St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SYNTHES L/S 5.0 X 26-38MM

Facility

$478.80

Service Code	HCPCS C1713
Hospital Charge Code	40209600
Hospital Revenue Code	278
Min. Negotiated Rate	$239.40
Max. Negotiated Rate	$239.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$239.40
Rate for Payer: Hamaspik Choice Inc Medicare	$239.40

SYNTHES L/S 5.0 X 26-38MM

Facility

$478.80

Service Code	HCPCS C1713
Hospital Charge Code	40209600
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$502.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$263.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$287.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$239.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$275.31
Rate for Payer: EmblemHealth Commercial	$239.40
Rate for Payer: Fidelis Medicare Advantage	$502.74
Rate for Payer: Group Health Inc Commercial	$239.40
Rate for Payer: Group Health Inc Medicare	$167.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$239.40
Rate for Payer: Hamaspik Choice Inc Medicare	$239.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$311.22

SYNTHES MATRIX HOLE BOARD PLATE

Facility

$970.00

Service Code	HCPCS C1713
Hospital Charge Code	40206064
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,018.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$533.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$582.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$485.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$557.75
Rate for Payer: EmblemHealth Commercial	$485.00
Rate for Payer: Fidelis Medicare Advantage	$1,018.50
Rate for Payer: Group Health Inc Commercial	$485.00
Rate for Payer: Group Health Inc Medicare	$339.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$485.00
Rate for Payer: Hamaspik Choice Inc Medicare	$485.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$630.50

SYNTHES MATRIX HOLE BOARD PLATE

Facility

$970.00

Service Code	HCPCS C1713
Hospital Charge Code	40206064
Hospital Revenue Code	278
Min. Negotiated Rate	$485.00
Max. Negotiated Rate	$485.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$485.00
Rate for Payer: Hamaspik Choice Inc Medicare	$485.00

SYNTHES M/F 26 H ADAPTION PLATE

Facility

$708.00

Service Code	HCPCS C1713
Hospital Charge Code	40207057
Hospital Revenue Code	278
Min. Negotiated Rate	$354.00
Max. Negotiated Rate	$354.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.00
Rate for Payer: Hamaspik Choice Inc Medicare	$354.00

SYNTHES M/F 26 H ADAPTION PLATE

Facility

$708.00

Service Code	HCPCS C1713
Hospital Charge Code	40207057
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$743.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$389.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$424.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$354.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$407.10
Rate for Payer: EmblemHealth Commercial	$354.00
Rate for Payer: Fidelis Medicare Advantage	$743.40
Rate for Payer: Group Health Inc Commercial	$354.00
Rate for Payer: Group Health Inc Medicare	$247.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.00
Rate for Payer: Hamaspik Choice Inc Medicare	$354.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$460.20

SYNTHES M/F OBLIQUE L 2X3 H PLT

Facility

$638.00

Service Code	HCPCS C1713
Hospital Charge Code	40207058
Hospital Revenue Code	278
Min. Negotiated Rate	$319.00
Max. Negotiated Rate	$319.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$319.00
Rate for Payer: Hamaspik Choice Inc Medicare	$319.00

SYNTHES M/F OBLIQUE L 2X3 H PLT

Facility

$638.00

Service Code	HCPCS C1713
Hospital Charge Code	40207058
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$669.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$350.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$382.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$319.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$366.85
Rate for Payer: EmblemHealth Commercial	$319.00
Rate for Payer: Fidelis Medicare Advantage	$669.90
Rate for Payer: Group Health Inc Commercial	$319.00
Rate for Payer: Group Health Inc Medicare	$223.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$319.00
Rate for Payer: Hamaspik Choice Inc Medicare	$319.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$414.70

SYNTHES M/F S/D SCREW

Facility

$176.00

Service Code	HCPCS C1713
Hospital Charge Code	40206072
Hospital Revenue Code	278
Min. Negotiated Rate	$61.60
Max. Negotiated Rate	$184.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$96.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$105.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$88.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$101.20
Rate for Payer: EmblemHealth Commercial	$88.00
Rate for Payer: Fidelis Medicare Advantage	$184.80
Rate for Payer: Group Health Inc Commercial	$88.00
Rate for Payer: Group Health Inc Medicare	$61.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$88.00
Rate for Payer: Hamaspik Choice Inc Medicare	$88.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$114.40

SYNTHES M/F S/D SCREW

Facility

$176.00

Service Code	HCPCS C1713
Hospital Charge Code	40206072
Hospital Revenue Code	278
Min. Negotiated Rate	$88.00
Max. Negotiated Rate	$88.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$88.00
Rate for Payer: Hamaspik Choice Inc Medicare	$88.00

SYNTHES MINI FRAGMENT PLT 442.62

Facility

$694.80

Service Code	HCPCS C1713
Hospital Charge Code	40205639
Hospital Revenue Code	278
Min. Negotiated Rate	$347.40
Max. Negotiated Rate	$347.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$347.40
Rate for Payer: Hamaspik Choice Inc Medicare	$347.40

SYNTHES MINI FRAGMENT PLT 442.62

Facility

$694.80

Service Code	HCPCS C1713
Hospital Charge Code	40205639
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$729.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$382.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$416.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$347.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$399.51
Rate for Payer: EmblemHealth Commercial	$347.40
Rate for Payer: Fidelis Medicare Advantage	$729.54
Rate for Payer: Group Health Inc Commercial	$347.40
Rate for Payer: Group Health Inc Medicare	$243.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$347.40
Rate for Payer: Hamaspik Choice Inc Medicare	$347.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$451.62

