St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

4.3MM FREE HAND DRILL 152.5MM

Facility

$273.60

Service Code	HCPCS C1713
Hospital Charge Code	40006474
Hospital Revenue Code	278
Min. Negotiated Rate	$136.80
Max. Negotiated Rate	$136.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.80
Rate for Payer: Hamaspik Choice Inc Medicare	$136.80

4.3MML DISTAL GRADUATED DRILL

Facility

$624.00

Service Code	HCPCS C1713
Hospital Charge Code	40006160
Hospital Revenue Code	278
Min. Negotiated Rate	$312.00
Max. Negotiated Rate	$312.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.00
Rate for Payer: Hamaspik Choice Inc Medicare	$312.00

4.3MML DISTAL GRADUATED DRILL

Facility

$624.00

Service Code	HCPCS C1713
Hospital Charge Code	40006160
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$655.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$374.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$358.80
Rate for Payer: EmblemHealth Commercial	$312.00
Rate for Payer: Fidelis Medicare Advantage	$655.20
Rate for Payer: Group Health Inc Commercial	$312.00
Rate for Payer: Group Health Inc Medicare	$218.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.00
Rate for Payer: Hamaspik Choice Inc Medicare	$312.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$405.60

4.3MM NCB CANNULA

Facility

$281.82

Hospital Charge Code	40006770
Hospital Revenue Code	272
Min. Negotiated Rate	$98.64
Max. Negotiated Rate	$225.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$155.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$140.91
Rate for Payer: Aetna Government	$140.91
Rate for Payer: Brighton Health Commercial	$211.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$225.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.64
Rate for Payer: Group Health Inc Commercial	$140.91
Rate for Payer: Group Health Inc Medicare	$98.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.91
Rate for Payer: Hamaspik Choice Inc Medicare	$140.91

4.3MMS DISTAL GRADUATED DRILL

Facility

$624.00

Service Code	HCPCS C1713
Hospital Charge Code	40006161
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$655.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$374.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$358.80
Rate for Payer: EmblemHealth Commercial	$312.00
Rate for Payer: Fidelis Medicare Advantage	$655.20
Rate for Payer: Group Health Inc Commercial	$312.00
Rate for Payer: Group Health Inc Medicare	$218.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.00
Rate for Payer: Hamaspik Choice Inc Medicare	$312.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$405.60

4.3MMS DISTAL GRADUATED DRILL

Facility

$624.00

Service Code	HCPCS C1713
Hospital Charge Code	40006161
Hospital Revenue Code	278
Min. Negotiated Rate	$312.00
Max. Negotiated Rate	$312.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.00
Rate for Payer: Hamaspik Choice Inc Medicare	$312.00

4.3X45MM TIT CANN SCRW

Facility

$692.00

Service Code	HCPCS C1781
Hospital Charge Code	40209709
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$726.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$380.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Brighton Health Commercial	$415.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$346.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$397.90
Rate for Payer: EmblemHealth Commercial	$346.00
Rate for Payer: Fidelis Medicare Advantage	$726.60
Rate for Payer: Group Health Inc Commercial	$346.00
Rate for Payer: Group Health Inc Medicare	$242.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$346.00
Rate for Payer: Hamaspik Choice Inc Medicare	$346.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$449.80

4.3X45MM TIT CANN SCRW

Facility

$692.00

Service Code	HCPCS C1781
Hospital Charge Code	40209709
Hospital Revenue Code	278
Min. Negotiated Rate	$346.00
Max. Negotiated Rate	$346.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$346.00
Rate for Payer: Hamaspik Choice Inc Medicare	$346.00

4.5 TAP

Facility

$218.00

Hospital Charge Code	40203576
Hospital Revenue Code	272
Min. Negotiated Rate	$76.30
Max. Negotiated Rate	$174.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$119.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$109.00
Rate for Payer: Aetna Government	$109.00
Rate for Payer: Brighton Health Commercial	$163.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$148.24
Rate for Payer: Group Health Inc Commercial	$109.00
Rate for Payer: Group Health Inc Medicare	$76.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.00
Rate for Payer: Hamaspik Choice Inc Medicare	$109.00

4.5X36MM SCREW

Facility

$420.00

Service Code	HCPCS C1713
Hospital Charge Code	40203556
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

4.5X36MM SCREW

Facility

$420.00

Service Code	HCPCS C1713
Hospital Charge Code	40203556
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$441.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$252.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$210.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.50
Rate for Payer: EmblemHealth Commercial	$210.00
Rate for Payer: Fidelis Medicare Advantage	$441.00
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$273.00

4.5X44MM SCREW

Facility

$420.00

Service Code	HCPCS C1713
Hospital Charge Code	40203557
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$441.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$252.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$210.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.50
Rate for Payer: EmblemHealth Commercial	$210.00
Rate for Payer: Fidelis Medicare Advantage	$441.00
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$273.00

