St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STEM HIP REVISN WGNR12/14-0102622

Facility

$6,116.34

Service Code	HCPCS C1776
Hospital Charge Code	64906418
Hospital Revenue Code	278
Min. Negotiated Rate	$3,058.17
Max. Negotiated Rate	$3,058.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,058.17
Rate for Payer: Hamaspik Choice Inc Medicare	$3,058.17

STEM HIP REVISN WGNR12/14-0102624

Facility

$6,116.34

Service Code	HCPCS C1776
Hospital Charge Code	64906419
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,422.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,363.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,669.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,058.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,516.90
Rate for Payer: EmblemHealth Commercial	$3,058.17
Rate for Payer: Fidelis Medicare Advantage	$6,422.16
Rate for Payer: Group Health Inc Commercial	$3,058.17
Rate for Payer: Group Health Inc Medicare	$2,140.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,058.17
Rate for Payer: Hamaspik Choice Inc Medicare	$3,058.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,975.62

STEM HIP REVISN WGNR12/14-0102624

Facility

$6,116.34

Service Code	HCPCS C1776
Hospital Charge Code	64906419
Hospital Revenue Code	278
Min. Negotiated Rate	$3,058.17
Max. Negotiated Rate	$3,058.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,058.17
Rate for Payer: Hamaspik Choice Inc Medicare	$3,058.17

STEM HUMERAL 10MM

Facility

$8,978.13

Service Code	HCPCS C1713
Hospital Charge Code	64903606
Hospital Revenue Code	278
Min. Negotiated Rate	$4,489.06
Max. Negotiated Rate	$4,489.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,489.06
Rate for Payer: Hamaspik Choice Inc Medicare	$4,489.06

STEM HUMERAL 10MM

Facility

$8,978.13

Service Code	HCPCS C1713
Hospital Charge Code	64903606
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$9,427.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,937.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$5,386.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,489.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,162.42
Rate for Payer: EmblemHealth Commercial	$4,489.06
Rate for Payer: Fidelis Medicare Advantage	$9,427.04
Rate for Payer: Group Health Inc Commercial	$4,489.06
Rate for Payer: Group Health Inc Medicare	$3,142.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,489.06
Rate for Payer: Hamaspik Choice Inc Medicare	$4,489.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,835.78

STEM HUM REUNION

Facility

$7,187.50

Service Code	HCPCS C1889
Hospital Charge Code	64907489
Hospital Revenue Code	278
Min. Negotiated Rate	$2,515.62
Max. Negotiated Rate	$7,546.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,953.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,593.75
Rate for Payer: Aetna Government	$3,593.75
Rate for Payer: Brighton Health Commercial	$4,312.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,593.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,132.81
Rate for Payer: EmblemHealth Commercial	$3,593.75
Rate for Payer: Fidelis Medicare Advantage	$7,546.88
Rate for Payer: Group Health Inc Commercial	$3,593.75
Rate for Payer: Group Health Inc Medicare	$2,515.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,593.75
Rate for Payer: Hamaspik Choice Inc Medicare	$3,593.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,671.88

STEM HUM REUNION

Facility

$7,187.50

Service Code	HCPCS C1889
Hospital Charge Code	64907489
Hospital Revenue Code	278
Min. Negotiated Rate	$3,593.75
Max. Negotiated Rate	$3,593.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,593.75
Rate for Payer: Hamaspik Choice Inc Medicare	$3,593.75

STEM L2L RADIAL 7MM +0MM

Facility

$6,320.00

Hospital Charge Code	64906694
Hospital Revenue Code	279
Min. Negotiated Rate	$2,212.00
Max. Negotiated Rate	$5,056.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,476.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,160.00
Rate for Payer: Aetna Government	$3,160.00
Rate for Payer: Brighton Health Commercial	$4,740.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,056.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,297.60
Rate for Payer: Group Health Inc Commercial	$3,160.00
Rate for Payer: Group Health Inc Medicare	$2,212.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,160.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,160.00

STEMMED TIBIA

Facility

$4,720.00

Service Code	HCPCS C1776
Hospital Charge Code	40202129
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,956.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,596.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,832.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,360.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,714.00
Rate for Payer: EmblemHealth Commercial	$2,360.00
Rate for Payer: Fidelis Medicare Advantage	$4,956.00
Rate for Payer: Group Health Inc Commercial	$2,360.00
Rate for Payer: Group Health Inc Medicare	$1,652.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,360.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,360.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,068.00

STEMMED TIBIA

Facility

$4,720.00

Service Code	HCPCS C1776
Hospital Charge Code	40202129
Hospital Revenue Code	278
Min. Negotiated Rate	$2,360.00
Max. Negotiated Rate	$2,360.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,360.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,360.00

STEMMED TIBIAL COMPONENT

Facility

$5,391.13

Service Code	HCPCS C1713
Hospital Charge Code	64903999
Hospital Revenue Code	278
Min. Negotiated Rate	$2,695.56
Max. Negotiated Rate	$2,695.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,695.56
Rate for Payer: Hamaspik Choice Inc Medicare	$2,695.56

STEMMED TIBIAL COMPONENT

Facility

$5,391.13

Service Code	HCPCS C1713
Hospital Charge Code	64903999
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,660.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,965.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,234.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,695.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,099.90
Rate for Payer: EmblemHealth Commercial	$2,695.56
Rate for Payer: Fidelis Medicare Advantage	$5,660.69
Rate for Payer: Group Health Inc Commercial	$2,695.56
Rate for Payer: Group Health Inc Medicare	$1,886.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,695.56
Rate for Payer: Hamaspik Choice Inc Medicare	$2,695.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,504.23

