St. Barnabas Hospital

All Charges

Charge

Type

Price

WIRE BOLTS

Facility OP

$532.50

Hospital Charge Code	64906018
Hospital Revenue Code	270
Min. Negotiated Rate	$186.38
Max. Negotiated Rate	$426.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$292.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$266.25
Rate for Payer: Aetna Government	$266.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$426.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$362.10
Rate for Payer: Group Health Inc Commercial	$266.25
Rate for Payer: Group Health Inc Medicare	$186.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$266.25
Rate for Payer: Hamaspik Choice Inc Medicare	$266.25

WIRE CANNULATED .8MM

Facility OP

$58.75

Hospital Charge Code	64905052
Hospital Revenue Code	270
Min. Negotiated Rate	$20.56
Max. Negotiated Rate	$47.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.38
Rate for Payer: Aetna Government	$29.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.95
Rate for Payer: Group Health Inc Commercial	$29.38
Rate for Payer: Group Health Inc Medicare	$20.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.38
Rate for Payer: Hamaspik Choice Inc Medicare	$29.38

WIRE COPE MANDRIL

Facility OP

$58.68

Hospital Charge Code	64903156
Hospital Revenue Code	270
Min. Negotiated Rate	$20.54
Max. Negotiated Rate	$46.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.34
Rate for Payer: Aetna Government	$29.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.90
Rate for Payer: Group Health Inc Commercial	$29.34
Rate for Payer: Group Health Inc Medicare	$20.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.34
Rate for Payer: Hamaspik Choice Inc Medicare	$29.34

WIRE FIXATION KIRSCHNER 0.9MM

Facility OP

$90.00

Hospital Charge Code	64905973
Hospital Revenue Code	270
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$72.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.00
Rate for Payer: Aetna Government	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.20
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00

WIRE GD NCB-PH 1.6MMX190MM THR TP

Facility OP

$70.00

Service Code	HCPCS C1769
Hospital Charge Code	40204572
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$56.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.60
Rate for Payer: Group Health Inc Commercial	$35.00
Rate for Payer: Group Health Inc Medicare	$24.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.00
Rate for Payer: Hamaspik Choice Inc Medicare	$35.00

WIRE GLIDE .035 150CM FLEX ANG

Facility OP

$102.41

Hospital Charge Code	64902745
Hospital Revenue Code	270
Min. Negotiated Rate	$35.84
Max. Negotiated Rate	$81.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.20
Rate for Payer: Aetna Government	$51.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.64
Rate for Payer: Group Health Inc Commercial	$51.20
Rate for Payer: Group Health Inc Medicare	$35.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.20
Rate for Payer: Hamaspik Choice Inc Medicare	$51.20

WIRE GLIDE .038 150CM FLEX ANG

Facility OP

$147.50

Hospital Charge Code	64904545
Hospital Revenue Code	270
Min. Negotiated Rate	$51.62
Max. Negotiated Rate	$118.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.75
Rate for Payer: Aetna Government	$73.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$118.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$100.30
Rate for Payer: Group Health Inc Commercial	$73.75
Rate for Payer: Group Health Inc Medicare	$51.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.75
Rate for Payer: Hamaspik Choice Inc Medicare	$73.75

WIRE GLIDE .038 150CM FLEX STR

Facility OP

$100.05

Hospital Charge Code	64903020
Hospital Revenue Code	270
Min. Negotiated Rate	$35.02
Max. Negotiated Rate	$80.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.02
Rate for Payer: Aetna Government	$50.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.03
Rate for Payer: Group Health Inc Commercial	$50.02
Rate for Payer: Group Health Inc Medicare	$35.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.02
Rate for Payer: Hamaspik Choice Inc Medicare	$50.02

WIRE GUIDE .062 6 LONG

Facility OP

$80.00

Service Code	HCPCS C1769
Hospital Charge Code	64906865
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$84.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.00
Rate for Payer: Fidelis Medicare Advantage	$84.00
Rate for Payer: Group Health Inc Commercial	$40.00
Rate for Payer: Group Health Inc Medicare	$28.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.00

WIRE GUIDE .062 6 LONG

Facility IP

$80.00

Service Code	HCPCS C1769
Hospital Charge Code	64906865
Hospital Revenue Code	278
Min. Negotiated Rate	$40.00
Max. Negotiated Rate	$40.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00

WIRE GUIDE .090 X 47

Facility IP

$158.00

Service Code	HCPCS C1769
Hospital Charge Code	64906864
Hospital Revenue Code	278
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$79.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.00
Rate for Payer: Hamaspik Choice Inc Medicare	$79.00

WIRE GUIDE .090 X 47

Facility OP

$158.00

Service Code	HCPCS C1769
Hospital Charge Code	64906864
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$165.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$86.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$90.85
Rate for Payer: Fidelis Medicare Advantage	$165.90
Rate for Payer: Group Health Inc Commercial	$79.00
Rate for Payer: Group Health Inc Medicare	$55.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.00
Rate for Payer: Hamaspik Choice Inc Medicare	$79.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$102.70

