St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZIM ACET NEUT LINER 36MM SZ KK

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40204250
Hospital Revenue Code	278
Min. Negotiated Rate	$1,700.00
Max. Negotiated Rate	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00

ZIM ACET NEUT LINER 46MM SZ LL

Facility

$3,800.00

Service Code	HCPCS C1776
Hospital Charge Code	40009278
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,990.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,090.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,280.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,185.00
Rate for Payer: EmblemHealth Commercial	$1,900.00
Rate for Payer: Fidelis Medicare Advantage	$3,990.00
Rate for Payer: Group Health Inc Commercial	$1,900.00
Rate for Payer: Group Health Inc Medicare	$1,330.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,470.00

ZIM ACET NEUT LINER 46MM SZ LL

Facility

$3,800.00

Service Code	HCPCS C1776
Hospital Charge Code	40009278
Hospital Revenue Code	278
Min. Negotiated Rate	$1,900.00
Max. Negotiated Rate	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,900.00

ZIM AC LINER 36MM SIZE II

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40008322
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,570.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,870.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,040.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,955.00
Rate for Payer: EmblemHealth Commercial	$1,700.00
Rate for Payer: Fidelis Medicare Advantage	$3,570.00
Rate for Payer: Group Health Inc Commercial	$1,700.00
Rate for Payer: Group Health Inc Medicare	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,210.00

ZIM AC LINER 36MM SIZE II

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40008322
Hospital Revenue Code	278
Min. Negotiated Rate	$1,700.00
Max. Negotiated Rate	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00

ZIM AVEN MUL STEM STD UNCEM 6 TAP

Facility

$466.00

Service Code	HCPCS C1776
Hospital Charge Code	40005240
Hospital Revenue Code	278
Min. Negotiated Rate	$163.10
Max. Negotiated Rate	$489.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$256.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$279.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$233.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$267.95
Rate for Payer: EmblemHealth Commercial	$233.00
Rate for Payer: Fidelis Medicare Advantage	$489.30
Rate for Payer: Group Health Inc Commercial	$233.00
Rate for Payer: Group Health Inc Medicare	$163.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.00
Rate for Payer: Hamaspik Choice Inc Medicare	$233.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$302.90

ZIM AVEN MUL STEM STD UNCEM 6 TAP

Facility

$466.00

Service Code	HCPCS C1776
Hospital Charge Code	40005240
Hospital Revenue Code	278
Min. Negotiated Rate	$233.00
Max. Negotiated Rate	$233.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.00
Rate for Payer: Hamaspik Choice Inc Medicare	$233.00

ZIMB FEM HEAD 36/+3.5 TAPER 12/14

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40204434
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

ZIMB FEM HEAD 36/+3.5 TAPER 12/14

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40204434
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,725.00
Rate for Payer: EmblemHealth Commercial	$1,500.00
Rate for Payer: Fidelis Medicare Advantage	$3,150.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,950.00

ZIM BIOLOX FEM HEAD 36/+3.5 TAP

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40009274
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

ZIM BIOLOX FEM HEAD 36/+3.5 TAP

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40009274
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,725.00
Rate for Payer: EmblemHealth Commercial	$1,500.00
Rate for Payer: Fidelis Medicare Advantage	$3,150.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,950.00

ZIM BIO OX PTL KNEE TWIG PEG FEMO

Facility

$3,324.00

Service Code	HCPCS C1776
Hospital Charge Code	40202638
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,490.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,828.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,994.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,662.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,911.30
Rate for Payer: EmblemHealth Commercial	$1,662.00
Rate for Payer: Fidelis Medicare Advantage	$3,490.20
Rate for Payer: Group Health Inc Commercial	$1,662.00
Rate for Payer: Group Health Inc Medicare	$1,163.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,662.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,662.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,160.60

ZIM BIO OX PTL KNEE TWIG PEG FEMO

Facility

$3,324.00

Service Code	HCPCS C1776
Hospital Charge Code	40202638
Hospital Revenue Code	278
Min. Negotiated Rate	$1,662.00
Max. Negotiated Rate	$1,662.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,662.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,662.00

