St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

RING EXT FIXATION 180MM ID

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	64903338
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,462.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,337.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,550.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,125.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,443.75
Rate for Payer: EmblemHealth Commercial	$2,125.00
Rate for Payer: Fidelis Medicare Advantage	$4,462.50
Rate for Payer: Group Health Inc Commercial	$2,125.00
Rate for Payer: Group Health Inc Medicare	$1,487.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,125.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,762.50

RING EXT FIXATION 180MM ID

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	64903338
Hospital Revenue Code	278
Min. Negotiated Rate	$2,125.00
Max. Negotiated Rate	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,125.00

RING EXT FIXATION 180MM ID

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903339
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,200.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,400.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,000.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,300.00
Rate for Payer: EmblemHealth Commercial	$2,000.00
Rate for Payer: Fidelis Medicare Advantage	$4,200.00
Rate for Payer: Group Health Inc Commercial	$2,000.00
Rate for Payer: Group Health Inc Medicare	$1,400.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,000.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,600.00

RING EXT FIXATION 210MM ID

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903983
Hospital Revenue Code	278
Min. Negotiated Rate	$2,000.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,000.00

RING EXT FIXATION 210MM ID

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903983
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,200.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,400.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,000.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,300.00
Rate for Payer: EmblemHealth Commercial	$2,000.00
Rate for Payer: Fidelis Medicare Advantage	$4,200.00
Rate for Payer: Group Health Inc Commercial	$2,000.00
Rate for Payer: Group Health Inc Medicare	$1,400.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,000.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,600.00

RING EXT FIXATION FULL 180

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64903336
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

RING EXT FIXATION FULL 180

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64903336
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,725.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,475.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,700.00
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: EmblemHealth Commercial	$2,250.00
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

RING EXT FIXATION FULL 210

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64903337
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

RING EXT FIXATION FULL 210

Facility

$4,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64903337
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,725.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,475.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,700.00
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: EmblemHealth Commercial	$2,250.00
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

RING EXT FIXATION OPEN 210

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	64903981
Hospital Revenue Code	278
Min. Negotiated Rate	$2,125.00
Max. Negotiated Rate	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,125.00

RING EXT FIXATION OPEN 210

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	64903981
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,462.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,337.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,550.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,125.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,443.75
Rate for Payer: EmblemHealth Commercial	$2,125.00
Rate for Payer: Fidelis Medicare Advantage	$4,462.50
Rate for Payer: Group Health Inc Commercial	$2,125.00
Rate for Payer: Group Health Inc Medicare	$1,487.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,125.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,762.50

RING FOOT CARBON FIB LNG 180

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64902968
Hospital Revenue Code	278
Min. Negotiated Rate	$2,500.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,500.00

RING FOOT CARBON FIB LNG 180

Facility

$5,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64902968
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,750.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,000.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,875.00
Rate for Payer: EmblemHealth Commercial	$2,500.00
Rate for Payer: Fidelis Medicare Advantage	$5,250.00
Rate for Payer: Group Health Inc Commercial	$2,500.00
Rate for Payer: Group Health Inc Medicare	$1,750.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,250.00

RING HALF

Facility

$205.80

Hospital Charge Code	40200765
Hospital Revenue Code	270
Min. Negotiated Rate	$72.03
Max. Negotiated Rate	$164.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$113.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$102.90
Rate for Payer: Aetna Government	$102.90
Rate for Payer: Brighton Health Commercial	$154.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$164.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$139.94
Rate for Payer: Group Health Inc Commercial	$102.90
Rate for Payer: Group Health Inc Medicare	$72.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$102.90
Rate for Payer: Hamaspik Choice Inc Medicare	$102.90

RING HOFFMAN HYBIRD OPEN

Facility

$1,155.00

Hospital Charge Code	40200472
Hospital Revenue Code	270
Min. Negotiated Rate	$404.25
Max. Negotiated Rate	$924.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$635.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$577.50
Rate for Payer: Aetna Government	$577.50
Rate for Payer: Brighton Health Commercial	$866.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$924.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$785.40
Rate for Payer: Group Health Inc Commercial	$577.50
Rate for Payer: Group Health Inc Medicare	$404.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$577.50
Rate for Payer: Hamaspik Choice Inc Medicare	$577.50

