St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BODY FLUID CELL COUNT

Facility

$11.80

Service Code	HCPCS 89050
Hospital Charge Code	40621595
Hospital Revenue Code	300
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$8.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.72
Rate for Payer: Aetna Government	$4.72
Rate for Payer: Affinity Essential Plan 1&2	$3.30
Rate for Payer: Affinity Essential Plan 3&4	$3.30
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.30
Rate for Payer: Brighton Health Commercial	$8.85
Rate for Payer: Cash Price	$4.72
Rate for Payer: Cash Price	$4.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.35
Rate for Payer: Elderplan Medicare Advantage	$4.72
Rate for Payer: EmblemHealth Commercial	$4.72
Rate for Payer: Fidelis Essential Plan Aliesa	$4.01
Rate for Payer: Fidelis Essential Plan QHP	$4.20
Rate for Payer: Fidelis Medicare Advantage	$4.72
Rate for Payer: Fidelis Qualified Health Plan	$4.20
Rate for Payer: Group Health Inc Commercial	$4.72
Rate for Payer: Group Health Inc Medicare	$4.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.90
Rate for Payer: Hamaspik Choice Inc Medicare	$4.72
Rate for Payer: Healthfirst Medicare Advantage	$4.72
Rate for Payer: Healthfirst QHP	$4.72
Rate for Payer: Humana Medicare	$4.81
Rate for Payer: Senior Whole Health Medicare Advantage	$4.72
Rate for Payer: United Healthcare Commercial	$5.98
Rate for Payer: United Healthcare Medicare Advantage	$4.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.78
Rate for Payer: Wellcare Medicare	$4.25

BODY FLUID CELL COUNT-CSF

Facility

$11.80

Service Code	HCPCS 89050
Hospital Charge Code	40621596
Hospital Revenue Code	300
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$8.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.72
Rate for Payer: Aetna Government	$4.72
Rate for Payer: Affinity Essential Plan 1&2	$3.30
Rate for Payer: Affinity Essential Plan 3&4	$3.30
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.30
Rate for Payer: Brighton Health Commercial	$8.85
Rate for Payer: Cash Price	$4.72
Rate for Payer: Cash Price	$4.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.35
Rate for Payer: Elderplan Medicare Advantage	$4.72
Rate for Payer: EmblemHealth Commercial	$4.72
Rate for Payer: Fidelis Essential Plan Aliesa	$4.01
Rate for Payer: Fidelis Essential Plan QHP	$4.20
Rate for Payer: Fidelis Medicare Advantage	$4.72
Rate for Payer: Fidelis Qualified Health Plan	$4.20
Rate for Payer: Group Health Inc Commercial	$4.72
Rate for Payer: Group Health Inc Medicare	$4.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.90
Rate for Payer: Hamaspik Choice Inc Medicare	$4.72
Rate for Payer: Healthfirst Medicare Advantage	$4.72
Rate for Payer: Healthfirst QHP	$4.72
Rate for Payer: Humana Medicare	$4.81
Rate for Payer: Senior Whole Health Medicare Advantage	$4.72
Rate for Payer: United Healthcare Commercial	$5.98
Rate for Payer: United Healthcare Medicare Advantage	$4.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.78
Rate for Payer: Wellcare Medicare	$4.25

BODY FLUID CELL COUNT-CSF

Facility

$11.80

Service Code	HCPCS 89050
Hospital Charge Code	40621596
Hospital Revenue Code	300
Rate for Payer: Cash Price	$4.72

BOLT CONNECTION 16MM S&N

Facility

$16.75

Hospital Charge Code	64904184
Hospital Revenue Code	270
Min. Negotiated Rate	$5.86
Max. Negotiated Rate	$13.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.38
Rate for Payer: Aetna Government	$8.38
Rate for Payer: Brighton Health Commercial	$12.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.39
Rate for Payer: Group Health Inc Commercial	$8.38
Rate for Payer: Group Health Inc Medicare	$5.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.38
Rate for Payer: Hamaspik Choice Inc Medicare	$8.38

BOLT EXTERNAL FIX 1.5MM-2MM1

Facility

$287.50

Hospital Charge Code	64905267
Hospital Revenue Code	270
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$230.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$158.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$143.75
Rate for Payer: Aetna Government	$143.75
Rate for Payer: Brighton Health Commercial	$215.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: Group Health Inc Commercial	$143.75
Rate for Payer: Group Health Inc Medicare	$100.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.75
Rate for Payer: Hamaspik Choice Inc Medicare	$143.75

