St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STRY 2 HOLE RIGID DOGBNE PLT

Facility

$185.52

Service Code	HCPCS C1713
Hospital Charge Code	40204214
Hospital Revenue Code	278
Min. Negotiated Rate	$64.93
Max. Negotiated Rate	$194.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$102.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$111.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$92.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$106.67
Rate for Payer: EmblemHealth Commercial	$92.76
Rate for Payer: Fidelis Medicare Advantage	$194.80
Rate for Payer: Group Health Inc Commercial	$92.76
Rate for Payer: Group Health Inc Medicare	$64.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$92.76
Rate for Payer: Hamaspik Choice Inc Medicare	$92.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$120.59

STRY 2 HOLE RIGID DOGBNE PLT

Facility

$185.52

Service Code	HCPCS C1713
Hospital Charge Code	40204214
Hospital Revenue Code	278
Min. Negotiated Rate	$92.76
Max. Negotiated Rate	$92.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$92.76
Rate for Payer: Hamaspik Choice Inc Medicare	$92.76

STRY 3.0MM ASN MCR CN DR BT 2.1MM

Facility

$325.00

Hospital Charge Code	40204264
Hospital Revenue Code	272
Min. Negotiated Rate	$113.75
Max. Negotiated Rate	$260.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$178.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$162.50
Rate for Payer: Aetna Government	$162.50
Rate for Payer: Brighton Health Commercial	$243.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$260.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$221.00
Rate for Payer: Group Health Inc Commercial	$162.50
Rate for Payer: Group Health Inc Medicare	$113.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$162.50
Rate for Payer: Hamaspik Choice Inc Medicare	$162.50

STRY 3.5 NON LK SCREW

Facility

$308.00

Service Code	HCPCS C1713
Hospital Charge Code	40008259
Hospital Revenue Code	278
Min. Negotiated Rate	$107.80
Max. Negotiated Rate	$323.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$169.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$184.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$154.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$177.10
Rate for Payer: EmblemHealth Commercial	$154.00
Rate for Payer: Fidelis Medicare Advantage	$323.40
Rate for Payer: Group Health Inc Commercial	$154.00
Rate for Payer: Group Health Inc Medicare	$107.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.00
Rate for Payer: Hamaspik Choice Inc Medicare	$154.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$200.20

STRY 3.5 NON LK SCREW

Facility

$308.00

Service Code	HCPCS C1713
Hospital Charge Code	40008259
Hospital Revenue Code	278
Min. Negotiated Rate	$154.00
Max. Negotiated Rate	$154.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$154.00
Rate for Payer: Hamaspik Choice Inc Medicare	$154.00

STRY 3.5 X 20MM HEADLESS SCREW

Facility

$1,046.00

Service Code	HCPCS C1713
Hospital Charge Code	40004605
Hospital Revenue Code	278
Min. Negotiated Rate	$523.00
Max. Negotiated Rate	$523.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$523.00
Rate for Payer: Hamaspik Choice Inc Medicare	$523.00

STRY 3.5 X 20MM HEADLESS SCREW

Facility

$1,046.00

Service Code	HCPCS C1713
Hospital Charge Code	40004605
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,098.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$575.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$627.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$523.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$601.45
Rate for Payer: EmblemHealth Commercial	$523.00
Rate for Payer: Fidelis Medicare Advantage	$1,098.30
Rate for Payer: Group Health Inc Commercial	$523.00
Rate for Payer: Group Health Inc Medicare	$366.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$523.00
Rate for Payer: Hamaspik Choice Inc Medicare	$523.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$679.90

STRY 4 HL PLT LONG SPAN

Facility

$163.90

Service Code	HCPCS C1713
Hospital Charge Code	40204444
Hospital Revenue Code	278
Min. Negotiated Rate	$81.95
Max. Negotiated Rate	$81.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.95
Rate for Payer: Hamaspik Choice Inc Medicare	$81.95

STRY 4 HL PLT LONG SPAN

Facility

$163.90

Service Code	HCPCS C1713
Hospital Charge Code	40204444
Hospital Revenue Code	278
Min. Negotiated Rate	$57.36
Max. Negotiated Rate	$172.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$90.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$98.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$94.24
Rate for Payer: EmblemHealth Commercial	$81.95
Rate for Payer: Fidelis Medicare Advantage	$172.10
Rate for Payer: Group Health Inc Commercial	$81.95
Rate for Payer: Group Health Inc Medicare	$57.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.95
Rate for Payer: Hamaspik Choice Inc Medicare	$81.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$106.54

STRY 6 HOLE PLATE

Facility

$2,782.00

Service Code	HCPCS C1776
Hospital Charge Code	40009287
Hospital Revenue Code	278
Min. Negotiated Rate	$1,391.00
Max. Negotiated Rate	$1,391.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,391.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,391.00

STRY 6 HOLE PLATE

Facility

$2,782.00

Service Code	HCPCS C1776
Hospital Charge Code	40009287
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,921.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,530.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,669.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,391.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,599.65
Rate for Payer: EmblemHealth Commercial	$1,391.00
Rate for Payer: Fidelis Medicare Advantage	$2,921.10
Rate for Payer: Group Health Inc Commercial	$1,391.00
Rate for Payer: Group Health Inc Medicare	$973.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,391.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,391.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,808.30

