St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ROD EXT FIX 300 11MM DIA

Facility

$908.25

Service Code	HCPCS C1713
Hospital Charge Code	64903114
Hospital Revenue Code	278
Min. Negotiated Rate	$454.12
Max. Negotiated Rate	$454.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$454.12
Rate for Payer: Hamaspik Choice Inc Medicare	$454.12

ROD EXT FIX 350 11MM DIA

Facility

$908.25

Service Code	HCPCS C1713
Hospital Charge Code	64902734
Hospital Revenue Code	278
Min. Negotiated Rate	$454.12
Max. Negotiated Rate	$454.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$454.12
Rate for Payer: Hamaspik Choice Inc Medicare	$454.12

ROD EXT FIX 350 11MM DIA

Facility

$908.25

Service Code	HCPCS C1713
Hospital Charge Code	64902734
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

ROD EXT FIX 400 11MM DIA

Facility

$1,039.50

Service Code	HCPCS C1713
Hospital Charge Code	64903179
Hospital Revenue Code	278
Min. Negotiated Rate	$519.75
Max. Negotiated Rate	$519.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$519.75
Rate for Payer: Hamaspik Choice Inc Medicare	$519.75

ROD EXT FIX 400 11MM DIA

Facility

$1,039.50

Service Code	HCPCS C1713
Hospital Charge Code	64903179
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,091.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$571.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$623.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$519.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$597.71
Rate for Payer: EmblemHealth Commercial	$519.75
Rate for Payer: Fidelis Medicare Advantage	$1,091.48
Rate for Payer: Group Health Inc Commercial	$519.75
Rate for Payer: Group Health Inc Medicare	$363.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$519.75
Rate for Payer: Hamaspik Choice Inc Medicare	$519.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$675.68

ROD EXT FIX 450 11MM DIA

Facility

$1,039.93

Service Code	HCPCS C1713
Hospital Charge Code	64903140
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,091.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$571.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$623.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$519.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$597.96
Rate for Payer: EmblemHealth Commercial	$519.96
Rate for Payer: Fidelis Medicare Advantage	$1,091.93
Rate for Payer: Group Health Inc Commercial	$519.96
Rate for Payer: Group Health Inc Medicare	$363.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$519.96
Rate for Payer: Hamaspik Choice Inc Medicare	$519.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$675.95

ROD EXT FIX 450 11MM DIA

Facility

$1,039.93

Service Code	HCPCS C1713
Hospital Charge Code	64903140
Hospital Revenue Code	278
Min. Negotiated Rate	$519.96
Max. Negotiated Rate	$519.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$519.96
Rate for Payer: Hamaspik Choice Inc Medicare	$519.96

ROD EXT FIX 500 11MM DIA

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	64903915
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,496.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$783.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$855.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$712.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$819.38
Rate for Payer: EmblemHealth Commercial	$712.50
Rate for Payer: Fidelis Medicare Advantage	$1,496.25
Rate for Payer: Group Health Inc Commercial	$712.50
Rate for Payer: Group Health Inc Medicare	$498.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$712.50
Rate for Payer: Hamaspik Choice Inc Medicare	$712.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$926.25

ROD EXT FIX 500 11MM DIA

Facility

$1,425.00

Service Code	HCPCS C1713
Hospital Charge Code	64903915
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$712.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$712.50
Rate for Payer: Hamaspik Choice Inc Medicare	$712.50

ROD EXT FIXATION 11MM DIA

Facility

$1,682.50

Service Code	HCPCS C1713
Hospital Charge Code	64903793
Hospital Revenue Code	278
Min. Negotiated Rate	$841.25
Max. Negotiated Rate	$841.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$841.25
Rate for Payer: Hamaspik Choice Inc Medicare	$841.25

ROD EXT FIXATION 11MM DIA

Facility

$1,682.50

Service Code	HCPCS C1713
Hospital Charge Code	64903793
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,766.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$925.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,009.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$841.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$967.44
Rate for Payer: EmblemHealth Commercial	$841.25
Rate for Payer: Fidelis Medicare Advantage	$1,766.62
Rate for Payer: Group Health Inc Commercial	$841.25
Rate for Payer: Group Health Inc Medicare	$588.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$841.25
Rate for Payer: Hamaspik Choice Inc Medicare	$841.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,093.62

ROD EXT FIXATION 250MML CA

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	64903950
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$236.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$135.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.38
Rate for Payer: EmblemHealth Commercial	$112.50
Rate for Payer: Fidelis Medicare Advantage	$236.25
Rate for Payer: Group Health Inc Commercial	$112.50
Rate for Payer: Group Health Inc Medicare	$78.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.50
Rate for Payer: Hamaspik Choice Inc Medicare	$112.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$146.25

