St. Barnabas Hospital

All Charges

Charge

Type

Price

ZIMMER PATELLA REAMER

Facility OP

$374.22

Service Code	HCPCS C1776
Hospital Charge Code	40024016
Hospital Revenue Code	278
Min. Negotiated Rate	$130.98
Max. Negotiated Rate	$392.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$205.82
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	$187.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$215.18
Rate for Payer: Fidelis Medicare Advantage	$392.93
Rate for Payer: Group Health Inc Commercial	$187.11
Rate for Payer: Group Health Inc Medicare	$130.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.11
Rate for Payer: Hamaspik Choice Inc Medicare	$187.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$243.24

ZIMMER PATELLA REAMER

Facility IP

$374.22

Service Code	HCPCS C1776
Hospital Charge Code	40024016
Hospital Revenue Code	278
Min. Negotiated Rate	$187.11
Max. Negotiated Rate	$187.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.11
Rate for Payer: Hamaspik Choice Inc Medicare	$187.11

ZIMMER PATELLA REAMER BLD

Facility OP

$326.40

Service Code	HCPCS C1776
Hospital Charge Code	40004693
Hospital Revenue Code	278
Min. Negotiated Rate	$114.24
Max. Negotiated Rate	$342.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$179.52
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	$163.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$187.68
Rate for Payer: Fidelis Medicare Advantage	$342.72
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$212.16

ZIMMER PATELLA REAMER BLD

Facility IP

$326.40

Service Code	HCPCS C1776
Hospital Charge Code	40004693
Hospital Revenue Code	278
Min. Negotiated Rate	$163.20
Max. Negotiated Rate	$163.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.20
Rate for Payer: Hamaspik Choice Inc Medicare	$163.20

ZIMMER SELF TAP BNE SCRW 6.5X25MM

Facility OP

$138.00

Service Code	HCPCS C1713
Hospital Charge Code	40005239
Hospital Revenue Code	278
Min. Negotiated Rate	$48.30
Max. Negotiated Rate	$144.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$75.90
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	$69.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$79.35
Rate for Payer: Fidelis Medicare Advantage	$144.90
Rate for Payer: Group Health Inc Commercial	$69.00
Rate for Payer: Group Health Inc Medicare	$48.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.00
Rate for Payer: Hamaspik Choice Inc Medicare	$69.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$89.70

ZIMMER SELF TAP BNE SCRW 6.5X25MM

Facility IP

$138.00

Service Code	HCPCS C1713
Hospital Charge Code	40005239
Hospital Revenue Code	278
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$69.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.00
Rate for Payer: Hamaspik Choice Inc Medicare	$69.00

ZIMMER SHORT OSTEO BLADE 12MM

Facility OP

$320.00

Hospital Charge Code	40004697
Hospital Revenue Code	272
Min. Negotiated Rate	$112.00
Max. Negotiated Rate	$256.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$176.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$160.00
Rate for Payer: Aetna Government	$160.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$256.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$217.60
Rate for Payer: Group Health Inc Commercial	$160.00
Rate for Payer: Group Health Inc Medicare	$112.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.00
Rate for Payer: Hamaspik Choice Inc Medicare	$160.00

ZIMMER STAPLE BARBED 2229-01

Facility OP

$68.64

Hospital Charge Code	40205160
Hospital Revenue Code	279
Min. Negotiated Rate	$24.02
Max. Negotiated Rate	$54.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.32
Rate for Payer: Aetna Government	$34.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$54.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.68
Rate for Payer: Group Health Inc Commercial	$34.32
Rate for Payer: Group Health Inc Medicare	$24.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.32
Rate for Payer: Hamaspik Choice Inc Medicare	$34.32

ZIMMER STEM STAND 3 TAPER 12/14

Facility OP

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40009273
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,802.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,134.80
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	$4,668.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,368.20
Rate for Payer: Fidelis Medicare Advantage	$9,802.80
Rate for Payer: Group Health Inc Commercial	$4,668.00
Rate for Payer: Group Health Inc Medicare	$3,267.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,068.40

ZIMMER STEM STAND 3 TAPER 12/14

Facility IP

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	40009273
Hospital Revenue Code	278
Min. Negotiated Rate	$4,668.00
Max. Negotiated Rate	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,668.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,668.00

ZIMMER SYSTEM BLADE PATELLA 35MM

Facility OP

$354.00

Hospital Charge Code	40203334
Hospital Revenue Code	272
Min. Negotiated Rate	$123.90
Max. Negotiated Rate	$283.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$177.00
Rate for Payer: Aetna Government	$177.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$283.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$240.72
Rate for Payer: Group Health Inc Commercial	$177.00
Rate for Payer: Group Health Inc Medicare	$123.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.00
Rate for Payer: Hamaspik Choice Inc Medicare	$177.00

ZIMMER SYSTEM BLADE PATELLLA 35MM

Facility OP

$354.00

Hospital Charge Code	40009316
Hospital Revenue Code	272
Min. Negotiated Rate	$123.90
Max. Negotiated Rate	$283.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$177.00
Rate for Payer: Aetna Government	$177.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$283.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$240.72
Rate for Payer: Group Health Inc Commercial	$177.00
Rate for Payer: Group Health Inc Medicare	$123.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.00
Rate for Payer: Hamaspik Choice Inc Medicare	$177.00

