St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZIM ORTHO SAL SYS AXLE

Facility

$1,335.00

Service Code	HCPCS C1776
Hospital Charge Code	40008333
Hospital Revenue Code	278
Min. Negotiated Rate	$667.50
Max. Negotiated Rate	$667.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$667.50
Rate for Payer: Hamaspik Choice Inc Medicare	$667.50

ZIM ORTHO SAL SYS AXLE

Facility

$1,335.00

Service Code	HCPCS C1776
Hospital Charge Code	40008333
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,401.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$734.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$801.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$667.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$767.62
Rate for Payer: EmblemHealth Commercial	$667.50
Rate for Payer: Fidelis Medicare Advantage	$1,401.75
Rate for Payer: Group Health Inc Commercial	$667.50
Rate for Payer: Group Health Inc Medicare	$467.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$667.50
Rate for Payer: Hamaspik Choice Inc Medicare	$667.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$867.75

ZIM ORTHO SAL YOKE

Facility

$3,090.00

Service Code	HCPCS C1776
Hospital Charge Code	40008332
Hospital Revenue Code	278
Min. Negotiated Rate	$1,545.00
Max. Negotiated Rate	$1,545.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,545.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,545.00

ZIM ORTHO SAL YOKE

Facility

$3,090.00

Service Code	HCPCS C1776
Hospital Charge Code	40008332
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,244.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,699.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,854.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,545.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,776.75
Rate for Payer: EmblemHealth Commercial	$1,545.00
Rate for Payer: Fidelis Medicare Advantage	$3,244.50
Rate for Payer: Group Health Inc Commercial	$1,545.00
Rate for Payer: Group Health Inc Medicare	$1,081.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,545.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,545.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,008.50

ZIM PATEL REAM BLD W/PLT HOLE 38M

Facility

$163.00

Service Code	HCPCS C1713
Hospital Charge Code	40005243
Hospital Revenue Code	278
Min. Negotiated Rate	$57.05
Max. Negotiated Rate	$171.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$97.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.72
Rate for Payer: EmblemHealth Commercial	$81.50
Rate for Payer: Fidelis Medicare Advantage	$171.15
Rate for Payer: Group Health Inc Commercial	$81.50
Rate for Payer: Group Health Inc Medicare	$57.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.50
Rate for Payer: Hamaspik Choice Inc Medicare	$81.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.95

ZIM PATEL REAM BLD W/PLT HOLE 38M

Facility

$163.00

Service Code	HCPCS C1713
Hospital Charge Code	40005243
Hospital Revenue Code	278
Min. Negotiated Rate	$81.50
Max. Negotiated Rate	$81.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.50
Rate for Payer: Hamaspik Choice Inc Medicare	$81.50

ZIM PER ART BEAR RT 13MM

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40203383
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 PER ART BEAR RT 13MM

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40203383
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 PER FEM POST RT SZ 5

Facility

$6,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40203385
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 PER FEM POST RT SZ 5

Facility

$6,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40203385
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 PER KNEE SYS PLY 32MM-8.5

Facility

$1,600.00

Service Code	HCPCS C1776
Hospital Charge Code	40203382
Hospital Revenue Code	278
Min. Negotiated Rate	$800.00
Max. Negotiated Rate	$800.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$800.00
Rate for Payer: Hamaspik Choice Inc Medicare	$800.00

ZIM PER KNEE SYS PLY 32MM-8.5

Facility

$1,600.00

Service Code	HCPCS C1776
Hospital Charge Code	40203382
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,680.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$880.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$960.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$800.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$920.00
Rate for Payer: EmblemHealth Commercial	$800.00
Rate for Payer: Fidelis Medicare Advantage	$1,680.00
Rate for Payer: Group Health Inc Commercial	$800.00
Rate for Payer: Group Health Inc Medicare	$560.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$800.00
Rate for Payer: Hamaspik Choice Inc Medicare	$800.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,040.00

ZIM PER KNEE SYS STAB RT SZ 5

Facility

$6,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40203380
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 PER KNEE SYS STAB RT SZ 5

Facility

$6,200.00

Service Code	HCPCS C1776
Hospital Charge Code	40203380
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 PER NAT TIBIA SZ D

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40203384
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,200.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,400.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,000.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,300.00
Rate for Payer: EmblemHealth Commercial	$2,000.00
Rate for Payer: Fidelis Medicare Advantage	$4,200.00
Rate for Payer: Group Health Inc Commercial	$2,000.00
Rate for Payer: Group Health Inc Medicare	$1,400.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,000.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,600.00

ZIM PER NAT TIBIA SZ D

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40203384
Hospital Revenue Code	278
Min. Negotiated Rate	$2,000.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,000.00

ZIM PERS KNEE SYS E-ARTIC RT 11MM

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40203379
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 PERS KNEE SYS E-ARTIC RT 11MM

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40203379
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 PER TIBIA STEMMED RT SZ F

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40204551
Hospital Revenue Code	278
Min. Negotiated Rate	$2,000.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,000.00

ZIM PER TIBIA STEMMED RT SZ F

Facility

$4,000.00

Service Code	HCPCS C1776
Hospital Charge Code	40204551
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,200.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,400.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,000.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,300.00
Rate for Payer: EmblemHealth Commercial	$2,000.00
Rate for Payer: Fidelis Medicare Advantage	$4,200.00
Rate for Payer: Group Health Inc Commercial	$2,000.00
Rate for Payer: Group Health Inc Medicare	$1,400.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,000.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,600.00

ZIM POLY PATEL CEM 29 X 8.0 MM

Facility

$1,600.00

Service Code	HCPCS C1776
Hospital Charge Code	40204554
Hospital Revenue Code	278
Min. Negotiated Rate	$800.00
Max. Negotiated Rate	$800.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$800.00
Rate for Payer: Hamaspik Choice Inc Medicare	$800.00

ZIM POLY PATEL CEM 29 X 8.0 MM

Facility

$1,600.00

Service Code	HCPCS C1776
Hospital Charge Code	40204554
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,680.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$880.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$960.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$800.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$920.00
Rate for Payer: EmblemHealth Commercial	$800.00
Rate for Payer: Fidelis Medicare Advantage	$1,680.00
Rate for Payer: Group Health Inc Commercial	$800.00
Rate for Payer: Group Health Inc Medicare	$560.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$800.00
Rate for Payer: Hamaspik Choice Inc Medicare	$800.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,040.00

ZIM POROUS PLASMA CEM

Facility

$10,125.00

Service Code	HCPCS C1713
Hospital Charge Code	40008340
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$10,631.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,568.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$6,075.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,062.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,821.88
Rate for Payer: EmblemHealth Commercial	$5,062.50
Rate for Payer: Fidelis Medicare Advantage	$10,631.25
Rate for Payer: Group Health Inc Commercial	$5,062.50
Rate for Payer: Group Health Inc Medicare	$3,543.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,062.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5,062.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,581.25

ZIM POROUS PLASMA CEM

Facility

$10,125.00

Service Code	HCPCS C1713
Hospital Charge Code	40008340
Hospital Revenue Code	278
Min. Negotiated Rate	$5,062.50
Max. Negotiated Rate	$5,062.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,062.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5,062.50

ZIM POROUS PLASMA SM

Facility

$11,955.00

Service Code	HCPCS C1713
Hospital Charge Code	40008337
Hospital Revenue Code	278
Min. Negotiated Rate	$5,977.50
Max. Negotiated Rate	$5,977.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,977.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5,977.50

Know your out-of-pocket cost for care.

All Charges