SYNTHES MINI FRAGMENT PLT 443.23

Facility

$444.60

Service Code	HCPCS C1713
Hospital Charge Code	40205640
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$466.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$244.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$266.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$222.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$255.64
Rate for Payer: EmblemHealth Commercial	$222.30
Rate for Payer: Fidelis Medicare Advantage	$466.83
Rate for Payer: Group Health Inc Commercial	$222.30
Rate for Payer: Group Health Inc Medicare	$155.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$222.30
Rate for Payer: Hamaspik Choice Inc Medicare	$222.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$288.99

SYNTHES MINI FRAGMENT PLT 443.23

Facility

$444.60

Service Code	HCPCS C1713
Hospital Charge Code	40205640
Hospital Revenue Code	278
Min. Negotiated Rate	$222.30
Max. Negotiated Rate	$222.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$222.30
Rate for Payer: Hamaspik Choice Inc Medicare	$222.30

SYNTHES NAIL

Facility

$529.79

Hospital Charge Code	40207034
Hospital Revenue Code	270
Min. Negotiated Rate	$185.43
Max. Negotiated Rate	$423.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$291.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$264.90
Rate for Payer: Aetna Government	$264.90
Rate for Payer: Brighton Health Commercial	$397.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$423.83
Rate for Payer: Cigna LocalPlus Benefit Plan	$360.26
Rate for Payer: Group Health Inc Commercial	$264.90
Rate for Payer: Group Health Inc Medicare	$185.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$264.90
Rate for Payer: Hamaspik Choice Inc Medicare	$264.90

SYNTHES NL TRCH FIX 11MM/130D/380

Facility

$3,036.00

Service Code	HCPCS C1713
Hospital Charge Code	40205387
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,187.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,669.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,821.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,518.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,745.70
Rate for Payer: EmblemHealth Commercial	$1,518.00
Rate for Payer: Fidelis Medicare Advantage	$3,187.80
Rate for Payer: Group Health Inc Commercial	$1,518.00
Rate for Payer: Group Health Inc Medicare	$1,062.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,518.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,518.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,973.40

SYNTHES NL TRCH FIX 11MM/130D/380

Facility

$3,036.00

Service Code	HCPCS C1713
Hospital Charge Code	40205387
Hospital Revenue Code	278
Min. Negotiated Rate	$1,518.00
Max. Negotiated Rate	$1,518.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,518.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,518.00

SYNTHES OBLIQUE L 5 H RIGID PLT

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	40205305
Hospital Revenue Code	278
Min. Negotiated Rate	$286.00
Max. Negotiated Rate	$286.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$286.00
Rate for Payer: Hamaspik Choice Inc Medicare	$286.00

SYNTHES OBLIQUE L 5 H RIGID PLT

Facility

$572.00

Service Code	HCPCS C1713
Hospital Charge Code	40205305
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$600.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$314.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$343.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$286.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$328.90
Rate for Payer: EmblemHealth Commercial	$286.00
Rate for Payer: Fidelis Medicare Advantage	$600.60
Rate for Payer: Group Health Inc Commercial	$286.00
Rate for Payer: Group Health Inc Medicare	$200.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$286.00
Rate for Payer: Hamaspik Choice Inc Medicare	$286.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$371.80

SYNTHES PLATE

Facility

$397.26

Service Code	HCPCS C1713
Hospital Charge Code	40207033
Hospital Revenue Code	278
Min. Negotiated Rate	$198.63
Max. Negotiated Rate	$198.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$198.63
Rate for Payer: Hamaspik Choice Inc Medicare	$198.63

SYNTHES PLATE

Facility

$397.26

Service Code	HCPCS C1713
Hospital Charge Code	40207033
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$417.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$218.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$238.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$198.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$228.42
Rate for Payer: EmblemHealth Commercial	$198.63
Rate for Payer: Fidelis Medicare Advantage	$417.12
Rate for Payer: Group Health Inc Commercial	$198.63
Rate for Payer: Group Health Inc Medicare	$139.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$198.63
Rate for Payer: Hamaspik Choice Inc Medicare	$198.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$258.22

SYNTHES PLATE 7HOLE LCP

Facility

$1,796.00

Service Code	HCPCS C1713
Hospital Charge Code	40209946
Hospital Revenue Code	278
Min. Negotiated Rate	$898.00
Max. Negotiated Rate	$898.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$898.00
Rate for Payer: Hamaspik Choice Inc Medicare	$898.00

SYNTHES PLATE 7HOLE LCP

Facility

$1,796.00

Service Code	HCPCS C1713
Hospital Charge Code	40209946
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,885.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$987.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,077.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$898.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,032.70
Rate for Payer: EmblemHealth Commercial	$898.00
Rate for Payer: Fidelis Medicare Advantage	$1,885.80
Rate for Payer: Group Health Inc Commercial	$898.00
Rate for Payer: Group Health Inc Medicare	$628.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$898.00
Rate for Payer: Hamaspik Choice Inc Medicare	$898.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,167.40

SYNTHES PLATE 8 HOLE

Facility

$682.20

Service Code	HCPCS C1713
Hospital Charge Code	40209985
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$716.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$375.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$409.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$341.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$392.26
Rate for Payer: EmblemHealth Commercial	$341.10
Rate for Payer: Fidelis Medicare Advantage	$716.31
Rate for Payer: Group Health Inc Commercial	$341.10
Rate for Payer: Group Health Inc Medicare	$238.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$341.10
Rate for Payer: Hamaspik Choice Inc Medicare	$341.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$443.43

SYNTHES PLATE 8 HOLE

Facility

$682.20

Service Code	HCPCS C1713
Hospital Charge Code	40209985
Hospital Revenue Code	278
Min. Negotiated Rate	$341.10
Max. Negotiated Rate	$341.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$341.10
Rate for Payer: Hamaspik Choice Inc Medicare	$341.10

Know your out-of-pocket cost for care.

All Charges