St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BONE BLOCK PRO OSTEON200 10X10X40

Facility

$1,212.50

Hospital Charge Code	64903998
Hospital Revenue Code	270
Min. Negotiated Rate	$424.38
Max. Negotiated Rate	$970.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$666.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$606.25
Rate for Payer: Aetna Government	$606.25
Rate for Payer: Brighton Health Commercial	$909.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$970.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$824.50
Rate for Payer: Group Health Inc Commercial	$606.25
Rate for Payer: Group Health Inc Medicare	$424.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$606.25
Rate for Payer: Hamaspik Choice Inc Medicare	$606.25

BONE BX

Facility

$4,157.25

Service Code	HCPCS 20220
Hospital Charge Code	40082785
Hospital Revenue Code	360
Min. Negotiated Rate	$1,188.00
Max. Negotiated Rate	$3,117.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,874.89
Rate for Payer: Aetna Government	$1,874.89
Rate for Payer: Affinity Essential Plan 1&2	$1,312.42
Rate for Payer: Affinity Essential Plan 3&4	$1,312.42
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,312.42
Rate for Payer: Brighton Health Commercial	$3,117.94
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,874.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$1,874.89
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$1,593.66
Rate for Payer: Fidelis Essential Plan QHP	$1,668.65
Rate for Payer: Fidelis Medicare Advantage	$1,874.89
Rate for Payer: Fidelis Qualified Health Plan	$1,668.65
Rate for Payer: Group Health Inc Commercial	$1,874.89
Rate for Payer: Group Health Inc Medicare	$1,874.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,874.89
Rate for Payer: Healthfirst Medicare Advantage	$1,593.66
Rate for Payer: Healthfirst QHP	$1,874.89
Rate for Payer: Humana Medicare	$1,912.39
Rate for Payer: Senior Whole Health Medicare Advantage	$1,874.89
Rate for Payer: United Healthcare Commercial	$1,188.00
Rate for Payer: United Healthcare Medicare Advantage	$1,874.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,874.89
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,499.91
Rate for Payer: Wellcare Medicare	$1,781.15

BONE BX

Facility

$4,157.25

Service Code	HCPCS 20220
Hospital Charge Code	30302489
Hospital Revenue Code	510
Rate for Payer: Cash Price	$1,874.89

BONE BX

Facility

$4,157.25

Service Code	HCPCS 20220
Hospital Charge Code	40082785
Hospital Revenue Code	360
Rate for Payer: Cash Price	$1,874.89

BONE BX

Facility

$4,157.25

Service Code	HCPCS 20220
Hospital Charge Code	30302489
Hospital Revenue Code	510
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,874.89
Rate for Payer: Aetna Government	$1,874.89
Rate for Payer: Affinity Essential Plan 1&2	$1,312.42
Rate for Payer: Affinity Essential Plan 3&4	$1,312.42
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,312.42
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Cash Price	$1,874.89
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,874.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$1,874.89
Rate for Payer: Fidelis Essential Plan Aliesa	$1,593.66
Rate for Payer: Fidelis Essential Plan QHP	$1,668.65
Rate for Payer: Fidelis Medicare Advantage	$1,874.89
Rate for Payer: Fidelis Qualified Health Plan	$1,668.65
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,078.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,874.89
Rate for Payer: Healthfirst Medicare Advantage	$1,593.66
Rate for Payer: Healthfirst QHP	$1,874.89
Rate for Payer: Humana Medicare	$1,912.39
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$1,874.89
Rate for Payer: Senior Whole Health Medicare Advantage	$1,874.89
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$1,874.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,874.89
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,499.91
Rate for Payer: Wellcare Medicare	$1,781.15

BONE CANCELLOUS CRUSHED 10CC

Facility

$485.00

Service Code	HCPCS C1713
Hospital Charge Code	64902410
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$509.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$266.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$291.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$242.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$278.88
Rate for Payer: EmblemHealth Commercial	$242.50
Rate for Payer: Fidelis Medicare Advantage	$509.25
Rate for Payer: Group Health Inc Commercial	$242.50
Rate for Payer: Group Health Inc Medicare	$169.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$242.50
Rate for Payer: Hamaspik Choice Inc Medicare	$242.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$315.25

