St. Barnabas Hospital

All Charges

Charge

Type

Price

STEM FEMORAL CEMENTLESS SIZE 1

Facility OP

$9,329.50

Service Code	HCPCS C1713
Hospital Charge Code	64902790
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$9,795.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,131.22
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	$4,664.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,364.46
Rate for Payer: Fidelis Medicare Advantage	$9,795.98
Rate for Payer: Group Health Inc Commercial	$4,664.75
Rate for Payer: Group Health Inc Medicare	$3,265.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,664.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4,664.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,064.18

STEM FEMORAL CEMENTLESS SZ12

Facility IP

$9,327.50

Service Code	HCPCS C1713
Hospital Charge Code	64903150
Hospital Revenue Code	278
Min. Negotiated Rate	$4,663.75
Max. Negotiated Rate	$4,663.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,663.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4,663.75

STEM FEMORAL CEMENTLESS SZ12

Facility OP

$9,327.50

Service Code	HCPCS C1713
Hospital Charge Code	64903150
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$9,793.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,130.12
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	$4,663.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,363.31
Rate for Payer: Fidelis Medicare Advantage	$9,793.88
Rate for Payer: Group Health Inc Commercial	$4,663.75
Rate for Payer: Group Health Inc Medicare	$3,264.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,663.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4,663.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,062.88

STEM FEMORAL CEMENT SZ2 35MM

Facility OP

$10,721.25

Service Code	HCPCS C1713
Hospital Charge Code	64904610
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$11,257.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,896.69
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	$5,360.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,164.72
Rate for Payer: Fidelis Medicare Advantage	$11,257.31
Rate for Payer: Group Health Inc Commercial	$5,360.62
Rate for Payer: Group Health Inc Medicare	$3,752.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,360.62
Rate for Payer: Hamaspik Choice Inc Medicare	$5,360.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,968.81

STEM FEMORAL CEMENT SZ2 35MM

Facility IP

$10,721.25

Service Code	HCPCS C1713
Hospital Charge Code	64904610
Hospital Revenue Code	278
Min. Negotiated Rate	$5,360.62
Max. Negotiated Rate	$5,360.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,360.62
Rate for Payer: Hamaspik Choice Inc Medicare	$5,360.62

STEM FEMORAL CEMLESS SZ4 38MM

Facility OP

$17,115.75

Service Code	HCPCS C1776
Hospital Charge Code	64904349
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$17,971.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,413.66
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	$8,557.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,841.56
Rate for Payer: Fidelis Medicare Advantage	$17,971.54
Rate for Payer: Group Health Inc Commercial	$8,557.88
Rate for Payer: Group Health Inc Medicare	$5,990.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8,557.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11,125.24

STEM FEMORAL CEMLESS SZ4 38MM

Facility IP

$17,115.75

Service Code	HCPCS C1776
Hospital Charge Code	64904349
Hospital Revenue Code	278
Min. Negotiated Rate	$8,557.88
Max. Negotiated Rate	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8,557.88

STEM,FEMORAL CLLRD CMTD 12/14 NCK

Facility IP

$4,480.00

Service Code	HCPCS C1776
Hospital Charge Code	40007537
Hospital Revenue Code	278
Min. Negotiated Rate	$2,240.00
Max. Negotiated Rate	$2,240.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,240.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,240.00

STEM,FEMORAL CLLRD CMTD 12/14 NCK

Facility OP

$4,480.00

Service Code	HCPCS C1776
Hospital Charge Code	40007537
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,704.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,464.00
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	$2,240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,576.00
Rate for Payer: Fidelis Medicare Advantage	$4,704.00
Rate for Payer: Group Health Inc Commercial	$2,240.00
Rate for Payer: Group Health Inc Medicare	$1,568.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,240.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,240.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,912.00

STEM FEMORAL REV CEMEN 250MML

Facility OP

$18,520.00

Service Code	HCPCS C1776
Hospital Charge Code	64903329
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$19,446.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10,186.00
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	$9,260.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$10,649.00
Rate for Payer: Fidelis Medicare Advantage	$19,446.00
Rate for Payer: Group Health Inc Commercial	$9,260.00
Rate for Payer: Group Health Inc Medicare	$6,482.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$9,260.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12,038.00

STEM FEMORAL REV CEMEN 250MML

Facility IP

$18,520.00

Service Code	HCPCS C1776
Hospital Charge Code	64903329
Hospital Revenue Code	278
Min. Negotiated Rate	$9,260.00
Max. Negotiated Rate	$9,260.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$9,260.00

STEM FEMOR SZ 4 40.22MM OF-S

Facility IP

$11,670.00

Service Code	HCPCS C1776
Hospital Charge Code	64905760
Hospital Revenue Code	278
Min. Negotiated Rate	$5,835.00
Max. Negotiated Rate	$5,835.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,835.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,835.00

