St. Barnabas Hospital

All Charges

Charge

Type

Price

1.2 BURR H COVER PLATE 10MM

Facility IP

$346.00

Service Code	HCPCS C1781
Hospital Charge Code	40209752
Hospital Revenue Code	278
Min. Negotiated Rate	$173.00
Max. Negotiated Rate	$173.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.00
Rate for Payer: Hamaspik Choice Inc Medicare	$173.00

1.2 BURR H COVER PLATE 14MM

Facility IP

$346.00

Service Code	HCPCS C1781
Hospital Charge Code	40209753
Hospital Revenue Code	278
Min. Negotiated Rate	$173.00
Max. Negotiated Rate	$173.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.00
Rate for Payer: Hamaspik Choice Inc Medicare	$173.00

1.2 BURR H COVER PLATE 14MM

Facility OP

$346.00

Service Code	HCPCS C1781
Hospital Charge Code	40209753
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$363.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$173.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$198.95
Rate for Payer: Fidelis Medicare Advantage	$363.30
Rate for Payer: Group Health Inc Commercial	$173.00
Rate for Payer: Group Health Inc Medicare	$121.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.00
Rate for Payer: Hamaspik Choice Inc Medicare	$173.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$224.90

1.2 BURR H COVER PLATE 7MM

Facility IP

$346.00

Service Code	HCPCS C1781
Hospital Charge Code	40209754
Hospital Revenue Code	278
Min. Negotiated Rate	$173.00
Max. Negotiated Rate	$173.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.00
Rate for Payer: Hamaspik Choice Inc Medicare	$173.00

1.2 BURR H COVER PLATE 7MM

Facility OP

$346.00

Service Code	HCPCS C1781
Hospital Charge Code	40209754
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$363.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$173.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$198.95
Rate for Payer: Fidelis Medicare Advantage	$363.30
Rate for Payer: Group Health Inc Commercial	$173.00
Rate for Payer: Group Health Inc Medicare	$121.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.00
Rate for Payer: Hamaspik Choice Inc Medicare	$173.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$224.90

12H CURVED PLT, 75 PROFILE

Facility OP

$582.00

Service Code	HCPCS C1713
Hospital Charge Code	40209809
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$611.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$320.10
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	$291.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$334.65
Rate for Payer: Fidelis Medicare Advantage	$611.10
Rate for Payer: Group Health Inc Commercial	$291.00
Rate for Payer: Group Health Inc Medicare	$203.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$291.00
Rate for Payer: Hamaspik Choice Inc Medicare	$291.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$378.30

12H CURVED PLT, 75 PROFILE

Facility IP

$582.00

Service Code	HCPCS C1713
Hospital Charge Code	40209809
Hospital Revenue Code	278
Min. Negotiated Rate	$291.00
Max. Negotiated Rate	$291.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$291.00
Rate for Payer: Hamaspik Choice Inc Medicare	$291.00

12 H DISTAL FEMUR LCKNG PLATE

Facility OP

$1,942.00

Service Code	HCPCS C1776
Hospital Charge Code	40205276
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,039.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,068.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$971.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,116.65
Rate for Payer: Fidelis Medicare Advantage	$2,039.10
Rate for Payer: Group Health Inc Commercial	$971.00
Rate for Payer: Group Health Inc Medicare	$679.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$971.00
Rate for Payer: Hamaspik Choice Inc Medicare	$971.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,262.30

12 H DISTAL FEMUR LCKNG PLATE

Facility IP

$1,942.00

Service Code	HCPCS C1776
Hospital Charge Code	40205276
Hospital Revenue Code	278
Min. Negotiated Rate	$971.00
Max. Negotiated Rate	$971.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$971.00
Rate for Payer: Hamaspik Choice Inc Medicare	$971.00

12 HOLE CURVED PLATE

Facility IP

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	40209394
Hospital Revenue Code	278
Min. Negotiated Rate	$170.00
Max. Negotiated Rate	$170.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00

12 HOLE CURVED PLATE

Facility OP

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	40209394
Hospital Revenue Code	278
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$357.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$187.00
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	$170.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: Fidelis Medicare Advantage	$357.00
Rate for Payer: Group Health Inc Commercial	$170.00
Rate for Payer: Group Health Inc Medicare	$119.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$221.00

1.2 MLBL BURR H COVER 10MM

Facility IP

$387.08

Service Code	HCPCS C1781
Hospital Charge Code	40209756
Hospital Revenue Code	278
Min. Negotiated Rate	$193.54
Max. Negotiated Rate	$193.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.54
Rate for Payer: Hamaspik Choice Inc Medicare	$193.54

1.2 MLBL BURR H COVER 10MM

Facility OP

$387.08

Service Code	HCPCS C1781
Hospital Charge Code	40209756
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$406.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$212.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$193.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.57
Rate for Payer: Fidelis Medicare Advantage	$406.43
Rate for Payer: Group Health Inc Commercial	$193.54
Rate for Payer: Group Health Inc Medicare	$135.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.54
Rate for Payer: Hamaspik Choice Inc Medicare	$193.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$251.60

