St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STEM AVENIR MULLER STAND.7-106010

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	64906457
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: Brighton Health Commercial	$5,601.60
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: EmblemHealth Commercial	$4,668.00
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

STEM AVENIR MULLER STAND.7-106010

Facility

$9,336.00

Service Code	HCPCS C1776
Hospital Charge Code	64906457
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

STEM AVENIR MULLER STANDARD 1

Facility

$13,984.00

Service Code	HCPCS C1776
Hospital Charge Code	40204650
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$14,683.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,691.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$8,390.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,992.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$8,040.80
Rate for Payer: EmblemHealth Commercial	$6,992.00
Rate for Payer: Fidelis Medicare Advantage	$14,683.20
Rate for Payer: Group Health Inc Commercial	$6,992.00
Rate for Payer: Group Health Inc Medicare	$4,894.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,992.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,992.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9,089.60

STEM AVENIR MULLER STANDARD 1

Facility

$13,984.00

Service Code	HCPCS C1776
Hospital Charge Code	40204650
Hospital Revenue Code	278
Min. Negotiated Rate	$6,992.00
Max. Negotiated Rate	$6,992.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,992.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,992.00

STEM AVENIR MULLER STANDARD 5

Facility

$13,984.00

Service Code	HCPCS C1776
Hospital Charge Code	40204659
Hospital Revenue Code	278
Min. Negotiated Rate	$6,992.00
Max. Negotiated Rate	$6,992.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,992.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,992.00

STEM AVENIR MULLER STANDARD 5

Facility

$13,984.00

Service Code	HCPCS C1776
Hospital Charge Code	40204659
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$14,683.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,691.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$8,390.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,992.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$8,040.80
Rate for Payer: EmblemHealth Commercial	$6,992.00
Rate for Payer: Fidelis Medicare Advantage	$14,683.20
Rate for Payer: Group Health Inc Commercial	$6,992.00
Rate for Payer: Group Health Inc Medicare	$4,894.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,992.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,992.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9,089.60

STEM AVENIR MULLER STND 1

Facility

$11,670.00

Service Code	HCPCS C1776
Hospital Charge Code	64905659
Hospital Revenue Code	278
Min. Negotiated Rate	$5,835.00
Max. Negotiated Rate	$5,835.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,835.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,835.00

STEM AVENIR MULLER STND 1

Facility

$11,670.00

Service Code	HCPCS C1776
Hospital Charge Code	64905659
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$12,253.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,418.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$7,002.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,835.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,710.25
Rate for Payer: EmblemHealth Commercial	$5,835.00
Rate for Payer: Fidelis Medicare Advantage	$12,253.50
Rate for Payer: Group Health Inc Commercial	$5,835.00
Rate for Payer: Group Health Inc Medicare	$4,084.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,835.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,835.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,585.50

STEM AVENIR MULLER STND 5

Facility

$11,670.00

Service Code	HCPCS C1776
Hospital Charge Code	64905679
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$12,253.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,418.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$7,002.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,835.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,710.25
Rate for Payer: EmblemHealth Commercial	$5,835.00
Rate for Payer: Fidelis Medicare Advantage	$12,253.50
Rate for Payer: Group Health Inc Commercial	$5,835.00
Rate for Payer: Group Health Inc Medicare	$4,084.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,835.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,835.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,585.50

STEM AVENIR MULLER STND 5

Facility

$11,670.00

Service Code	HCPCS C1776
Hospital Charge Code	64905679
Hospital Revenue Code	278
Min. Negotiated Rate	$5,835.00
Max. Negotiated Rate	$5,835.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,835.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,835.00

STEM AVENIR STD 6 12/14

Facility

$5,176.00

Service Code	HCPCS C1776
Hospital Charge Code	64906918
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,434.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,846.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,105.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,588.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,976.20
Rate for Payer: EmblemHealth Commercial	$2,588.00
Rate for Payer: Fidelis Medicare Advantage	$5,434.80
Rate for Payer: Group Health Inc Commercial	$2,588.00
Rate for Payer: Group Health Inc Medicare	$1,811.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,588.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,588.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,364.40

STEM AVENIR STD 6 12/14

Facility

$5,176.00

Service Code	HCPCS C1776
Hospital Charge Code	64906918
Hospital Revenue Code	278
Min. Negotiated Rate	$2,588.00
Max. Negotiated Rate	$2,588.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,588.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,588.00

STEM CENTRALIZER

Facility

$407.75

Service Code	HCPCS C1776
Hospital Charge Code	64907317
Hospital Revenue Code	278
Min. Negotiated Rate	$142.71
Max. Negotiated Rate	$428.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$224.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$244.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$203.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$234.46
Rate for Payer: EmblemHealth Commercial	$203.88
Rate for Payer: Fidelis Medicare Advantage	$428.14
Rate for Payer: Group Health Inc Commercial	$203.88
Rate for Payer: Group Health Inc Medicare	$142.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.88
Rate for Payer: Hamaspik Choice Inc Medicare	$203.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$265.04

STEM CENTRALIZER

Facility

$407.75

Service Code	HCPCS C1776
Hospital Charge Code	64907317
Hospital Revenue Code	278
Min. Negotiated Rate	$203.88
Max. Negotiated Rate	$203.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.88
Rate for Payer: Hamaspik Choice Inc Medicare	$203.88