STRY 6-HOLE PLATE

Facility

$742.32

Service Code	HCPCS C1713
Hospital Charge Code	40004608
Hospital Revenue Code	278
Min. Negotiated Rate	$371.16
Max. Negotiated Rate	$371.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$371.16
Rate for Payer: Hamaspik Choice Inc Medicare	$371.16

STRY 6-HOLE PLATE

Facility

$742.32

Service Code	HCPCS C1713
Hospital Charge Code	40004608
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$779.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$408.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$445.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$371.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$426.83
Rate for Payer: EmblemHealth Commercial	$371.16
Rate for Payer: Fidelis Medicare Advantage	$779.44
Rate for Payer: Group Health Inc Commercial	$371.16
Rate for Payer: Group Health Inc Medicare	$259.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$371.16
Rate for Payer: Hamaspik Choice Inc Medicare	$371.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$482.51

STRY 8 HOLE MED PLATE

Facility

$408.80

Service Code	HCPCS C1713
Hospital Charge Code	40008287
Hospital Revenue Code	278
Min. Negotiated Rate	$204.40
Max. Negotiated Rate	$204.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.40
Rate for Payer: Hamaspik Choice Inc Medicare	$204.40

STRY 8 HOLE MED PLATE

Facility

$408.80

Service Code	HCPCS C1713
Hospital Charge Code	40008287
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$429.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$224.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$245.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$235.06
Rate for Payer: EmblemHealth Commercial	$204.40
Rate for Payer: Fidelis Medicare Advantage	$429.24
Rate for Payer: Group Health Inc Commercial	$204.40
Rate for Payer: Group Health Inc Medicare	$143.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.40
Rate for Payer: Hamaspik Choice Inc Medicare	$204.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$265.72

STRY 8 HOLE MED TIBIA PLATE

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	40008281
Hospital Revenue Code	278
Min. Negotiated Rate	$400.00
Max. Negotiated Rate	$400.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$400.00
Rate for Payer: Hamaspik Choice Inc Medicare	$400.00

STRY 8 HOLE MED TIBIA PLATE

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	40008281
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$840.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$440.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$480.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$460.00
Rate for Payer: EmblemHealth Commercial	$400.00
Rate for Payer: Fidelis Medicare Advantage	$840.00
Rate for Payer: Group Health Inc Commercial	$400.00
Rate for Payer: Group Health Inc Medicare	$280.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$400.00
Rate for Payer: Hamaspik Choice Inc Medicare	$400.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$520.00

STRY 8-HOLE OLECRAN PLT_RT

Facility

$2,144.00

Service Code	HCPCS C1713
Hospital Charge Code	40004629
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,251.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,179.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,286.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,072.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,232.80
Rate for Payer: EmblemHealth Commercial	$1,072.00
Rate for Payer: Fidelis Medicare Advantage	$2,251.20
Rate for Payer: Group Health Inc Commercial	$1,072.00
Rate for Payer: Group Health Inc Medicare	$750.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,072.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,072.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,393.60

STRY 8-HOLE OLECRAN PLT_RT

Facility

$2,144.00

Service Code	HCPCS C1713
Hospital Charge Code	40004629
Hospital Revenue Code	278
Min. Negotiated Rate	$1,072.00
Max. Negotiated Rate	$1,072.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,072.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,072.00

STRY 8-HOLE PLATE

Facility

$2,381.00

Service Code	HCPCS C1713
Hospital Charge Code	40009290
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,500.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,309.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,428.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,190.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,369.08
Rate for Payer: EmblemHealth Commercial	$1,190.50
Rate for Payer: Fidelis Medicare Advantage	$2,500.05
Rate for Payer: Group Health Inc Commercial	$1,190.50
Rate for Payer: Group Health Inc Medicare	$833.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,190.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,190.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,547.65

STRY 8-HOLE PLATE

Facility

$2,381.00

Service Code	HCPCS C1713
Hospital Charge Code	40009290
Hospital Revenue Code	278
Min. Negotiated Rate	$1,190.50
Max. Negotiated Rate	$1,190.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,190.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,190.50

STRY ACCOLADE BLZF PLUS 1 SYSTE

Facility

$13,041.00

Service Code	HCPCS C1776
Hospital Charge Code	40009288
Hospital Revenue Code	278
Min. Negotiated Rate	$6,520.50
Max. Negotiated Rate	$6,520.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,520.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,520.50

STRY ACCOLADE BLZF PLUS 1 SYSTE

Facility

$13,041.00

Service Code	HCPCS C1776
Hospital Charge Code	40009288
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$13,693.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,172.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$7,824.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,520.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,498.58
Rate for Payer: EmblemHealth Commercial	$6,520.50
Rate for Payer: Fidelis Medicare Advantage	$13,693.05
Rate for Payer: Group Health Inc Commercial	$6,520.50
Rate for Payer: Group Health Inc Medicare	$4,564.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,520.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,520.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,476.65

STRY A LCK SCREW 4.0X60MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40008288
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$527.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$301.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$251.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.65
Rate for Payer: EmblemHealth Commercial	$251.00
Rate for Payer: Fidelis Medicare Advantage	$527.10
Rate for Payer: Group Health Inc Commercial	$251.00
Rate for Payer: Group Health Inc Medicare	$175.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$326.30

STRY A LCK SCREW 4.0X60MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40008288
Hospital Revenue Code	278
Min. Negotiated Rate	$251.00
Max. Negotiated Rate	$251.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00

Know your out-of-pocket cost for care.

All Charges