St. Barnabas Hospital

All Charges

Charge

Type

Price

8X28MM LEFT NAIL

Facility IP

$5,100.00

Service Code	HCPCS C1713
Hospital Charge Code	40203555
Hospital Revenue Code	278
Min. Negotiated Rate	$2,550.00
Max. Negotiated Rate	$2,550.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,550.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,550.00

8X345MM T2 TIBIAL NAIL STANDARD

Facility OP

$2,209.20

Service Code	HCPCS C1713
Hospital Charge Code	40200562
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,319.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,215.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,104.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,270.29
Rate for Payer: Fidelis Medicare Advantage	$2,319.66
Rate for Payer: Group Health Inc Commercial	$1,104.60
Rate for Payer: Group Health Inc Medicare	$773.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,104.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,104.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,435.98

8X345MM T2 TIBIAL NAIL STANDARD

Facility IP

$2,209.20

Service Code	HCPCS C1713
Hospital Charge Code	40200562
Hospital Revenue Code	278
Min. Negotiated Rate	$1,104.60
Max. Negotiated Rate	$1,104.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,104.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,104.60

90 DEGREE ANGLED POST

Facility IP

$186.20

Service Code	HCPCS C1713
Hospital Charge Code	40201183
Hospital Revenue Code	278
Min. Negotiated Rate	$93.10
Max. Negotiated Rate	$93.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.10
Rate for Payer: Hamaspik Choice Inc Medicare	$93.10

90 DEGREE ANGLED POST

Facility OP

$186.20

Service Code	HCPCS C1713
Hospital Charge Code	40201183
Hospital Revenue Code	278
Min. Negotiated Rate	$65.17
Max. Negotiated Rate	$195.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$102.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$93.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$107.06
Rate for Payer: Fidelis Medicare Advantage	$195.51
Rate for Payer: Group Health Inc Commercial	$93.10
Rate for Payer: Group Health Inc Medicare	$65.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.10
Rate for Payer: Hamaspik Choice Inc Medicare	$93.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$121.03

90 DEGREE POST

Facility IP

$170.00

Service Code	HCPCS C1713
Hospital Charge Code	40200567
Hospital Revenue Code	278
Min. Negotiated Rate	$85.00
Max. Negotiated Rate	$85.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00

90 DEGREE POST

Facility OP

$170.00

Service Code	HCPCS C1713
Hospital Charge Code	40200567
Hospital Revenue Code	278
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$178.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$85.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.75
Rate for Payer: Fidelis Medicare Advantage	$178.50
Rate for Payer: Group Health Inc Commercial	$85.00
Rate for Payer: Group Health Inc Medicare	$59.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$110.50

90 DEGREE T-BONE PLATE NO BAR

Facility OP

$368.00

Service Code	HCPCS C1713
Hospital Charge Code	40201184
Hospital Revenue Code	278
Min. Negotiated Rate	$128.80
Max. Negotiated Rate	$386.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$184.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$211.60
Rate for Payer: Fidelis Medicare Advantage	$386.40
Rate for Payer: Group Health Inc Commercial	$184.00
Rate for Payer: Group Health Inc Medicare	$128.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$239.20

90 DEGREE T-BONE PLATE NO BAR

Facility IP

$368.00

Service Code	HCPCS C1713
Hospital Charge Code	40201184
Hospital Revenue Code	278
Min. Negotiated Rate	$184.00
Max. Negotiated Rate	$184.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00

950 GUIDE FOR NCB-DF PLT LEFT

Facility OP

$1,364.56

Hospital Charge Code	40006764
Hospital Revenue Code	272
Min. Negotiated Rate	$477.60
Max. Negotiated Rate	$1,091.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$750.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$682.28
Rate for Payer: Aetna Government	$682.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,091.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$927.90
Rate for Payer: Group Health Inc Commercial	$682.28
Rate for Payer: Group Health Inc Medicare	$477.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$682.28
Rate for Payer: Hamaspik Choice Inc Medicare	$682.28

950 GUIDE FOR NCB-DF PLT RIGHT

Facility OP

$1,364.56

Hospital Charge Code	40006763
Hospital Revenue Code	272
Min. Negotiated Rate	$477.60
Max. Negotiated Rate	$1,091.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$750.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$682.28
Rate for Payer: Aetna Government	$682.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,091.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$927.90
Rate for Payer: Group Health Inc Commercial	$682.28
Rate for Payer: Group Health Inc Medicare	$477.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$682.28
Rate for Payer: Hamaspik Choice Inc Medicare	$682.28

9.5FR SHEATH INTRODUCER

Facility OP

$100.00

Hospital Charge Code	66526906
Hospital Revenue Code	272
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$80.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.00
Rate for Payer: Aetna Government	$50.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.00
Rate for Payer: Group Health Inc Commercial	$50.00
Rate for Payer: Group Health Inc Medicare	$35.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.00
Rate for Payer: Hamaspik Choice Inc Medicare	$50.00

9.5MM ENTRY REAMER

Facility OP

$750.00

Hospital Charge Code	40203559
Hospital Revenue Code	272
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$600.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$412.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$375.00
Rate for Payer: Aetna Government	$375.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$600.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$510.00
Rate for Payer: Group Health Inc Commercial	$375.00
Rate for Payer: Group Health Inc Medicare	$262.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$375.00
Rate for Payer: Hamaspik Choice Inc Medicare	$375.00

