St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STRY UN3 COVER 20MM W/TAB

Facility

$448.66

Service Code	HCPCS C1713
Hospital Charge Code	40001788
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$471.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$246.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$269.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$224.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$257.98
Rate for Payer: EmblemHealth Commercial	$224.33
Rate for Payer: Fidelis Medicare Advantage	$471.09
Rate for Payer: Group Health Inc Commercial	$224.33
Rate for Payer: Group Health Inc Medicare	$157.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$224.33
Rate for Payer: Hamaspik Choice Inc Medicare	$224.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$291.63

STRY UN3 COVER 20MM W/TAB

Facility

$448.66

Service Code	HCPCS C1713
Hospital Charge Code	40001788
Hospital Revenue Code	278
Min. Negotiated Rate	$224.33
Max. Negotiated Rate	$224.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$224.33
Rate for Payer: Hamaspik Choice Inc Medicare	$224.33

STRY UN3 HOLE PLT W/O TAB 0.6MM

Facility

$267.44

Service Code	HCPCS C1713
Hospital Charge Code	40001789
Hospital Revenue Code	278
Min. Negotiated Rate	$93.60
Max. Negotiated Rate	$280.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$147.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$160.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$133.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.78
Rate for Payer: EmblemHealth Commercial	$133.72
Rate for Payer: Fidelis Medicare Advantage	$280.81
Rate for Payer: Group Health Inc Commercial	$133.72
Rate for Payer: Group Health Inc Medicare	$93.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.72
Rate for Payer: Hamaspik Choice Inc Medicare	$133.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$173.84

STRY UN3 HOLE PLT W/O TAB 0.6MM

Facility

$267.44

Service Code	HCPCS C1713
Hospital Charge Code	40001789
Hospital Revenue Code	278
Min. Negotiated Rate	$133.72
Max. Negotiated Rate	$133.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.72
Rate for Payer: Hamaspik Choice Inc Medicare	$133.72

STRY UNI BONE REP INST 3.2MM

Facility

$925.86

Hospital Charge Code	40204213
Hospital Revenue Code	272
Min. Negotiated Rate	$324.05
Max. Negotiated Rate	$740.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$509.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$462.93
Rate for Payer: Aetna Government	$462.93
Rate for Payer: Brighton Health Commercial	$694.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$740.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$629.58
Rate for Payer: Group Health Inc Commercial	$462.93
Rate for Payer: Group Health Inc Medicare	$324.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$462.93
Rate for Payer: Hamaspik Choice Inc Medicare	$462.93

STRY VARIAX CAN SCREW 3.0MM 12

Facility

$196.00

Service Code	HCPCS C1713
Hospital Charge Code	40204262
Hospital Revenue Code	278
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$98.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.00
Rate for Payer: Hamaspik Choice Inc Medicare	$98.00

STRY VARIAX CAN SCREW 3.0MM 12

Facility

$196.00

Service Code	HCPCS C1713
Hospital Charge Code	40204262
Hospital Revenue Code	278
Min. Negotiated Rate	$68.60
Max. Negotiated Rate	$205.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$117.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$98.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.70
Rate for Payer: EmblemHealth Commercial	$98.00
Rate for Payer: Fidelis Medicare Advantage	$205.80
Rate for Payer: Group Health Inc Commercial	$98.00
Rate for Payer: Group Health Inc Medicare	$68.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.00
Rate for Payer: Hamaspik Choice Inc Medicare	$98.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.40

STRY VITOSS BIM 10CC

Facility

$7,472.66

Service Code	HCPCS C1713
Hospital Charge Code	40003444
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$7,846.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,109.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$4,483.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,736.33
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,296.78
Rate for Payer: EmblemHealth Commercial	$3,736.33
Rate for Payer: Fidelis Medicare Advantage	$7,846.29
Rate for Payer: Group Health Inc Commercial	$3,736.33
Rate for Payer: Group Health Inc Medicare	$2,615.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,736.33
Rate for Payer: Hamaspik Choice Inc Medicare	$3,736.33
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,857.23

STRY VITOSS BIM 10CC

Facility

$7,472.66

Service Code	HCPCS C1713
Hospital Charge Code	40003444
Hospital Revenue Code	278
Min. Negotiated Rate	$3,736.33
Max. Negotiated Rate	$3,736.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,736.33
Rate for Payer: Hamaspik Choice Inc Medicare	$3,736.33

STRY VITOSS BIMODAL 2.5CC

Facility

$4,009.72

Service Code	HCPCS C1713
Hospital Charge Code	40204252
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,210.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,205.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,405.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,004.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,305.59
Rate for Payer: EmblemHealth Commercial	$2,004.86
Rate for Payer: Fidelis Medicare Advantage	$4,210.21
Rate for Payer: Group Health Inc Commercial	$2,004.86
Rate for Payer: Group Health Inc Medicare	$1,403.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,004.86
Rate for Payer: Hamaspik Choice Inc Medicare	$2,004.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,606.32

