St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

POST ANGLE

Facility

$161.00

Hospital Charge Code	40200762
Hospital Revenue Code	270
Min. Negotiated Rate	$56.35
Max. Negotiated Rate	$128.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$80.50
Rate for Payer: Aetna Government	$80.50
Rate for Payer: Brighton Health Commercial	$120.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$128.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$109.48
Rate for Payer: Group Health Inc Commercial	$80.50
Rate for Payer: Group Health Inc Medicare	$56.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.50
Rate for Payer: Hamaspik Choice Inc Medicare	$80.50

POST ANGLED

Facility

$211.75

Hospital Charge Code	64901251
Hospital Revenue Code	270
Min. Negotiated Rate	$74.11
Max. Negotiated Rate	$169.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$116.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$105.88
Rate for Payer: Aetna Government	$105.88
Rate for Payer: Brighton Health Commercial	$158.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$169.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$143.99
Rate for Payer: Group Health Inc Commercial	$105.88
Rate for Payer: Group Health Inc Medicare	$74.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.88
Rate for Payer: Hamaspik Choice Inc Medicare	$105.88

POST ANGLED 30DEGREE

Facility

$280.00

Hospital Charge Code	40205089
Hospital Revenue Code	270
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$224.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$154.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$140.00
Rate for Payer: Aetna Government	$140.00
Rate for Payer: Brighton Health Commercial	$210.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$224.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$190.40
Rate for Payer: Group Health Inc Commercial	$140.00
Rate for Payer: Group Health Inc Medicare	$98.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00

POST ANGLED 90 DEGREE

Facility

$369.00

Service Code	HCPCS C1713
Hospital Charge Code	64901716
Hospital Revenue Code	278
Min. Negotiated Rate	$184.50
Max. Negotiated Rate	$184.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.50
Rate for Payer: Hamaspik Choice Inc Medicare	$184.50

POST ANGLED 90 DEGREE

Facility

$369.00

Service Code	HCPCS C1713
Hospital Charge Code	64901716
Hospital Revenue Code	278
Min. Negotiated Rate	$129.15
Max. Negotiated Rate	$387.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$221.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$184.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$212.18
Rate for Payer: EmblemHealth Commercial	$184.50
Rate for Payer: Fidelis Medicare Advantage	$387.45
Rate for Payer: Group Health Inc Commercial	$184.50
Rate for Payer: Group Health Inc Medicare	$129.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.50
Rate for Payer: Hamaspik Choice Inc Medicare	$184.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$239.85

POST ARTCLR SR SZ 2 17MM RV

Facility

$2,936.00

Service Code	HCPCS C1776
Hospital Charge Code	64906417
Hospital Revenue Code	278
Min. Negotiated Rate	$1,468.00
Max. Negotiated Rate	$1,468.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,468.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,468.00

POST ARTCLR SR SZ 2 17MM RV

Facility

$2,936.00

Service Code	HCPCS C1776
Hospital Charge Code	64906417
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,082.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,614.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,761.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,468.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,688.20
Rate for Payer: EmblemHealth Commercial	$1,468.00
Rate for Payer: Fidelis Medicare Advantage	$3,082.80
Rate for Payer: Group Health Inc Commercial	$1,468.00
Rate for Payer: Group Health Inc Medicare	$1,027.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,468.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,468.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,908.40

POST BRONCHODILATOR

Facility

$766.58

Service Code	HCPCS 94060 TC
Hospital Charge Code	40402909
Hospital Revenue Code	460
Min. Negotiated Rate	$254.09
Max. Negotiated Rate	$613.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$362.98
Rate for Payer: Aetna Government	$362.98
Rate for Payer: Affinity Essential Plan 1&2	$254.09
Rate for Payer: Affinity Essential Plan 3&4	$254.09
Rate for Payer: Affinity Medicaid/CHP/HARP	$254.09
Rate for Payer: Brighton Health Commercial	$574.94
Rate for Payer: Cash Price	$362.98
Rate for Payer: Cash Price	$362.98
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$362.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$613.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$521.27
Rate for Payer: Elderplan Medicare Advantage	$362.98
Rate for Payer: EmblemHealth Commercial	$362.98
Rate for Payer: Fidelis Essential Plan Aliesa	$308.53
Rate for Payer: Fidelis Essential Plan QHP	$323.05
Rate for Payer: Fidelis Medicare Advantage	$362.98
Rate for Payer: Fidelis Qualified Health Plan	$323.05
Rate for Payer: Group Health Inc Commercial	$362.98
Rate for Payer: Group Health Inc Medicare	$362.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.29
Rate for Payer: Hamaspik Choice Inc Medicare	$362.98
Rate for Payer: Healthfirst Medicare Advantage	$308.53
Rate for Payer: Healthfirst QHP	$362.98
Rate for Payer: Humana Medicare	$370.24
Rate for Payer: Senior Whole Health Medicare Advantage	$362.98
Rate for Payer: United Healthcare Commercial	$383.29
Rate for Payer: United Healthcare Medicare Advantage	$362.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$362.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$290.38
Rate for Payer: Wellcare Medicare	$344.83

