St. Barnabas Hospital

All Charges

Charge

Type

Price

DEPUY HOOK LAM NRWBLD 5.0 SS 1745

Facility OP

$1,310.00

Hospital Charge Code	40029563
Hospital Revenue Code	279
Min. Negotiated Rate	$458.50
Max. Negotiated Rate	$1,048.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$720.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$655.00
Rate for Payer: Aetna Government	$655.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,048.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$890.80
Rate for Payer: Group Health Inc Commercial	$655.00
Rate for Payer: Group Health Inc Medicare	$458.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$655.00
Rate for Payer: Hamaspik Choice Inc Medicare	$655.00

DEPUY HOOK LAM RD DIST 5.0 SS

Facility OP

$1,240.00

Hospital Charge Code	40029562
Hospital Revenue Code	279
Min. Negotiated Rate	$434.00
Max. Negotiated Rate	$992.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$682.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$620.00
Rate for Payer: Aetna Government	$620.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$992.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$843.20
Rate for Payer: Group Health Inc Commercial	$620.00
Rate for Payer: Group Health Inc Medicare	$434.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$620.00
Rate for Payer: Hamaspik Choice Inc Medicare	$620.00

DEPUY HOOK LAM SS M 5.0 (1745-57)

Facility OP

$1,940.00

Hospital Charge Code	40029552
Hospital Revenue Code	279
Min. Negotiated Rate	$679.00
Max. Negotiated Rate	$1,552.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,067.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$970.00
Rate for Payer: Aetna Government	$970.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,552.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,319.20
Rate for Payer: Group Health Inc Commercial	$970.00
Rate for Payer: Group Health Inc Medicare	$679.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$970.00
Rate for Payer: Hamaspik Choice Inc Medicare	$970.00

DEPUY HOOK LAM WIDE BLADE 5.0 SS

Facility OP

$1,240.00

Hospital Charge Code	40203349
Hospital Revenue Code	272
Min. Negotiated Rate	$434.00
Max. Negotiated Rate	$992.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$682.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$620.00
Rate for Payer: Aetna Government	$620.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$992.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$843.20
Rate for Payer: Group Health Inc Commercial	$620.00
Rate for Payer: Group Health Inc Medicare	$434.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$620.00
Rate for Payer: Hamaspik Choice Inc Medicare	$620.00

DEPUY HOOK LAM WIDE BLADE 5.0 SS

Facility OP

$1,240.00

Hospital Charge Code	40009332
Hospital Revenue Code	272
Min. Negotiated Rate	$434.00
Max. Negotiated Rate	$992.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$682.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$620.00
Rate for Payer: Aetna Government	$620.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$992.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$843.20
Rate for Payer: Group Health Inc Commercial	$620.00
Rate for Payer: Group Health Inc Medicare	$434.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$620.00
Rate for Payer: Hamaspik Choice Inc Medicare	$620.00

DEPUY HOOK OFFSET W1745-54-501

Facility OP

$1,940.00

Hospital Charge Code	40029553
Hospital Revenue Code	279
Min. Negotiated Rate	$679.00
Max. Negotiated Rate	$1,552.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,067.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$970.00
Rate for Payer: Aetna Government	$970.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,552.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,319.20
Rate for Payer: Group Health Inc Commercial	$970.00
Rate for Payer: Group Health Inc Medicare	$679.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$970.00
Rate for Payer: Hamaspik Choice Inc Medicare	$970.00

DEPUY HOOK PED 5.0 SS MIAMI 1745-

Facility OP

$1,240.00

Hospital Charge Code	40029561
Hospital Revenue Code	279
Min. Negotiated Rate	$434.00
Max. Negotiated Rate	$992.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$682.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$620.00
Rate for Payer: Aetna Government	$620.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$992.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$843.20
Rate for Payer: Group Health Inc Commercial	$620.00
Rate for Payer: Group Health Inc Medicare	$434.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$620.00
Rate for Payer: Hamaspik Choice Inc Medicare	$620.00

DEPUY INNER SCREW

Facility OP

$210.00

Service Code	HCPCS C1713
Hospital Charge Code	40024022
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$220.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$115.50
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	$105.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$120.75
Rate for Payer: Fidelis Medicare Advantage	$220.50
Rate for Payer: Group Health Inc Commercial	$105.00
Rate for Payer: Group Health Inc Medicare	$73.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$136.50

DEPUY INNER SCREW

Facility IP

$210.00

Service Code	HCPCS C1713
Hospital Charge Code	40024022
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00

DEPUY LEFT ANGLE LAM HOOK

Facility OP

$2,050.00

Hospital Charge Code	40029554
Hospital Revenue Code	279
Min. Negotiated Rate	$717.50
Max. Negotiated Rate	$1,640.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,127.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,025.00
Rate for Payer: Aetna Government	$1,025.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,640.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,394.00
Rate for Payer: Group Health Inc Commercial	$1,025.00
Rate for Payer: Group Health Inc Medicare	$717.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,025.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,025.00

DEPUY LOANER

Facility OP

$190.00

Hospital Charge Code	40029575
Hospital Revenue Code	270
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$152.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$95.00
Rate for Payer: Aetna Government	$95.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$152.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.20
Rate for Payer: Group Health Inc Commercial	$95.00
Rate for Payer: Group Health Inc Medicare	$66.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$95.00
Rate for Payer: Hamaspik Choice Inc Medicare	$95.00

