St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BLADE REAMER PATELLA 35MM

Facility

$326.40

Service Code	HCPCS C1776
Hospital Charge Code	40205086
Hospital Revenue Code	278
Min. Negotiated Rate	$114.24
Max. Negotiated Rate	$342.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$179.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$195.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$163.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$187.68
Rate for Payer: EmblemHealth Commercial	$163.20
Rate for Payer: Fidelis Medicare Advantage	$342.72
Rate for Payer: Group Health Inc Commercial	$163.20
Rate for Payer: Group Health Inc Medicare	$114.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.20
Rate for Payer: Hamaspik Choice Inc Medicare	$163.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$212.16

BLADE REAMER PATELLA 35MM

Facility

$326.40

Service Code	HCPCS C1776
Hospital Charge Code	40205086
Hospital Revenue Code	278
Min. Negotiated Rate	$163.20
Max. Negotiated Rate	$163.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.20
Rate for Payer: Hamaspik Choice Inc Medicare	$163.20

BLADE REAMER PATELLA 35MM

Facility

$408.00

Service Code	HCPCS C1776
Hospital Charge Code	64901307
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$204.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.00
Rate for Payer: Hamaspik Choice Inc Medicare	$204.00

BLADE REAMER PATELLA 46MM

Facility

$408.00

Service Code	HCPCS C1776
Hospital Charge Code	64907004
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$204.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.00
Rate for Payer: Hamaspik Choice Inc Medicare	$204.00

BLADE REAMER PATELLA 46MM

Facility

$408.00

Service Code	HCPCS C1776
Hospital Charge Code	64907004
Hospital Revenue Code	278
Min. Negotiated Rate	$142.80
Max. Negotiated Rate	$428.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$224.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$244.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$234.60
Rate for Payer: EmblemHealth Commercial	$204.00
Rate for Payer: Fidelis Medicare Advantage	$428.40
Rate for Payer: Group Health Inc Commercial	$204.00
Rate for Payer: Group Health Inc Medicare	$142.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.00
Rate for Payer: Hamaspik Choice Inc Medicare	$204.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$265.20

BLADE REAMER PATEL W/PIL38MM

Facility

$408.00

Service Code	HCPCS C1776
Hospital Charge Code	64905814
Hospital Revenue Code	278
Min. Negotiated Rate	$142.80
Max. Negotiated Rate	$428.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$224.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$244.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$234.60
Rate for Payer: EmblemHealth Commercial	$204.00
Rate for Payer: Fidelis Medicare Advantage	$428.40
Rate for Payer: Group Health Inc Commercial	$204.00
Rate for Payer: Group Health Inc Medicare	$142.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.00
Rate for Payer: Hamaspik Choice Inc Medicare	$204.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$265.20

BLADE REAMER PATEL W/PIL38MM

Facility

$408.00

Service Code	HCPCS C1776
Hospital Charge Code	64905814
Hospital Revenue Code	278
Min. Negotiated Rate	$204.00
Max. Negotiated Rate	$204.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.00
Rate for Payer: Hamaspik Choice Inc Medicare	$204.00

BLADE RECIPROCATING 12.5X89X1.5

Facility

$62.50

Hospital Charge Code	64903057
Hospital Revenue Code	270
Min. Negotiated Rate	$21.88
Max. Negotiated Rate	$50.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.25
Rate for Payer: Aetna Government	$31.25
Rate for Payer: Brighton Health Commercial	$46.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$42.50
Rate for Payer: Group Health Inc Commercial	$31.25
Rate for Payer: Group Health Inc Medicare	$21.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.25
Rate for Payer: Hamaspik Choice Inc Medicare	$31.25

BLADE SAGITAL SAW MEDIUM

Facility

$21.45

Hospital Charge Code	64904214
Hospital Revenue Code	270
Min. Negotiated Rate	$7.51
Max. Negotiated Rate	$17.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.72
Rate for Payer: Aetna Government	$10.72
Rate for Payer: Brighton Health Commercial	$16.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.59
Rate for Payer: Group Health Inc Commercial	$10.72
Rate for Payer: Group Health Inc Medicare	$7.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.72
Rate for Payer: Hamaspik Choice Inc Medicare	$10.72