STEM CMTD TRI

Facility

$4,321.88

Service Code	HCPCS C1776
Hospital Charge Code	64907226
Hospital Revenue Code	278
Min. Negotiated Rate	$2,160.94
Max. Negotiated Rate	$2,160.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,160.94
Rate for Payer: Hamaspik Choice Inc Medicare	$2,160.94

STEM CMTD TRI

Facility

$4,321.88

Service Code	HCPCS C1776
Hospital Charge Code	64907226
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,537.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,377.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,593.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,160.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,485.08
Rate for Payer: EmblemHealth Commercial	$2,160.94
Rate for Payer: Fidelis Medicare Advantage	$4,537.97
Rate for Payer: Group Health Inc Commercial	$2,160.94
Rate for Payer: Group Health Inc Medicare	$1,512.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,160.94
Rate for Payer: Hamaspik Choice Inc Medicare	$2,160.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,809.22

STEM COLLARLESS FOR 11MM X 135MM

Facility

$10,667.50

Service Code	HCPCS C1713
Hospital Charge Code	64904053
Hospital Revenue Code	278
Min. Negotiated Rate	$5,333.75
Max. Negotiated Rate	$5,333.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$5,333.75

STEM COLLARLESS FOR 11MM X 135MM

Facility

$10,667.50

Service Code	HCPCS C1713
Hospital Charge Code	64904053
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$11,200.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,867.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$6,400.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,333.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,133.81
Rate for Payer: EmblemHealth Commercial	$5,333.75
Rate for Payer: Fidelis Medicare Advantage	$11,200.88
Rate for Payer: Group Health Inc Commercial	$5,333.75
Rate for Payer: Group Health Inc Medicare	$3,733.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$5,333.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,933.88

STEM EVOLVE

Facility

$9,715.00

Service Code	HCPCS C1889
Hospital Charge Code	64907473
Hospital Revenue Code	278
Min. Negotiated Rate	$3,400.25
Max. Negotiated Rate	$10,200.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,343.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,857.50
Rate for Payer: Aetna Government	$4,857.50
Rate for Payer: Brighton Health Commercial	$5,829.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,857.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,586.12
Rate for Payer: EmblemHealth Commercial	$4,857.50
Rate for Payer: Fidelis Medicare Advantage	$10,200.75
Rate for Payer: Group Health Inc Commercial	$4,857.50
Rate for Payer: Group Health Inc Medicare	$3,400.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,857.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4,857.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,314.75

STEM EVOLVE

Facility

$9,715.00

Service Code	HCPCS C1889
Hospital Charge Code	64907473
Hospital Revenue Code	278
Min. Negotiated Rate	$4,857.50
Max. Negotiated Rate	$4,857.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,857.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4,857.50

STEM EXTENDER TRI

Facility

$3,920.63

Service Code	HCPCS C1776
Hospital Charge Code	64907229
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,116.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,156.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,352.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,960.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,254.36
Rate for Payer: EmblemHealth Commercial	$1,960.32
Rate for Payer: Fidelis Medicare Advantage	$4,116.66
Rate for Payer: Group Health Inc Commercial	$1,960.32
Rate for Payer: Group Health Inc Medicare	$1,372.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,960.32
Rate for Payer: Hamaspik Choice Inc Medicare	$1,960.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,548.41

STEM EXTENDER TRI

Facility

$3,920.63

Service Code	HCPCS C1776
Hospital Charge Code	64907229
Hospital Revenue Code	278
Min. Negotiated Rate	$1,960.32
Max. Negotiated Rate	$1,960.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,960.32
Rate for Payer: Hamaspik Choice Inc Medicare	$1,960.32

STEM EXTENSION

Facility

$8,450.00

Service Code	HCPCS C1889
Hospital Charge Code	64907523
Hospital Revenue Code	278
Min. Negotiated Rate	$2,957.50
Max. Negotiated Rate	$8,872.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,647.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,225.00
Rate for Payer: Aetna Government	$4,225.00
Rate for Payer: Brighton Health Commercial	$5,070.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,225.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,858.75
Rate for Payer: EmblemHealth Commercial	$4,225.00
Rate for Payer: Fidelis Medicare Advantage	$8,872.50
Rate for Payer: Group Health Inc Commercial	$4,225.00
Rate for Payer: Group Health Inc Medicare	$2,957.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,225.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,225.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,492.50

STEM EXTENSION

Facility

$8,450.00

Service Code	HCPCS C1889
Hospital Charge Code	64907523
Hospital Revenue Code	278
Min. Negotiated Rate	$4,225.00
Max. Negotiated Rate	$4,225.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,225.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,225.00

STEM EXTENSION REPLACEMENT SCREW

Facility

$194.00

Service Code	HCPCS C1713
Hospital Charge Code	40202128
Hospital Revenue Code	278
Min. Negotiated Rate	$67.90
Max. Negotiated Rate	$203.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$106.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$116.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$97.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$111.55
Rate for Payer: EmblemHealth Commercial	$97.00
Rate for Payer: Fidelis Medicare Advantage	$203.70
Rate for Payer: Group Health Inc Commercial	$97.00
Rate for Payer: Group Health Inc Medicare	$67.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.00
Rate for Payer: Hamaspik Choice Inc Medicare	$97.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$126.10

Know your out-of-pocket cost for care.

All Charges