St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ZIM SZ D 5MM AUG 2/SCREW

Facility

$4,398.00

Service Code	HCPCS C1713
Hospital Charge Code	40001793
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,617.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,418.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,638.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,199.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,528.85
Rate for Payer: EmblemHealth Commercial	$2,199.00
Rate for Payer: Fidelis Medicare Advantage	$4,617.90
Rate for Payer: Group Health Inc Commercial	$2,199.00
Rate for Payer: Group Health Inc Medicare	$1,539.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,199.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,199.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,858.70

ZIM SZ D 5MM AUG 2/SCREW

Facility

$4,398.00

Service Code	HCPCS C1713
Hospital Charge Code	40001793
Hospital Revenue Code	278
Min. Negotiated Rate	$2,199.00
Max. Negotiated Rate	$2,199.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,199.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,199.00

ZIM TIBIAL BRUSH

Facility

$885.00

Service Code	HCPCS C1776
Hospital Charge Code	40008338
Hospital Revenue Code	278
Min. Negotiated Rate	$309.75
Max. Negotiated Rate	$929.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$486.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$531.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$442.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$508.88
Rate for Payer: EmblemHealth Commercial	$442.50
Rate for Payer: Fidelis Medicare Advantage	$929.25
Rate for Payer: Group Health Inc Commercial	$442.50
Rate for Payer: Group Health Inc Medicare	$309.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$442.50
Rate for Payer: Hamaspik Choice Inc Medicare	$442.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$575.25

ZIM TIBIAL BRUSH

Facility

$885.00

Service Code	HCPCS C1776
Hospital Charge Code	40008338
Hospital Revenue Code	278
Min. Negotiated Rate	$442.50
Max. Negotiated Rate	$442.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$442.50
Rate for Payer: Hamaspik Choice Inc Medicare	$442.50

ZIM TRABEC SHELL 52MM OD SZ II

Facility

$3,800.00

Service Code	HCPCS C1776
Hospital Charge Code	40003449
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,990.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,090.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,280.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,185.00
Rate for Payer: EmblemHealth Commercial	$1,900.00
Rate for Payer: Fidelis Medicare Advantage	$3,990.00
Rate for Payer: Group Health Inc Commercial	$1,900.00
Rate for Payer: Group Health Inc Medicare	$1,330.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,470.00

ZIM TRABEC SHELL 52MM OD SZ II

Facility

$3,800.00

Service Code	HCPCS C1776
Hospital Charge Code	40003449
Hospital Revenue Code	278
Min. Negotiated Rate	$1,900.00
Max. Negotiated Rate	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,900.00

ZIM TRABEC SHOULDER SYS GLEN 36MM

Facility

$3,328.00

Service Code	HCPCS C1776
Hospital Charge Code	40008305
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,494.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,830.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,996.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,664.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,913.60
Rate for Payer: EmblemHealth Commercial	$1,664.00
Rate for Payer: Fidelis Medicare Advantage	$3,494.40
Rate for Payer: Group Health Inc Commercial	$1,664.00
Rate for Payer: Group Health Inc Medicare	$1,164.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,664.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,664.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,163.20

ZIM TRABEC SHOULDER SYS GLEN 36MM

Facility

$3,328.00

Service Code	HCPCS C1776
Hospital Charge Code	40008305
Hospital Revenue Code	278
Min. Negotiated Rate	$1,664.00
Max. Negotiated Rate	$1,664.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,664.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,664.00

ZIM TRAB METAL SHELL 58MM OD LL

Facility

$3,800.00

Service Code	HCPCS C1776
Hospital Charge Code	40009277
Hospital Revenue Code	278
Min. Negotiated Rate	$1,900.00
Max. Negotiated Rate	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,900.00

ZIM TRAB METAL SHELL 58MM OD LL

Facility

$3,800.00

Service Code	HCPCS C1776
Hospital Charge Code	40009277
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,990.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,090.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,280.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,185.00
Rate for Payer: EmblemHealth Commercial	$1,900.00
Rate for Payer: Fidelis Medicare Advantage	$3,990.00
Rate for Payer: Group Health Inc Commercial	$1,900.00
Rate for Payer: Group Health Inc Medicare	$1,330.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,470.00

ZIM TRAE METAL SHELL 54MM OD JJ

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40009275
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 TRAE METAL SHELL 54MM OD JJ

Facility

$3,400.00

Service Code	HCPCS C1776
Hospital Charge Code	40009275
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 TRANSV PIN DEV 32MM LNG

