St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZIMM SCREW 5.0 34MM

Facility

$348.00

Service Code	HCPCS C1713
Hospital Charge Code	40008326
Hospital Revenue Code	278
Min. Negotiated Rate	$121.80
Max. Negotiated Rate	$365.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$208.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.10
Rate for Payer: EmblemHealth Commercial	$174.00
Rate for Payer: Fidelis Medicare Advantage	$365.40
Rate for Payer: Group Health Inc Commercial	$174.00
Rate for Payer: Group Health Inc Medicare	$121.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.00
Rate for Payer: Hamaspik Choice Inc Medicare	$174.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.20

ZIMM SCREW 5.0 36MM

Facility

$348.00

Service Code	HCPCS C1713
Hospital Charge Code	40008325
Hospital Revenue Code	278
Min. Negotiated Rate	$121.80
Max. Negotiated Rate	$365.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$208.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.10
Rate for Payer: EmblemHealth Commercial	$174.00
Rate for Payer: Fidelis Medicare Advantage	$365.40
Rate for Payer: Group Health Inc Commercial	$174.00
Rate for Payer: Group Health Inc Medicare	$121.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.00
Rate for Payer: Hamaspik Choice Inc Medicare	$174.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.20

ZIMM SCREW 5.0 36MM

Facility

$348.00

Service Code	HCPCS C1713
Hospital Charge Code	40008325
Hospital Revenue Code	278
Min. Negotiated Rate	$174.00
Max. Negotiated Rate	$174.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.00
Rate for Payer: Hamaspik Choice Inc Medicare	$174.00

ZIMM SCREW 5.0 40MM

Facility

$348.00

Service Code	HCPCS C1713
Hospital Charge Code	40008327
Hospital Revenue Code	278
Min. Negotiated Rate	$174.00
Max. Negotiated Rate	$174.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.00
Rate for Payer: Hamaspik Choice Inc Medicare	$174.00

ZIMM SCREW 5.0 40MM

Facility

$348.00

Service Code	HCPCS C1713
Hospital Charge Code	40008327
Hospital Revenue Code	278
Min. Negotiated Rate	$121.80
Max. Negotiated Rate	$365.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$208.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.10
Rate for Payer: EmblemHealth Commercial	$174.00
Rate for Payer: Fidelis Medicare Advantage	$365.40
Rate for Payer: Group Health Inc Commercial	$174.00
Rate for Payer: Group Health Inc Medicare	$121.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.00
Rate for Payer: Hamaspik Choice Inc Medicare	$174.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.20

ZIMM SCREW 5.0 46MM

Facility

$348.00

Service Code	HCPCS C1713
Hospital Charge Code	40008328
Hospital Revenue Code	278
Min. Negotiated Rate	$174.00
Max. Negotiated Rate	$174.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.00
Rate for Payer: Hamaspik Choice Inc Medicare	$174.00

ZIMM SCREW 5.0 46MM

Facility

$348.00

Service Code	HCPCS C1713
Hospital Charge Code	40008328
Hospital Revenue Code	278
Min. Negotiated Rate	$121.80
Max. Negotiated Rate	$365.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$208.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.10
Rate for Payer: EmblemHealth Commercial	$174.00
Rate for Payer: Fidelis Medicare Advantage	$365.40
Rate for Payer: Group Health Inc Commercial	$174.00
Rate for Payer: Group Health Inc Medicare	$121.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.00
Rate for Payer: Hamaspik Choice Inc Medicare	$174.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.20

ZIMM SCREW 5.0 48MM

Facility

$348.00

Service Code	HCPCS C1713
Hospital Charge Code	40008329
Hospital Revenue Code	278
Min. Negotiated Rate	$174.00
Max. Negotiated Rate	$174.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.00
Rate for Payer: Hamaspik Choice Inc Medicare	$174.00

ZIMM SCREW 5.0 48MM

Facility

$348.00

Service Code	HCPCS C1713
Hospital Charge Code	40008329
Hospital Revenue Code	278
Min. Negotiated Rate	$121.80
Max. Negotiated Rate	$365.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$208.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.10
Rate for Payer: EmblemHealth Commercial	$174.00
Rate for Payer: Fidelis Medicare Advantage	$365.40
Rate for Payer: Group Health Inc Commercial	$174.00
Rate for Payer: Group Health Inc Medicare	$121.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.00
Rate for Payer: Hamaspik Choice Inc Medicare	$174.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.20

ZIMM STEM BLON STRAIG X

Facility

$2,425.54

Service Code	HCPCS C1776
Hospital Charge Code	40009297
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,546.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,334.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,455.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,212.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,394.69
Rate for Payer: EmblemHealth Commercial	$1,212.77
Rate for Payer: Fidelis Medicare Advantage	$2,546.82
Rate for Payer: Group Health Inc Commercial	$1,212.77
Rate for Payer: Group Health Inc Medicare	$848.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,212.77
Rate for Payer: Hamaspik Choice Inc Medicare	$1,212.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,576.60