4.5X44MM SCREW

Facility

$420.00

Service Code	HCPCS C1713
Hospital Charge Code	40203557
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

4.5X46MM SCREW

Facility

$420.00

Service Code	HCPCS C1713
Hospital Charge Code	40203558
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$441.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$252.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$210.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$241.50
Rate for Payer: EmblemHealth Commercial	$210.00
Rate for Payer: Fidelis Medicare Advantage	$441.00
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$273.00

4.5X46MM SCREW

Facility

$420.00

Service Code	HCPCS C1713
Hospital Charge Code	40203558
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

4-6 TOTAL VISITS, ROUTINE OB

Facility

$1,215.00

Service Code	HCPCS 59425
Hospital Charge Code	30301246
Hospital Revenue Code	510
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$428.75
Rate for Payer: Aetna Government	$428.75
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$607.50
Rate for Payer: Hamaspik Choice Inc Medicare	$607.50
Rate for Payer: United Healthcare Commercial	$222.00

4HL 29MM STRAIGHT RIGID PLATE

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	40209993
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$345.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$345.00
Rate for Payer: Hamaspik Choice Inc Medicare	$345.00

4HL 29MM STRAIGHT RIGID PLATE

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	40209993
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$724.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$379.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$414.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$345.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$396.75
Rate for Payer: EmblemHealth Commercial	$345.00
Rate for Payer: Fidelis Medicare Advantage	$724.50
Rate for Payer: Group Health Inc Commercial	$345.00
Rate for Payer: Group Health Inc Medicare	$241.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$345.00
Rate for Payer: Hamaspik Choice Inc Medicare	$345.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$448.50

4 HOLE BP NO BAR FRACTURE PLATE

Facility

$441.00

Service Code	HCPCS C1713
Hospital Charge Code	40201073
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$463.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$242.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$264.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$220.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$253.58
Rate for Payer: EmblemHealth Commercial	$220.50
Rate for Payer: Fidelis Medicare Advantage	$463.05
Rate for Payer: Group Health Inc Commercial	$220.50
Rate for Payer: Group Health Inc Medicare	$154.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$220.50
Rate for Payer: Hamaspik Choice Inc Medicare	$220.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$286.65

4 HOLE BP NO BAR FRACTURE PLATE

Facility

$441.00

Service Code	HCPCS C1713
Hospital Charge Code	40201073
Hospital Revenue Code	278
Min. Negotiated Rate	$220.50
Max. Negotiated Rate	$220.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$220.50
Rate for Payer: Hamaspik Choice Inc Medicare	$220.50

4 HOLE BP STRAIGHT NO BAR

Facility

$234.00

Service Code	HCPCS C1713
Hospital Charge Code	40201074
Hospital Revenue Code	278
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$117.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$117.00
Rate for Payer: Hamaspik Choice Inc Medicare	$117.00

4 HOLE BP STRAIGHT NO BAR

Facility

$234.00

Service Code	HCPCS C1713
Hospital Charge Code	40201074
Hospital Revenue Code	278
Min. Negotiated Rate	$81.90
Max. Negotiated Rate	$245.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$128.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$140.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$117.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$134.55
Rate for Payer: EmblemHealth Commercial	$117.00
Rate for Payer: Fidelis Medicare Advantage	$245.70
Rate for Payer: Group Health Inc Commercial	$117.00
Rate for Payer: Group Health Inc Medicare	$81.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$117.00
Rate for Payer: Hamaspik Choice Inc Medicare	$117.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$152.10

4 HOLE BP WITH BAR

Facility

$272.00

Service Code	HCPCS C1713
Hospital Charge Code	40201075
Hospital Revenue Code	278
Min. Negotiated Rate	$136.00
Max. Negotiated Rate	$136.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00

4 HOLE BP WITH BAR

Facility

$272.00

Service Code	HCPCS C1713
Hospital Charge Code	40201075
Hospital Revenue Code	278
Min. Negotiated Rate	$95.20
Max. Negotiated Rate	$285.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$149.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$163.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.40
Rate for Payer: EmblemHealth Commercial	$136.00
Rate for Payer: Fidelis Medicare Advantage	$285.60
Rate for Payer: Group Health Inc Commercial	$136.00
Rate for Payer: Group Health Inc Medicare	$95.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$176.80

4 HOLE CURVED PLATE

Facility

$266.26

Service Code	HCPCS C1713
Hospital Charge Code	40005306
Hospital Revenue Code	278
Min. Negotiated Rate	$93.19
Max. Negotiated Rate	$279.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$159.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$133.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.10
Rate for Payer: EmblemHealth Commercial	$133.13
Rate for Payer: Fidelis Medicare Advantage	$279.57
Rate for Payer: Group Health Inc Commercial	$133.13
Rate for Payer: Group Health Inc Medicare	$93.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.13
Rate for Payer: Hamaspik Choice Inc Medicare	$133.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$173.07

Know your out-of-pocket cost for care.

All Charges