1.2 MLBL BURR H COVER 20MM

Facility IP

$387.08

Service Code	HCPCS C1781
Hospital Charge Code	40209757
Hospital Revenue Code	278
Min. Negotiated Rate	$193.54
Max. Negotiated Rate	$193.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.54
Rate for Payer: Hamaspik Choice Inc Medicare	$193.54

1.2 MLBL BURR H COVER 20MM

Facility OP

$387.08

Service Code	HCPCS C1781
Hospital Charge Code	40209757
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$406.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$212.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$193.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.57
Rate for Payer: Fidelis Medicare Advantage	$406.43
Rate for Payer: Group Health Inc Commercial	$193.54
Rate for Payer: Group Health Inc Medicare	$135.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.54
Rate for Payer: Hamaspik Choice Inc Medicare	$193.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$251.60

1.2 MLBL BURR H COVER 7MM

Facility IP

$387.08

Service Code	HCPCS C1781
Hospital Charge Code	40209758
Hospital Revenue Code	278
Min. Negotiated Rate	$193.54
Max. Negotiated Rate	$193.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.54
Rate for Payer: Hamaspik Choice Inc Medicare	$193.54

1.2 MLBL BURR H COVER 7MM

Facility OP

$387.08

Service Code	HCPCS C1781
Hospital Charge Code	40209758
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$406.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$212.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$193.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.57
Rate for Payer: Fidelis Medicare Advantage	$406.43
Rate for Payer: Group Health Inc Commercial	$193.54
Rate for Payer: Group Health Inc Medicare	$135.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.54
Rate for Payer: Hamaspik Choice Inc Medicare	$193.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$251.60

1.2 MLBL BURR HOLE COVER 14MM

Facility OP

$432.00

Service Code	HCPCS C1713
Hospital Charge Code	40201234
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$453.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$237.60
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	$216.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$248.40
Rate for Payer: Fidelis Medicare Advantage	$453.60
Rate for Payer: Group Health Inc Commercial	$216.00
Rate for Payer: Group Health Inc Medicare	$151.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$216.00
Rate for Payer: Hamaspik Choice Inc Medicare	$216.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$280.80

1.2 MLBL BURR HOLE COVER 14MM

Facility IP

$432.00

Service Code	HCPCS C1713
Hospital Charge Code	40201234
Hospital Revenue Code	278
Min. Negotiated Rate	$216.00
Max. Negotiated Rate	$216.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$216.00
Rate for Payer: Hamaspik Choice Inc Medicare	$216.00

1.2 MLBL BURR HOLE CVR 10MM

Facility OP

$388.00

Service Code	HCPCS C1713
Hospital Charge Code	40202315
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$407.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$213.40
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	$194.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$223.10
Rate for Payer: Fidelis Medicare Advantage	$407.40
Rate for Payer: Group Health Inc Commercial	$194.00
Rate for Payer: Group Health Inc Medicare	$135.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$194.00
Rate for Payer: Hamaspik Choice Inc Medicare	$194.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$252.20

1.2 MLBL BURR HOLE CVR 10MM

Facility IP

$388.00

Service Code	HCPCS C1713
Hospital Charge Code	40202315
Hospital Revenue Code	278
Min. Negotiated Rate	$194.00
Max. Negotiated Rate	$194.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$194.00
Rate for Payer: Hamaspik Choice Inc Medicare	$194.00

12 MM LARGE ROUND ENDCAP

Facility OP

$383.00

Hospital Charge Code	40001656
Hospital Revenue Code	270
Min. Negotiated Rate	$134.05
Max. Negotiated Rate	$306.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$210.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$191.50
Rate for Payer: Aetna Government	$191.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$306.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$260.44
Rate for Payer: Group Health Inc Commercial	$191.50
Rate for Payer: Group Health Inc Medicare	$134.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$191.50
Rate for Payer: Hamaspik Choice Inc Medicare	$191.50

1.2MM ORBITAL FL PLT,BSC,MED,3MM

Facility IP

$1,424.00

Service Code	HCPCS C1781
Hospital Charge Code	40209759
Hospital Revenue Code	278
Min. Negotiated Rate	$712.00
Max. Negotiated Rate	$712.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$712.00
Rate for Payer: Hamaspik Choice Inc Medicare	$712.00

1.2MM ORBITAL FL PLT,BSC,MED,3MM

Facility OP

$1,424.00

Service Code	HCPCS C1781
Hospital Charge Code	40209759
Hospital Revenue Code	278
Min. Negotiated Rate	$69.35
Max. Negotiated Rate	$1,495.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$783.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$712.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$818.80
Rate for Payer: Fidelis Medicare Advantage	$1,495.20
Rate for Payer: Group Health Inc Commercial	$712.00
Rate for Payer: Group Health Inc Medicare	$498.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$712.00
Rate for Payer: Hamaspik Choice Inc Medicare	$712.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$925.60

1.2MM ORBITAL FL PLT,BSC,MED 4MM

Facility IP

$1,424.00

Service Code	HCPCS C1781
Hospital Charge Code	40209760
Hospital Revenue Code	278
Min. Negotiated Rate	$712.00
Max. Negotiated Rate	$712.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$712.00
Rate for Payer: Hamaspik Choice Inc Medicare	$712.00

Price Transparency.

All Charges