BLADE SAGITTAL MEDIUM LONG

Facility

$191.40

Hospital Charge Code	64903938
Hospital Revenue Code	270
Min. Negotiated Rate	$66.99
Max. Negotiated Rate	$153.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$105.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$95.70
Rate for Payer: Aetna Government	$95.70
Rate for Payer: Brighton Health Commercial	$143.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$153.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$130.15
Rate for Payer: Group Health Inc Commercial	$95.70
Rate for Payer: Group Health Inc Medicare	$66.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$95.70
Rate for Payer: Hamaspik Choice Inc Medicare	$95.70

BLADE SAW INTRA ORAL 32TH/IN

Facility

$514.80

Hospital Charge Code	64904389
Hospital Revenue Code	270
Min. Negotiated Rate	$180.18
Max. Negotiated Rate	$411.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$283.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$257.40
Rate for Payer: Aetna Government	$257.40
Rate for Payer: Brighton Health Commercial	$386.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$411.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$350.06
Rate for Payer: Group Health Inc Commercial	$257.40
Rate for Payer: Group Health Inc Medicare	$180.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$257.40
Rate for Payer: Hamaspik Choice Inc Medicare	$257.40

BLADE SAW LARGE BONE

Facility

$60.00

Hospital Charge Code	64905358
Hospital Revenue Code	270
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Brighton Health Commercial	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00

BLADE SAW OSCILATING 15.0X9MM

Facility

$15.00

Hospital Charge Code	40201011
Hospital Revenue Code	270
Min. Negotiated Rate	$5.25
Max. Negotiated Rate	$12.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.50
Rate for Payer: Aetna Government	$7.50
Rate for Payer: Brighton Health Commercial	$11.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.20
Rate for Payer: Group Health Inc Commercial	$7.50
Rate for Payer: Group Health Inc Medicare	$5.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.50
Rate for Payer: Hamaspik Choice Inc Medicare	$7.50

BLADE SAW OSCILATING 15.0X9MM

Facility

$21.45

Hospital Charge Code	64904119
Hospital Revenue Code	270
Min. Negotiated Rate	$7.51
Max. Negotiated Rate	$17.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.72
Rate for Payer: Aetna Government	$10.72
Rate for Payer: Brighton Health Commercial	$16.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.59
Rate for Payer: Group Health Inc Commercial	$10.72
Rate for Payer: Group Health Inc Medicare	$7.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.72
Rate for Payer: Hamaspik Choice Inc Medicare	$10.72

BLADE SAW OSCILATING 29.5X7.0MM

Facility

$21.45

Hospital Charge Code	64904117
Hospital Revenue Code	270
Min. Negotiated Rate	$7.51
Max. Negotiated Rate	$17.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.72
Rate for Payer: Aetna Government	$10.72
Rate for Payer: Brighton Health Commercial	$16.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.59
Rate for Payer: Group Health Inc Commercial	$10.72
Rate for Payer: Group Health Inc Medicare	$7.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.72
Rate for Payer: Hamaspik Choice Inc Medicare	$10.72

BLADE SAW RECIP 27MMW .38

Facility

$226.03

Hospital Charge Code	64905894
Hospital Revenue Code	270
Min. Negotiated Rate	$79.11
Max. Negotiated Rate	$180.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$124.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$113.02
Rate for Payer: Aetna Government	$113.02
Rate for Payer: Brighton Health Commercial	$169.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$180.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.70
Rate for Payer: Group Health Inc Commercial	$113.02
Rate for Payer: Group Health Inc Medicare	$79.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$113.02
Rate for Payer: Hamaspik Choice Inc Medicare	$113.02

BLADE SAW RECIPRICATING

Facility

$29.00

Hospital Charge Code	64904420
Hospital Revenue Code	270
Min. Negotiated Rate	$10.15
Max. Negotiated Rate	$23.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.50
Rate for Payer: Aetna Government	$14.50
Rate for Payer: Brighton Health Commercial	$21.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.72
Rate for Payer: Group Health Inc Commercial	$14.50
Rate for Payer: Group Health Inc Medicare	$10.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.50
Rate for Payer: Hamaspik Choice Inc Medicare	$14.50

