St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BEARING ANATOMIC MENISCAL

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	64907423
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

BEARING FXD VVCT RT SZ 10MM

Facility

$3,400.00

Hospital Charge Code	64906665
Hospital Revenue Code	279
Min. Negotiated Rate	$1,190.00
Max. Negotiated Rate	$2,720.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,870.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,700.00
Rate for Payer: Aetna Government	$1,700.00
Rate for Payer: Brighton Health Commercial	$2,550.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,720.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,312.00
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

BEARING HMRS

Facility

$982.50

Service Code	HCPCS C1776
Hospital Charge Code	64907250
Hospital Revenue Code	278
Min. Negotiated Rate	$491.25
Max. Negotiated Rate	$491.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$491.25
Rate for Payer: Hamaspik Choice Inc Medicare	$491.25

BEARING HMRS

Facility

$982.50

Service Code	HCPCS C1776
Hospital Charge Code	64907250
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,031.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$540.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$589.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$491.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$564.94
Rate for Payer: EmblemHealth Commercial	$491.25
Rate for Payer: Fidelis Medicare Advantage	$1,031.62
Rate for Payer: Group Health Inc Commercial	$491.25
Rate for Payer: Group Health Inc Medicare	$343.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$491.25
Rate for Payer: Hamaspik Choice Inc Medicare	$491.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$638.62

BEARING INSERT

Facility

$269.68

Hospital Charge Code	40202230
Hospital Revenue Code	270
Min. Negotiated Rate	$94.39
Max. Negotiated Rate	$215.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$148.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.84
Rate for Payer: Aetna Government	$134.84
Rate for Payer: Brighton Health Commercial	$202.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$215.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.38
Rate for Payer: Group Health Inc Commercial	$134.84
Rate for Payer: Group Health Inc Medicare	$94.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$134.84
Rate for Payer: Hamaspik Choice Inc Medicare	$134.84

BEARING KNEE PSN L 13MM 6-9

Facility

$1,700.00

Service Code	HCPCS C1776
Hospital Charge Code	64906339
Hospital Revenue Code	278
Min. Negotiated Rate	$850.00
Max. Negotiated Rate	$850.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$850.00

BEARING KNEE PSN L 13MM 6-9

Facility

$1,700.00

Service Code	HCPCS C1776
Hospital Charge Code	64906339
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,785.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$935.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,020.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$850.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$977.50
Rate for Payer: EmblemHealth Commercial	$850.00
Rate for Payer: Fidelis Medicare Advantage	$1,785.00
Rate for Payer: Group Health Inc Commercial	$850.00
Rate for Payer: Group Health Inc Medicare	$595.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$850.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,105.00

BEARING KNEE TIB

Facility

$9,620.62

Service Code	HCPCS C1776
Hospital Charge Code	64907252
Hospital Revenue Code	278
Min. Negotiated Rate	$4,810.31
Max. Negotiated Rate	$4,810.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,810.31
Rate for Payer: Hamaspik Choice Inc Medicare	$4,810.31

BEARING KNEE TIB

Facility

$9,620.62

Service Code	HCPCS C1776
Hospital Charge Code	64907252
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$10,101.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,291.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,772.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,810.31
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,531.86
Rate for Payer: EmblemHealth Commercial	$4,810.31
Rate for Payer: Fidelis Medicare Advantage	$10,101.65
Rate for Payer: Group Health Inc Commercial	$4,810.31
Rate for Payer: Group Health Inc Medicare	$3,367.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,810.31
Rate for Payer: Hamaspik Choice Inc Medicare	$4,810.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,253.40

BEARING PSN 12MM VE 6-9 EF

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	64905890
Hospital Revenue Code	278
Min. Negotiated Rate	$2,125.00
Max. Negotiated Rate	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,125.00

BEARING PSN 12MM VE 6-9 EF

Facility

$4,250.00

Service Code	HCPCS C1713
Hospital Charge Code	64905890
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,462.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,337.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,550.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,125.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,443.75
Rate for Payer: EmblemHealth Commercial	$2,125.00
Rate for Payer: Fidelis Medicare Advantage	$4,462.50
Rate for Payer: Group Health Inc Commercial	$2,125.00
Rate for Payer: Group Health Inc Medicare	$1,487.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,125.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,762.50