STRY VITOSS BIMODAL 2.5CC

Facility

$4,009.72

Service Code	HCPCS C1713
Hospital Charge Code	40204252
Hospital Revenue Code	278
Min. Negotiated Rate	$2,004.86
Max. Negotiated Rate	$2,004.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,004.86
Rate for Payer: Hamaspik Choice Inc Medicare	$2,004.86

STRY XIA3 PA SCR 6.0X35MM

Facility

$4,057.02

Service Code	HCPCS C1713
Hospital Charge Code	40003440
Hospital Revenue Code	278
Min. Negotiated Rate	$2,028.51
Max. Negotiated Rate	$2,028.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,028.51
Rate for Payer: Hamaspik Choice Inc Medicare	$2,028.51

STRY XIA3 PA SCR 6.0X35MM

Facility

$4,057.02

Service Code	HCPCS C1713
Hospital Charge Code	40003440
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,259.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,231.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,434.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,028.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,332.79
Rate for Payer: EmblemHealth Commercial	$2,028.51
Rate for Payer: Fidelis Medicare Advantage	$4,259.87
Rate for Payer: Group Health Inc Commercial	$2,028.51
Rate for Payer: Group Health Inc Medicare	$1,419.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,028.51
Rate for Payer: Hamaspik Choice Inc Medicare	$2,028.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,637.06

STRY XIA ROD 480X6MM

Facility

$1,508.72

Service Code	HCPCS C1713
Hospital Charge Code	40008318
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,584.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$829.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$905.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$754.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$867.51
Rate for Payer: EmblemHealth Commercial	$754.36
Rate for Payer: Fidelis Medicare Advantage	$1,584.16
Rate for Payer: Group Health Inc Commercial	$754.36
Rate for Payer: Group Health Inc Medicare	$528.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$754.36
Rate for Payer: Hamaspik Choice Inc Medicare	$754.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$980.67

STRY XIA ROD 480X6MM

Facility

$1,508.72

Service Code	HCPCS C1713
Hospital Charge Code	40008318
Hospital Revenue Code	278
Min. Negotiated Rate	$754.36
Max. Negotiated Rate	$754.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$754.36
Rate for Payer: Hamaspik Choice Inc Medicare	$754.36

STUDIES W/&W/O BRONCHDIALTOR

Facility

$766.58

Service Code	HCPCS 94060 TC
Hospital Charge Code	40401500
Hospital Revenue Code	460
Rate for Payer: Cash Price	$362.98

STUDIES W/&W/O BRONCHDIALTOR

Facility

$766.58

Service Code	HCPCS 94060 TC
Hospital Charge Code	40401500
Hospital Revenue Code	460
Min. Negotiated Rate	$268.30
Max. Negotiated Rate	$613.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$383.29
Rate for Payer: Aetna Government	$383.29
Rate for Payer: Brighton Health Commercial	$574.94
Rate for Payer: Cash Price	$362.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$613.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$521.27
Rate for Payer: Group Health Inc Commercial	$383.29
Rate for Payer: Group Health Inc Medicare	$268.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.29
Rate for Payer: Hamaspik Choice Inc Medicare	$383.29

STUDY-HALOPERIDL/METOCLPRM INJ

Facility

$0.01

Service Code	HCPCS J3490 Q0
Hospital Charge Code	41640239
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

STUDY-HALOPERIDL/METOCLPRM INJ

Facility

$0.01

Service Code	HCPCS J3490 Q0
Hospital Charge Code	41650239
Hospital Revenue Code	636
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

STUDY-HALOPERIDL/METOCLPRM INJ

Facility

$0.01

Service Code	HCPCS J3490 Q0
Hospital Charge Code	41640239
Hospital Revenue Code	636
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

STUDY-HALOPERIDL/METOCLPRM INJ

Facility

$0.01

Service Code	HCPCS J3490 Q0
Hospital Charge Code	41650239
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

STYKER LOCKING 2.7MMX12MM 656312

Facility

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40005354
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$590.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$337.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$281.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$323.15
Rate for Payer: EmblemHealth Commercial	$281.00
Rate for Payer: Fidelis Medicare Advantage	$590.10
Rate for Payer: Group Health Inc Commercial	$281.00
Rate for Payer: Group Health Inc Medicare	$196.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$365.30

STYKER LOCKING 2.7MMX12MM 656312

Facility

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40005354
Hospital Revenue Code	278
Min. Negotiated Rate	$281.00
Max. Negotiated Rate	$281.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00

STYKER LOCKING 2.7MMX14MM 656314

Facility

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40005352
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$590.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$337.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$281.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$323.15
Rate for Payer: EmblemHealth Commercial	$281.00
Rate for Payer: Fidelis Medicare Advantage	$590.10
Rate for Payer: Group Health Inc Commercial	$281.00
Rate for Payer: Group Health Inc Medicare	$196.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$365.30

STYKER LOCKING 2.7MMX14MM 656314

Facility

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40005352
Hospital Revenue Code	278
Min. Negotiated Rate	$281.00
Max. Negotiated Rate	$281.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00

Know your out-of-pocket cost for care.

All Charges