STEM FEMOR SZ 4 40.22MM OF-S

Facility OP

$11,670.00

Service Code	HCPCS C1776
Hospital Charge Code	64905760
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$12,253.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,418.50
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	$5,835.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,710.25
Rate for Payer: Fidelis Medicare Advantage	$12,253.50
Rate for Payer: Group Health Inc Commercial	$5,835.00
Rate for Payer: Group Health Inc Medicare	$4,084.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,835.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,835.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,585.50

STEM FEM SZ 6 127MML

Facility OP

$18,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64903602
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$19,018.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,961.88
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	$9,056.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$10,414.69
Rate for Payer: Fidelis Medicare Advantage	$19,018.12
Rate for Payer: Group Health Inc Commercial	$9,056.25
Rate for Payer: Group Health Inc Medicare	$6,339.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,056.25
Rate for Payer: Hamaspik Choice Inc Medicare	$9,056.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11,773.12

STEM FEM SZ 6 127MML

Facility IP

$18,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64903602
Hospital Revenue Code	278
Min. Negotiated Rate	$9,056.25
Max. Negotiated Rate	$9,056.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,056.25
Rate for Payer: Hamaspik Choice Inc Medicare	$9,056.25

STEM HEI

Facility IP

$6,715.00

Service Code	HCPCS C1776
Hospital Charge Code	64907184
Hospital Revenue Code	278
Min. Negotiated Rate	$3,357.50
Max. Negotiated Rate	$3,357.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,357.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,357.50

STEM HEI

Facility OP

$6,715.00

Service Code	HCPCS C1776
Hospital Charge Code	64907184
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,050.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,693.25
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	$3,357.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,861.12
Rate for Payer: Fidelis Medicare Advantage	$7,050.75
Rate for Payer: Group Health Inc Commercial	$3,357.50
Rate for Payer: Group Health Inc Medicare	$2,350.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,357.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,357.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,364.75

STEM HIP 127 DEG NECK

Facility IP

$17,115.75

Service Code	HCPCS C1776
Hospital Charge Code	64902777
Hospital Revenue Code	278
Min. Negotiated Rate	$8,557.88
Max. Negotiated Rate	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8,557.88

STEM HIP 127 DEG NECK

Facility OP

$17,115.75

Service Code	HCPCS C1776
Hospital Charge Code	64902777
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$17,971.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,413.66
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	$8,557.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,841.56
Rate for Payer: Fidelis Medicare Advantage	$17,971.54
Rate for Payer: Group Health Inc Commercial	$8,557.88
Rate for Payer: Group Health Inc Medicare	$5,990.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8,557.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11,125.24

STEM HIP 127 DEG NECK ANGLE

Facility OP

$17,115.75

Service Code	HCPCS C1713
Hospital Charge Code	64902666
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$17,971.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,413.66
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	$8,557.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,841.56
Rate for Payer: Fidelis Medicare Advantage	$17,971.54
Rate for Payer: Group Health Inc Commercial	$8,557.88
Rate for Payer: Group Health Inc Medicare	$5,990.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8,557.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11,125.24

STEM HIP 127 DEG NECK ANGLE

Facility IP

$17,115.75

Service Code	HCPCS C1713
Hospital Charge Code	64902666
Hospital Revenue Code	278
Min. Negotiated Rate	$8,557.88
Max. Negotiated Rate	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8,557.88

STEM HIP 127DEG NECK ANGLE

Facility OP

$17,115.75

Service Code	HCPCS C1776
Hospital Charge Code	64902771
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$17,971.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,413.66
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	$8,557.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,841.56
Rate for Payer: Fidelis Medicare Advantage	$17,971.54
Rate for Payer: Group Health Inc Commercial	$8,557.88
Rate for Payer: Group Health Inc Medicare	$5,990.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8,557.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11,125.24

STEM HIP 127DEG NECK ANGLE

Facility IP

$17,115.75

Service Code	HCPCS C1776
Hospital Charge Code	64902771
Hospital Revenue Code	278
Min. Negotiated Rate	$8,557.88
Max. Negotiated Rate	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8,557.88

STEM HIP 127 NECK ANGLE

Facility OP

$17,115.75

Service Code	HCPCS C1776
Hospital Charge Code	64902689
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$17,971.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,413.66
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	$8,557.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,841.56
Rate for Payer: Fidelis Medicare Advantage	$17,971.54
Rate for Payer: Group Health Inc Commercial	$8,557.88
Rate for Payer: Group Health Inc Medicare	$5,990.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8,557.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11,125.24

STEM HIP 127 NECK ANGLE

Facility IP

$17,115.75

Service Code	HCPCS C1776
Hospital Charge Code	64902689
Hospital Revenue Code	278
Min. Negotiated Rate	$8,557.88
Max. Negotiated Rate	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,557.88
Rate for Payer: Hamaspik Choice Inc Medicare	$8,557.88

Price Transparency.

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