St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PLATE STR MED 6H COMMAND

Facility

$934.00

Service Code	HCPCS C1713
Hospital Charge Code	40200736
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$980.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$513.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$560.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$467.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$537.05
Rate for Payer: EmblemHealth Commercial	$467.00
Rate for Payer: Fidelis Medicare Advantage	$980.70
Rate for Payer: Group Health Inc Commercial	$467.00
Rate for Payer: Group Health Inc Medicare	$326.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$467.00
Rate for Payer: Hamaspik Choice Inc Medicare	$467.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$607.10

PLATE STR MED 6H COMMAND

Facility

$934.00

Service Code	HCPCS C1713
Hospital Charge Code	40200736
Hospital Revenue Code	278
Min. Negotiated Rate	$467.00
Max. Negotiated Rate	$467.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$467.00
Rate for Payer: Hamaspik Choice Inc Medicare	$467.00

PLATE STRT 16-HOLE MDFACE LOCK

Facility

$764.28

Service Code	HCPCS C1713
Hospital Charge Code	64901579
Hospital Revenue Code	278
Min. Negotiated Rate	$382.14
Max. Negotiated Rate	$382.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$382.14
Rate for Payer: Hamaspik Choice Inc Medicare	$382.14

PLATE STRT 16-HOLE MDFACE LOCK

Facility

$764.28

Service Code	HCPCS C1713
Hospital Charge Code	64901579
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$802.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$420.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$458.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$382.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$439.46
Rate for Payer: EmblemHealth Commercial	$382.14
Rate for Payer: Fidelis Medicare Advantage	$802.49
Rate for Payer: Group Health Inc Commercial	$382.14
Rate for Payer: Group Health Inc Medicare	$267.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$382.14
Rate for Payer: Hamaspik Choice Inc Medicare	$382.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$496.78

PLATE STRT PELV

Facility

$641.78

Service Code	HCPCS C1713
Hospital Charge Code	64907413
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$673.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$352.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$385.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$320.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$369.02
Rate for Payer: EmblemHealth Commercial	$320.89
Rate for Payer: Fidelis Medicare Advantage	$673.87
Rate for Payer: Group Health Inc Commercial	$320.89
Rate for Payer: Group Health Inc Medicare	$224.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$320.89
Rate for Payer: Hamaspik Choice Inc Medicare	$320.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$417.16

PLATE STRT PELV

Facility

$641.78

Service Code	HCPCS C1713
Hospital Charge Code	64907413
Hospital Revenue Code	278
Min. Negotiated Rate	$320.89
Max. Negotiated Rate	$320.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$320.89
Rate for Payer: Hamaspik Choice Inc Medicare	$320.89

PLATE STRT PELV L 42.5MM/3H

Facility

$671.13

Service Code	HCPCS C1713
Hospital Charge Code	64905742
Hospital Revenue Code	278
Min. Negotiated Rate	$335.56
Max. Negotiated Rate	$335.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$335.56
Rate for Payer: Hamaspik Choice Inc Medicare	$335.56

PLATE STRT PELV L 42.5MM/3H

Facility

$671.13

Service Code	HCPCS C1713
Hospital Charge Code	64905742
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$704.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$369.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$402.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$335.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$385.90
Rate for Payer: EmblemHealth Commercial	$335.56
Rate for Payer: Fidelis Medicare Advantage	$704.69
Rate for Payer: Group Health Inc Commercial	$335.56
Rate for Payer: Group Health Inc Medicare	$234.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$335.56
Rate for Payer: Hamaspik Choice Inc Medicare	$335.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$436.23

PLATE SUBOCCIP MALLEABLE

Facility

$1,687.15

Service Code	HCPCS C1713
Hospital Charge Code	64907340
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,771.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$927.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,012.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$843.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$970.11
Rate for Payer: EmblemHealth Commercial	$843.58
Rate for Payer: Fidelis Medicare Advantage	$1,771.51
Rate for Payer: Group Health Inc Commercial	$843.58
Rate for Payer: Group Health Inc Medicare	$590.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$843.58
Rate for Payer: Hamaspik Choice Inc Medicare	$843.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,096.65

PLATE SUBOCCIP MALLEABLE

Facility

$1,687.15

Service Code	HCPCS C1713
Hospital Charge Code	64907340
Hospital Revenue Code	278
Min. Negotiated Rate	$843.58
Max. Negotiated Rate	$843.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$843.58
Rate for Payer: Hamaspik Choice Inc Medicare	$843.58

PLATE SUPERIOR

Facility

$3,020.05

Service Code	HCPCS C1713
Hospital Charge Code	64907419
Hospital Revenue Code	278
Min. Negotiated Rate	$1,510.02
Max. Negotiated Rate	$1,510.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,510.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,510.02

PLATE SUPERIOR

Facility

$3,020.05

Service Code	HCPCS C1713
Hospital Charge Code	64907419
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,171.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,661.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,812.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,510.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,736.53
Rate for Payer: EmblemHealth Commercial	$1,510.02
Rate for Payer: Fidelis Medicare Advantage	$3,171.05
Rate for Payer: Group Health Inc Commercial	$1,510.02
Rate for Payer: Group Health Inc Medicare	$1,057.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,510.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,510.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,963.03