ZIMM STEM BLON STRAIG X

Facility

$2,425.54

Service Code	HCPCS C1776
Hospital Charge Code	40009297
Hospital Revenue Code	278
Min. Negotiated Rate	$1,212.77
Max. Negotiated Rate	$1,212.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,212.77
Rate for Payer: Hamaspik Choice Inc Medicare	$1,212.77

ZIMM TIBIAL BLRIGHT LAR X 34

Facility

$9,366.52

Service Code	HCPCS C1776
Hospital Charge Code	40009298
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,834.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,151.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,619.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,683.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,385.75
Rate for Payer: EmblemHealth Commercial	$4,683.26
Rate for Payer: Fidelis Medicare Advantage	$9,834.85
Rate for Payer: Group Health Inc Commercial	$4,683.26
Rate for Payer: Group Health Inc Medicare	$3,278.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,683.26
Rate for Payer: Hamaspik Choice Inc Medicare	$4,683.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,088.24

ZIMM TIBIAL BLRIGHT LAR X 34

Facility

$9,366.52

Service Code	HCPCS C1776
Hospital Charge Code	40009298
Hospital Revenue Code	278
Min. Negotiated Rate	$4,683.26
Max. Negotiated Rate	$4,683.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,683.26
Rate for Payer: Hamaspik Choice Inc Medicare	$4,683.26

ZIMM TRABECULAR BLETAL REVE TA

Facility

$5,328.00

Service Code	HCPCS C1713
Hospital Charge Code	40009732
Hospital Revenue Code	278
Min. Negotiated Rate	$2,664.00
Max. Negotiated Rate	$2,664.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,664.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,664.00

ZIMM TRABECULAR BLETAL REVE TA

Facility

$5,328.00

Service Code	HCPCS C1713
Hospital Charge Code	40009732
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,594.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,930.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,196.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,664.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,063.60
Rate for Payer: EmblemHealth Commercial	$2,664.00
Rate for Payer: Fidelis Medicare Advantage	$5,594.40
Rate for Payer: Group Health Inc Commercial	$2,664.00
Rate for Payer: Group Health Inc Medicare	$1,864.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,664.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,664.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,463.20

ZIM NCB 14 HOLE PERI PLT

Facility

$1,409.04

Service Code	HCPCS C1713
Hospital Charge Code	40008330
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,479.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$774.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$845.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$704.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$810.20
Rate for Payer: EmblemHealth Commercial	$704.52
Rate for Payer: Fidelis Medicare Advantage	$1,479.49
Rate for Payer: Group Health Inc Commercial	$704.52
Rate for Payer: Group Health Inc Medicare	$493.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$704.52
Rate for Payer: Hamaspik Choice Inc Medicare	$704.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$915.88

ZIM NCB 14 HOLE PERI PLT

Facility

$1,409.04

Service Code	HCPCS C1713
Hospital Charge Code	40008330
Hospital Revenue Code	278
Min. Negotiated Rate	$704.52
Max. Negotiated Rate	$704.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$704.52
Rate for Payer: Hamaspik Choice Inc Medicare	$704.52

ZIM NEUT LINER 36MM SIZE JJ

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40009276
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 NEUT LINER 36MM SIZE JJ

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40009276
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 NEX COMP KNEE SZ C D 14MM

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40001782
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 NEX COMP KNEE SZ C D 14MM

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40001782
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 NEX COMPL KNEE 32MMX10MM

Facility

$3,171.20

Service Code	HCPCS C1776
Hospital Charge Code	40203390
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,329.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,744.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,902.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,585.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,823.44
Rate for Payer: EmblemHealth Commercial	$1,585.60
Rate for Payer: Fidelis Medicare Advantage	$3,329.76
Rate for Payer: Group Health Inc Commercial	$1,585.60
Rate for Payer: Group Health Inc Medicare	$1,109.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,585.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,585.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,061.28

ZIM NEX COMPL KNEE 32MMX10MM

Facility

$3,171.20

Service Code	HCPCS C1776
Hospital Charge Code	40203390
Hospital Revenue Code	278
Min. Negotiated Rate	$1,585.60
Max. Negotiated Rate	$1,585.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,585.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,585.60

ZIM ORTHO SAL LCK PIN

Facility

$660.00

Service Code	HCPCS C1776
Hospital Charge Code	40008334
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$330.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00

ZIM ORTHO SAL LCK PIN

Facility

$660.00

Service Code	HCPCS C1776
Hospital Charge Code	40008334
Hospital Revenue Code	278
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$693.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$363.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$396.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$330.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$379.50
Rate for Payer: EmblemHealth Commercial	$330.00
Rate for Payer: Fidelis Medicare Advantage	$693.00
Rate for Payer: Group Health Inc Commercial	$330.00
Rate for Payer: Group Health Inc Medicare	$231.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$429.00

Know your out-of-pocket cost for care.

All Charges