BLADE SAW RECIPROCATING

Facility

$25.85

Hospital Charge Code	64904227
Hospital Revenue Code	270
Min. Negotiated Rate	$9.05
Max. Negotiated Rate	$20.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.92
Rate for Payer: Aetna Government	$12.92
Rate for Payer: Brighton Health Commercial	$19.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.58
Rate for Payer: Group Health Inc Commercial	$12.92
Rate for Payer: Group Health Inc Medicare	$9.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.92
Rate for Payer: Hamaspik Choice Inc Medicare	$12.92

BLADE SAW RECIPROCATING

Facility

$22.00

Hospital Charge Code	40201013
Hospital Revenue Code	270
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$17.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.00
Rate for Payer: Aetna Government	$11.00
Rate for Payer: Brighton Health Commercial	$16.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.96
Rate for Payer: Group Health Inc Commercial	$11.00
Rate for Payer: Group Health Inc Medicare	$7.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11.00

BLADE SAW ROUND GIGLI 510MM

Facility

$51.30

Hospital Charge Code	64904192
Hospital Revenue Code	270
Min. Negotiated Rate	$17.96
Max. Negotiated Rate	$41.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.65
Rate for Payer: Aetna Government	$25.65
Rate for Payer: Brighton Health Commercial	$38.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.88
Rate for Payer: Group Health Inc Commercial	$25.65
Rate for Payer: Group Health Inc Medicare	$17.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.65
Rate for Payer: Hamaspik Choice Inc Medicare	$25.65

BLADE SHAVER 3-1/2MM F

Facility

$56.10

Hospital Charge Code	64905661
Hospital Revenue Code	270
Min. Negotiated Rate	$19.64
Max. Negotiated Rate	$44.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.05
Rate for Payer: Aetna Government	$28.05
Rate for Payer: Brighton Health Commercial	$42.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.15
Rate for Payer: Group Health Inc Commercial	$28.05
Rate for Payer: Group Health Inc Medicare	$19.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.05
Rate for Payer: Hamaspik Choice Inc Medicare	$28.05

BLADE SHAVER 5.0MM F SERIES

Facility

$100.38

Hospital Charge Code	64904966
Hospital Revenue Code	270
Min. Negotiated Rate	$35.13
Max. Negotiated Rate	$80.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.19
Rate for Payer: Aetna Government	$50.19
Rate for Payer: Brighton Health Commercial	$75.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.26
Rate for Payer: Group Health Inc Commercial	$50.19
Rate for Payer: Group Health Inc Medicare	$35.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.19
Rate for Payer: Hamaspik Choice Inc Medicare	$50.19

BLADE SHAVER ANG 4.0MM

Facility

$210.00

Hospital Charge Code	64904972
Hospital Revenue Code	270
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$115.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$105.00
Rate for Payer: Aetna Government	$105.00
Rate for Payer: Brighton Health Commercial	$157.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$168.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.80
Rate for Payer: Group Health Inc Commercial	$105.00
Rate for Payer: Group Health Inc Medicare	$73.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00

BLADE SHAVER RESCETOR 4.0MM

Facility

$100.00

Hospital Charge Code	64904970
Hospital Revenue Code	270
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$80.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.00
Rate for Payer: Aetna Government	$50.00
Rate for Payer: Brighton Health Commercial	$75.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.00
Rate for Payer: Group Health Inc Commercial	$50.00
Rate for Payer: Group Health Inc Medicare	$35.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.00
Rate for Payer: Hamaspik Choice Inc Medicare	$50.00

BLADE STAPLECUT(506298)

Facility

$1,051.20

Hospital Charge Code	64906714
Hospital Revenue Code	279
Min. Negotiated Rate	$367.92
Max. Negotiated Rate	$840.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$578.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$525.60
Rate for Payer: Aetna Government	$525.60
Rate for Payer: Brighton Health Commercial	$788.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$840.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$714.82
Rate for Payer: Group Health Inc Commercial	$525.60
Rate for Payer: Group Health Inc Medicare	$367.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$525.60
Rate for Payer: Hamaspik Choice Inc Medicare	$525.60

Know your out-of-pocket cost for care.

All Charges