St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZIM CABLE BUTTON PLT 2.5MM

Facility

$448.00

Service Code	HCPCS C1713
Hospital Charge Code	40008324
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$470.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$246.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$268.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$224.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$257.60
Rate for Payer: EmblemHealth Commercial	$224.00
Rate for Payer: Fidelis Medicare Advantage	$470.40
Rate for Payer: Group Health Inc Commercial	$224.00
Rate for Payer: Group Health Inc Medicare	$156.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$224.00
Rate for Payer: Hamaspik Choice Inc Medicare	$224.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$291.20

ZIM CABLE BUTTON PLT 2.5MM

Facility

$448.00

Service Code	HCPCS C1713
Hospital Charge Code	40008324
Hospital Revenue Code	278
Min. Negotiated Rate	$224.00
Max. Negotiated Rate	$224.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$224.00
Rate for Payer: Hamaspik Choice Inc Medicare	$224.00

ZIM CABLE GRIP SYS 1.8MM 36 IN

Facility

$1,152.00

Service Code	HCPCS C1776
Hospital Charge Code	40008298
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,209.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$633.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$691.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$576.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$662.40
Rate for Payer: EmblemHealth Commercial	$576.00
Rate for Payer: Fidelis Medicare Advantage	$1,209.60
Rate for Payer: Group Health Inc Commercial	$576.00
Rate for Payer: Group Health Inc Medicare	$403.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$576.00
Rate for Payer: Hamaspik Choice Inc Medicare	$576.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$748.80

ZIM CABLE GRIP SYS 1.8MM 36 IN

Facility

$1,152.00

Service Code	HCPCS C1776
Hospital Charge Code	40008298
Hospital Revenue Code	278
Min. Negotiated Rate	$576.00
Max. Negotiated Rate	$576.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$576.00
Rate for Payer: Hamaspik Choice Inc Medicare	$576.00

ZIM CABLE GRIP SYS 1.8MM 36IN

Facility

$1,152.00

Service Code	HCPCS C1776
Hospital Charge Code	40008300
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,209.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$633.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$691.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$576.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$662.40
Rate for Payer: EmblemHealth Commercial	$576.00
Rate for Payer: Fidelis Medicare Advantage	$1,209.60
Rate for Payer: Group Health Inc Commercial	$576.00
Rate for Payer: Group Health Inc Medicare	$403.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$576.00
Rate for Payer: Hamaspik Choice Inc Medicare	$576.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$748.80

ZIM CABLE GRIP SYS 1.8MM 36IN

Facility

$1,152.00

Service Code	HCPCS C1776
Hospital Charge Code	40008300
Hospital Revenue Code	278
Min. Negotiated Rate	$576.00
Max. Negotiated Rate	$576.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$576.00
Rate for Payer: Hamaspik Choice Inc Medicare	$576.00

ZIM CENTER SLEVE 24M

Facility

$1,110.00

Service Code	HCPCS C1776
Hospital Charge Code	40008342
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,165.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$610.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$666.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$555.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$638.25
Rate for Payer: EmblemHealth Commercial	$555.00
Rate for Payer: Fidelis Medicare Advantage	$1,165.50
Rate for Payer: Group Health Inc Commercial	$555.00
Rate for Payer: Group Health Inc Medicare	$388.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$555.00
Rate for Payer: Hamaspik Choice Inc Medicare	$555.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$721.50

ZIM CENTER SLEVE 24M

Facility

$1,110.00

Service Code	HCPCS C1776
Hospital Charge Code	40008342
Hospital Revenue Code	278
Min. Negotiated Rate	$555.00
Max. Negotiated Rate	$555.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$555.00
Rate for Payer: Hamaspik Choice Inc Medicare	$555.00

ZIM COMPL KNEE SZ 3 FEM C-H 10MM

Facility

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	40005200
Hospital Revenue Code	278
Min. Negotiated Rate	$3,884.00
Max. Negotiated Rate	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00

ZIM COMPL KNEE SZ 3 FEM C-H 10MM

Facility

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	40005200
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,156.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,272.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,660.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,884.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,466.60
Rate for Payer: EmblemHealth Commercial	$3,884.00
Rate for Payer: Fidelis Medicare Advantage	$8,156.40
Rate for Payer: Group Health Inc Commercial	$3,884.00
Rate for Payer: Group Health Inc Medicare	$2,718.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,049.20

ZIM COMPRES DEV DIS FEMUR

Facility

$22,035.00

Service Code	HCPCS C1776
Hospital Charge Code	40008336
Hospital Revenue Code	278
Min. Negotiated Rate	$11,017.50
Max. Negotiated Rate	$11,017.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,017.50
Rate for Payer: Hamaspik Choice Inc Medicare	$11,017.50