BONE CANCELLOUS CRUSHED 10CC

Facility

$485.00

Service Code	HCPCS C1713
Hospital Charge Code	64902410
Hospital Revenue Code	278
Min. Negotiated Rate	$242.50
Max. Negotiated Rate	$242.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$242.50
Rate for Payer: Hamaspik Choice Inc Medicare	$242.50

BONE CANCELLOUS CRUSHED 15CC

Facility

$697.50

Service Code	HCPCS C1713
Hospital Charge Code	64902412
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$732.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$383.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$418.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$348.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$401.06
Rate for Payer: EmblemHealth Commercial	$348.75
Rate for Payer: Fidelis Medicare Advantage	$732.38
Rate for Payer: Group Health Inc Commercial	$348.75
Rate for Payer: Group Health Inc Medicare	$244.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$348.75
Rate for Payer: Hamaspik Choice Inc Medicare	$348.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$453.38

BONE CANCELLOUS CRUSHED 15CC

Facility

$697.50

Service Code	HCPCS C1713
Hospital Charge Code	64902412
Hospital Revenue Code	278
Min. Negotiated Rate	$348.75
Max. Negotiated Rate	$348.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$348.75
Rate for Payer: Hamaspik Choice Inc Medicare	$348.75

BONE CANCELLOUS CRUSHED 20CC

Facility

$758.63

Service Code	HCPCS C1713
Hospital Charge Code	64902605
Hospital Revenue Code	278
Min. Negotiated Rate	$379.32
Max. Negotiated Rate	$379.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$379.32
Rate for Payer: Hamaspik Choice Inc Medicare	$379.32

BONE CANCELLOUS CRUSHED 20CC

Facility

$758.63

Service Code	HCPCS C1713
Hospital Charge Code	64902605
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$796.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$417.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$455.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$379.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$436.21
Rate for Payer: EmblemHealth Commercial	$379.32
Rate for Payer: Fidelis Medicare Advantage	$796.56
Rate for Payer: Group Health Inc Commercial	$379.32
Rate for Payer: Group Health Inc Medicare	$265.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$379.32
Rate for Payer: Hamaspik Choice Inc Medicare	$379.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$493.11

BONE CEMENT 1

Facility

$816.60

Service Code	HCPCS C1713
Hospital Charge Code	40202081
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$857.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$449.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$489.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$408.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$469.54
Rate for Payer: EmblemHealth Commercial	$408.30
Rate for Payer: Fidelis Medicare Advantage	$857.43
Rate for Payer: Group Health Inc Commercial	$408.30
Rate for Payer: Group Health Inc Medicare	$285.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$408.30
Rate for Payer: Hamaspik Choice Inc Medicare	$408.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$530.79

BONE CEMENT 1

Facility

$816.60

Service Code	HCPCS C1713
Hospital Charge Code	40202081
Hospital Revenue Code	278
Min. Negotiated Rate	$408.30
Max. Negotiated Rate	$408.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$408.30
Rate for Payer: Hamaspik Choice Inc Medicare	$408.30

BONE CEMENT 2

Facility

$460.00

Service Code	HCPCS C1713
Hospital Charge Code	40201296
Hospital Revenue Code	278
Min. Negotiated Rate	$230.00
Max. Negotiated Rate	$230.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00

BONE CEMENT 2

Facility

$460.00

Service Code	HCPCS C1713
Hospital Charge Code	40201296
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$483.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$253.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$276.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$264.50
Rate for Payer: EmblemHealth Commercial	$230.00
Rate for Payer: Fidelis Medicare Advantage	$483.00
Rate for Payer: Group Health Inc Commercial	$230.00
Rate for Payer: Group Health Inc Medicare	$161.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$299.00

BONE CEMENT 3

Facility

$816.60

Service Code	HCPCS C1713
Hospital Charge Code	40201187
Hospital Revenue Code	278
Min. Negotiated Rate	$408.30
Max. Negotiated Rate	$408.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$408.30
Rate for Payer: Hamaspik Choice Inc Medicare	$408.30

BONE CEMENT 3

Facility

$816.60

Service Code	HCPCS C1713
Hospital Charge Code	40201187
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$857.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$449.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$489.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$408.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$469.54
Rate for Payer: EmblemHealth Commercial	$408.30
Rate for Payer: Fidelis Medicare Advantage	$857.43
Rate for Payer: Group Health Inc Commercial	$408.30
Rate for Payer: Group Health Inc Medicare	$285.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$408.30
Rate for Payer: Hamaspik Choice Inc Medicare	$408.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$530.79

