St. Barnabas Hospital

All Charges

Charge

Type

Price

ZIM KNEE VIVACIT-E ART SUR 12MM

Facility OP

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40009280
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,750.00
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	$2,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,875.00
Rate for Payer: Fidelis Medicare Advantage	$5,250.00
Rate for Payer: Group Health Inc Commercial	$2,500.00
Rate for Payer: Group Health Inc Medicare	$1,750.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,250.00

ZIM KNEE VIVACIT-E ART SUR 12MM

Facility IP

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40009280
Hospital Revenue Code	278
Min. Negotiated Rate	$2,500.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,500.00

ZIM LINER 36MM ID SIZE II

Facility IP

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40003451
Hospital Revenue Code	278
Min. Negotiated Rate	$1,700.00
Max. Negotiated Rate	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00

ZIM LINER 36MM ID SIZE II

Facility OP

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40003451
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,570.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,870.00
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	$1,700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,955.00
Rate for Payer: Fidelis Medicare Advantage	$3,570.00
Rate for Payer: Group Health Inc Commercial	$1,700.00
Rate for Payer: Group Health Inc Medicare	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,210.00

ZIM L LINER 36 MM SIZE KK

Facility OP

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40009263
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,570.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,870.00
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	$1,700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,955.00
Rate for Payer: Fidelis Medicare Advantage	$3,570.00
Rate for Payer: Group Health Inc Commercial	$1,700.00
Rate for Payer: Group Health Inc Medicare	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,210.00

ZIM L LINER 36 MM SIZE KK

Facility IP

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40009263
Hospital Revenue Code	278
Min. Negotiated Rate	$1,700.00
Max. Negotiated Rate	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00

ZIMMER 3.5X14 MM DRILLING SCREW

Facility IP

$890.00

Service Code	HCPCS C1776
Hospital Charge Code	40005208
Hospital Revenue Code	278
Min. Negotiated Rate	$445.00
Max. Negotiated Rate	$445.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.00
Rate for Payer: Hamaspik Choice Inc Medicare	$445.00

ZIMMER 3.5X14 MM DRILLING SCREW

Facility OP

$890.00

Service Code	HCPCS C1776
Hospital Charge Code	40005208
Hospital Revenue Code	278
Min. Negotiated Rate	$311.50
Max. Negotiated Rate	$934.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$489.50
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	$445.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$511.75
Rate for Payer: Fidelis Medicare Advantage	$934.50
Rate for Payer: Group Health Inc Commercial	$445.00
Rate for Payer: Group Health Inc Medicare	$311.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.00
Rate for Payer: Hamaspik Choice Inc Medicare	$445.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$578.50

ZIMMER 4.0X12 MM SCREW

Facility IP

$890.00

Service Code	HCPCS C1776
Hospital Charge Code	40005207
Hospital Revenue Code	278
Min. Negotiated Rate	$445.00
Max. Negotiated Rate	$445.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.00
Rate for Payer: Hamaspik Choice Inc Medicare	$445.00

ZIMMER 4.0X12 MM SCREW

Facility OP

$890.00

Service Code	HCPCS C1776
Hospital Charge Code	40005207
Hospital Revenue Code	278
Min. Negotiated Rate	$311.50
Max. Negotiated Rate	$934.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$489.50
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	$445.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$511.75
Rate for Payer: Fidelis Medicare Advantage	$934.50
Rate for Payer: Group Health Inc Commercial	$445.00
Rate for Payer: Group Health Inc Medicare	$311.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.00
Rate for Payer: Hamaspik Choice Inc Medicare	$445.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$578.50

ZIMMER 4.0 X 14MM SCREW

Facility OP

$890.00

Service Code	HCPCS C1713
Hospital Charge Code	40005205
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$934.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$489.50
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	$445.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$511.75
Rate for Payer: Fidelis Medicare Advantage	$934.50
Rate for Payer: Group Health Inc Commercial	$445.00
Rate for Payer: Group Health Inc Medicare	$311.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.00
Rate for Payer: Hamaspik Choice Inc Medicare	$445.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$578.50

ZIMMER 4.0 X 14MM SCREW

Facility IP

$890.00

Service Code	HCPCS C1713
Hospital Charge Code	40005205
Hospital Revenue Code	278
Min. Negotiated Rate	$445.00
Max. Negotiated Rate	$445.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.00
Rate for Payer: Hamaspik Choice Inc Medicare	$445.00

ZIMMER 6 FULL PLATE

Facility OP

$5,260.00

Service Code	HCPCS C1776
Hospital Charge Code	40005206
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,523.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,893.00
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	$2,630.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,024.50
Rate for Payer: Fidelis Medicare Advantage	$5,523.00
Rate for Payer: Group Health Inc Commercial	$2,630.00
Rate for Payer: Group Health Inc Medicare	$1,841.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,630.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,630.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,419.00