95MM SCREW

Facility IP

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64902886
Hospital Revenue Code	278
Min. Negotiated Rate	$307.12
Max. Negotiated Rate	$307.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12

95MM SCREW

Facility OP

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64902886
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$644.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$337.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$307.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$353.19
Rate for Payer: Fidelis Medicare Advantage	$644.96
Rate for Payer: Group Health Inc Commercial	$307.12
Rate for Payer: Group Health Inc Medicare	$214.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$399.26

9 NORMAL SALINE 1000 CC

Facility OP

$4.25

Hospital Charge Code	40504000
Hospital Revenue Code	260
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$3.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.12
Rate for Payer: Aetna Government	$2.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.89
Rate for Payer: Group Health Inc Commercial	$2.12
Rate for Payer: Group Health Inc Medicare	$1.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.12
Rate for Payer: Hamaspik Choice Inc Medicare	$2.12

9 NORMAL SALINE 100 CC

Facility OP

$6.03

Hospital Charge Code	40509789
Hospital Revenue Code	260
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$4.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.02
Rate for Payer: Aetna Government	$3.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.10
Rate for Payer: Group Health Inc Commercial	$3.02
Rate for Payer: Group Health Inc Medicare	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.02
Rate for Payer: Hamaspik Choice Inc Medicare	$3.02

9 NORMAL SALINE 250 CC

Facility OP

$3.55

Hospital Charge Code	40504002
Hospital Revenue Code	260
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$2.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.78
Rate for Payer: Aetna Government	$1.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.41
Rate for Payer: Group Health Inc Commercial	$1.78
Rate for Payer: Group Health Inc Medicare	$1.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.78
Rate for Payer: Hamaspik Choice Inc Medicare	$1.78

9 NORMAL SALINE 500 CC

Facility OP

$3.90

Hospital Charge Code	40504001
Hospital Revenue Code	260
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$3.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.95
Rate for Payer: Aetna Government	$1.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.65
Rate for Payer: Group Health Inc Commercial	$1.95
Rate for Payer: Group Health Inc Medicare	$1.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.95
Rate for Payer: Hamaspik Choice Inc Medicare	$1.95

9 NORMAL SALINE 50 CC

Facility OP

$6.03

Hospital Charge Code	40509788
Hospital Revenue Code	260
Min. Negotiated Rate	$2.11
Max. Negotiated Rate	$4.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.02
Rate for Payer: Aetna Government	$3.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.10
Rate for Payer: Group Health Inc Commercial	$3.02
Rate for Payer: Group Health Inc Medicare	$2.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.02
Rate for Payer: Hamaspik Choice Inc Medicare	$3.02

9+ REGIONS

Facility OP

$189.23

Service Code	HCPCS 98929
Hospital Charge Code	30305017
Hospital Revenue Code	530
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$151.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Cash Price	$30.00
Rate for Payer: Cash Price	$30.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$30.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$151.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.68
Rate for Payer: Elderplan Medicare Advantage	$30.00
Rate for Payer: EmblemHealth Commercial	$30.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$71.87
Rate for Payer: Fidelis Essential Plan Aliesa	$25.50
Rate for Payer: Fidelis Essential Plan QHP	$26.70
Rate for Payer: Fidelis Medicare Advantage	$30.00
Rate for Payer: Fidelis Qualified Health Plan	$26.70
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$30.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.62
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$79.86
Rate for Payer: Healthfirst Medicare Advantage	$25.50
Rate for Payer: Healthfirst QHP	$30.00
Rate for Payer: Senior Whole Health Medicare Advantage	$30.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$30.00
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24.00
Rate for Payer: Wellcare Medicare	$28.50

.9 SOD. CHLOR. IRRIG. 3000CC

Facility OP

$35.08

Hospital Charge Code	40509812
Hospital Revenue Code	260
Min. Negotiated Rate	$12.28
Max. Negotiated Rate	$28.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.54
Rate for Payer: Aetna Government	$17.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.85
Rate for Payer: Group Health Inc Commercial	$17.54
Rate for Payer: Group Health Inc Medicare	$12.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.54
Rate for Payer: Hamaspik Choice Inc Medicare	$17.54

9% SODIUM CHLORIDE IRR.1000CC

Facility OP

$9.22

Hospital Charge Code	40509792
Hospital Revenue Code	260
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$7.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.61
Rate for Payer: Aetna Government	$4.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.27
Rate for Payer: Group Health Inc Commercial	$4.61
Rate for Payer: Group Health Inc Medicare	$3.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.61
Rate for Payer: Hamaspik Choice Inc Medicare	$4.61

9X300MM T2 TIBIAL NAIL STANDARD

Facility OP

$2,066.00

Service Code	HCPCS C1713
Hospital Charge Code	40200564
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,169.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,136.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,033.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,187.95
Rate for Payer: Fidelis Medicare Advantage	$2,169.30
Rate for Payer: Group Health Inc Commercial	$1,033.00
Rate for Payer: Group Health Inc Medicare	$723.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,033.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,033.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,342.90

9X300MM T2 TIBIAL NAIL STANDARD

Facility IP

$2,066.00

Service Code	HCPCS C1713
Hospital Charge Code	40200564
Hospital Revenue Code	278
Min. Negotiated Rate	$1,033.00
Max. Negotiated Rate	$1,033.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,033.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,033.00

Price Transparency.

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