St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ROD CONN CARBON 5X150

Facility

$270.00

Service Code	HCPCS C1713
Hospital Charge Code	40200775
Hospital Revenue Code	278
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$283.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$148.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$162.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$135.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.25
Rate for Payer: EmblemHealth Commercial	$135.00
Rate for Payer: Fidelis Medicare Advantage	$283.50
Rate for Payer: Group Health Inc Commercial	$135.00
Rate for Payer: Group Health Inc Medicare	$94.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.00
Rate for Payer: Hamaspik Choice Inc Medicare	$135.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$175.50

ROD CONN CARBON 5X150

Facility

$213.50

Service Code	HCPCS C1713
Hospital Charge Code	64901261
Hospital Revenue Code	278
Min. Negotiated Rate	$106.75
Max. Negotiated Rate	$106.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.75
Rate for Payer: Hamaspik Choice Inc Medicare	$106.75

ROD CONN CARBON 5X150

Facility

$270.00

Service Code	HCPCS C1713
Hospital Charge Code	40200775
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.00
Rate for Payer: Hamaspik Choice Inc Medicare	$135.00

ROD CONN CARBON 5X150

Facility

$213.50

Service Code	HCPCS C1713
Hospital Charge Code	64901261
Hospital Revenue Code	278
Min. Negotiated Rate	$74.72
Max. Negotiated Rate	$224.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$117.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$128.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$106.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$122.76
Rate for Payer: EmblemHealth Commercial	$106.75
Rate for Payer: Fidelis Medicare Advantage	$224.18
Rate for Payer: Group Health Inc Commercial	$106.75
Rate for Payer: Group Health Inc Medicare	$74.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.75
Rate for Payer: Hamaspik Choice Inc Medicare	$106.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$138.78

ROD CONNECTOR TRANS

Facility

$3,390.00

Service Code	HCPCS C1713
Hospital Charge Code	40200776
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,559.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,864.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,034.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,695.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,949.25
Rate for Payer: EmblemHealth Commercial	$1,695.00
Rate for Payer: Fidelis Medicare Advantage	$3,559.50
Rate for Payer: Group Health Inc Commercial	$1,695.00
Rate for Payer: Group Health Inc Medicare	$1,186.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,695.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,695.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,203.50

ROD CONNECTOR TRANS

Facility

$3,390.00

Service Code	HCPCS C1713
Hospital Charge Code	40200776
Hospital Revenue Code	278
Min. Negotiated Rate	$1,695.00
Max. Negotiated Rate	$1,695.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,695.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,695.00

ROD CONNECTOR TRANS S

Facility

$3,390.00

Service Code	HCPCS C1713
Hospital Charge Code	64904833
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,559.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,864.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,034.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,695.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,949.25
Rate for Payer: EmblemHealth Commercial	$1,695.00
Rate for Payer: Fidelis Medicare Advantage	$3,559.50
Rate for Payer: Group Health Inc Commercial	$1,695.00
Rate for Payer: Group Health Inc Medicare	$1,186.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,695.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,695.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,203.50

ROD CONNECTOR TRANS S

Facility

$3,390.00

Service Code	HCPCS C1713
Hospital Charge Code	64904833
Hospital Revenue Code	278
Min. Negotiated Rate	$1,695.00
Max. Negotiated Rate	$1,695.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,695.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,695.00

ROD CONNECTOR TRANS XS

Facility

$3,390.00

Service Code	HCPCS C1713
Hospital Charge Code	64904831
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,559.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,864.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,034.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,695.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,949.25
Rate for Payer: EmblemHealth Commercial	$1,695.00
Rate for Payer: Fidelis Medicare Advantage	$3,559.50
Rate for Payer: Group Health Inc Commercial	$1,695.00
Rate for Payer: Group Health Inc Medicare	$1,186.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,695.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,695.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,203.50

ROD CONNECTOR TRANS XS

Facility

$3,390.00

Service Code	HCPCS C1713
Hospital Charge Code	64904831
Hospital Revenue Code	278
Min. Negotiated Rate	$1,695.00
Max. Negotiated Rate	$1,695.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,695.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,695.00

ROD EXTERNAL FIXATION 11MM DIA

Facility

$1,467.00

Service Code	HCPCS C1713
Hospital Charge Code	64902943
Hospital Revenue Code	278
Min. Negotiated Rate	$733.50
Max. Negotiated Rate	$733.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$733.50
Rate for Payer: Hamaspik Choice Inc Medicare	$733.50

ROD EXTERNAL FIXATION 11MM DIA

Facility

$1,467.00

Service Code	HCPCS C1713
Hospital Charge Code	64902943
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,540.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$806.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$880.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$733.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$843.52
Rate for Payer: EmblemHealth Commercial	$733.50
Rate for Payer: Fidelis Medicare Advantage	$1,540.35
Rate for Payer: Group Health Inc Commercial	$733.50
Rate for Payer: Group Health Inc Medicare	$513.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$733.50
Rate for Payer: Hamaspik Choice Inc Medicare	$733.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$953.55

ROD EXTERNAL FIXATION <8.0MM

Facility

$271.85

Service Code	HCPCS C1713
Hospital Charge Code	40209990
Hospital Revenue Code	278
Min. Negotiated Rate	$95.15
Max. Negotiated Rate	$285.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$149.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$163.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$135.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.31
Rate for Payer: EmblemHealth Commercial	$135.92
Rate for Payer: Fidelis Medicare Advantage	$285.44
Rate for Payer: Group Health Inc Commercial	$135.92
Rate for Payer: Group Health Inc Medicare	$95.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.92
Rate for Payer: Hamaspik Choice Inc Medicare	$135.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$176.70

