St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ROD SPINAL 6MM DIA 55MML TITN

Facility

$3,235.33

Service Code	HCPCS C1776
Hospital Charge Code	64904647
Hospital Revenue Code	278
Min. Negotiated Rate	$1,617.66
Max. Negotiated Rate	$1,617.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,617.66
Rate for Payer: Hamaspik Choice Inc Medicare	$1,617.66

ROD SPINAL 6MM DIA 55MML TITN

Facility

$3,235.33

Service Code	HCPCS C1776
Hospital Charge Code	64904647
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,397.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,779.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,941.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,617.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,860.31
Rate for Payer: EmblemHealth Commercial	$1,617.66
Rate for Payer: Fidelis Medicare Advantage	$3,397.10
Rate for Payer: Group Health Inc Commercial	$1,617.66
Rate for Payer: Group Health Inc Medicare	$1,132.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,617.66
Rate for Payer: Hamaspik Choice Inc Medicare	$1,617.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,102.96

ROD SPINAL 6MM DIA 600MML

Facility

$3,734.53

Service Code	HCPCS C1776
Hospital Charge Code	64903943
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,921.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,053.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,240.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,867.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,147.35
Rate for Payer: EmblemHealth Commercial	$1,867.26
Rate for Payer: Fidelis Medicare Advantage	$3,921.26
Rate for Payer: Group Health Inc Commercial	$1,867.26
Rate for Payer: Group Health Inc Medicare	$1,307.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,867.26
Rate for Payer: Hamaspik Choice Inc Medicare	$1,867.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,427.44

ROD SPINAL 6MM DIA 600MML

Facility

$3,734.53

Service Code	HCPCS C1776
Hospital Charge Code	64903943
Hospital Revenue Code	278
Min. Negotiated Rate	$1,867.26
Max. Negotiated Rate	$1,867.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,867.26
Rate for Payer: Hamaspik Choice Inc Medicare	$1,867.26

ROD SPINAL 6MM DIA 70MML TITN

Facility

$3,235.33

Service Code	HCPCS C1776
Hospital Charge Code	64904649
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,397.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,779.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,941.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,617.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,860.31
Rate for Payer: EmblemHealth Commercial	$1,617.66
Rate for Payer: Fidelis Medicare Advantage	$3,397.10
Rate for Payer: Group Health Inc Commercial	$1,617.66
Rate for Payer: Group Health Inc Medicare	$1,132.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,617.66
Rate for Payer: Hamaspik Choice Inc Medicare	$1,617.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,102.96

ROD SPINAL 6MM DIA 70MML TITN

Facility

$3,235.33

Service Code	HCPCS C1776
Hospital Charge Code	64904649
Hospital Revenue Code	278
Min. Negotiated Rate	$1,617.66
Max. Negotiated Rate	$1,617.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,617.66
Rate for Payer: Hamaspik Choice Inc Medicare	$1,617.66

ROD SPINAL 6MM DIA 80MML

Facility

$3,235.00

Service Code	HCPCS C1776
Hospital Charge Code	64904933
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,396.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,779.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,941.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,617.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,860.12
Rate for Payer: EmblemHealth Commercial	$1,617.50
Rate for Payer: Fidelis Medicare Advantage	$3,396.75
Rate for Payer: Group Health Inc Commercial	$1,617.50
Rate for Payer: Group Health Inc Medicare	$1,132.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,617.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,617.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,102.75

ROD SPINAL 6MM DIA 80MML

Facility

$3,235.00

Service Code	HCPCS C1776
Hospital Charge Code	64904933
Hospital Revenue Code	278
Min. Negotiated Rate	$1,617.50
Max. Negotiated Rate	$1,617.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,617.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,617.50

ROD SPINE 140MM -487140

Facility

$2,588.20

Service Code	HCPCS C1713
Hospital Charge Code	64906690
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,717.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,423.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,552.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,294.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,488.22
Rate for Payer: EmblemHealth Commercial	$1,294.10
Rate for Payer: Fidelis Medicare Advantage	$2,717.61
Rate for Payer: Group Health Inc Commercial	$1,294.10
Rate for Payer: Group Health Inc Medicare	$905.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,294.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,294.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,682.33

ROD SPINE 140MM -487140

Facility

$2,588.20

Service Code	HCPCS C1713
Hospital Charge Code	64906690
Hospital Revenue Code	278
Min. Negotiated Rate	$1,294.10
Max. Negotiated Rate	$1,294.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,294.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,294.10

RODS, PREBENT ROD 5X45 L

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64904588
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

RODS, PREBENT ROD 5X45 L

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64904588
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

RODS, PREBENT ROD 5X60, L

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64904590
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

RODS, PREBENT ROD 5X60, L

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64904590
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 STAINLESS STEEL

Facility

$928.00

Service Code	HCPCS C1713
Hospital Charge Code	40200936
Hospital Revenue Code	278
Min. Negotiated Rate	$464.00
Max. Negotiated Rate	$464.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$464.00
Rate for Payer: Hamaspik Choice Inc Medicare	$464.00