POST BRONCHODILATOR

Facility

$766.58

Service Code	HCPCS 94060 TC
Hospital Charge Code	40402909
Hospital Revenue Code	460
Rate for Payer: Cash Price	$362.98

POST CAP HEMI 9.5MM TAPER

Facility

$300.00

Service Code	HCPCS C1776
Hospital Charge Code	64906475
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

POST CAP HEMI 9.5MM TAPER

Facility

$300.00

Service Code	HCPCS C1776
Hospital Charge Code	64906475
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$180.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.50
Rate for Payer: EmblemHealth Commercial	$150.00
Rate for Payer: Fidelis Medicare Advantage	$315.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$195.00

POST CHAMBER INTRAOCULAR LENS

Facility

$315.00

Service Code	HCPCS V2632
Hospital Charge Code	40074113
Hospital Revenue Code	276
Min. Negotiated Rate	$73.48
Max. Negotiated Rate	$330.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$173.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.48
Rate for Payer: Aetna Government	$73.48
Rate for Payer: Brighton Health Commercial	$189.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$252.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$214.20
Rate for Payer: EmblemHealth Commercial	$157.50
Rate for Payer: Fidelis Medicare Advantage	$330.75
Rate for Payer: Group Health Inc Commercial	$157.50
Rate for Payer: Group Health Inc Medicare	$110.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$157.50
Rate for Payer: Hamaspik Choice Inc Medicare	$157.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$204.75

POST-DIALYSIS BUN

Facility

$9.88

Service Code	HCPCS 84520
Hospital Charge Code	40602415
Hospital Revenue Code	301
Rate for Payer: Cash Price	$3.95

POST-DIALYSIS BUN

Facility

$9.88

Service Code	HCPCS 84520
Hospital Charge Code	40602415
Hospital Revenue Code	301
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$7.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.95
Rate for Payer: Aetna Government	$3.95
Rate for Payer: Affinity Essential Plan 1&2	$2.76
Rate for Payer: Affinity Essential Plan 3&4	$2.76
Rate for Payer: Affinity Medicaid/CHP/HARP	$2.76
Rate for Payer: Brighton Health Commercial	$7.41
Rate for Payer: Cash Price	$3.95
Rate for Payer: Cash Price	$3.95
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.30
Rate for Payer: Elderplan Medicare Advantage	$3.95
Rate for Payer: EmblemHealth Commercial	$3.95
Rate for Payer: Fidelis Essential Plan Aliesa	$3.36
Rate for Payer: Fidelis Essential Plan QHP	$3.52
Rate for Payer: Fidelis Medicare Advantage	$3.95
Rate for Payer: Fidelis Qualified Health Plan	$3.52
Rate for Payer: Group Health Inc Commercial	$3.95
Rate for Payer: Group Health Inc Medicare	$3.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.94
Rate for Payer: Hamaspik Choice Inc Medicare	$3.95
Rate for Payer: Healthfirst Medicare Advantage	$3.95
Rate for Payer: Healthfirst QHP	$3.95
Rate for Payer: Humana Medicare	$4.03
Rate for Payer: Senior Whole Health Medicare Advantage	$3.95
Rate for Payer: United Healthcare Commercial	$5.00
Rate for Payer: United Healthcare Medicare Advantage	$3.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.95
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.16
Rate for Payer: Wellcare Medicare	$3.56

POSTERIOR LATERAL 629244

Facility

$1,450.00

Service Code	HCPCS C1713
Hospital Charge Code	64906432
Hospital Revenue Code	278
Min. Negotiated Rate	$725.00
Max. Negotiated Rate	$725.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$725.00