BEARING PSN ASF FIXED LT

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	64906767
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

BEARING PSN ASF FIXED LT

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	64906767
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: Brighton Health Commercial	$2,040.00
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: EmblemHealth Commercial	$1,700.00
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

BEARING PSN FIXED LEFT SZ 10

Facility

$1,700.00

Service Code	HCPCS C1776
Hospital Charge Code	64906291
Hospital Revenue Code	278
Min. Negotiated Rate	$850.00
Max. Negotiated Rate	$850.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$850.00

BEARING PSN FIXED LEFT SZ 10

Facility

$1,700.00

Service Code	HCPCS C1776
Hospital Charge Code	64906291
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,785.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$935.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,020.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$850.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$977.50
Rate for Payer: EmblemHealth Commercial	$850.00
Rate for Payer: Fidelis Medicare Advantage	$1,785.00
Rate for Payer: Group Health Inc Commercial	$850.00
Rate for Payer: Group Health Inc Medicare	$595.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$850.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,105.00

BEARING PSN FIXED RGT 10MM

Facility

$1,700.00

Service Code	HCPCS C1776
Hospital Charge Code	64906270
Hospital Revenue Code	278
Min. Negotiated Rate	$850.00
Max. Negotiated Rate	$850.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$850.00

BEARING PSN FIXED RGT 10MM

Facility

$1,700.00

Service Code	HCPCS C1776
Hospital Charge Code	64906270
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,785.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$935.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,020.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$850.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$977.50
Rate for Payer: EmblemHealth Commercial	$850.00
Rate for Payer: Fidelis Medicare Advantage	$1,785.00
Rate for Payer: Group Health Inc Commercial	$850.00
Rate for Payer: Group Health Inc Medicare	$595.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$850.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,105.00

BEARING PSN FX L 10 C-D,3-5

Facility

$1,700.00

Service Code	HCPCS C1776
Hospital Charge Code	64906482
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,785.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$935.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,020.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$850.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$977.50
Rate for Payer: EmblemHealth Commercial	$850.00
Rate for Payer: Fidelis Medicare Advantage	$1,785.00
Rate for Payer: Group Health Inc Commercial	$850.00
Rate for Payer: Group Health Inc Medicare	$595.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$850.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,105.00

BEARING PSN FX L 10 C-D,3-5

Facility

$1,700.00

Service Code	HCPCS C1776
Hospital Charge Code	64906482
Hospital Revenue Code	278
Min. Negotiated Rate	$850.00
Max. Negotiated Rate	$850.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$850.00

BEARING PSN KNEE LFT 20MM

Facility

$1,700.00

Hospital Charge Code	64906271
Hospital Revenue Code	270
Min. Negotiated Rate	$595.00
Max. Negotiated Rate	$1,360.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$935.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$850.00
Rate for Payer: Aetna Government	$850.00
Rate for Payer: Brighton Health Commercial	$1,275.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,360.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,156.00
Rate for Payer: Group Health Inc Commercial	$850.00
Rate for Payer: Group Health Inc Medicare	$595.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$850.00

BEARING PSN L TB E-F FM 6-9

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	64906657
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: Brighton Health Commercial	$2,040.00
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: EmblemHealth Commercial	$1,700.00
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

BEARING PSN L TB E-F FM 6-9

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	64906657
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

BEARING PSN RGT 11MM C-D 00511

Facility

$3,400.00

Hospital Charge Code	64906734
Hospital Revenue Code	279
Min. Negotiated Rate	$1,190.00
Max. Negotiated Rate	$2,720.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,870.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,700.00
Rate for Payer: Aetna Government	$1,700.00
Rate for Payer: Brighton Health Commercial	$2,550.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,720.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,312.00
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

BEARING PSN RGT SZ 12MM C-D

Facility

$3,400.00

Hospital Charge Code	64906713
Hospital Revenue Code	279
Min. Negotiated Rate	$1,190.00
Max. Negotiated Rate	$2,720.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,870.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,700.00
Rate for Payer: Aetna Government	$1,700.00
Rate for Payer: Brighton Health Commercial	$2,550.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,720.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,312.00
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

BEARING PSN R TB C-D FM 6-9

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	64906659
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

Know your out-of-pocket cost for care.

All Charges