BOLT EXTERNAL FIX 1.5MM-2MM2

Facility

$287.50

Hospital Charge Code	64905269
Hospital Revenue Code	270
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$230.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$158.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$143.75
Rate for Payer: Aetna Government	$143.75
Rate for Payer: Brighton Health Commercial	$215.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: Group Health Inc Commercial	$143.75
Rate for Payer: Group Health Inc Medicare	$100.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.75
Rate for Payer: Hamaspik Choice Inc Medicare	$143.75

BOLT EXTERNAL FIX 1.5MM-2MM3

Facility

$287.50

Hospital Charge Code	64905757
Hospital Revenue Code	270
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$230.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$158.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$143.75
Rate for Payer: Aetna Government	$143.75
Rate for Payer: Brighton Health Commercial	$215.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: Group Health Inc Commercial	$143.75
Rate for Payer: Group Health Inc Medicare	$100.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.75
Rate for Payer: Hamaspik Choice Inc Medicare	$143.75

BOLT EXTERNAL FIX 1.5MM-2MM4

Facility

$875.00

Hospital Charge Code	64905761
Hospital Revenue Code	270
Min. Negotiated Rate	$306.25
Max. Negotiated Rate	$700.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$481.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$437.50
Rate for Payer: Aetna Government	$437.50
Rate for Payer: Brighton Health Commercial	$656.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$595.00
Rate for Payer: Group Health Inc Commercial	$437.50
Rate for Payer: Group Health Inc Medicare	$306.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.50
Rate for Payer: Hamaspik Choice Inc Medicare	$437.50

BOLT EXTERNAL FIX 30MML THRE

Facility

$600.00

Hospital Charge Code	64905273
Hospital Revenue Code	270
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$480.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$330.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$300.00
Rate for Payer: Aetna Government	$300.00
Rate for Payer: Brighton Health Commercial	$450.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$480.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$408.00
Rate for Payer: Group Health Inc Commercial	$300.00
Rate for Payer: Group Health Inc Medicare	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00

BOLT EXTERNAL FIX 6MM DIA 40

Facility

$60.00

Hospital Charge Code	64905265
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

BOLT EXTERNAL FIX LONG F/3MM

Facility

$1,150.00

Hospital Charge Code	64905759
Hospital Revenue Code	270
Min. Negotiated Rate	$402.50
Max. Negotiated Rate	$920.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$632.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$575.00
Rate for Payer: Aetna Government	$575.00
Rate for Payer: Brighton Health Commercial	$862.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$920.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$782.00
Rate for Payer: Group Health Inc Commercial	$575.00
Rate for Payer: Group Health Inc Medicare	$402.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$575.00
Rate for Payer: Hamaspik Choice Inc Medicare	$575.00

BOLT, HINGE MD

Facility

$162.65

Service Code	HCPCS C1713
Hospital Charge Code	64907408
Hospital Revenue Code	278
Min. Negotiated Rate	$81.32
Max. Negotiated Rate	$81.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.32
Rate for Payer: Hamaspik Choice Inc Medicare	$81.32

BOLT, HINGE MD

Facility

$162.65

Service Code	HCPCS C1713
Hospital Charge Code	64907408
Hospital Revenue Code	278
Min. Negotiated Rate	$56.93
Max. Negotiated Rate	$170.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$97.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.52
Rate for Payer: EmblemHealth Commercial	$81.32
Rate for Payer: Fidelis Medicare Advantage	$170.78
Rate for Payer: Group Health Inc Commercial	$81.32
Rate for Payer: Group Health Inc Medicare	$56.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.32
Rate for Payer: Hamaspik Choice Inc Medicare	$81.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.72

BOLT LOCK 4.9X32MM FEM/TIB NAIL

Facility

$324.00

Service Code	HCPCS C1713
Hospital Charge Code	40200118
Hospital Revenue Code	278
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$340.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$178.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$194.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$162.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$186.30
Rate for Payer: EmblemHealth Commercial	$162.00
Rate for Payer: Fidelis Medicare Advantage	$340.20
Rate for Payer: Group Health Inc Commercial	$162.00
Rate for Payer: Group Health Inc Medicare	$113.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$162.00
Rate for Payer: Hamaspik Choice Inc Medicare	$162.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$210.60

BOLT LOCK 4.9X32MM FEM/TIB NAIL

Facility

$324.00

Service Code	HCPCS C1713
Hospital Charge Code	40200118
Hospital Revenue Code	278
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$162.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$162.00
Rate for Payer: Hamaspik Choice Inc Medicare	$162.00

BOLT LOCKING 50MM

Facility

$296.00

Service Code	HCPCS C1713
Hospital Charge Code	40200119
Hospital Revenue Code	278
Min. Negotiated Rate	$148.00
Max. Negotiated Rate	$148.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$148.00
Rate for Payer: Hamaspik Choice Inc Medicare	$148.00

