St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZIMMER 4.0 X 14MM SCREW

Facility

$890.00

Service Code	HCPCS C1713
Hospital Charge Code	40005205
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$934.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$489.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$534.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$445.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$511.75
Rate for Payer: EmblemHealth Commercial	$445.00
Rate for Payer: Fidelis Medicare Advantage	$934.50
Rate for Payer: Group Health Inc Commercial	$445.00
Rate for Payer: Group Health Inc Medicare	$311.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.00
Rate for Payer: Hamaspik Choice Inc Medicare	$445.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$578.50

ZIMMER 4.0 X 14MM SCREW

Facility

$890.00

Service Code	HCPCS C1713
Hospital Charge Code	40005205
Hospital Revenue Code	278
Min. Negotiated Rate	$445.00
Max. Negotiated Rate	$445.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.00
Rate for Payer: Hamaspik Choice Inc Medicare	$445.00

ZIMMER 6 FULL PLATE

Facility

$5,260.00

Service Code	HCPCS C1776
Hospital Charge Code	40005206
Hospital Revenue Code	278
Min. Negotiated Rate	$2,630.00
Max. Negotiated Rate	$2,630.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,630.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,630.00

ZIMMER 6 FULL PLATE

Facility

$5,260.00

Service Code	HCPCS C1776
Hospital Charge Code	40005206
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,523.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,893.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,156.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,630.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,024.50
Rate for Payer: EmblemHealth Commercial	$2,630.00
Rate for Payer: Fidelis Medicare Advantage	$5,523.00
Rate for Payer: Group Health Inc Commercial	$2,630.00
Rate for Payer: Group Health Inc Medicare	$1,841.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,630.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,630.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,419.00

ZIMMER ART SURGACE CR Y C-H 10MM

Facility

$3,538.00

Service Code	HCPCS C1776
Hospital Charge Code	40205159
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,714.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,945.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,122.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,769.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,034.35
Rate for Payer: EmblemHealth Commercial	$1,769.00
Rate for Payer: Fidelis Medicare Advantage	$3,714.90
Rate for Payer: Group Health Inc Commercial	$1,769.00
Rate for Payer: Group Health Inc Medicare	$1,238.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,299.70

ZIMMER ART SURGACE CR Y C-H 10MM

Facility

$3,538.00

Service Code	HCPCS C1776
Hospital Charge Code	40205159
Hospital Revenue Code	278
Min. Negotiated Rate	$1,769.00
Max. Negotiated Rate	$1,769.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.00

ZIMMER ART SURG CR GR C-H 12MM

Facility

$3,539.40

Service Code	HCPCS C1776
Hospital Charge Code	40209098
Hospital Revenue Code	278
Min. Negotiated Rate	$1,769.70
Max. Negotiated Rate	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.70

ZIMMER ART SURG CR GR C-H 12MM

Facility

$3,539.40

Service Code	HCPCS C1776
Hospital Charge Code	40209098
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,716.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,946.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,123.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,769.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,035.16
Rate for Payer: EmblemHealth Commercial	$1,769.70
Rate for Payer: Fidelis Medicare Advantage	$3,716.37
Rate for Payer: Group Health Inc Commercial	$1,769.70
Rate for Payer: Group Health Inc Medicare	$1,238.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,300.61

ZIMMER ART SURG CR Y C-H 12MM H

Facility

$3,539.40

Service Code	HCPCS C1776
Hospital Charge Code	40205316
Hospital Revenue Code	278
Min. Negotiated Rate	$1,769.70
Max. Negotiated Rate	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.70

ZIMMER ART SURG CR Y C-H 12MM H

Facility

$3,539.40

Service Code	HCPCS C1776
Hospital Charge Code	40205316
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,716.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,946.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,123.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,769.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,035.16
Rate for Payer: EmblemHealth Commercial	$1,769.70
Rate for Payer: Fidelis Medicare Advantage	$3,716.37
Rate for Payer: Group Health Inc Commercial	$1,769.70
Rate for Payer: Group Health Inc Medicare	$1,238.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,300.61

ZIMMER BIOMET STABLECUT

Facility

$525.60

Service Code	HCPCS C1776
Hospital Charge Code	40201558
Hospital Revenue Code	278
Min. Negotiated Rate	$262.80
Max. Negotiated Rate	$262.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$262.80
Rate for Payer: Hamaspik Choice Inc Medicare	$262.80

ZIMMER BIOMET STABLECUT

Facility

$525.60

Service Code	HCPCS C1776
Hospital Charge Code	40201558
Hospital Revenue Code	278
Min. Negotiated Rate	$183.96
Max. Negotiated Rate	$551.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$289.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$315.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$262.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$302.22
Rate for Payer: EmblemHealth Commercial	$262.80
Rate for Payer: Fidelis Medicare Advantage	$551.88
Rate for Payer: Group Health Inc Commercial	$262.80
Rate for Payer: Group Health Inc Medicare	$183.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$262.80
Rate for Payer: Hamaspik Choice Inc Medicare	$262.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$341.64

ZIMMER BLADE PAT SZ41 W/PILOT H

Facility

$326.40

Hospital Charge Code	40205401
Hospital Revenue Code	270
Min. Negotiated Rate	$114.24
Max. Negotiated Rate	$261.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$179.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$163.20
Rate for Payer: Aetna Government	$163.20
Rate for Payer: Brighton Health Commercial	$244.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$261.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$221.95
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

