St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STEM NEXGEN 100MM REV

Facility

$3,031.93

Service Code	HCPCS C1776
Hospital Charge Code	64906990
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,183.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,667.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,819.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,515.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,743.36
Rate for Payer: EmblemHealth Commercial	$1,515.96
Rate for Payer: Fidelis Medicare Advantage	$3,183.53
Rate for Payer: Group Health Inc Commercial	$1,515.96
Rate for Payer: Group Health Inc Medicare	$1,061.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,515.96
Rate for Payer: Hamaspik Choice Inc Medicare	$1,515.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,970.75

STEM NEXGEN 13 X 145MM 100

Facility

$4,460.00

Service Code	HCPCS C1713
Hospital Charge Code	64905872
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 13 X 145MM 100

Facility

$4,460.00

Service Code	HCPCS C1713
Hospital Charge Code	64905872
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 NEXGEN EXT 13MM OFFSET-2013

Facility

$1,582.04

Service Code	HCPCS C1776
Hospital Charge Code	64906492
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,661.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$870.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$949.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$791.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$909.67
Rate for Payer: EmblemHealth Commercial	$791.02
Rate for Payer: Fidelis Medicare Advantage	$1,661.14
Rate for Payer: Group Health Inc Commercial	$791.02
Rate for Payer: Group Health Inc Medicare	$553.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$791.02
Rate for Payer: Hamaspik Choice Inc Medicare	$791.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,028.33

STEM NEXGEN EXT 13MM OFFSET-2013

Facility

$1,582.04

Service Code	HCPCS C1776
Hospital Charge Code	64906492
Hospital Revenue Code	278
Min. Negotiated Rate	$791.02
Max. Negotiated Rate	$791.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$791.02
Rate for Payer: Hamaspik Choice Inc Medicare	$791.02

STEM NEXGEN EXT 17MM OFFSET-2017

Facility

$1,582.04

Service Code	HCPCS C1776
Hospital Charge Code	64906493
Hospital Revenue Code	278
Min. Negotiated Rate	$791.02
Max. Negotiated Rate	$791.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$791.02
Rate for Payer: Hamaspik Choice Inc Medicare	$791.02

STEM NEXGEN EXT 17MM OFFSET-2017

Facility

$1,582.04

Service Code	HCPCS C1776
Hospital Charge Code	64906493
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,661.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$870.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$949.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$791.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$909.67
Rate for Payer: EmblemHealth Commercial	$791.02
Rate for Payer: Fidelis Medicare Advantage	$1,661.14
Rate for Payer: Group Health Inc Commercial	$791.02
Rate for Payer: Group Health Inc Medicare	$553.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$791.02
Rate for Payer: Hamaspik Choice Inc Medicare	$791.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,028.33

STEM OMNIFIT EON #10 40MM

Facility

$4,289.00

Service Code	HCPCS C1776
Hospital Charge Code	64906264
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,503.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,358.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,573.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,144.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,466.18
Rate for Payer: EmblemHealth Commercial	$2,144.50
Rate for Payer: Fidelis Medicare Advantage	$4,503.45
Rate for Payer: Group Health Inc Commercial	$2,144.50
Rate for Payer: Group Health Inc Medicare	$1,501.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,144.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,144.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,787.85

STEM OMNIFIT EON #10 40MM

Facility

$4,289.00

Service Code	HCPCS C1776
Hospital Charge Code	64906264
Hospital Revenue Code	278
Min. Negotiated Rate	$2,144.50
Max. Negotiated Rate	$2,144.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,144.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,144.50

STEM OMNIFIT EON 132DEG #6 30MM

Facility

$4,288.50

Service Code	HCPCS C1776
Hospital Charge Code	64906487
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,502.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,358.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,573.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,144.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,465.89
Rate for Payer: EmblemHealth Commercial	$2,144.25
Rate for Payer: Fidelis Medicare Advantage	$4,502.92
Rate for Payer: Group Health Inc Commercial	$2,144.25
Rate for Payer: Group Health Inc Medicare	$1,500.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,144.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,144.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,787.52

STEM OMNIFIT EON 132DEG #6 30MM

Facility

$4,288.50

Service Code	HCPCS C1776
Hospital Charge Code	64906487
Hospital Revenue Code	278
Min. Negotiated Rate	$2,144.25
Max. Negotiated Rate	$2,144.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,144.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,144.25

STEM OMNIFIT EON #7 35MM

Facility

$4,288.50

Service Code	HCPCS C1713
Hospital Charge Code	64906377
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,502.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,358.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,573.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,144.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,465.89
Rate for Payer: EmblemHealth Commercial	$2,144.25
Rate for Payer: Fidelis Medicare Advantage	$4,502.92
Rate for Payer: Group Health Inc Commercial	$2,144.25
Rate for Payer: Group Health Inc Medicare	$1,500.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,144.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,144.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,787.52