ZIMMER TAPER STEM PLUG

Facility OP

$1,604.80

Service Code	HCPCS C1776
Hospital Charge Code	40209955
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,685.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$882.64
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	$802.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$922.76
Rate for Payer: Fidelis Medicare Advantage	$1,685.04
Rate for Payer: Group Health Inc Commercial	$802.40
Rate for Payer: Group Health Inc Medicare	$561.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$802.40
Rate for Payer: Hamaspik Choice Inc Medicare	$802.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,043.12

ZIMMER TAPER STEM PLUG

Facility IP

$1,604.80

Service Code	HCPCS C1776
Hospital Charge Code	40209955
Hospital Revenue Code	278
Min. Negotiated Rate	$802.40
Max. Negotiated Rate	$802.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$802.40
Rate for Payer: Hamaspik Choice Inc Medicare	$802.40

ZIMMER TIBIAL COMP 8

Facility IP

$7,768.00

Service Code	HCPCS C1713
Hospital Charge Code	40205813
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

ZIMMER TIBIAL COMP 8

Facility OP

$7,768.00

Service Code	HCPCS C1713
Hospital Charge Code	40205813
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,156.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,272.40
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	$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

ZIMMER TIBIAL COMPONENT

Facility IP

$4,876.20

Service Code	HCPCS C1776
Hospital Charge Code	40024014
Hospital Revenue Code	278
Min. Negotiated Rate	$2,438.10
Max. Negotiated Rate	$2,438.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,438.10
Rate for Payer: Hamaspik Choice Inc Medicare	$2,438.10

ZIMMER TIBIAL COMPONENT

Facility OP

$4,876.20

Service Code	HCPCS C1776
Hospital Charge Code	40024014
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,120.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,681.91
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	$2,438.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,803.82
Rate for Payer: Fidelis Medicare Advantage	$5,120.01
Rate for Payer: Group Health Inc Commercial	$2,438.10
Rate for Payer: Group Health Inc Medicare	$1,706.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,438.10
Rate for Payer: Hamaspik Choice Inc Medicare	$2,438.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,169.53

ZIMMER TIBIAL POLY

Facility IP

$2,679.08

Service Code	HCPCS C1776
Hospital Charge Code	40024015
Hospital Revenue Code	278
Min. Negotiated Rate	$1,339.54
Max. Negotiated Rate	$1,339.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,339.54
Rate for Payer: Hamaspik Choice Inc Medicare	$1,339.54

ZIMMER TIBIAL POLY

Facility OP

$2,679.08

Service Code	HCPCS C1776
Hospital Charge Code	40024015
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,813.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,473.49
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	$1,339.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,540.47
Rate for Payer: Fidelis Medicare Advantage	$2,813.03
Rate for Payer: Group Health Inc Commercial	$1,339.54
Rate for Payer: Group Health Inc Medicare	$937.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,339.54
Rate for Payer: Hamaspik Choice Inc Medicare	$1,339.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,741.40

ZIMMER TRAB MTL ST P PAT35MMX10MM

Facility OP

$3,171.20

Service Code	HCPCS C1776
Hospital Charge Code	40206095
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,329.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,744.16
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	$1,585.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,823.44
Rate for Payer: Fidelis Medicare Advantage	$3,329.76
Rate for Payer: Group Health Inc Commercial	$1,585.60
Rate for Payer: Group Health Inc Medicare	$1,109.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,585.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,585.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,061.28

ZIMMER TRAB MTL ST P PAT35MMX10MM

Facility IP

$3,171.20

Service Code	HCPCS C1776
Hospital Charge Code	40206095
Hospital Revenue Code	278
Min. Negotiated Rate	$1,585.60
Max. Negotiated Rate	$1,585.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,585.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,585.60

ZIMM FEMORAL BLONENT SIZ ZE

Facility IP

$6,600.00

Service Code	HCPCS C1776
Hospital Charge Code	40009744
Hospital Revenue Code	278
Min. Negotiated Rate	$3,300.00
Max. Negotiated Rate	$3,300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,300.00

ZIMM FEMORAL BLONENT SIZ ZE

Facility OP

$6,600.00

Service Code	HCPCS C1776
Hospital Charge Code	40009744
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,930.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,630.00
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	$3,300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,795.00
Rate for Payer: Fidelis Medicare Advantage	$6,930.00
Rate for Payer: Group Health Inc Commercial	$3,300.00
Rate for Payer: Group Health Inc Medicare	$2,310.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,290.00

ZIMM NEXGEN BLETE KNEE

Facility IP

$1,920.00

Service Code	HCPCS C1776
Hospital Charge Code	40009745
Hospital Revenue Code	278
Min. Negotiated Rate	$960.00
Max. Negotiated Rate	$960.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$960.00
Rate for Payer: Hamaspik Choice Inc Medicare	$960.00

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