ZIM BIO PTL KNE ANATC MENSL MEDL

Facility

$1,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40202636
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,260.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$660.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$720.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$690.00
Rate for Payer: EmblemHealth Commercial	$600.00
Rate for Payer: Fidelis Medicare Advantage	$1,260.00
Rate for Payer: Group Health Inc Commercial	$600.00
Rate for Payer: Group Health Inc Medicare	$420.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$780.00

ZIM BIO PTL KNE ANATC MENSL MEDL

Facility

$1,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40202636
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$600.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00

ZIM BIPOLA CUP LINER 28 MM I

Facility

$980.00

Service Code	HCPCS C1776
Hospital Charge Code	40004601
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,029.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$539.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$588.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$490.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$563.50
Rate for Payer: EmblemHealth Commercial	$490.00
Rate for Payer: Fidelis Medicare Advantage	$1,029.00
Rate for Payer: Group Health Inc Commercial	$490.00
Rate for Payer: Group Health Inc Medicare	$343.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$490.00
Rate for Payer: Hamaspik Choice Inc Medicare	$490.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$637.00

ZIM BIPOLA CUP LINER 28 MM I

Facility

$980.00

Service Code	HCPCS C1776
Hospital Charge Code	40004601
Hospital Revenue Code	278
Min. Negotiated Rate	$490.00
Max. Negotiated Rate	$490.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$490.00
Rate for Payer: Hamaspik Choice Inc Medicare	$490.00

ZIM BIPOLA CUP SHELL 48 MM O.D.

Facility

$1,638.00

Service Code	HCPCS C1776
Hospital Charge Code	40004602
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,719.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$900.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$982.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$819.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$941.85
Rate for Payer: EmblemHealth Commercial	$819.00
Rate for Payer: Fidelis Medicare Advantage	$1,719.90
Rate for Payer: Group Health Inc Commercial	$819.00
Rate for Payer: Group Health Inc Medicare	$573.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$819.00
Rate for Payer: Hamaspik Choice Inc Medicare	$819.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,064.70

ZIM BIPOLA CUP SHELL 48 MM O.D.

Facility

$1,638.00

Service Code	HCPCS C1776
Hospital Charge Code	40004602
Hospital Revenue Code	278
Min. Negotiated Rate	$819.00
Max. Negotiated Rate	$819.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$819.00
Rate for Payer: Hamaspik Choice Inc Medicare	$819.00

ZIM BN SCR 6.5MMX30MM

Facility

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40003452
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00

ZIM BN SCR 6.5MMX30MM

Facility

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40003452
Hospital Revenue Code	278
Min. Negotiated Rate	$96.60
Max. Negotiated Rate	$289.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$165.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$138.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.70
Rate for Payer: EmblemHealth Commercial	$138.00
Rate for Payer: Fidelis Medicare Advantage	$289.80
Rate for Payer: Group Health Inc Commercial	$138.00
Rate for Payer: Group Health Inc Medicare	$96.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$179.40

ZIM BN SCREW 6.5MMX40MM

Facility

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40003450
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00

ZIM BN SCREW 6.5MMX40MM

Facility

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40003450
Hospital Revenue Code	278
Min. Negotiated Rate	$96.60
Max. Negotiated Rate	$289.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$165.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$138.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.70
Rate for Payer: EmblemHealth Commercial	$138.00
Rate for Payer: Fidelis Medicare Advantage	$289.80
Rate for Payer: Group Health Inc Commercial	$138.00
Rate for Payer: Group Health Inc Medicare	$96.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$179.40

ZIM BONE SCR 6.5 DIA 35 MM LT

Facility

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40204223
Hospital Revenue Code	278
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00

ZIM BONE SCR 6.5 DIA 35 MM LT

Facility

$276.00

Service Code	HCPCS C1713
Hospital Charge Code	40204223
Hospital Revenue Code	278
Min. Negotiated Rate	$96.60
Max. Negotiated Rate	$289.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$165.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$138.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.70
Rate for Payer: EmblemHealth Commercial	$138.00
Rate for Payer: Fidelis Medicare Advantage	$289.80
Rate for Payer: Group Health Inc Commercial	$138.00
Rate for Payer: Group Health Inc Medicare	$96.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.00
Rate for Payer: Hamaspik Choice Inc Medicare	$138.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$179.40

Know your out-of-pocket cost for care.

All Charges