ZIMMER EX GEN COMP KNEE ART

Facility

$6,848.00

Service Code	HCPCS C1776
Hospital Charge Code	40004696
Hospital Revenue Code	278
Min. Negotiated Rate	$3,424.00
Max. Negotiated Rate	$3,424.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,424.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,424.00

ZIMMER EX GEN COMP KNEE ART

Facility

$6,848.00

Service Code	HCPCS C1776
Hospital Charge Code	40004696
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,190.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,766.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,108.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,424.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,937.60
Rate for Payer: EmblemHealth Commercial	$3,424.00
Rate for Payer: Fidelis Medicare Advantage	$7,190.40
Rate for Payer: Group Health Inc Commercial	$3,424.00
Rate for Payer: Group Health Inc Medicare	$2,396.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,424.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,424.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,451.20

ZIMMER FEM COMP POROUS SZF RGHT

Facility

$8,686.00

Service Code	HCPCS C1776
Hospital Charge Code	40208125
Hospital Revenue Code	278
Min. Negotiated Rate	$4,343.00
Max. Negotiated Rate	$4,343.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,343.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,343.00

ZIMMER FEM COMP POROUS SZF RGHT

Facility

$8,686.00

Service Code	HCPCS C1776
Hospital Charge Code	40208125
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,120.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,777.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,211.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,343.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,994.45
Rate for Payer: EmblemHealth Commercial	$4,343.00
Rate for Payer: Fidelis Medicare Advantage	$9,120.30
Rate for Payer: Group Health Inc Commercial	$4,343.00
Rate for Payer: Group Health Inc Medicare	$3,040.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,343.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,343.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,645.90

ZIMMER FEMORAL COMP CEMENTED

Facility

$7,232.09

Service Code	HCPCS C1776
Hospital Charge Code	40024012
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,593.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,977.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,339.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,616.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,158.45
Rate for Payer: EmblemHealth Commercial	$3,616.04
Rate for Payer: Fidelis Medicare Advantage	$7,593.69
Rate for Payer: Group Health Inc Commercial	$3,616.04
Rate for Payer: Group Health Inc Medicare	$2,531.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,616.04
Rate for Payer: Hamaspik Choice Inc Medicare	$3,616.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,700.86

ZIMMER FEMORAL COMP CEMENTED

Facility

$7,232.09

Service Code	HCPCS C1776
Hospital Charge Code	40024012
Hospital Revenue Code	278
Min. Negotiated Rate	$3,616.04
Max. Negotiated Rate	$3,616.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,616.04
Rate for Payer: Hamaspik Choice Inc Medicare	$3,616.04

ZIMMER FEMORAL COMP NON CEMENTED

Facility

$9,208.08

Service Code	HCPCS C1776
Hospital Charge Code	40024013
Hospital Revenue Code	278
Min. Negotiated Rate	$4,604.04
Max. Negotiated Rate	$4,604.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,604.04
Rate for Payer: Hamaspik Choice Inc Medicare	$4,604.04

ZIMMER FEMORAL COMP NON CEMENTED

Facility

$9,208.08

Service Code	HCPCS C1776
Hospital Charge Code	40024013
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,668.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,064.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,524.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,604.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,294.65
Rate for Payer: EmblemHealth Commercial	$4,604.04
Rate for Payer: Fidelis Medicare Advantage	$9,668.48
Rate for Payer: Group Health Inc Commercial	$4,604.04
Rate for Payer: Group Health Inc Medicare	$3,222.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,604.04
Rate for Payer: Hamaspik Choice Inc Medicare	$4,604.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,985.25

ZIMMER FEMORAL COMPONENT SZC LEFT

Facility

$6,907.10

Service Code	HCPCS C1776
Hospital Charge Code	40209109
Hospital Revenue Code	278
Min. Negotiated Rate	$3,453.55
Max. Negotiated Rate	$3,453.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,453.55
Rate for Payer: Hamaspik Choice Inc Medicare	$3,453.55

ZIMMER FEMORAL COMPONENT SZC LEFT

Facility

$6,907.10

Service Code	HCPCS C1776
Hospital Charge Code	40209109
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,252.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,798.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,144.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,453.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,971.58
Rate for Payer: EmblemHealth Commercial	$3,453.55
Rate for Payer: Fidelis Medicare Advantage	$7,252.46
Rate for Payer: Group Health Inc Commercial	$3,453.55
Rate for Payer: Group Health Inc Medicare	$2,417.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,453.55
Rate for Payer: Hamaspik Choice Inc Medicare	$3,453.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,489.62

ZIMMER FEMORAL COMP/POROUS SZ G L

Facility

$8,374.70

Service Code	HCPCS C1776
Hospital Charge Code	40205822
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,793.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,606.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,024.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,187.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,815.45
Rate for Payer: EmblemHealth Commercial	$4,187.35
Rate for Payer: Fidelis Medicare Advantage	$8,793.44
Rate for Payer: Group Health Inc Commercial	$4,187.35
Rate for Payer: Group Health Inc Medicare	$2,931.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,187.35
Rate for Payer: Hamaspik Choice Inc Medicare	$4,187.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,443.56

ZIMMER FEMORAL COMP/POROUS SZ G L

Facility

$8,374.70

Service Code	HCPCS C1776
Hospital Charge Code	40205822
Hospital Revenue Code	278
Min. Negotiated Rate	$4,187.35
Max. Negotiated Rate	$4,187.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,187.35
Rate for Payer: Hamaspik Choice Inc Medicare	$4,187.35

Know your out-of-pocket cost for care.

All Charges