WIRE,GUIDE 1.6MMX190MM THREAD TIP

Facility OP

$44.50

Service Code	HCPCS C1769
Hospital Charge Code	40006598
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$35.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.26
Rate for Payer: Group Health Inc Commercial	$22.25
Rate for Payer: Group Health Inc Medicare	$15.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.25
Rate for Payer: Hamaspik Choice Inc Medicare	$22.25

WIRE, GUIDE 3.2 X 444MM THRD

Facility IP

$460.00

Service Code	HCPCS C1769
Hospital Charge Code	64906106
Hospital Revenue Code	278
Min. Negotiated Rate	$230.00
Max. Negotiated Rate	$230.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00

WIRE, GUIDE 3.2 X 444MM THRD

Facility OP

$460.00

Service Code	HCPCS C1769
Hospital Charge Code	64906106
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$483.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$253.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$264.50
Rate for Payer: Fidelis Medicare Advantage	$483.00
Rate for Payer: Group Health Inc Commercial	$230.00
Rate for Payer: Group Health Inc Medicare	$161.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$299.00

WIRE, GUIDE 3.2 X 444MM THRD

Facility OP

$368.00

Service Code	HCPCS C1769
Hospital Charge Code	40003334
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$294.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$294.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$250.24
Rate for Payer: Group Health Inc Commercial	$184.00
Rate for Payer: Group Health Inc Medicare	$128.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00

WIRE, GUIDE 3.2X444MM THRD

Facility OP

$368.00

Service Code	HCPCS C1769
Hospital Charge Code	40204591
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$294.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$294.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$250.24
Rate for Payer: Group Health Inc Commercial	$184.00
Rate for Payer: Group Health Inc Medicare	$128.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00

WIRE, GUIDE 3.2 X 44MM THRD

Facility OP

$368.00

Service Code	HCPCS C1769
Hospital Charge Code	40007510
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$294.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$294.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$250.24
Rate for Payer: Group Health Inc Commercial	$184.00
Rate for Payer: Group Health Inc Medicare	$128.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00

WIRE, GUIDE BALLT 3.0X100CM

Facility IP

$440.00

Service Code	HCPCS C1769
Hospital Charge Code	64906105
Hospital Revenue Code	278
Min. Negotiated Rate	$220.00
Max. Negotiated Rate	$220.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$220.00
Rate for Payer: Hamaspik Choice Inc Medicare	$220.00

WIRE, GUIDE BALLT 3.0X100CM

Facility OP

$440.00

Service Code	HCPCS C1769
Hospital Charge Code	64906105
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$462.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$242.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$220.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$253.00
Rate for Payer: Fidelis Medicare Advantage	$462.00
Rate for Payer: Group Health Inc Commercial	$220.00
Rate for Payer: Group Health Inc Medicare	$154.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$220.00
Rate for Payer: Hamaspik Choice Inc Medicare	$220.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$286.00

WIRE, GUIDE BALLT 3.0X100CM

Facility OP

$352.00

Service Code	HCPCS C1769
Hospital Charge Code	40204590
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$281.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$193.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$281.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$239.36
Rate for Payer: Group Health Inc Commercial	$176.00
Rate for Payer: Group Health Inc Medicare	$123.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$176.00
Rate for Payer: Hamaspik Choice Inc Medicare	$176.00

WIRE, GUIDE BALLT 3.0X100CM

Facility OP

$352.00

Service Code	HCPCS C1769
Hospital Charge Code	40007509
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$281.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$193.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$281.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$239.36
Rate for Payer: Group Health Inc Commercial	$176.00
Rate for Payer: Group Health Inc Medicare	$123.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$176.00
Rate for Payer: Hamaspik Choice Inc Medicare	$176.00

WIRE GUIDE B-TIP 3.0 X 125MM

Facility IP

$305.98

Service Code	HCPCS C1713
Hospital Charge Code	64907005
Hospital Revenue Code	278
Min. Negotiated Rate	$152.99
Max. Negotiated Rate	$152.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$152.99
Rate for Payer: Hamaspik Choice Inc Medicare	$152.99

WIRE GUIDE B-TIP 3.0 X 125MM

Facility OP

$305.98

Service Code	HCPCS C1713
Hospital Charge Code	64907005
Hospital Revenue Code	278
Min. Negotiated Rate	$107.09
Max. Negotiated Rate	$321.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$168.29
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	$152.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$175.94
Rate for Payer: Fidelis Medicare Advantage	$321.28
Rate for Payer: Group Health Inc Commercial	$152.99
Rate for Payer: Group Health Inc Medicare	$107.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$152.99
Rate for Payer: Hamaspik Choice Inc Medicare	$152.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$198.89

WIRE GUIDE EXTRA ST

Facility OP

$278.00

Service Code	HCPCS C1769
Hospital Charge Code	64906027
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$291.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$139.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.85
Rate for Payer: Fidelis Medicare Advantage	$291.90
Rate for Payer: Group Health Inc Commercial	$139.00
Rate for Payer: Group Health Inc Medicare	$97.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$139.00
Rate for Payer: Hamaspik Choice Inc Medicare	$139.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$180.70

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