ROD EXTERNAL FIXATION <8.0MM

Facility

$271.85

Service Code	HCPCS C1713
Hospital Charge Code	40209990
Hospital Revenue Code	278
Min. Negotiated Rate	$135.92
Max. Negotiated Rate	$135.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.92
Rate for Payer: Hamaspik Choice Inc Medicare	$135.92

ROD EXTERNAL FIXATION >8.0MM

Facility

$958.75

Service Code	HCPCS C1713
Hospital Charge Code	40205458
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,006.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$527.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$575.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$479.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$551.28
Rate for Payer: EmblemHealth Commercial	$479.38
Rate for Payer: Fidelis Medicare Advantage	$1,006.69
Rate for Payer: Group Health Inc Commercial	$479.38
Rate for Payer: Group Health Inc Medicare	$335.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$479.38
Rate for Payer: Hamaspik Choice Inc Medicare	$479.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$623.19

ROD EXTERNAL FIXATION >8.0MM

Facility

$958.75

Service Code	HCPCS C1713
Hospital Charge Code	40205458
Hospital Revenue Code	278
Min. Negotiated Rate	$479.38
Max. Negotiated Rate	$479.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$479.38
Rate for Payer: Hamaspik Choice Inc Medicare	$479.38

ROD EXT FIX 100 11MM DIA

Facility

$1,127.50

Service Code	HCPCS C1713
Hospital Charge Code	64903619
Hospital Revenue Code	278
Min. Negotiated Rate	$563.75
Max. Negotiated Rate	$563.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$563.75
Rate for Payer: Hamaspik Choice Inc Medicare	$563.75

ROD EXT FIX 100 11MM DIA

Facility

$1,127.50

Service Code	HCPCS C1713
Hospital Charge Code	64903619
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,183.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$620.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$676.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$563.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$648.31
Rate for Payer: EmblemHealth Commercial	$563.75
Rate for Payer: Fidelis Medicare Advantage	$1,183.88
Rate for Payer: Group Health Inc Commercial	$563.75
Rate for Payer: Group Health Inc Medicare	$394.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$563.75
Rate for Payer: Hamaspik Choice Inc Medicare	$563.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$732.88

ROD EXT FIX 150 11MM DIA

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64903116
Hospital Revenue Code	278
Min. Negotiated Rate	$437.50
Max. Negotiated Rate	$437.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.50
Rate for Payer: Hamaspik Choice Inc Medicare	$437.50

ROD EXT FIX 150 11MM DIA

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64903116
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$918.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$481.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$525.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$437.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$503.12
Rate for Payer: EmblemHealth Commercial	$437.50
Rate for Payer: Fidelis Medicare Advantage	$918.75
Rate for Payer: Group Health Inc Commercial	$437.50
Rate for Payer: Group Health Inc Medicare	$306.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.50
Rate for Payer: Hamaspik Choice Inc Medicare	$437.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$568.75

ROD EXT FIX 200 11MM DIA

Facility

$885.50

Service Code	HCPCS C1713
Hospital Charge Code	64903118
Hospital Revenue Code	278
Min. Negotiated Rate	$442.75
Max. Negotiated Rate	$442.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$442.75
Rate for Payer: Hamaspik Choice Inc Medicare	$442.75

ROD EXT FIX 200 11MM DIA

Facility

$885.50

Service Code	HCPCS C1713
Hospital Charge Code	64903118
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$929.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$487.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$531.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$442.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$509.16
Rate for Payer: EmblemHealth Commercial	$442.75
Rate for Payer: Fidelis Medicare Advantage	$929.78
Rate for Payer: Group Health Inc Commercial	$442.75
Rate for Payer: Group Health Inc Medicare	$309.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$442.75
Rate for Payer: Hamaspik Choice Inc Medicare	$442.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$575.58

ROD EXT FIX 250 11MM DIA

Facility

$885.50

Service Code	HCPCS C1713
Hospital Charge Code	64902732
Hospital Revenue Code	278
Min. Negotiated Rate	$442.75
Max. Negotiated Rate	$442.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$442.75
Rate for Payer: Hamaspik Choice Inc Medicare	$442.75

ROD EXT FIX 250 11MM DIA

Facility

$885.50

Service Code	HCPCS C1713
Hospital Charge Code	64902732
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$929.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$487.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$531.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$442.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$509.16
Rate for Payer: EmblemHealth Commercial	$442.75
Rate for Payer: Fidelis Medicare Advantage	$929.78
Rate for Payer: Group Health Inc Commercial	$442.75
Rate for Payer: Group Health Inc Medicare	$309.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$442.75
Rate for Payer: Hamaspik Choice Inc Medicare	$442.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$575.58

ROD EXT FIX 300 11MM DIA

Facility

$908.25

Service Code	HCPCS C1713
Hospital Charge Code	64903114
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$953.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$499.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$544.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$454.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$522.24
Rate for Payer: EmblemHealth Commercial	$454.12
Rate for Payer: Fidelis Medicare Advantage	$953.66
Rate for Payer: Group Health Inc Commercial	$454.12
Rate for Payer: Group Health Inc Medicare	$317.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$454.12
Rate for Payer: Hamaspik Choice Inc Medicare	$454.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$590.36

Know your out-of-pocket cost for care.

All Charges