ZIM COMPRES DEV DIS FEMUR

Facility

$22,035.00

Service Code	HCPCS C1776
Hospital Charge Code	40008336
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$23,136.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12,119.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$13,221.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11,017.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$12,670.12
Rate for Payer: EmblemHealth Commercial	$11,017.50
Rate for Payer: Fidelis Medicare Advantage	$23,136.75
Rate for Payer: Group Health Inc Commercial	$11,017.50
Rate for Payer: Group Health Inc Medicare	$7,712.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,017.50
Rate for Payer: Hamaspik Choice Inc Medicare	$11,017.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14,322.75

ZIM FEMUR CEME POST STAB RT SZ 4

Facility

$6,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40204553
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,510.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,410.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,720.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,565.00
Rate for Payer: EmblemHealth Commercial	$3,100.00
Rate for Payer: Fidelis Medicare Advantage	$6,510.00
Rate for Payer: Group Health Inc Commercial	$3,100.00
Rate for Payer: Group Health Inc Medicare	$2,170.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,030.00

ZIM FEMUR CEME POST STAB RT SZ 4

Facility

$6,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40204553
Hospital Revenue Code	278
Min. Negotiated Rate	$3,100.00
Max. Negotiated Rate	$3,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,100.00

ZIM HIP FEM HEAD 12/14 3.5MMX36MM

Facility

$1,908.00

Service Code	HCPCS C1776
Hospital Charge Code	40003453
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,003.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,049.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,144.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$954.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,097.10
Rate for Payer: EmblemHealth Commercial	$954.00
Rate for Payer: Fidelis Medicare Advantage	$2,003.40
Rate for Payer: Group Health Inc Commercial	$954.00
Rate for Payer: Group Health Inc Medicare	$667.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.00
Rate for Payer: Hamaspik Choice Inc Medicare	$954.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,240.20

ZIM HIP FEM HEAD 12/14 3.5MMX36MM

Facility

$1,908.00

Service Code	HCPCS C1776
Hospital Charge Code	40003453
Hospital Revenue Code	278
Min. Negotiated Rate	$954.00
Max. Negotiated Rate	$954.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.00
Rate for Payer: Hamaspik Choice Inc Medicare	$954.00

ZIM HIP FEM HEAD 12/14-40MM DI

Facility

$1,908.00

Service Code	HCPCS C1776
Hospital Charge Code	40008299
Hospital Revenue Code	278
Min. Negotiated Rate	$954.00
Max. Negotiated Rate	$954.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.00
Rate for Payer: Hamaspik Choice Inc Medicare	$954.00

ZIM HIP FEM HEAD 12/14-40MM DI

Facility

$1,908.00

Service Code	HCPCS C1776
Hospital Charge Code	40008299
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,003.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,049.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,144.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$954.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,097.10
Rate for Payer: EmblemHealth Commercial	$954.00
Rate for Payer: Fidelis Medicare Advantage	$2,003.40
Rate for Payer: Group Health Inc Commercial	$954.00
Rate for Payer: Group Health Inc Medicare	$667.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.00
Rate for Payer: Hamaspik Choice Inc Medicare	$954.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,240.20

ZIM HIP SYS FM HD 12/14-10.5X36NK

Facility

$2,544.00

Service Code	HCPCS C1776
Hospital Charge Code	40204222
Hospital Revenue Code	278
Min. Negotiated Rate	$1,272.00
Max. Negotiated Rate	$1,272.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,272.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,272.00

ZIM HIP SYS FM HD 12/14-10.5X36NK

Facility

$2,544.00

Service Code	HCPCS C1776
Hospital Charge Code	40204222
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,671.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,399.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,526.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,272.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,462.80
Rate for Payer: EmblemHealth Commercial	$1,272.00
Rate for Payer: Fidelis Medicare Advantage	$2,671.20
Rate for Payer: Group Health Inc Commercial	$1,272.00
Rate for Payer: Group Health Inc Medicare	$890.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,272.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,272.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,653.60

ZIM KNEE-12MM EF/PS FEMUR 69

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40008297
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 KNEE-12MM EF/PS FEMUR 69

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40008297
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 KNEE ART SUR LT 14MM HT

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40009283
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 KNEE ART SUR LT 14MM HT

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40009283
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 KNEE FEM TRAB POST LT SZ 6

Facility

$8,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40009282
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,610.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,510.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,920.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,715.00
Rate for Payer: EmblemHealth Commercial	$4,100.00
Rate for Payer: Fidelis Medicare Advantage	$8,610.00
Rate for Payer: Group Health Inc Commercial	$4,100.00
Rate for Payer: Group Health Inc Medicare	$2,870.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,330.00

Know your out-of-pocket cost for care.

All Charges