St. Barnabas Hospital

All Charges

Charge

Type

Price

BIOMET JUGGER KNOT W/NEEDLE

Facility IP

$550.00

Service Code	HCPCS C1713
Hospital Charge Code	40205315
Hospital Revenue Code	278
Min. Negotiated Rate	$275.00
Max. Negotiated Rate	$275.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$275.00

BIOMET KIT OPTIVAC 80G DOUBLE MIX

Facility OP

$266.00

Hospital Charge Code	40009323
Hospital Revenue Code	272
Min. Negotiated Rate	$93.10
Max. Negotiated Rate	$212.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$133.00
Rate for Payer: Aetna Government	$133.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$212.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$180.88
Rate for Payer: Group Health Inc Commercial	$133.00
Rate for Payer: Group Health Inc Medicare	$93.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.00
Rate for Payer: Hamaspik Choice Inc Medicare	$133.00

BIOMET KIT OPTIVAC 80G DOUBLE MIX

Facility OP

$266.00

Hospital Charge Code	40203341
Hospital Revenue Code	272
Min. Negotiated Rate	$93.10
Max. Negotiated Rate	$212.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$133.00
Rate for Payer: Aetna Government	$133.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$212.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$180.88
Rate for Payer: Group Health Inc Commercial	$133.00
Rate for Payer: Group Health Inc Medicare	$93.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.00
Rate for Payer: Hamaspik Choice Inc Medicare	$133.00

BIOMET L/P S/T BONE SCRW 6.5 X

Facility IP

$282.00

Service Code	HCPCS C1713
Hospital Charge Code	40205685
Hospital Revenue Code	278
Min. Negotiated Rate	$141.00
Max. Negotiated Rate	$141.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$141.00
Rate for Payer: Hamaspik Choice Inc Medicare	$141.00

BIOMET L/P S/T BONE SCRW 6.5 X

Facility OP

$282.00

Service Code	HCPCS C1713
Hospital Charge Code	40205685
Hospital Revenue Code	278
Min. Negotiated Rate	$98.70
Max. Negotiated Rate	$296.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$155.10
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	$141.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$162.15
Rate for Payer: Fidelis Medicare Advantage	$296.10
Rate for Payer: Group Health Inc Commercial	$141.00
Rate for Payer: Group Health Inc Medicare	$98.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$141.00
Rate for Payer: Hamaspik Choice Inc Medicare	$141.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$183.30

BIOMET M2A MAG(TM) MODHD 58MM DIA

Facility IP

$2,816.00

Service Code	HCPCS C1776
Hospital Charge Code	40206026
Hospital Revenue Code	278
Min. Negotiated Rate	$1,408.00
Max. Negotiated Rate	$1,408.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,408.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,408.00

BIOMET M2A MAG(TM) MODHD 58MM DIA

Facility OP

$2,816.00

Service Code	HCPCS C1776
Hospital Charge Code	40206026
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,956.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,548.80
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	$1,408.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,619.20
Rate for Payer: Fidelis Medicare Advantage	$2,956.80
Rate for Payer: Group Health Inc Commercial	$1,408.00
Rate for Payer: Group Health Inc Medicare	$985.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,408.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,408.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,830.40

BIOMET M2A MAG(TM)PF CUP56MMX50MM

Facility OP

$7,422.00

Service Code	HCPCS C1776
Hospital Charge Code	40205096
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,793.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,082.10
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	$3,711.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,267.65
Rate for Payer: Fidelis Medicare Advantage	$7,793.10
Rate for Payer: Group Health Inc Commercial	$3,711.00
Rate for Payer: Group Health Inc Medicare	$2,597.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,711.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,711.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,824.30

BIOMET M2A MAG(TM)PF CUP56MMX50MM

Facility IP

$7,422.00

Service Code	HCPCS C1776
Hospital Charge Code	40205096
Hospital Revenue Code	278
Min. Negotiated Rate	$3,711.00
Max. Negotiated Rate	$3,711.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,711.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,711.00

BIOMET MAC CORRECTION MODULE

Facility OP

$8,184.00

Hospital Charge Code	40205829
Hospital Revenue Code	279
Min. Negotiated Rate	$2,864.40
Max. Negotiated Rate	$6,547.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,501.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,092.00
Rate for Payer: Aetna Government	$4,092.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,547.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,565.12
Rate for Payer: Group Health Inc Commercial	$4,092.00
Rate for Payer: Group Health Inc Medicare	$2,864.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,092.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,092.00

BIOMET MAC RING BOLT

Facility OP

$216.00

Hospital Charge Code	40205830
Hospital Revenue Code	279
Min. Negotiated Rate	$75.60
Max. Negotiated Rate	$172.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$118.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$108.00
Rate for Payer: Aetna Government	$108.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$172.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$146.88
Rate for Payer: Group Health Inc Commercial	$108.00
Rate for Payer: Group Health Inc Medicare	$75.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.00
Rate for Payer: Hamaspik Choice Inc Medicare	$108.00