Facility

$1,215.00

Service Code	HCPCS C1713
Hospital Charge Code	40008331
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,275.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$668.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$729.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$607.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$698.62
Rate for Payer: EmblemHealth Commercial	$607.50
Rate for Payer: Fidelis Medicare Advantage	$1,275.75
Rate for Payer: Group Health Inc Commercial	$607.50
Rate for Payer: Group Health Inc Medicare	$425.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$607.50
Rate for Payer: Hamaspik Choice Inc Medicare	$607.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$789.75

ZIM TRANSV PIN DEV 32MM LNG

Facility

$1,215.00

Service Code	HCPCS C1713
Hospital Charge Code	40008331
Hospital Revenue Code	278
Min. Negotiated Rate	$607.50
Max. Negotiated Rate	$607.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$607.50
Rate for Payer: Hamaspik Choice Inc Medicare	$607.50

ZIM TRILY ALFIT AETABLR SYS LG 36

Facility

$1,700.00

Service Code	HCPCS C1776
Hospital Charge Code	40202637
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,785.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$935.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,020.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$850.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$977.50
Rate for Payer: EmblemHealth Commercial	$850.00
Rate for Payer: Fidelis Medicare Advantage	$1,785.00
Rate for Payer: Group Health Inc Commercial	$850.00
Rate for Payer: Group Health Inc Medicare	$595.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$850.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,105.00

ZIM TRILY ALFIT AETABLR SYS LG 36

Facility

$1,700.00

Service Code	HCPCS C1776
Hospital Charge Code	40202637
Hospital Revenue Code	278
Min. Negotiated Rate	$850.00
Max. Negotiated Rate	$850.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$850.00
Rate for Payer: Hamaspik Choice Inc Medicare	$850.00

ZIM VRSY FEM HD 12/14-28+0MM NK

Facility

$2,550.00

Service Code	HCPCS C1776
Hospital Charge Code	40204219
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,677.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,402.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,530.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,275.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,466.25
Rate for Payer: EmblemHealth Commercial	$1,275.00
Rate for Payer: Fidelis Medicare Advantage	$2,677.50
Rate for Payer: Group Health Inc Commercial	$1,275.00
Rate for Payer: Group Health Inc Medicare	$892.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,275.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,657.50

ZIM VRSY FEM HD 12/14-28+0MM NK

Facility

$2,550.00

Service Code	HCPCS C1776
Hospital Charge Code	40204219
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$1,275.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,275.00

ZIM VRZY END-FEM HD 12/14 TP 43MM

Facility

$3,324.00

Service Code	HCPCS C1776
Hospital Charge Code	40204218
Hospital Revenue Code	278
Min. Negotiated Rate	$1,662.00
Max. Negotiated Rate	$1,662.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,662.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,662.00

ZIM VRZY END-FEM HD 12/14 TP 43MM

Facility

$3,324.00

Service Code	HCPCS C1776
Hospital Charge Code	40204218
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,490.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,828.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,994.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,662.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,911.30
Rate for Payer: EmblemHealth Commercial	$1,662.00
Rate for Payer: Fidelis Medicare Advantage	$3,490.20
Rate for Payer: Group Health Inc Commercial	$1,662.00
Rate for Payer: Group Health Inc Medicare	$1,163.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,662.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,662.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,160.60

ZINC OXIDE 20 % EX OINT [8874]

Facility

$0.23

Service Code	NDC 75834017001
Hospital Charge Code	75834017001
Hospital Revenue Code	250
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.12
Rate for Payer: Aetna Government	$0.12
Rate for Payer: Brighton Health Commercial	$0.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.16
Rate for Payer: Group Health Inc Commercial	$0.12
Rate for Payer: Group Health Inc Medicare	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.12
Rate for Payer: Hamaspik Choice Inc Medicare	$0.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.15

ZINC OXIDE 20 % EX OINT [8874]

Facility

$0.06

Service Code	NDC 00536131625
Hospital Charge Code	00536131625
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.03
Rate for Payer: Aetna Government	$0.03
Rate for Payer: Brighton Health Commercial	$0.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.04
Rate for Payer: Group Health Inc Commercial	$0.03
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.03
Rate for Payer: Hamaspik Choice Inc Medicare	$0.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.04

ZINC OXIDE 20 % EX OINT [8874]

Facility

$0.08

Service Code	NDC 00536131628
Hospital Charge Code	00536131628
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.06
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

ZINC OXIDE 20% OINT 30 GRAMS

Facility

$5.00

Hospital Charge Code	41640023
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$4.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.50
Rate for Payer: Aetna Government	$2.50
Rate for Payer: Brighton Health Commercial	$3.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.40
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

ZINC OXIDE 20% OINT 30 GRAMS

Facility

$5.00

Hospital Charge Code	41650023
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$4.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.50
Rate for Payer: Aetna Government	$2.50
Rate for Payer: Brighton Health Commercial	$3.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.40
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

Know your out-of-pocket cost for care.

All Charges