ZIMMER 6 FULL PLATE

Facility IP

$5,260.00

Service Code	HCPCS C1776
Hospital Charge Code	40005206
Hospital Revenue Code	278
Min. Negotiated Rate	$2,630.00
Max. Negotiated Rate	$2,630.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,630.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,630.00

ZIMMER ART SURGACE CR Y C-H 10MM

Facility OP

$3,538.00

Service Code	HCPCS C1776
Hospital Charge Code	40205159
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,714.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,945.90
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	$1,769.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,034.35
Rate for Payer: Fidelis Medicare Advantage	$3,714.90
Rate for Payer: Group Health Inc Commercial	$1,769.00
Rate for Payer: Group Health Inc Medicare	$1,238.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,299.70

ZIMMER ART SURGACE CR Y C-H 10MM

Facility IP

$3,538.00

Service Code	HCPCS C1776
Hospital Charge Code	40205159
Hospital Revenue Code	278
Min. Negotiated Rate	$1,769.00
Max. Negotiated Rate	$1,769.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.00

ZIMMER ART SURG CR GR C-H 12MM

Facility IP

$3,539.40

Service Code	HCPCS C1776
Hospital Charge Code	40209098
Hospital Revenue Code	278
Min. Negotiated Rate	$1,769.70
Max. Negotiated Rate	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.70

ZIMMER ART SURG CR GR C-H 12MM

Facility OP

$3,539.40

Service Code	HCPCS C1776
Hospital Charge Code	40209098
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,716.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,946.67
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	$1,769.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,035.16
Rate for Payer: Fidelis Medicare Advantage	$3,716.37
Rate for Payer: Group Health Inc Commercial	$1,769.70
Rate for Payer: Group Health Inc Medicare	$1,238.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,300.61

ZIMMER ART SURG CR Y C-H 12MM H

Facility IP

$3,539.40

Service Code	HCPCS C1776
Hospital Charge Code	40205316
Hospital Revenue Code	278
Min. Negotiated Rate	$1,769.70
Max. Negotiated Rate	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.70

ZIMMER ART SURG CR Y C-H 12MM H

Facility OP

$3,539.40

Service Code	HCPCS C1776
Hospital Charge Code	40205316
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,716.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,946.67
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	$1,769.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,035.16
Rate for Payer: Fidelis Medicare Advantage	$3,716.37
Rate for Payer: Group Health Inc Commercial	$1,769.70
Rate for Payer: Group Health Inc Medicare	$1,238.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,300.61

ZIMMER BIOMET STABLECUT

Facility IP

$525.60

Service Code	HCPCS C1776
Hospital Charge Code	40201558
Hospital Revenue Code	278
Min. Negotiated Rate	$262.80
Max. Negotiated Rate	$262.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$262.80
Rate for Payer: Hamaspik Choice Inc Medicare	$262.80

ZIMMER BIOMET STABLECUT

Facility OP

$525.60

Service Code	HCPCS C1776
Hospital Charge Code	40201558
Hospital Revenue Code	278
Min. Negotiated Rate	$183.96
Max. Negotiated Rate	$551.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$289.08
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	$262.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$302.22
Rate for Payer: Fidelis Medicare Advantage	$551.88
Rate for Payer: Group Health Inc Commercial	$262.80
Rate for Payer: Group Health Inc Medicare	$183.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$262.80
Rate for Payer: Hamaspik Choice Inc Medicare	$262.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$341.64

ZIMMER BLADE PAT SZ41 W/PILOT H

Facility OP

$326.40

Hospital Charge Code	40205401
Hospital Revenue Code	270
Min. Negotiated Rate	$114.24
Max. Negotiated Rate	$261.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$179.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$163.20
Rate for Payer: Aetna Government	$163.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$261.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$221.95
Rate for Payer: Group Health Inc Commercial	$163.20
Rate for Payer: Group Health Inc Medicare	$114.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.20
Rate for Payer: Hamaspik Choice Inc Medicare	$163.20

ZIMMER EX GEN COMP KNEE ART

Facility IP

$6,848.00

Service Code	HCPCS C1776
Hospital Charge Code	40004696
Hospital Revenue Code	278
Min. Negotiated Rate	$3,424.00
Max. Negotiated Rate	$3,424.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,424.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,424.00

ZIMMER EX GEN COMP KNEE ART

Facility OP

$6,848.00

Service Code	HCPCS C1776
Hospital Charge Code	40004696
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,190.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,766.40
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	$3,424.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,937.60
Rate for Payer: Fidelis Medicare Advantage	$7,190.40
Rate for Payer: Group Health Inc Commercial	$3,424.00
Rate for Payer: Group Health Inc Medicare	$2,396.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,424.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,424.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,451.20

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