BOLT LOCKING 50MM

Facility

$296.00

Service Code	HCPCS C1713
Hospital Charge Code	40200119
Hospital Revenue Code	278
Min. Negotiated Rate	$103.60
Max. Negotiated Rate	$310.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$162.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$177.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$148.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$170.20
Rate for Payer: EmblemHealth Commercial	$148.00
Rate for Payer: Fidelis Medicare Advantage	$310.80
Rate for Payer: Group Health Inc Commercial	$148.00
Rate for Payer: Group Health Inc Medicare	$103.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$148.00
Rate for Payer: Hamaspik Choice Inc Medicare	$148.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$192.40

BOLT LOCKING 54MM

Facility

$274.00

Service Code	HCPCS C1713
Hospital Charge Code	40200120
Hospital Revenue Code	278
Min. Negotiated Rate	$137.00
Max. Negotiated Rate	$137.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.00
Rate for Payer: Hamaspik Choice Inc Medicare	$137.00

BOLT LOCKING 54MM

Facility

$274.00

Service Code	HCPCS C1713
Hospital Charge Code	40200120
Hospital Revenue Code	278
Min. Negotiated Rate	$95.90
Max. Negotiated Rate	$287.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$150.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$164.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$137.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$157.55
Rate for Payer: EmblemHealth Commercial	$137.00
Rate for Payer: Fidelis Medicare Advantage	$287.70
Rate for Payer: Group Health Inc Commercial	$137.00
Rate for Payer: Group Health Inc Medicare	$95.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.00
Rate for Payer: Hamaspik Choice Inc Medicare	$137.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$178.10

BOLT LOCKING 58MM

Facility

$324.00

Service Code	HCPCS C1713
Hospital Charge Code	40200121
Hospital Revenue Code	278
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$162.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$162.00
Rate for Payer: Hamaspik Choice Inc Medicare	$162.00

BOLT LOCKING 58MM

Facility

$324.00

Service Code	HCPCS C1713
Hospital Charge Code	40200121
Hospital Revenue Code	278
Min. Negotiated Rate	$113.40
Max. Negotiated Rate	$340.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$178.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$194.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$162.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$186.30
Rate for Payer: EmblemHealth Commercial	$162.00
Rate for Payer: Fidelis Medicare Advantage	$340.20
Rate for Payer: Group Health Inc Commercial	$162.00
Rate for Payer: Group Health Inc Medicare	$113.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$162.00
Rate for Payer: Hamaspik Choice Inc Medicare	$162.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$210.60

BOLT LOCKING 60MM

Facility

$296.00

Service Code	HCPCS C1713
Hospital Charge Code	40200122
Hospital Revenue Code	278
Min. Negotiated Rate	$148.00
Max. Negotiated Rate	$148.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$148.00
Rate for Payer: Hamaspik Choice Inc Medicare	$148.00

BOLT LOCKING 60MM

Facility

$296.00

Service Code	HCPCS C1713
Hospital Charge Code	40200122
Hospital Revenue Code	278
Min. Negotiated Rate	$103.60
Max. Negotiated Rate	$310.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$162.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$177.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$148.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$170.20
Rate for Payer: EmblemHealth Commercial	$148.00
Rate for Payer: Fidelis Medicare Advantage	$310.80
Rate for Payer: Group Health Inc Commercial	$148.00
Rate for Payer: Group Health Inc Medicare	$103.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$148.00
Rate for Payer: Hamaspik Choice Inc Medicare	$148.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$192.40

BOLT LOCKING TI 26MM

Facility

$296.00

Service Code	HCPCS C1713
Hospital Charge Code	40200123
Hospital Revenue Code	278
Min. Negotiated Rate	$103.60
Max. Negotiated Rate	$310.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$162.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$177.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$148.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$170.20
Rate for Payer: EmblemHealth Commercial	$148.00
Rate for Payer: Fidelis Medicare Advantage	$310.80
Rate for Payer: Group Health Inc Commercial	$148.00
Rate for Payer: Group Health Inc Medicare	$103.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$148.00
Rate for Payer: Hamaspik Choice Inc Medicare	$148.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$192.40

BOLT LOCKING TI 26MM

Facility

$296.00

Service Code	HCPCS C1713
Hospital Charge Code	40200123
Hospital Revenue Code	278
Min. Negotiated Rate	$148.00
Max. Negotiated Rate	$148.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$148.00
Rate for Payer: Hamaspik Choice Inc Medicare	$148.00

Know your out-of-pocket cost for care.

All Charges