PLATE SUPR DECREASED 10 HL LT

Facility

$1,208.03

Service Code	HCPCS C1713
Hospital Charge Code	64906513
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,268.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$664.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$724.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$604.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$694.62
Rate for Payer: EmblemHealth Commercial	$604.02
Rate for Payer: Fidelis Medicare Advantage	$1,268.43
Rate for Payer: Group Health Inc Commercial	$604.02
Rate for Payer: Group Health Inc Medicare	$422.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$604.02
Rate for Payer: Hamaspik Choice Inc Medicare	$604.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$785.22

PLATE SUPR DECREASED 10 HL LT

Facility

$1,208.03

Service Code	HCPCS C1713
Hospital Charge Code	64906513
Hospital Revenue Code	278
Min. Negotiated Rate	$604.02
Max. Negotiated Rate	$604.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$604.02
Rate for Payer: Hamaspik Choice Inc Medicare	$604.02

PLATE SYSTEM 3.5 X 14 LOCKING

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902910
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

PLATE SYSTEM 3.5 X 14 LOCKING

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902910
Hospital Revenue Code	278
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.55
Rate for Payer: EmblemHealth Commercial	$166.56
Rate for Payer: Fidelis Medicare Advantage	$349.79
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.53

PLATE T 5 HOLE MIDFACE

Facility

$320.35

Service Code	HCPCS C1713
Hospital Charge Code	64901564
Hospital Revenue Code	278
Min. Negotiated Rate	$160.18
Max. Negotiated Rate	$160.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.18
Rate for Payer: Hamaspik Choice Inc Medicare	$160.18

PLATE T 5 HOLE MIDFACE

Facility

$320.35

Service Code	HCPCS C1713
Hospital Charge Code	64901564
Hospital Revenue Code	278
Min. Negotiated Rate	$112.12
Max. Negotiated Rate	$336.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$176.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$192.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$160.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.20
Rate for Payer: EmblemHealth Commercial	$160.18
Rate for Payer: Fidelis Medicare Advantage	$336.37
Rate for Payer: Group Health Inc Commercial	$160.18
Rate for Payer: Group Health Inc Medicare	$112.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.18
Rate for Payer: Hamaspik Choice Inc Medicare	$160.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$208.23

PLATE TACK

Facility

$202.50

Service Code	HCPCS C1713
Hospital Charge Code	64907354
Hospital Revenue Code	278
Min. Negotiated Rate	$101.25
Max. Negotiated Rate	$101.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$101.25
Rate for Payer: Hamaspik Choice Inc Medicare	$101.25

PLATE TACK

Facility

$202.50

Service Code	HCPCS C1713
Hospital Charge Code	64907354
Hospital Revenue Code	278
Min. Negotiated Rate	$70.88
Max. Negotiated Rate	$212.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$111.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$121.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$101.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$116.44
Rate for Payer: EmblemHealth Commercial	$101.25
Rate for Payer: Fidelis Medicare Advantage	$212.62
Rate for Payer: Group Health Inc Commercial	$101.25
Rate for Payer: Group Health Inc Medicare	$70.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$101.25
Rate for Payer: Hamaspik Choice Inc Medicare	$101.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$131.62

PLATE TBIA DST ANT RT 8HL L153MM

Facility

$2,345.15

Service Code	HCPCS C1713
Hospital Charge Code	64906443
Hospital Revenue Code	278
Min. Negotiated Rate	$1,172.58
Max. Negotiated Rate	$1,172.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,172.58
Rate for Payer: Hamaspik Choice Inc Medicare	$1,172.58

PLATE TBIA DST ANT RT 8HL L153MM

Facility

$2,345.15

Service Code	HCPCS C1713
Hospital Charge Code	64906443
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,462.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,289.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,407.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,172.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,348.46
Rate for Payer: EmblemHealth Commercial	$1,172.58
Rate for Payer: Fidelis Medicare Advantage	$2,462.41
Rate for Payer: Group Health Inc Commercial	$1,172.58
Rate for Payer: Group Health Inc Medicare	$820.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,172.58
Rate for Payer: Hamaspik Choice Inc Medicare	$1,172.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,524.35

PLATE TIBIA DIS RIGHT 14H/L229MM

Facility

$6,245.38

Service Code	HCPCS C1713
Hospital Charge Code	64905745
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,557.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,434.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,747.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,122.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,591.09
Rate for Payer: EmblemHealth Commercial	$3,122.69
Rate for Payer: Fidelis Medicare Advantage	$6,557.65
Rate for Payer: Group Health Inc Commercial	$3,122.69
Rate for Payer: Group Health Inc Medicare	$2,185.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,122.69
Rate for Payer: Hamaspik Choice Inc Medicare	$3,122.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,059.50

PLATE TIBIA DIS RIGHT 14H/L229MM

Facility

$6,245.38

Service Code	HCPCS C1713
Hospital Charge Code	64905745
Hospital Revenue Code	278
Min. Negotiated Rate	$3,122.69
Max. Negotiated Rate	$3,122.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,122.69
Rate for Payer: Hamaspik Choice Inc Medicare	$3,122.69

PLATE TIBIA DIST MD RGT 16H L253M

Facility

$1,968.56

Service Code	HCPCS C1713
Hospital Charge Code	64906503
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,066.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,082.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,181.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$984.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,131.92
Rate for Payer: EmblemHealth Commercial	$984.28
Rate for Payer: Fidelis Medicare Advantage	$2,066.99
Rate for Payer: Group Health Inc Commercial	$984.28
Rate for Payer: Group Health Inc Medicare	$689.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$984.28
Rate for Payer: Hamaspik Choice Inc Medicare	$984.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,279.56

Know your out-of-pocket cost for care.

All Charges