RING HOFFMAN OPEN

Facility

$1,156.00

Hospital Charge Code	40200677
Hospital Revenue Code	270
Min. Negotiated Rate	$404.60
Max. Negotiated Rate	$924.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$635.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$578.00
Rate for Payer: Aetna Government	$578.00
Rate for Payer: Brighton Health Commercial	$867.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$924.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$786.08
Rate for Payer: Group Health Inc Commercial	$578.00
Rate for Payer: Group Health Inc Medicare	$404.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$578.00
Rate for Payer: Hamaspik Choice Inc Medicare	$578.00

RINGLOC ACTBLR LINER 32MM SZ 24

Facility

$2,596.00

Service Code	HCPCS C1776
Hospital Charge Code	40209755
Hospital Revenue Code	278
Min. Negotiated Rate	$1,298.00
Max. Negotiated Rate	$1,298.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,298.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,298.00

RINGLOC ACTBLR LINER 32MM SZ 24

Facility

$2,596.00

Service Code	HCPCS C1776
Hospital Charge Code	40209755
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,725.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,427.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,557.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,298.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,492.70
Rate for Payer: EmblemHealth Commercial	$1,298.00
Rate for Payer: Fidelis Medicare Advantage	$2,725.80
Rate for Payer: Group Health Inc Commercial	$1,298.00
Rate for Payer: Group Health Inc Medicare	$908.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,298.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,298.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,687.40

RINGLOC ACTBLR LINER SZ 25

Facility

$2,596.00

Service Code	HCPCS C1776
Hospital Charge Code	40200876
Hospital Revenue Code	278
Min. Negotiated Rate	$1,298.00
Max. Negotiated Rate	$1,298.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,298.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,298.00

RINGLOC ACTBLR LINER SZ 25

Facility

$2,596.00

Service Code	HCPCS C1776
Hospital Charge Code	40200876
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,725.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,427.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,557.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,298.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,492.70
Rate for Payer: EmblemHealth Commercial	$1,298.00
Rate for Payer: Fidelis Medicare Advantage	$2,725.80
Rate for Payer: Group Health Inc Commercial	$1,298.00
Rate for Payer: Group Health Inc Medicare	$908.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,298.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,298.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,687.40

RING LOC BIPOLAR ACTBLR CUP

Facility

$1,320.00

Service Code	HCPCS C1776
Hospital Charge Code	40202207
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,386.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$726.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$792.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$660.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$759.00
Rate for Payer: EmblemHealth Commercial	$660.00
Rate for Payer: Fidelis Medicare Advantage	$1,386.00
Rate for Payer: Group Health Inc Commercial	$660.00
Rate for Payer: Group Health Inc Medicare	$462.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$660.00
Rate for Payer: Hamaspik Choice Inc Medicare	$660.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$858.00

RING LOC BIPOLAR ACTBLR CUP

Facility

$1,320.00

Service Code	HCPCS C1776
Hospital Charge Code	40202207
Hospital Revenue Code	278
Min. Negotiated Rate	$660.00
Max. Negotiated Rate	$660.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$660.00
Rate for Payer: Hamaspik Choice Inc Medicare	$660.00

RING LOC BIPOLAR ACTBLR CUP 28MM

Facility

$2,596.00

Hospital Charge Code	40202208
Hospital Revenue Code	270
Min. Negotiated Rate	$908.60
Max. Negotiated Rate	$2,076.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,427.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,298.00
Rate for Payer: Aetna Government	$1,298.00
Rate for Payer: Brighton Health Commercial	$1,947.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,076.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,765.28
Rate for Payer: Group Health Inc Commercial	$1,298.00
Rate for Payer: Group Health Inc Medicare	$908.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,298.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,298.00

RING OPEN 155MM

Facility

$2,744.55

Service Code	HCPCS C1713
Hospital Charge Code	64907405
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,881.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,509.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,646.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,372.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,578.12
Rate for Payer: EmblemHealth Commercial	$1,372.28
Rate for Payer: Fidelis Medicare Advantage	$2,881.78
Rate for Payer: Group Health Inc Commercial	$1,372.28
Rate for Payer: Group Health Inc Medicare	$960.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,372.28
Rate for Payer: Hamaspik Choice Inc Medicare	$1,372.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,783.96

RING OPEN 155MM

Facility

$2,744.55

Service Code	HCPCS C1713
Hospital Charge Code	64907405
Hospital Revenue Code	278
Min. Negotiated Rate	$1,372.28
Max. Negotiated Rate	$1,372.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,372.28
Rate for Payer: Hamaspik Choice Inc Medicare	$1,372.28

Know your out-of-pocket cost for care.

All Charges