BONE CEMENT RADIOPAQUE

Facility

$460.00

Service Code	HCPCS C1713
Hospital Charge Code	40202094
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$483.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$253.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$276.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$264.50
Rate for Payer: EmblemHealth Commercial	$230.00
Rate for Payer: Fidelis Medicare Advantage	$483.00
Rate for Payer: Group Health Inc Commercial	$230.00
Rate for Payer: Group Health Inc Medicare	$161.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$299.00

BONE CEMENT RADIOPAQUE

Facility

$460.00

Service Code	HCPCS C1713
Hospital Charge Code	40202094
Hospital Revenue Code	278
Min. Negotiated Rate	$230.00
Max. Negotiated Rate	$230.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00

BONE CUBE CANCELLOUS 5CC

Facility

$380.00

Service Code	HCPCS C1713
Hospital Charge Code	64901829
Hospital Revenue Code	278
Min. Negotiated Rate	$133.00
Max. Negotiated Rate	$399.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$209.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$228.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$218.50
Rate for Payer: EmblemHealth Commercial	$190.00
Rate for Payer: Fidelis Medicare Advantage	$399.00
Rate for Payer: Group Health Inc Commercial	$190.00
Rate for Payer: Group Health Inc Medicare	$133.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$247.00

BONE CUBE CANCELLOUS 5CC

Facility

$270.00

Service Code	HCPCS C1713
Hospital Charge Code	40202361
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.00
Rate for Payer: Hamaspik Choice Inc Medicare	$135.00

BONE CUBE CANCELLOUS 5CC

Facility

$380.00

Service Code	HCPCS C1713
Hospital Charge Code	64901829
Hospital Revenue Code	278
Min. Negotiated Rate	$190.00
Max. Negotiated Rate	$190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$190.00

BONE CUBE CANCELLOUS 5CC

Facility

$270.00

Service Code	HCPCS C1713
Hospital Charge Code	40202361
Hospital Revenue Code	278
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$283.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$148.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$162.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$135.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.25
Rate for Payer: EmblemHealth Commercial	$135.00
Rate for Payer: Fidelis Medicare Advantage	$283.50
Rate for Payer: Group Health Inc Commercial	$135.00
Rate for Payer: Group Health Inc Medicare	$94.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.00
Rate for Payer: Hamaspik Choice Inc Medicare	$135.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$175.50

BONE CURETTE SET

Facility

$18.78

Hospital Charge Code	40200640
Hospital Revenue Code	270
Min. Negotiated Rate	$6.57
Max. Negotiated Rate	$15.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.39
Rate for Payer: Aetna Government	$9.39
Rate for Payer: Brighton Health Commercial	$14.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.77
Rate for Payer: Group Health Inc Commercial	$9.39
Rate for Payer: Group Health Inc Medicare	$6.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.39
Rate for Payer: Hamaspik Choice Inc Medicare	$9.39

BONE DISEASES AND ARTHROPATHIES WITH MCC

Facility

$35,845.70

Service Code	MSDRG 553
Min. Negotiated Rate	$11,589.10
Max. Negotiated Rate	$35,845.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19,927.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26,069.60
Rate for Payer: Aetna Government	$26,069.60
Rate for Payer: Brighton Health Commercial	$19,596.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$26,590.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23,339.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$19,260.39
Rate for Payer: Elderplan Medicare Advantage	$24,766.12
Rate for Payer: EmblemHealth Commercial	$11,589.10
Rate for Payer: Fidelis Medicare Advantage	$26,069.60
Rate for Payer: Group Health Inc Commercial	$26,069.60
Rate for Payer: Group Health Inc Medicare	$26,069.60
Rate for Payer: Hamaspik Choice Inc Medicare	$26,069.60
Rate for Payer: Healthfirst Medicare Advantage	$12,122.36
Rate for Payer: Humana Medicare	$35,845.70
Rate for Payer: Senior Whole Health Medicare Advantage	$26,069.60
Rate for Payer: United Healthcare Commercial	$26,877.28
Rate for Payer: United Healthcare Medicare Advantage	$26,069.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26,069.60
Rate for Payer: Wellcare Medicare	$24,766.12

Know your out-of-pocket cost for care.

All Charges