St. Barnabas Hospital

All Charges

Charge

Type

Price

BONE SCREW T8 FT 2.4MM / L28MM

Facility OP

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64904988
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$406.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$213.12
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	$193.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.81
Rate for Payer: Fidelis Medicare Advantage	$406.88
Rate for Payer: Group Health Inc Commercial	$193.75
Rate for Payer: Group Health Inc Medicare	$135.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$251.88

BONE SCREW T8 FT 2.4MM / L28MM

Facility IP

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64904988
Hospital Revenue Code	278
Min. Negotiated Rate	$193.75
Max. Negotiated Rate	$193.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75

BONE SCREW T8 FT 2.7MM / L10MM

Facility IP

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64904421
Hospital Revenue Code	278
Min. Negotiated Rate	$193.75
Max. Negotiated Rate	$193.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75

BONE SCREW T8 FT 2.7MM / L10MM

Facility OP

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64904421
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$406.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$213.12
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	$193.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.81
Rate for Payer: Fidelis Medicare Advantage	$406.88
Rate for Payer: Group Health Inc Commercial	$193.75
Rate for Payer: Group Health Inc Medicare	$135.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$251.88

BONE SCREW T8 FT 2.7MM / L12MM

Facility IP

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904409
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.50
Rate for Payer: Hamaspik Choice Inc Medicare	$187.50

BONE SCREW T8 FT 2.7MM / L12MM

Facility OP

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904409
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$393.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.25
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	$187.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$215.62
Rate for Payer: Fidelis Medicare Advantage	$393.75
Rate for Payer: Group Health Inc Commercial	$187.50
Rate for Payer: Group Health Inc Medicare	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.50
Rate for Payer: Hamaspik Choice Inc Medicare	$187.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$243.75

BONE SCREW T8 FT 2.7MM / L14MM

Facility IP

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904407
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.50
Rate for Payer: Hamaspik Choice Inc Medicare	$187.50

BONE SCREW T8 FT 2.7MM / L14MM

Facility OP

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904407
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$393.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$206.25
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	$187.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$215.62
Rate for Payer: Fidelis Medicare Advantage	$393.75
Rate for Payer: Group Health Inc Commercial	$187.50
Rate for Payer: Group Health Inc Medicare	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.50
Rate for Payer: Hamaspik Choice Inc Medicare	$187.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$243.75

BONE SCREW T8 FT 2.7MM / L16MM

Facility OP

$329.38

Service Code	HCPCS C1713
Hospital Charge Code	64904519
Hospital Revenue Code	278
Min. Negotiated Rate	$115.28
Max. Negotiated Rate	$345.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.16
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	$164.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$189.39
Rate for Payer: Fidelis Medicare Advantage	$345.85
Rate for Payer: Group Health Inc Commercial	$164.69
Rate for Payer: Group Health Inc Medicare	$115.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$164.69
Rate for Payer: Hamaspik Choice Inc Medicare	$164.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$214.10

BONE SCREW T8 FT 2.7MM / L16MM

Facility IP

$329.38

Service Code	HCPCS C1713
Hospital Charge Code	64904519
Hospital Revenue Code	278
Min. Negotiated Rate	$164.69
Max. Negotiated Rate	$164.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$164.69
Rate for Payer: Hamaspik Choice Inc Medicare	$164.69

BONE SCREW T8 FT 2.7MM / L18MM

Facility OP

$329.38

Service Code	HCPCS C1713
Hospital Charge Code	64904796
Hospital Revenue Code	278
Min. Negotiated Rate	$115.28
Max. Negotiated Rate	$345.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.16
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	$164.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$189.39
Rate for Payer: Fidelis Medicare Advantage	$345.85
Rate for Payer: Group Health Inc Commercial	$164.69
Rate for Payer: Group Health Inc Medicare	$115.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$164.69
Rate for Payer: Hamaspik Choice Inc Medicare	$164.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$214.10

BONE SCREW T8 FT 2.7MM / L18MM

Facility IP

$329.38

Service Code	HCPCS C1713
Hospital Charge Code	64904796
Hospital Revenue Code	278
Min. Negotiated Rate	$164.69
Max. Negotiated Rate	$164.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$164.69
Rate for Payer: Hamaspik Choice Inc Medicare	$164.69

BONE SCREW T8 FT 2.7MM / L20MM

Facility IP

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64904628
Hospital Revenue Code	278
Min. Negotiated Rate	$193.75
Max. Negotiated Rate	$193.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75

BONE SCREW T8 FT 2.7MM / L20MM

Facility OP

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64904628
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$406.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$213.12
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	$193.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.81
Rate for Payer: Fidelis Medicare Advantage	$406.88
Rate for Payer: Group Health Inc Commercial	$193.75
Rate for Payer: Group Health Inc Medicare	$135.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$251.88

