St. Barnabas Hospital

All Charges

Charge

Type

Price

ZIM BIPOLA CUP LINER 28 MM I

Facility OP

$980.00

Service Code	HCPCS C1776
Hospital Charge Code	40004601
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,029.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$539.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$490.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$563.50
Rate for Payer: Fidelis Medicare Advantage	$1,029.00
Rate for Payer: Group Health Inc Commercial	$490.00
Rate for Payer: Group Health Inc Medicare	$343.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$490.00
Rate for Payer: Hamaspik Choice Inc Medicare	$490.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$637.00

ZIM BIPOLA CUP LINER 28 MM I

Facility IP

$980.00

Service Code	HCPCS C1776
Hospital Charge Code	40004601
Hospital Revenue Code	278
Min. Negotiated Rate	$490.00
Max. Negotiated Rate	$490.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$490.00
Rate for Payer: Hamaspik Choice Inc Medicare	$490.00

ZIM BIPOLA CUP SHELL 48 MM O.D.

Facility IP

$1,638.00

Service Code	HCPCS C1776
Hospital Charge Code	40004602
Hospital Revenue Code	278
Min. Negotiated Rate	$819.00
Max. Negotiated Rate	$819.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$819.00
Rate for Payer: Hamaspik Choice Inc Medicare	$819.00

ZIM BIPOLA CUP SHELL 48 MM O.D.

Facility OP

$1,638.00

Service Code	HCPCS C1776
Hospital Charge Code	40004602
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,719.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$900.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$819.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$941.85
Rate for Payer: Fidelis Medicare Advantage	$1,719.90
Rate for Payer: Group Health Inc Commercial	$819.00
Rate for Payer: Group Health Inc Medicare	$573.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$819.00
Rate for Payer: Hamaspik Choice Inc Medicare	$819.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,064.70

ZIM BN SCR 6.5MMX30MM

Facility OP

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40003452
Hospital Revenue Code	278
Min. Negotiated Rate	$96.60
Max. Negotiated Rate	$289.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.80
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	$138.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.70
Rate for Payer: Fidelis Medicare Advantage	$289.80
Rate for Payer: Group Health Inc Commercial	$138.00
Rate for Payer: Group Health Inc Medicare	$96.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$179.40

ZIM BN SCR 6.5MMX30MM

Facility IP

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40003452
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00

ZIM BN SCREW 6.5MMX40MM

Facility IP

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40003450
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00

ZIM BN SCREW 6.5MMX40MM

Facility OP

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40003450
Hospital Revenue Code	278
Min. Negotiated Rate	$96.60
Max. Negotiated Rate	$289.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.80
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	$138.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.70
Rate for Payer: Fidelis Medicare Advantage	$289.80
Rate for Payer: Group Health Inc Commercial	$138.00
Rate for Payer: Group Health Inc Medicare	$96.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$179.40

ZIM BONE SCR 6.5 DIA 35 MM LT

Facility OP

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40204223
Hospital Revenue Code	278
Min. Negotiated Rate	$96.60
Max. Negotiated Rate	$289.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.80
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	$138.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.70
Rate for Payer: Fidelis Medicare Advantage	$289.80
Rate for Payer: Group Health Inc Commercial	$138.00
Rate for Payer: Group Health Inc Medicare	$96.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$179.40

ZIM BONE SCR 6.5 DIA 35 MM LT

Facility IP

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40204223
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00

ZIM CABLE BUTTON PLT 2.5MM

Facility IP

$448.00

Service Code	HCPCS C1713
Hospital Charge Code	40008324
Hospital Revenue Code	278
Min. Negotiated Rate	$224.00
Max. Negotiated Rate	$224.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$224.00
Rate for Payer: Hamaspik Choice Inc Medicare	$224.00

ZIM CABLE BUTTON PLT 2.5MM

Facility OP

$448.00

Service Code	HCPCS C1713
Hospital Charge Code	40008324
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$470.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$246.40
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	$224.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$257.60
Rate for Payer: Fidelis Medicare Advantage	$470.40
Rate for Payer: Group Health Inc Commercial	$224.00
Rate for Payer: Group Health Inc Medicare	$156.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$224.00
Rate for Payer: Hamaspik Choice Inc Medicare	$224.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$291.20

ZIM CABLE GRIP SYS 1.8MM 36 IN

Facility OP

$1,152.00

Service Code	HCPCS C1776
Hospital Charge Code	40008298
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,209.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$633.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$576.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$662.40
Rate for Payer: Fidelis Medicare Advantage	$1,209.60
Rate for Payer: Group Health Inc Commercial	$576.00
Rate for Payer: Group Health Inc Medicare	$403.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$576.00
Rate for Payer: Hamaspik Choice Inc Medicare	$576.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$748.80