STEMMED TIBIAL COMPONENT SIZE 3

Facility

$4,720.00

Service Code	HCPCS C1776
Hospital Charge Code	40202131
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,956.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,596.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,832.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,360.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,714.00
Rate for Payer: EmblemHealth Commercial	$2,360.00
Rate for Payer: Fidelis Medicare Advantage	$4,956.00
Rate for Payer: Group Health Inc Commercial	$2,360.00
Rate for Payer: Group Health Inc Medicare	$1,652.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,360.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,360.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,068.00

STEMMED TIBIAL COMPONENT SIZE 3

Facility

$4,720.00

Service Code	HCPCS C1776
Hospital Charge Code	40202131
Hospital Revenue Code	278
Min. Negotiated Rate	$2,360.00
Max. Negotiated Rate	$2,360.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,360.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,360.00

STEMMED TIBIAL COMPONENT SZ 2

Facility

$4,550.90

Service Code	HCPCS C1776
Hospital Charge Code	40200251
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,778.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,503.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,730.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,275.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,616.77
Rate for Payer: EmblemHealth Commercial	$2,275.45
Rate for Payer: Fidelis Medicare Advantage	$4,778.44
Rate for Payer: Group Health Inc Commercial	$2,275.45
Rate for Payer: Group Health Inc Medicare	$1,592.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,275.45
Rate for Payer: Hamaspik Choice Inc Medicare	$2,275.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,958.08

STEMMED TIBIAL COMPONENT SZ 2

Facility

$4,550.90

Service Code	HCPCS C1776
Hospital Charge Code	40200251
Hospital Revenue Code	278
Min. Negotiated Rate	$2,275.45
Max. Negotiated Rate	$2,275.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,275.45
Rate for Payer: Hamaspik Choice Inc Medicare	$2,275.45

STEMMED TIBIAL COMPONENT SZ4

Facility

$4,312.90

Service Code	HCPCS C1776
Hospital Charge Code	40200064
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,528.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,372.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,587.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,156.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,479.92
Rate for Payer: EmblemHealth Commercial	$2,156.45
Rate for Payer: Fidelis Medicare Advantage	$4,528.54
Rate for Payer: Group Health Inc Commercial	$2,156.45
Rate for Payer: Group Health Inc Medicare	$1,509.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,156.45
Rate for Payer: Hamaspik Choice Inc Medicare	$2,156.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,803.38

STEMMED TIBIAL COMPONENT SZ4

Facility

$4,312.90

Service Code	HCPCS C1776
Hospital Charge Code	40200064
Hospital Revenue Code	278
Min. Negotiated Rate	$2,156.45
Max. Negotiated Rate	$2,156.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,156.45
Rate for Payer: Hamaspik Choice Inc Medicare	$2,156.45

STEMMED TIBIAL COMPT SZ 5

Facility

$4,312.90

Service Code	HCPCS C1776
Hospital Charge Code	40209913
Hospital Revenue Code	278
Min. Negotiated Rate	$2,156.45
Max. Negotiated Rate	$2,156.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,156.45
Rate for Payer: Hamaspik Choice Inc Medicare	$2,156.45

STEMMED TIBIAL COMPT SZ 5

Facility

$4,312.90

Service Code	HCPCS C1776
Hospital Charge Code	40209913
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,528.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,372.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,587.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,156.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,479.92
Rate for Payer: EmblemHealth Commercial	$2,156.45
Rate for Payer: Fidelis Medicare Advantage	$4,528.54
Rate for Payer: Group Health Inc Commercial	$2,156.45
Rate for Payer: Group Health Inc Medicare	$1,509.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,156.45
Rate for Payer: Hamaspik Choice Inc Medicare	$2,156.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,803.38

STEM MODULAR REJUV SPT SZ 7

Facility

$12,048.75

Service Code	HCPCS C1713
Hospital Charge Code	64902208
Hospital Revenue Code	278
Min. Negotiated Rate	$6,024.38
Max. Negotiated Rate	$6,024.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,024.38
Rate for Payer: Hamaspik Choice Inc Medicare	$6,024.38

STEM MODULAR REJUV SPT SZ 7

Facility

$12,048.75

Service Code	HCPCS C1713
Hospital Charge Code	64902208
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$12,651.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,626.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$7,229.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,024.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,928.03
Rate for Payer: EmblemHealth Commercial	$6,024.38
Rate for Payer: Fidelis Medicare Advantage	$12,651.19
Rate for Payer: Group Health Inc Commercial	$6,024.38
Rate for Payer: Group Health Inc Medicare	$4,217.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,024.38
Rate for Payer: Hamaspik Choice Inc Medicare	$6,024.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,831.69

STEM NEXG 12 X 145MM 100MM

Facility

$4,460.00

Service Code	HCPCS C1713
Hospital Charge Code	64905874
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,683.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,453.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,676.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,564.50
Rate for Payer: EmblemHealth Commercial	$2,230.00
Rate for Payer: Fidelis Medicare Advantage	$4,683.00
Rate for Payer: Group Health Inc Commercial	$2,230.00
Rate for Payer: Group Health Inc Medicare	$1,561.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,230.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,899.00

STEM NEXG 12 X 145MM 100MM

Facility

$4,460.00

Service Code	HCPCS C1713
Hospital Charge Code	64905874
Hospital Revenue Code	278
Min. Negotiated Rate	$2,230.00
Max. Negotiated Rate	$2,230.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,230.00

STEM NEXGEN 100MM REV

Facility

$3,031.93

Service Code	HCPCS C1776
Hospital Charge Code	64906990
Hospital Revenue Code	278
Min. Negotiated Rate	$1,515.96
Max. Negotiated Rate	$1,515.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,515.96
Rate for Payer: Hamaspik Choice Inc Medicare	$1,515.96

Know your out-of-pocket cost for care.

All Charges