POSTERIOR LATERAL 629244

Facility

$1,450.00

Service Code	HCPCS C1713
Hospital Charge Code	64906432
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,522.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$797.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$870.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$725.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$833.75
Rate for Payer: EmblemHealth Commercial	$725.00
Rate for Payer: Fidelis Medicare Advantage	$1,522.50
Rate for Payer: Group Health Inc Commercial	$725.00
Rate for Payer: Group Health Inc Medicare	$507.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$725.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$942.50

POSTERIORLY STABILIZED FEM #5

Facility

$5,958.40

Service Code	HCPCS C1776
Hospital Charge Code	40202370
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,256.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,277.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,575.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,979.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,426.08
Rate for Payer: EmblemHealth Commercial	$2,979.20
Rate for Payer: Fidelis Medicare Advantage	$6,256.32
Rate for Payer: Group Health Inc Commercial	$2,979.20
Rate for Payer: Group Health Inc Medicare	$2,085.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,979.20
Rate for Payer: Hamaspik Choice Inc Medicare	$2,979.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,872.96

POSTERIORLY STABILIZED FEM #5

Facility

$5,958.40

Service Code	HCPCS C1776
Hospital Charge Code	40202370
Hospital Revenue Code	278
Min. Negotiated Rate	$2,979.20
Max. Negotiated Rate	$2,979.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,979.20
Rate for Payer: Hamaspik Choice Inc Medicare	$2,979.20

POSTERIORLY STABILIZED FEMORAL

Facility

$5,622.00

Service Code	HCPCS C1776
Hospital Charge Code	40201277
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,903.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,092.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,373.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,811.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,232.65
Rate for Payer: EmblemHealth Commercial	$2,811.00
Rate for Payer: Fidelis Medicare Advantage	$5,903.10
Rate for Payer: Group Health Inc Commercial	$2,811.00
Rate for Payer: Group Health Inc Medicare	$1,967.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,811.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,811.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,654.30

POSTERIORLY STABILIZED FEMORAL

Facility

$5,622.00

Service Code	HCPCS C1776
Hospital Charge Code	40201277
Hospital Revenue Code	278
Min. Negotiated Rate	$2,811.00
Max. Negotiated Rate	$2,811.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,811.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,811.00

POSTERIORLY STABILIZED FEMORAL #6

Facility

$5,960.00

Service Code	HCPCS C1776
Hospital Charge Code	40201278
Hospital Revenue Code	278
Min. Negotiated Rate	$2,980.00
Max. Negotiated Rate	$2,980.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,980.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,980.00

POSTERIORLY STABILIZED FEMORAL #6

Facility

$5,960.00

Service Code	HCPCS C1776
Hospital Charge Code	40201278
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,258.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,278.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,576.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,980.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,427.00
Rate for Payer: EmblemHealth Commercial	$2,980.00
Rate for Payer: Fidelis Medicare Advantage	$6,258.00
Rate for Payer: Group Health Inc Commercial	$2,980.00
Rate for Payer: Group Health Inc Medicare	$2,086.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,980.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,980.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,874.00

POST EXT FIXATION 11MM DIA A

Facility

$322.20

Service Code	HCPCS C1713
Hospital Charge Code	64902944
Hospital Revenue Code	278
Min. Negotiated Rate	$161.10
Max. Negotiated Rate	$161.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$161.10
Rate for Payer: Hamaspik Choice Inc Medicare	$161.10

POST EXT FIXATION 11MM DIA A

Facility

$322.20

Service Code	HCPCS C1713
Hospital Charge Code	64902944
Hospital Revenue Code	278
Min. Negotiated Rate	$112.77
Max. Negotiated Rate	$338.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$177.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$193.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$161.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$185.26
Rate for Payer: EmblemHealth Commercial	$161.10
Rate for Payer: Fidelis Medicare Advantage	$338.31
Rate for Payer: Group Health Inc Commercial	$161.10
Rate for Payer: Group Health Inc Medicare	$112.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$161.10
Rate for Payer: Hamaspik Choice Inc Medicare	$161.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$209.43

POST EXT FIXATION 11MM DIA B

Facility

$450.00

Service Code	HCPCS C1713
Hospital Charge Code	64902949
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.00
Rate for Payer: Hamaspik Choice Inc Medicare	$225.00

Know your out-of-pocket cost for care.

All Charges