St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PLATE,VARIAX COMP 7HL/L90 2LCK HL

Facility

$1,390.00

Service Code	HCPCS C1713
Hospital Charge Code	40005905
Hospital Revenue Code	278
Min. Negotiated Rate	$695.00
Max. Negotiated Rate	$695.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$695.00
Rate for Payer: Hamaspik Choice Inc Medicare	$695.00

PLATE,VARIAX COMP 7HL/L90 2LCK HL

Facility

$1,390.00

Service Code	HCPCS C1713
Hospital Charge Code	40005905
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,459.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$764.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$834.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$695.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$799.25
Rate for Payer: EmblemHealth Commercial	$695.00
Rate for Payer: Fidelis Medicare Advantage	$1,459.50
Rate for Payer: Group Health Inc Commercial	$695.00
Rate for Payer: Group Health Inc Medicare	$486.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$695.00
Rate for Payer: Hamaspik Choice Inc Medicare	$695.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$903.50

PLATE VARIAX COMP 7HL/L91 4LCK HL

Facility

$1,390.00

Service Code	HCPCS C1713
Hospital Charge Code	40005920
Hospital Revenue Code	278
Min. Negotiated Rate	$695.00
Max. Negotiated Rate	$695.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$695.00
Rate for Payer: Hamaspik Choice Inc Medicare	$695.00

PLATE VARIAX COMP 7HL/L91 4LCK HL

Facility

$1,390.00

Service Code	HCPCS C1713
Hospital Charge Code	40005920
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,459.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$764.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$834.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$695.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$799.25
Rate for Payer: EmblemHealth Commercial	$695.00
Rate for Payer: Fidelis Medicare Advantage	$1,459.50
Rate for Payer: Group Health Inc Commercial	$695.00
Rate for Payer: Group Health Inc Medicare	$486.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$695.00
Rate for Payer: Hamaspik Choice Inc Medicare	$695.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$903.50

PLATE VARIAX COMP 7 HOLE/L91MM

Facility

$1,737.50

Service Code	HCPCS C1713
Hospital Charge Code	64905590
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,824.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$955.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,042.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$868.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$999.06
Rate for Payer: EmblemHealth Commercial	$868.75
Rate for Payer: Fidelis Medicare Advantage	$1,824.38
Rate for Payer: Group Health Inc Commercial	$868.75
Rate for Payer: Group Health Inc Medicare	$608.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$868.75
Rate for Payer: Hamaspik Choice Inc Medicare	$868.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,129.38

PLATE VARIAX COMP 7 HOLE/L91MM

Facility

$1,737.50

Service Code	HCPCS C1713
Hospital Charge Code	64905590
Hospital Revenue Code	278
Min. Negotiated Rate	$868.75
Max. Negotiated Rate	$868.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$868.75
Rate for Payer: Hamaspik Choice Inc Medicare	$868.75

PLATE VARIAX COMP NARROW

Facility

$1,737.50

Service Code	HCPCS C1713
Hospital Charge Code	64905013
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,824.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$955.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,042.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$868.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$999.06
Rate for Payer: EmblemHealth Commercial	$868.75
Rate for Payer: Fidelis Medicare Advantage	$1,824.38
Rate for Payer: Group Health Inc Commercial	$868.75
Rate for Payer: Group Health Inc Medicare	$608.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$868.75
Rate for Payer: Hamaspik Choice Inc Medicare	$868.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,129.38

PLATE VARIAX COMP NARROW

Facility

$1,737.50

Service Code	HCPCS C1713
Hospital Charge Code	64905013
Hospital Revenue Code	278
Min. Negotiated Rate	$868.75
Max. Negotiated Rate	$868.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$868.75
Rate for Payer: Hamaspik Choice Inc Medicare	$868.75

PLATE VARIAX STRAIGHT 5 HOLE

Facility

$751.40

Service Code	HCPCS C1713
Hospital Charge Code	40005926
Hospital Revenue Code	278
Min. Negotiated Rate	$375.70
Max. Negotiated Rate	$375.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$375.70
Rate for Payer: Hamaspik Choice Inc Medicare	$375.70

PLATE VARIAX STRAIGHT 5 HOLE

Facility

$751.40

Service Code	HCPCS C1713
Hospital Charge Code	40005926
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$788.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$413.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$450.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$375.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$432.06
Rate for Payer: EmblemHealth Commercial	$375.70
Rate for Payer: Fidelis Medicare Advantage	$788.97
Rate for Payer: Group Health Inc Commercial	$375.70
Rate for Payer: Group Health Inc Medicare	$262.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$375.70
Rate for Payer: Hamaspik Choice Inc Medicare	$375.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$488.41

PLATE VARIAX STRAIGHT 5 HOLE

Facility

$939.25

Service Code	HCPCS C1713
Hospital Charge Code	64905611
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 VARIAX STRAIGHT 5 HOLE

Facility

$939.25

Service Code	HCPCS C1713
Hospital Charge Code	64905611
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 VARIAX STRAIGHT 6-HOLE

Facility

$989.25

Service Code	HCPCS C1713
Hospital Charge Code	64902626
Hospital Revenue Code	278
Min. Negotiated Rate	$494.62
Max. Negotiated Rate	$494.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$494.62
Rate for Payer: Hamaspik Choice Inc Medicare	$494.62