ZIM CABLE GRIP SYS 1.8MM 36 IN

Facility IP

$1,152.00

Service Code	HCPCS C1776
Hospital Charge Code	40008298
Hospital Revenue Code	278
Min. Negotiated Rate	$576.00
Max. Negotiated Rate	$576.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$576.00
Rate for Payer: Hamaspik Choice Inc Medicare	$576.00

ZIM CABLE GRIP SYS 1.8MM 36IN

Facility IP

$1,152.00

Service Code	HCPCS C1776
Hospital Charge Code	40008300
Hospital Revenue Code	278
Min. Negotiated Rate	$576.00
Max. Negotiated Rate	$576.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$576.00
Rate for Payer: Hamaspik Choice Inc Medicare	$576.00

ZIM CABLE GRIP SYS 1.8MM 36IN

Facility OP

$1,152.00

Service Code	HCPCS C1776
Hospital Charge Code	40008300
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,209.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$633.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$576.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$662.40
Rate for Payer: Fidelis Medicare Advantage	$1,209.60
Rate for Payer: Group Health Inc Commercial	$576.00
Rate for Payer: Group Health Inc Medicare	$403.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$576.00
Rate for Payer: Hamaspik Choice Inc Medicare	$576.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$748.80

ZIM CENTER SLEVE 24M

Facility OP

$1,110.00

Service Code	HCPCS C1776
Hospital Charge Code	40008342
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,165.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$610.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$555.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$638.25
Rate for Payer: Fidelis Medicare Advantage	$1,165.50
Rate for Payer: Group Health Inc Commercial	$555.00
Rate for Payer: Group Health Inc Medicare	$388.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$555.00
Rate for Payer: Hamaspik Choice Inc Medicare	$555.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$721.50

ZIM CENTER SLEVE 24M

Facility IP

$1,110.00

Service Code	HCPCS C1776
Hospital Charge Code	40008342
Hospital Revenue Code	278
Min. Negotiated Rate	$555.00
Max. Negotiated Rate	$555.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$555.00
Rate for Payer: Hamaspik Choice Inc Medicare	$555.00

ZIM COMPL KNEE SZ 3 FEM C-H 10MM

Facility IP

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	40005200
Hospital Revenue Code	278
Min. Negotiated Rate	$3,884.00
Max. Negotiated Rate	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00

ZIM COMPL KNEE SZ 3 FEM C-H 10MM

Facility OP

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	40005200
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,156.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,272.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,884.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,466.60
Rate for Payer: Fidelis Medicare Advantage	$8,156.40
Rate for Payer: Group Health Inc Commercial	$3,884.00
Rate for Payer: Group Health Inc Medicare	$2,718.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,049.20

ZIM COMPRES DEV DIS FEMUR

Facility IP

$22,035.00

Service Code	HCPCS C1776
Hospital Charge Code	40008336
Hospital Revenue Code	278
Min. Negotiated Rate	$11,017.50
Max. Negotiated Rate	$11,017.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,017.50
Rate for Payer: Hamaspik Choice Inc Medicare	$11,017.50

ZIM COMPRES DEV DIS FEMUR

Facility OP

$22,035.00

Service Code	HCPCS C1776
Hospital Charge Code	40008336
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$23,136.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12,119.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11,017.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$12,670.12
Rate for Payer: Fidelis Medicare Advantage	$23,136.75
Rate for Payer: Group Health Inc Commercial	$11,017.50
Rate for Payer: Group Health Inc Medicare	$7,712.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,017.50
Rate for Payer: Hamaspik Choice Inc Medicare	$11,017.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14,322.75

ZIM FEMUR CEME POST STAB RT SZ 4

Facility OP

$6,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40204553
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,510.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,410.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,565.00
Rate for Payer: Fidelis Medicare Advantage	$6,510.00
Rate for Payer: Group Health Inc Commercial	$3,100.00
Rate for Payer: Group Health Inc Medicare	$2,170.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,030.00

ZIM FEMUR CEME POST STAB RT SZ 4

Facility IP

$6,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40204553
Hospital Revenue Code	278
Min. Negotiated Rate	$3,100.00
Max. Negotiated Rate	$3,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,100.00

ZIM HIP FEM HEAD 12/14 3.5MMX36MM

Facility IP

$1,908.00

Service Code	HCPCS C1776
Hospital Charge Code	40003453
Hospital Revenue Code	278
Min. Negotiated Rate	$954.00
Max. Negotiated Rate	$954.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.00
Rate for Payer: Hamaspik Choice Inc Medicare	$954.00

Price Transparency.

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