STEM OMNIFIT EON #7 35MM

Facility

$4,288.50

Service Code	HCPCS C1713
Hospital Charge Code	64906377
Hospital Revenue Code	278
Min. Negotiated Rate	$2,144.25
Max. Negotiated Rate	$2,144.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,144.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,144.25

STEM P/F FLUTED

Facility

$15,418.12

Service Code	HCPCS C1776
Hospital Charge Code	64907275
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$16,189.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8,479.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$9,250.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7,709.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$8,865.42
Rate for Payer: EmblemHealth Commercial	$7,709.06
Rate for Payer: Fidelis Medicare Advantage	$16,189.03
Rate for Payer: Group Health Inc Commercial	$7,709.06
Rate for Payer: Group Health Inc Medicare	$5,396.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,709.06
Rate for Payer: Hamaspik Choice Inc Medicare	$7,709.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10,021.78

STEM P/F FLUTED

Facility

$15,418.12

Service Code	HCPCS C1776
Hospital Charge Code	64907275
Hospital Revenue Code	278
Min. Negotiated Rate	$7,709.06
Max. Negotiated Rate	$7,709.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,709.06
Rate for Payer: Hamaspik Choice Inc Medicare	$7,709.06

STEM P-F TRI

Facility

$4,528.13

Service Code	HCPCS C1776
Hospital Charge Code	64907227
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,754.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,490.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,716.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,264.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,603.67
Rate for Payer: EmblemHealth Commercial	$2,264.06
Rate for Payer: Fidelis Medicare Advantage	$4,754.54
Rate for Payer: Group Health Inc Commercial	$2,264.06
Rate for Payer: Group Health Inc Medicare	$1,584.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,264.06
Rate for Payer: Hamaspik Choice Inc Medicare	$2,264.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,943.28

STEM P-F TRI

Facility

$4,528.13

Service Code	HCPCS C1776
Hospital Charge Code	64907227
Hospital Revenue Code	278
Min. Negotiated Rate	$2,264.06
Max. Negotiated Rate	$2,264.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,264.06
Rate for Payer: Hamaspik Choice Inc Medicare	$2,264.06

STEM PRESSFIT 16MM X 120MM

Facility

$3,840.00

Service Code	HCPCS C1713
Hospital Charge Code	64903975
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,032.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,112.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,304.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,920.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,208.00
Rate for Payer: EmblemHealth Commercial	$1,920.00
Rate for Payer: Fidelis Medicare Advantage	$4,032.00
Rate for Payer: Group Health Inc Commercial	$1,920.00
Rate for Payer: Group Health Inc Medicare	$1,344.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,920.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,920.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,496.00

STEM PRESSFIT 16MM X 120MM

Facility

$3,840.00

Service Code	HCPCS C1713
Hospital Charge Code	64903975
Hospital Revenue Code	278
Min. Negotiated Rate	$1,920.00
Max. Negotiated Rate	$1,920.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,920.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,920.00

STEM PSN REV

Facility

$8,450.00

Service Code	HCPCS C1776
Hospital Charge Code	64907168
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,872.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,647.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
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 PSN REV

Facility

$8,450.00

Service Code	HCPCS C1776
Hospital Charge Code	64907168
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 RADIAL SZ 2

Facility

$7,570.00

Service Code	HCPCS C1713
Hospital Charge Code	64905300
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$7,948.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,163.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$4,542.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,785.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,352.75
Rate for Payer: EmblemHealth Commercial	$3,785.00
Rate for Payer: Fidelis Medicare Advantage	$7,948.50
Rate for Payer: Group Health Inc Commercial	$3,785.00
Rate for Payer: Group Health Inc Medicare	$2,649.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,785.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,785.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,920.50

STEM RADIAL SZ 2

Facility

$7,570.00

Service Code	HCPCS C1713
Hospital Charge Code	64905300
Hospital Revenue Code	278
Min. Negotiated Rate	$3,785.00
Max. Negotiated Rate	$3,785.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,785.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,785.00

STEM RADIAL SZ 3

Facility

$4,602.50

Service Code	HCPCS C1713
Hospital Charge Code	64905298
Hospital Revenue Code	278
Min. Negotiated Rate	$2,301.25
Max. Negotiated Rate	$2,301.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,301.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,301.25

STEM RADIAL SZ 3

Facility

$4,602.50

Service Code	HCPCS C1713
Hospital Charge Code	64905298
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,832.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,531.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,761.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,301.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,646.44
Rate for Payer: EmblemHealth Commercial	$2,301.25
Rate for Payer: Fidelis Medicare Advantage	$4,832.62
Rate for Payer: Group Health Inc Commercial	$2,301.25
Rate for Payer: Group Health Inc Medicare	$1,610.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,301.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,301.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,991.62

Know your out-of-pocket cost for care.

All Charges