BONE SCREW T8 FT 2.7MM / L22MM

Facility IP

$329.38

Service Code	HCPCS C1713
Hospital Charge Code	64904630
Hospital Revenue Code	278
Min. Negotiated Rate	$164.69
Max. Negotiated Rate	$164.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$164.69
Rate for Payer: Hamaspik Choice Inc Medicare	$164.69

BONE SCREW T8 FT 2.7MM / L22MM

Facility OP

$329.38

Service Code	HCPCS C1713
Hospital Charge Code	64904630
Hospital Revenue Code	278
Min. Negotiated Rate	$115.28
Max. Negotiated Rate	$345.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.16
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	$164.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$189.39
Rate for Payer: Fidelis Medicare Advantage	$345.85
Rate for Payer: Group Health Inc Commercial	$164.69
Rate for Payer: Group Health Inc Medicare	$115.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$164.69
Rate for Payer: Hamaspik Choice Inc Medicare	$164.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$214.10

BONE SUBSTITUTE

Facility IP

$822.60

Service Code	HCPCS C1713
Hospital Charge Code	40203151
Hospital Revenue Code	278
Min. Negotiated Rate	$411.30
Max. Negotiated Rate	$411.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.30
Rate for Payer: Hamaspik Choice Inc Medicare	$411.30

BONE SUBSTITUTE

Facility IP

$6,300.00

Service Code	HCPCS C1713
Hospital Charge Code	40009115
Hospital Revenue Code	278
Min. Negotiated Rate	$3,150.00
Max. Negotiated Rate	$3,150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,150.00

BONE SUBSTITUTE

Facility OP

$822.60

Service Code	HCPCS C1713
Hospital Charge Code	40203151
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$863.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$452.43
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	$411.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$473.00
Rate for Payer: Fidelis Medicare Advantage	$863.73
Rate for Payer: Group Health Inc Commercial	$411.30
Rate for Payer: Group Health Inc Medicare	$287.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.30
Rate for Payer: Hamaspik Choice Inc Medicare	$411.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$534.69

BONE SUBSTITUTE

Facility OP

$6,300.00

Service Code	HCPCS C1713
Hospital Charge Code	40009115
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,615.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,465.00
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	$3,150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,622.50
Rate for Payer: Fidelis Medicare Advantage	$6,615.00
Rate for Payer: Group Health Inc Commercial	$3,150.00
Rate for Payer: Group Health Inc Medicare	$2,205.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,095.00

BONE VOID FILLER

Facility OP

$2,076.00

Service Code	HCPCS C1713
Hospital Charge Code	40200072
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,179.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,141.80
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	$1,038.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,193.70
Rate for Payer: Fidelis Medicare Advantage	$2,179.80
Rate for Payer: Group Health Inc Commercial	$1,038.00
Rate for Payer: Group Health Inc Medicare	$726.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,038.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,038.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,349.40

BONE VOID FILLER

Facility IP

$2,076.00

Service Code	HCPCS C1713
Hospital Charge Code	40200072
Hospital Revenue Code	278
Min. Negotiated Rate	$1,038.00
Max. Negotiated Rate	$1,038.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,038.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,038.00

BONNEY TISSUE FORCEP

Facility OP

$50.28

Hospital Charge Code	64903644
Hospital Revenue Code	270
Min. Negotiated Rate	$17.60
Max. Negotiated Rate	$40.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.14
Rate for Payer: Aetna Government	$25.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.19
Rate for Payer: Group Health Inc Commercial	$25.14
Rate for Payer: Group Health Inc Medicare	$17.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.14
Rate for Payer: Hamaspik Choice Inc Medicare	$25.14

BONSTON SCI ACCOLADE EL DR L321

Facility OP

$13,300.00

Service Code	HCPCS C1785
Hospital Charge Code	66572892
Hospital Revenue Code	275
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$13,965.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,315.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,647.50
Rate for Payer: Fidelis Medicare Advantage	$13,965.00
Rate for Payer: Group Health Inc Commercial	$6,650.00
Rate for Payer: Group Health Inc Medicare	$4,655.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,650.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,650.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,645.00

BOOTS BUCKS TRACTION FULL

Facility OP

$47.17

Hospital Charge Code	64901795
Hospital Revenue Code	270
Min. Negotiated Rate	$16.51
Max. Negotiated Rate	$37.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.58
Rate for Payer: Aetna Government	$23.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$37.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.08
Rate for Payer: Group Health Inc Commercial	$23.58
Rate for Payer: Group Health Inc Medicare	$16.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.58
Rate for Payer: Hamaspik Choice Inc Medicare	$23.58

Price Transparency.

All Charges