PLATE VARIAX STRAIGHT 6-HOLE

Facility

$989.25

Service Code	HCPCS C1713
Hospital Charge Code	64902626
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,038.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$544.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$593.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$494.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$568.82
Rate for Payer: EmblemHealth Commercial	$494.62
Rate for Payer: Fidelis Medicare Advantage	$1,038.71
Rate for Payer: Group Health Inc Commercial	$494.62
Rate for Payer: Group Health Inc Medicare	$346.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$494.62
Rate for Payer: Hamaspik Choice Inc Medicare	$494.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$643.01

PLATE VOLAR LEFT 10 XTRA SHRT

Facility

$3,476.25

Service Code	HCPCS C1713
Hospital Charge Code	64905202
Hospital Revenue Code	278
Min. Negotiated Rate	$1,738.12
Max. Negotiated Rate	$1,738.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,738.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,738.12

PLATE VOLAR LEFT 10 XTRA SHRT

Facility

$3,476.25

Service Code	HCPCS C1713
Hospital Charge Code	64905202
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,650.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,911.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,085.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,738.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,998.84
Rate for Payer: EmblemHealth Commercial	$1,738.12
Rate for Payer: Fidelis Medicare Advantage	$3,650.06
Rate for Payer: Group Health Inc Commercial	$1,738.12
Rate for Payer: Group Health Inc Medicare	$1,216.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,738.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1,738.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,259.56

PLATE VOLAR WIDE SHORT

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	40201407
Hospital Revenue Code	278
Min. Negotiated Rate	$625.00
Max. Negotiated Rate	$625.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$625.00
Rate for Payer: Hamaspik Choice Inc Medicare	$625.00

PLATE VOLAR WIDE SHORT

Facility

$1,250.00

Service Code	HCPCS C1713
Hospital Charge Code	40201407
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,312.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$687.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$750.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$625.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$718.75
Rate for Payer: EmblemHealth Commercial	$625.00
Rate for Payer: Fidelis Medicare Advantage	$1,312.50
Rate for Payer: Group Health Inc Commercial	$625.00
Rate for Payer: Group Health Inc Medicare	$437.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$625.00
Rate for Payer: Hamaspik Choice Inc Medicare	$625.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$812.50

PLATE WHOLE 1.5MM

Facility

$1,756.95

Service Code	HCPCS C1713
Hospital Charge Code	64903264
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,844.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$966.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,054.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$878.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,010.25
Rate for Payer: EmblemHealth Commercial	$878.48
Rate for Payer: Fidelis Medicare Advantage	$1,844.80
Rate for Payer: Group Health Inc Commercial	$878.48
Rate for Payer: Group Health Inc Medicare	$614.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$878.48
Rate for Payer: Hamaspik Choice Inc Medicare	$878.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,142.02

PLATE WHOLE 1.5MM

Facility

$1,756.95

Service Code	HCPCS C1713
Hospital Charge Code	64903264
Hospital Revenue Code	278
Min. Negotiated Rate	$878.48
Max. Negotiated Rate	$878.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$878.48
Rate for Payer: Hamaspik Choice Inc Medicare	$878.48

PLATE WRIST FUS SHRT BND 123MM

Facility

$4,592.65

Service Code	HCPCS C1713
Hospital Charge Code	64907442
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,822.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,525.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,755.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,296.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,640.77
Rate for Payer: EmblemHealth Commercial	$2,296.32
Rate for Payer: Fidelis Medicare Advantage	$4,822.28
Rate for Payer: Group Health Inc Commercial	$2,296.32
Rate for Payer: Group Health Inc Medicare	$1,607.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,296.32
Rate for Payer: Hamaspik Choice Inc Medicare	$2,296.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,985.22

PLATE WRIST FUS SHRT BND 123MM

Facility

$4,592.65

Service Code	HCPCS C1713
Hospital Charge Code	64907442
Hospital Revenue Code	278
Min. Negotiated Rate	$2,296.32
Max. Negotiated Rate	$2,296.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,296.32
Rate for Payer: Hamaspik Choice Inc Medicare	$2,296.32

PLATE Y 5-HOLE W/4MM BAR MDFC

Facility

$343.88

Service Code	HCPCS C1713
Hospital Charge Code	64901567
Hospital Revenue Code	278
Min. Negotiated Rate	$120.36
Max. Negotiated Rate	$361.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$189.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$206.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$171.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$197.73
Rate for Payer: EmblemHealth Commercial	$171.94
Rate for Payer: Fidelis Medicare Advantage	$361.07
Rate for Payer: Group Health Inc Commercial	$171.94
Rate for Payer: Group Health Inc Medicare	$120.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.94
Rate for Payer: Hamaspik Choice Inc Medicare	$171.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$223.52

PLATE Y 5-HOLE W/4MM BAR MDFC

Facility

$343.88

Service Code	HCPCS C1713
Hospital Charge Code	64901567
Hospital Revenue Code	278
Min. Negotiated Rate	$171.94
Max. Negotiated Rate	$171.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.94
Rate for Payer: Hamaspik Choice Inc Medicare	$171.94

PLATE Y 5H W/4MM BAR MDFC LOCK

Facility

$470.30

Service Code	HCPCS C1713
Hospital Charge Code	64901586
Hospital Revenue Code	278
Min. Negotiated Rate	$235.15
Max. Negotiated Rate	$235.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.15
Rate for Payer: Hamaspik Choice Inc Medicare	$235.15

Know your out-of-pocket cost for care.

All Charges