ROD STAINLESS STEEL

Facility

$928.00

Service Code	HCPCS C1713
Hospital Charge Code	40200936
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$974.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$510.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$556.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$464.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$533.60
Rate for Payer: EmblemHealth Commercial	$464.00
Rate for Payer: Fidelis Medicare Advantage	$974.40
Rate for Payer: Group Health Inc Commercial	$464.00
Rate for Payer: Group Health Inc Medicare	$324.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$464.00
Rate for Payer: Hamaspik Choice Inc Medicare	$464.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$603.20

ROD STRAIGHT

Facility

$1,485.00

Service Code	HCPCS C1821
Hospital Charge Code	64907466
Hospital Revenue Code	278
Min. Negotiated Rate	$519.75
Max. Negotiated Rate	$1,609.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$816.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,609.27
Rate for Payer: Aetna Government	$1,609.27
Rate for Payer: Brighton Health Commercial	$891.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$742.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$853.88
Rate for Payer: EmblemHealth Commercial	$742.50
Rate for Payer: Fidelis Medicare Advantage	$1,559.25
Rate for Payer: Group Health Inc Commercial	$742.50
Rate for Payer: Group Health Inc Medicare	$519.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$742.50
Rate for Payer: Hamaspik Choice Inc Medicare	$742.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$965.25

ROD STRAIGHT

Facility

$1,485.00

Service Code	HCPCS C1821
Hospital Charge Code	64907466
Hospital Revenue Code	278
Min. Negotiated Rate	$742.50
Max. Negotiated Rate	$742.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$742.50
Rate for Payer: Hamaspik Choice Inc Medicare	$742.50

ROD THREADED

Facility

$124.20

Service Code	HCPCS C1713
Hospital Charge Code	64907402
Hospital Revenue Code	278
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$62.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.10
Rate for Payer: Hamaspik Choice Inc Medicare	$62.10

ROD THREADED

Facility

$124.20

Service Code	HCPCS C1713
Hospital Charge Code	64907402
Hospital Revenue Code	278
Min. Negotiated Rate	$43.47
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$74.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$62.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.42
Rate for Payer: EmblemHealth Commercial	$62.10
Rate for Payer: Fidelis Medicare Advantage	$130.41
Rate for Payer: Group Health Inc Commercial	$62.10
Rate for Payer: Group Health Inc Medicare	$43.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.10
Rate for Payer: Hamaspik Choice Inc Medicare	$62.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.73

ROD TI HEX

Facility

$1,635.48

Service Code	HCPCS C1713
Hospital Charge Code	64906869
Hospital Revenue Code	278
Min. Negotiated Rate	$817.74
Max. Negotiated Rate	$817.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$817.74
Rate for Payer: Hamaspik Choice Inc Medicare	$817.74

ROD TI HEX

Facility

$1,635.48

Service Code	HCPCS C1713
Hospital Charge Code	64906869
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,717.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$899.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$981.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$817.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$940.40
Rate for Payer: EmblemHealth Commercial	$817.74
Rate for Payer: Fidelis Medicare Advantage	$1,717.25
Rate for Payer: Group Health Inc Commercial	$817.74
Rate for Payer: Group Health Inc Medicare	$572.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$817.74
Rate for Payer: Hamaspik Choice Inc Medicare	$817.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,063.06

ROD TO ROD COUPLING

Facility

$965.00

Service Code	HCPCS C1713
Hospital Charge Code	40201313
Hospital Revenue Code	278
Min. Negotiated Rate	$482.50
Max. Negotiated Rate	$482.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$482.50
Rate for Payer: Hamaspik Choice Inc Medicare	$482.50

ROD TO ROD COUPLING

Facility

$965.00

Service Code	HCPCS C1713
Hospital Charge Code	40201313
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,013.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$530.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$579.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$482.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$554.88
Rate for Payer: EmblemHealth Commercial	$482.50
Rate for Payer: Fidelis Medicare Advantage	$1,013.25
Rate for Payer: Group Health Inc Commercial	$482.50
Rate for Payer: Group Health Inc Medicare	$337.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$482.50
Rate for Payer: Hamaspik Choice Inc Medicare	$482.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$627.25

ROD TO ROD COUPLING 5/5MM

Facility

$522.00

Service Code	HCPCS C1713
Hospital Charge Code	40202369
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$548.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$287.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$313.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$261.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$300.15
Rate for Payer: EmblemHealth Commercial	$261.00
Rate for Payer: Fidelis Medicare Advantage	$548.10
Rate for Payer: Group Health Inc Commercial	$261.00
Rate for Payer: Group Health Inc Medicare	$182.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$261.00
Rate for Payer: Hamaspik Choice Inc Medicare	$261.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$339.30

Know your out-of-pocket cost for care.

All Charges