St. Barnabas Hospital

All Charges

Charge

Type

Price

SPACER, 15X13X8MM 5EGREE SCDF

Facility IP

$5,812.50

Service Code	HCPCS C1713
Hospital Charge Code	64905521
Hospital Revenue Code	278
Min. Negotiated Rate	$2,906.25
Max. Negotiated Rate	$2,906.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,906.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,906.25

SPACER, 15X13X8MM 5EGREE SCDF

Facility OP

$5,812.50

Service Code	HCPCS C1713
Hospital Charge Code	64905521
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,103.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,196.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,906.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,342.19
Rate for Payer: Fidelis Medicare Advantage	$6,103.12
Rate for Payer: Group Health Inc Commercial	$2,906.25
Rate for Payer: Group Health Inc Medicare	$2,034.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,906.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,906.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,778.12

SPACER AUS 5MM X 14 X 16

Facility OP

$5,842.34

Hospital Charge Code	64906764
Hospital Revenue Code	279
Min. Negotiated Rate	$2,044.82
Max. Negotiated Rate	$4,673.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,213.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,921.17
Rate for Payer: Aetna Government	$2,921.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,673.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,972.79
Rate for Payer: Group Health Inc Commercial	$2,921.17
Rate for Payer: Group Health Inc Medicare	$2,044.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,921.17
Rate for Payer: Hamaspik Choice Inc Medicare	$2,921.17

SPACER AVS AS 4X12X14X4 DEG

Facility IP

$2,921.17

Service Code	HCPCS C1776
Hospital Charge Code	64906238
Hospital Revenue Code	278
Min. Negotiated Rate	$1,460.58
Max. Negotiated Rate	$1,460.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,460.58
Rate for Payer: Hamaspik Choice Inc Medicare	$1,460.58

SPACER AVS AS 4X12X14X4 DEG

Facility OP

$2,921.17

Service Code	HCPCS C1776
Hospital Charge Code	64906238
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,067.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,606.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,460.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,679.67
Rate for Payer: Fidelis Medicare Advantage	$3,067.23
Rate for Payer: Group Health Inc Commercial	$1,460.58
Rate for Payer: Group Health Inc Medicare	$1,022.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,460.58
Rate for Payer: Hamaspik Choice Inc Medicare	$1,460.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,898.76

SPACER DISTAL ACCOLADE

Facility IP

$407.75

Service Code	HCPCS C1776
Hospital Charge Code	64907278
Hospital Revenue Code	278
Min. Negotiated Rate	$203.88
Max. Negotiated Rate	$203.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.88
Rate for Payer: Hamaspik Choice Inc Medicare	$203.88

SPACER DISTAL ACCOLADE

Facility OP

$407.75

Service Code	HCPCS C1776
Hospital Charge Code	64907278
Hospital Revenue Code	278
Min. Negotiated Rate	$142.71
Max. Negotiated Rate	$428.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$224.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$203.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$234.46
Rate for Payer: Fidelis Medicare Advantage	$428.14
Rate for Payer: Group Health Inc Commercial	$203.88
Rate for Payer: Group Health Inc Medicare	$142.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.88
Rate for Payer: Hamaspik Choice Inc Medicare	$203.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$265.04

SPACER DISTAL CEMENT (1067-0011)

Facility OP

$180.00

Service Code	HCPCS C1776
Hospital Charge Code	64906471
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$99.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$103.50
Rate for Payer: Fidelis Medicare Advantage	$189.00
Rate for Payer: Group Health Inc Commercial	$90.00
Rate for Payer: Group Health Inc Medicare	$63.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.00
Rate for Payer: Hamaspik Choice Inc Medicare	$90.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$117.00

SPACER DISTAL CEMENT (1067-0011)

Facility IP

$180.00

Service Code	HCPCS C1776
Hospital Charge Code	64906471
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.00
Rate for Payer: Hamaspik Choice Inc Medicare	$90.00

SPACER DISTAL OSTEONICS UNIV

Facility IP

$407.75

Service Code	HCPCS C1776
Hospital Charge Code	64907279
Hospital Revenue Code	278
Min. Negotiated Rate	$203.88
Max. Negotiated Rate	$203.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.88
Rate for Payer: Hamaspik Choice Inc Medicare	$203.88

SPACER DISTAL OSTEONICS UNIV

Facility OP

$407.75

Service Code	HCPCS C1776
Hospital Charge Code	64907279
Hospital Revenue Code	278
Min. Negotiated Rate	$142.71
Max. Negotiated Rate	$428.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$224.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$203.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$234.46
Rate for Payer: Fidelis Medicare Advantage	$428.14
Rate for Payer: Group Health Inc Commercial	$203.88
Rate for Payer: Group Health Inc Medicare	$142.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.88
Rate for Payer: Hamaspik Choice Inc Medicare	$203.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$265.04

SPACER OMNIFIT CEMENT 12MM

Facility OP

$180.00

Service Code	HCPCS C1776
Hospital Charge Code	64906267
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$99.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$103.50
Rate for Payer: Fidelis Medicare Advantage	$189.00
Rate for Payer: Group Health Inc Commercial	$90.00
Rate for Payer: Group Health Inc Medicare	$63.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.00
Rate for Payer: Hamaspik Choice Inc Medicare	$90.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$117.00

