 12MM

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64904699
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$11,025.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,775.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$6,300.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,037.50
Rate for Payer: EmblemHealth Commercial	$5,250.00
Rate for Payer: Fidelis Medicare Advantage	$11,025.00
Rate for Payer: Group Health Inc Commercial	$5,250.00
Rate for Payer: Group Health Inc Medicare	$3,675.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,825.00

PLATE, POST PODT 10MM

Facility

$12,162.50

Service Code	HCPCS C1713
Hospital Charge Code	64905765
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$12,770.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,689.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$7,297.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,081.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,993.44
Rate for Payer: EmblemHealth Commercial	$6,081.25
Rate for Payer: Fidelis Medicare Advantage	$12,770.62
Rate for Payer: Group Health Inc Commercial	$6,081.25
Rate for Payer: Group Health Inc Medicare	$4,256.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,081.25
Rate for Payer: Hamaspik Choice Inc Medicare	$6,081.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,905.62

PLATE, POST PODT 10MM

Facility

$12,162.50

Service Code	HCPCS C1713
Hospital Charge Code	64905765
Hospital Revenue Code	278
Min. Negotiated Rate	$6,081.25
Max. Negotiated Rate	$6,081.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,081.25
Rate for Payer: Hamaspik Choice Inc Medicare	$6,081.25

PLATE PREBENT LEFORT 6MM

Facility

$712.78

Service Code	HCPCS C1713
Hospital Charge Code	64905673
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$748.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$392.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$427.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$356.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$409.85
Rate for Payer: EmblemHealth Commercial	$356.39
Rate for Payer: Fidelis Medicare Advantage	$748.42
Rate for Payer: Group Health Inc Commercial	$356.39
Rate for Payer: Group Health Inc Medicare	$249.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$356.39
Rate for Payer: Hamaspik Choice Inc Medicare	$356.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$463.31

PLATE PREBENT LEFORT 6MM

Facility

$712.78

Service Code	HCPCS C1713
Hospital Charge Code	64905673
Hospital Revenue Code	278
Min. Negotiated Rate	$356.39
Max. Negotiated Rate	$356.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$356.39
Rate for Payer: Hamaspik Choice Inc Medicare	$356.39

PLATE PRIMARY HEMI MAND LEFT

Facility

$2,414.15

Service Code	HCPCS C1713
Hospital Charge Code	64901524
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,534.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,327.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,448.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,207.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,388.14
Rate for Payer: EmblemHealth Commercial	$1,207.08
Rate for Payer: Fidelis Medicare Advantage	$2,534.86
Rate for Payer: Group Health Inc Commercial	$1,207.08
Rate for Payer: Group Health Inc Medicare	$844.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,207.08
Rate for Payer: Hamaspik Choice Inc Medicare	$1,207.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,569.20

PLATE PRIMARY HEMI MAND LEFT

Facility

$2,414.15

Service Code	HCPCS C1713
Hospital Charge Code	64901524
Hospital Revenue Code	278
Min. Negotiated Rate	$1,207.08
Max. Negotiated Rate	$1,207.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,207.08
Rate for Payer: Hamaspik Choice Inc Medicare	$1,207.08

PLATE PRIMARY RECON 11 HOLES

Facility

$1,400.53

Service Code	HCPCS C1713
Hospital Charge Code	64901520
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,470.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$770.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$840.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$700.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$805.30
Rate for Payer: EmblemHealth Commercial	$700.26
Rate for Payer: Fidelis Medicare Advantage	$1,470.56
Rate for Payer: Group Health Inc Commercial	$700.26
Rate for Payer: Group Health Inc Medicare	$490.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$700.26
Rate for Payer: Hamaspik Choice Inc Medicare	$700.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$910.34

PLATE PRIMARY RECON 11 HOLES

Facility

$1,400.53

Service Code	HCPCS C1713
Hospital Charge Code	64901520
Hospital Revenue Code	278
Min. Negotiated Rate	$700.26
Max. Negotiated Rate	$700.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$700.26
Rate for Payer: Hamaspik Choice Inc Medicare	$700.26

PLATE PRIMARY RECON 17 HOLES

Facility

$1,777.45

Service Code	HCPCS C1713
Hospital Charge Code	64901522
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,866.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$977.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,066.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$888.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,022.03
Rate for Payer: EmblemHealth Commercial	$888.72
Rate for Payer: Fidelis Medicare Advantage	$1,866.32
Rate for Payer: Group Health Inc Commercial	$888.72
Rate for Payer: Group Health Inc Medicare	$622.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$888.72
Rate for Payer: Hamaspik Choice Inc Medicare	$888.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,155.34

PLATE PRIMARY RECON 17 HOLES

Facility

$1,777.45

Service Code	HCPCS C1713
Hospital Charge Code	64901522
Hospital Revenue Code	278
Min. Negotiated Rate	$888.72
Max. Negotiated Rate	$888.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$888.72
Rate for Payer: Hamaspik Choice Inc Medicare	$888.72

PLATE PRIMARY RECON 2.0MM

Facility

$4,482.20

Service Code	HCPCS C1713
Hospital Charge Code	64904112
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,706.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,465.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,689.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,241.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,577.26
Rate for Payer: EmblemHealth Commercial	$2,241.10
Rate for Payer: Fidelis Medicare Advantage	$4,706.31
Rate for Payer: Group Health Inc Commercial	$2,241.10
Rate for Payer: Group Health Inc Medicare	$1,568.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,241.10
Rate for Payer: Hamaspik Choice Inc Medicare	$2,241.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,913.43

PLATE PRIMARY RECON 2.0MM

Facility

$4,482.20

Service Code	HCPCS C1713
Hospital Charge Code	64904112
Hospital Revenue Code	278
Min. Negotiated Rate	$2,241.10
Max. Negotiated Rate	$2,241.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,241.10
Rate for Payer: Hamaspik Choice Inc Medicare	$2,241.10

PLATE PRIMRY RECON 17HOLE-5515917

Facility

$710.98

Service Code	HCPCS C1713
Hospital Charge Code	64906397
Hospital Revenue Code	278
Min. Negotiated Rate	$355.49
Max. Negotiated Rate	$355.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$355.49
Rate for Payer: Hamaspik Choice Inc Medicare	$355.49

PLATE PRIMRY RECON 17HOLE-5515917

Facility

$710.98

Service Code	HCPCS C1713
Hospital Charge Code	64906397
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$746.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$391.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$426.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$355.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$408.81
Rate for Payer: EmblemHealth Commercial	$355.49
Rate for Payer: Fidelis Medicare Advantage	$746.53
Rate for Payer: Group Health Inc Commercial	$355.49
Rate for Payer: Group Health Inc Medicare	$248.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$355.49
Rate for Payer: Hamaspik Choice Inc Medicare	$355.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$462.14

Know your out-of-pocket cost for care.

All Charges