BIOMET MODULAR HEAD/ TAPER 36MM

Facility OP

$1,394.00

Service Code	HCPCS C1776
Hospital Charge Code	40205132
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,463.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$766.70
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	$697.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$801.55
Rate for Payer: Fidelis Medicare Advantage	$1,463.70
Rate for Payer: Group Health Inc Commercial	$697.00
Rate for Payer: Group Health Inc Medicare	$487.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$697.00
Rate for Payer: Hamaspik Choice Inc Medicare	$697.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$906.10

BIOMET MODULAR HEAD/ TAPER 36MM

Facility IP

$1,394.00

Service Code	HCPCS C1776
Hospital Charge Code	40205132
Hospital Revenue Code	278
Min. Negotiated Rate	$697.00
Max. Negotiated Rate	$697.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$697.00
Rate for Payer: Hamaspik Choice Inc Medicare	$697.00

BIOMET ON POINT TM SCOPE

Facility OP

$1,000.00

Hospital Charge Code	40205488
Hospital Revenue Code	270
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$800.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$550.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$500.00
Rate for Payer: Aetna Government	$500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$800.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$680.00
Rate for Payer: Group Health Inc Commercial	$500.00
Rate for Payer: Group Health Inc Medicare	$350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$500.00

BIOMET ORTHO BONE CEMENT

Facility OP

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	40205905
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$404.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$211.75
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	$192.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$221.38
Rate for Payer: Fidelis Medicare Advantage	$404.25
Rate for Payer: Group Health Inc Commercial	$192.50
Rate for Payer: Group Health Inc Medicare	$134.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$192.50
Rate for Payer: Hamaspik Choice Inc Medicare	$192.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$250.25

BIOMET ORTHO BONE CEMENT

Facility IP

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	40205905
Hospital Revenue Code	278
Min. Negotiated Rate	$192.50
Max. Negotiated Rate	$192.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$192.50
Rate for Payer: Hamaspik Choice Inc Medicare	$192.50

BIOMET PATELLA COMPONENT

Facility IP

$1,933.47

Service Code	HCPCS C1776
Hospital Charge Code	40024006
Hospital Revenue Code	278
Min. Negotiated Rate	$966.74
Max. Negotiated Rate	$966.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$966.74
Rate for Payer: Hamaspik Choice Inc Medicare	$966.74

BIOMET PATELLA COMPONENT

Facility OP

$1,933.47

Service Code	HCPCS C1776
Hospital Charge Code	40024006
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,030.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,063.41
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	$966.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,111.75
Rate for Payer: Fidelis Medicare Advantage	$2,030.14
Rate for Payer: Group Health Inc Commercial	$966.74
Rate for Payer: Group Health Inc Medicare	$676.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$966.74
Rate for Payer: Hamaspik Choice Inc Medicare	$966.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,256.76

BIOMET PLTE FIXED CRU TIB 141232

Facility OP

$3,470.00

Service Code	HCPCS C1776
Hospital Charge Code	40208107
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,643.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,908.50
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	$1,735.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,995.25
Rate for Payer: Fidelis Medicare Advantage	$3,643.50
Rate for Payer: Group Health Inc Commercial	$1,735.00
Rate for Payer: Group Health Inc Medicare	$1,214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,735.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,735.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,255.50

BIOMET PLTE FIXED CRU TIB 141232

Facility IP

$3,470.00

Service Code	HCPCS C1776
Hospital Charge Code	40208107
Hospital Revenue Code	278
Min. Negotiated Rate	$1,735.00
Max. Negotiated Rate	$1,735.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,735.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,735.00

BIOMET PROCEDURE KIT

Facility OP

$160.00

Hospital Charge Code	40205481
Hospital Revenue Code	270
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$128.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$80.00
Rate for Payer: Aetna Government	$80.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$128.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$108.80
Rate for Payer: Group Health Inc Commercial	$80.00
Rate for Payer: Group Health Inc Medicare	$56.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00

BIOMET RING LOC ACETAB HI WALL

Facility OP

$4,072.00

Service Code	HCPCS C1776
Hospital Charge Code	40200394
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,275.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,239.60
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	$2,036.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,341.40
Rate for Payer: Fidelis Medicare Advantage	$4,275.60
Rate for Payer: Group Health Inc Commercial	$2,036.00
Rate for Payer: Group Health Inc Medicare	$1,425.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,036.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,036.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,646.80

BIOMET RING LOC ACETAB HI WALL

Facility IP

$4,072.00

Service Code	HCPCS C1776
Hospital Charge Code	40200394
Hospital Revenue Code	278
Min. Negotiated Rate	$2,036.00
Max. Negotiated Rate	$2,036.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,036.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,036.00

BIOMET RING LOC B/P ACETAB LINER

Facility OP

$4,276.00

Service Code	HCPCS C1776
Hospital Charge Code	40205684
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,489.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,351.80
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	$2,138.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,458.70
Rate for Payer: Fidelis Medicare Advantage	$4,489.80
Rate for Payer: Group Health Inc Commercial	$2,138.00
Rate for Payer: Group Health Inc Medicare	$1,496.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,138.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,779.40

BIOMET RING LOC B/P ACETAB LINER

Facility IP

$4,276.00

Service Code	HCPCS C1776
Hospital Charge Code	40205684
Hospital Revenue Code	278
Min. Negotiated Rate	$2,138.00
Max. Negotiated Rate	$2,138.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,138.00

Price Transparency.

All Charges