SPACER OMNIFIT CEMENT 12MM

Facility IP

$180.00

Service Code	HCPCS C1776
Hospital Charge Code	64906267
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.00
Rate for Payer: Hamaspik Choice Inc Medicare	$90.00

SPACER OMNIFT CEMNT 10MM-10670010

Facility OP

$180.00

Service Code	HCPCS C1776
Hospital Charge Code	64906405
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$99.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$103.50
Rate for Payer: Fidelis Medicare Advantage	$189.00
Rate for Payer: Group Health Inc Commercial	$90.00
Rate for Payer: Group Health Inc Medicare	$63.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.00
Rate for Payer: Hamaspik Choice Inc Medicare	$90.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$117.00

SPACER OMNIFT CEMNT 10MM-10670010

Facility IP

$180.00

Service Code	HCPCS C1776
Hospital Charge Code	64906405
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.00
Rate for Payer: Hamaspik Choice Inc Medicare	$90.00

SPACER SPINAL 11X11 9MM

Facility OP

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	64904366
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,725.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,475.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,587.50
Rate for Payer: Fidelis Medicare Advantage	$4,725.00
Rate for Payer: Group Health Inc Commercial	$2,250.00
Rate for Payer: Group Health Inc Medicare	$1,575.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,925.00

SPACER SPINAL 11X11 9MM

Facility IP

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	64904366
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$2,250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,250.00

SPACER SPINAL 12MM X 22MM X 28

Facility IP

$18,741.75

Service Code	HCPCS C1776
Hospital Charge Code	64904642
Hospital Revenue Code	278
Min. Negotiated Rate	$9,370.88
Max. Negotiated Rate	$9,370.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,370.88
Rate for Payer: Hamaspik Choice Inc Medicare	$9,370.88

SPACER SPINAL 12MM X 22MM X 28

Facility OP

$18,741.75

Service Code	HCPCS C1776
Hospital Charge Code	64904642
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$19,678.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10,307.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9,370.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$10,776.51
Rate for Payer: Fidelis Medicare Advantage	$19,678.84
Rate for Payer: Group Health Inc Commercial	$9,370.88
Rate for Payer: Group Health Inc Medicare	$6,559.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,370.88
Rate for Payer: Hamaspik Choice Inc Medicare	$9,370.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12,182.14

SPACER SPINAL 13MM X 15MM X 7

Facility IP

$5,812.50

Service Code	HCPCS C1776
Hospital Charge Code	64904837
Hospital Revenue Code	278
Min. Negotiated Rate	$2,906.25
Max. Negotiated Rate	$2,906.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,906.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,906.25

SPACER SPINAL 13MM X 15MM X 7

Facility OP

$5,812.50

Service Code	HCPCS C1776
Hospital Charge Code	64904837
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,103.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,196.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,906.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,342.19
Rate for Payer: Fidelis Medicare Advantage	$6,103.12
Rate for Payer: Group Health Inc Commercial	$2,906.25
Rate for Payer: Group Health Inc Medicare	$2,034.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,906.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,906.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,778.12

SPACER SPINAL 24MMX32MMX12

Facility OP

$9,082.50

Service Code	HCPCS C1776
Hospital Charge Code	64904675
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,536.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,995.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,541.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,222.44
Rate for Payer: Fidelis Medicare Advantage	$9,536.62
Rate for Payer: Group Health Inc Commercial	$4,541.25
Rate for Payer: Group Health Inc Medicare	$3,178.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,541.25
Rate for Payer: Hamaspik Choice Inc Medicare	$4,541.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,903.62

SPACER SPINAL 24MMX32MMX12

Facility IP

$9,082.50

Service Code	HCPCS C1776
Hospital Charge Code	64904675
Hospital Revenue Code	278
Min. Negotiated Rate	$4,541.25
Max. Negotiated Rate	$4,541.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,541.25
Rate for Payer: Hamaspik Choice Inc Medicare	$4,541.25

SPACER SPINAL 26MMX9MMX8MM

Facility OP

$11,541.25

Service Code	HCPCS C1776
Hospital Charge Code	64904508
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$12,118.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,347.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,770.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,636.22
Rate for Payer: Fidelis Medicare Advantage	$12,118.31
Rate for Payer: Group Health Inc Commercial	$5,770.62
Rate for Payer: Group Health Inc Medicare	$4,039.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,770.62
Rate for Payer: Hamaspik Choice Inc Medicare	$5,770.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,501.81

SPACER SPINAL 26MMX9MMX8MM

Facility IP

$11,541.25

Service Code	HCPCS C1776
Hospital Charge Code	64904508
Hospital Revenue Code	278
Min. Negotiated Rate	$5,770.62
Max. Negotiated Rate	$5,770.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,770.62
Rate for Payer: Hamaspik Choice Inc Medicare	$5,770.62

Price Transparency.

All Charges