ROD EXT FIXATION 250MML CA

Facility

$225.00

Service Code	HCPCS C1713
Hospital Charge Code	64903950
Hospital Revenue Code	278
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.50
Rate for Payer: Hamaspik Choice Inc Medicare	$112.50

ROD EXT FIXATION 5MM DIA 1

Facility

$258.38

Service Code	HCPCS C1713
Hospital Charge Code	64902116
Hospital Revenue Code	278
Min. Negotiated Rate	$129.19
Max. Negotiated Rate	$129.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$129.19
Rate for Payer: Hamaspik Choice Inc Medicare	$129.19

ROD EXT FIXATION 5MM DIA 1

Facility

$258.38

Service Code	HCPCS C1713
Hospital Charge Code	64902116
Hospital Revenue Code	278
Min. Negotiated Rate	$90.43
Max. Negotiated Rate	$271.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$142.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$155.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$129.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$148.57
Rate for Payer: EmblemHealth Commercial	$129.19
Rate for Payer: Fidelis Medicare Advantage	$271.30
Rate for Payer: Group Health Inc Commercial	$129.19
Rate for Payer: Group Health Inc Medicare	$90.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$129.19
Rate for Payer: Hamaspik Choice Inc Medicare	$129.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$167.95

ROD EXT FIXATION 5MM DIA 2

Facility

$213.50

Service Code	HCPCS C1713
Hospital Charge Code	64901257
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 EXT FIXATION 5MM DIA 2

Facility

$213.50

Service Code	HCPCS C1713
Hospital Charge Code	64901257
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 EXT FIXATION 6MM DIA 1

Facility

$200.00

Service Code	HCPCS C1713
Hospital Charge Code	64904368
Hospital Revenue Code	278
Min. Negotiated Rate	$100.00
Max. Negotiated Rate	$100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

ROD EXT FIXATION 6MM DIA 1

Facility

$200.00

Service Code	HCPCS C1713
Hospital Charge Code	64904368
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$210.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.00
Rate for Payer: EmblemHealth Commercial	$100.00
Rate for Payer: Fidelis Medicare Advantage	$210.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$130.00

ROD EXT FIXATION 8MM DIA 1

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64901778
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$551.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$288.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$315.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$262.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$301.88
Rate for Payer: EmblemHealth Commercial	$262.50
Rate for Payer: Fidelis Medicare Advantage	$551.25
Rate for Payer: Group Health Inc Commercial	$262.50
Rate for Payer: Group Health Inc Medicare	$183.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$262.50
Rate for Payer: Hamaspik Choice Inc Medicare	$262.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$341.25

ROD EXT FIXATION 8MM DIA 1

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64901778
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$262.50
Rate for Payer: Hamaspik Choice Inc Medicare	$262.50

ROD EXT FIXATION 8MM DIA 2 A

Facility

$796.25

Service Code	HCPCS C1713
Hospital Charge Code	64901759
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$836.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$437.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$477.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$398.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$457.84
Rate for Payer: EmblemHealth Commercial	$398.12
Rate for Payer: Fidelis Medicare Advantage	$836.06
Rate for Payer: Group Health Inc Commercial	$398.12
Rate for Payer: Group Health Inc Medicare	$278.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$398.12
Rate for Payer: Hamaspik Choice Inc Medicare	$398.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$517.56

ROD EXT FIXATION 8MM DIA 2 A

Facility

$796.25

Service Code	HCPCS C1713
Hospital Charge Code	64901759
Hospital Revenue Code	278
Min. Negotiated Rate	$398.12
Max. Negotiated Rate	$398.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$398.12
Rate for Payer: Hamaspik Choice Inc Medicare	$398.12

ROD EXT FIXATION 8MM DIA 2 B

Facility

$796.25

Service Code	HCPCS C1713
Hospital Charge Code	64901760
Hospital Revenue Code	278
Min. Negotiated Rate	$398.12
Max. Negotiated Rate	$398.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$398.12
Rate for Payer: Hamaspik Choice Inc Medicare	$398.12

ROD EXT FIXATION 8MM DIA 2 B

Facility

$796.25

Service Code	HCPCS C1713
Hospital Charge Code	64901760
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$836.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$437.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$477.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$398.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$457.84
Rate for Payer: EmblemHealth Commercial	$398.12
Rate for Payer: Fidelis Medicare Advantage	$836.06
Rate for Payer: Group Health Inc Commercial	$398.12
Rate for Payer: Group Health Inc Medicare	$278.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$398.12
Rate for Payer: Hamaspik Choice Inc Medicare	$398.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$517.56

Know your out-of-pocket cost for care.

All Charges