DEPUY MIN HIP INSTRMNT LOANER

Facility OP

$1,900.00

Hospital Charge Code	40029556
Hospital Revenue Code	270
Min. Negotiated Rate	$665.00
Max. Negotiated Rate	$1,520.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,045.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$950.00
Rate for Payer: Aetna Government	$950.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,520.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,292.00
Rate for Payer: Group Health Inc Commercial	$950.00
Rate for Payer: Group Health Inc Medicare	$665.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$950.00
Rate for Payer: Hamaspik Choice Inc Medicare	$950.00

DEPUY MITEK BIO ANCHOR W/ORTHOCRD

Facility IP

$706.00

Service Code	HCPCS C1713
Hospital Charge Code	40205927
Hospital Revenue Code	278
Min. Negotiated Rate	$353.00
Max. Negotiated Rate	$353.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$353.00
Rate for Payer: Hamaspik Choice Inc Medicare	$353.00

DEPUY MITEK BIO ANCHOR W/ORTHOCRD

Facility OP

$706.00

Service Code	HCPCS C1713
Hospital Charge Code	40205927
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$741.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$388.30
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	$353.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$405.95
Rate for Payer: Fidelis Medicare Advantage	$741.30
Rate for Payer: Group Health Inc Commercial	$353.00
Rate for Payer: Group Health Inc Medicare	$247.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$353.00
Rate for Payer: Hamaspik Choice Inc Medicare	$353.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$458.90

DEPUY MITEK LUP BR ANCH W/DS ORTH

Facility OP

$1,054.00

Service Code	HCPCS C1713
Hospital Charge Code	40204710
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,106.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$579.70
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	$527.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$606.05
Rate for Payer: Fidelis Medicare Advantage	$1,106.70
Rate for Payer: Group Health Inc Commercial	$527.00
Rate for Payer: Group Health Inc Medicare	$368.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$527.00
Rate for Payer: Hamaspik Choice Inc Medicare	$527.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$685.10

DEPUY MITEK LUP BR ANCH W/DS ORTH

Facility IP

$1,054.00

Service Code	HCPCS C1713
Hospital Charge Code	40204710
Hospital Revenue Code	278
Min. Negotiated Rate	$527.00
Max. Negotiated Rate	$527.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$527.00
Rate for Payer: Hamaspik Choice Inc Medicare	$527.00

DEPUY MITEK OMIN MENISCL SYSTEM

Facility IP

$600.00

Service Code	HCPCS C1776
Hospital Charge Code	40205667
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00

DEPUY MITEK OMIN MENISCL SYSTEM

Facility OP

$600.00

Service Code	HCPCS C1776
Hospital Charge Code	40205667
Hospital Revenue Code	278
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$630.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$330.00
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	$300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$345.00
Rate for Payer: Fidelis Medicare Advantage	$630.00
Rate for Payer: Group Health Inc Commercial	$300.00
Rate for Payer: Group Health Inc Medicare	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$390.00

DEPUY NARROW HOOK

Facility OP

$1,403.33

Hospital Charge Code	40024020
Hospital Revenue Code	270
Min. Negotiated Rate	$491.17
Max. Negotiated Rate	$1,122.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$771.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$701.66
Rate for Payer: Aetna Government	$701.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,122.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$954.26
Rate for Payer: Group Health Inc Commercial	$701.66
Rate for Payer: Group Health Inc Medicare	$491.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$701.66
Rate for Payer: Hamaspik Choice Inc Medicare	$701.66

DEPUY NUT OUTER 5.0

Facility OP

$170.00

Hospital Charge Code	40029578
Hospital Revenue Code	270
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$136.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$85.00
Rate for Payer: Aetna Government	$85.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.60
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

DEPUY OUTER NUT

Facility OP

$170.10

Hospital Charge Code	40024023
Hospital Revenue Code	270
Min. Negotiated Rate	$59.54
Max. Negotiated Rate	$136.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$85.05
Rate for Payer: Aetna Government	$85.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.67
Rate for Payer: Group Health Inc Commercial	$85.05
Rate for Payer: Group Health Inc Medicare	$59.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.05
Rate for Payer: Hamaspik Choice Inc Medicare	$85.05

DEPUY PEDICLE HOOK

Facility OP

$1,403.33

Hospital Charge Code	40024021
Hospital Revenue Code	279
Min. Negotiated Rate	$491.17
Max. Negotiated Rate	$1,122.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$771.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$701.66
Rate for Payer: Aetna Government	$701.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,122.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$954.26
Rate for Payer: Group Health Inc Commercial	$701.66
Rate for Payer: Group Health Inc Medicare	$491.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$701.66
Rate for Payer: Hamaspik Choice Inc Medicare	$701.66

DEPUY PINNACLE LINER 28-54

Facility IP

$2,830.00

Service Code	HCPCS C1776
Hospital Charge Code	40029546
Hospital Revenue Code	278
Min. Negotiated Rate	$1,415.00
Max. Negotiated Rate	$1,415.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,415.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,415.00

DEPUY PINNACLE LINER 28-54

Facility OP

$2,830.00

Service Code	HCPCS C1776
Hospital Charge Code	40029546
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,971.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,556.50
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	$1,415.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,627.25
Rate for Payer: Fidelis Medicare Advantage	$2,971.50
Rate for Payer: Group Health Inc Commercial	$1,415.00
Rate for Payer: Group Health Inc Medicare	$990.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,415.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,415.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,839.50

DEPUY PINNACLE SECTOR 54 CUP

Facility IP

$4,250.00

Service Code	HCPCS C1776
Hospital Charge Code	40029545
Hospital Revenue Code	278
Min. Negotiated Rate	$2,125.00
Max. Negotiated Rate	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,125.00

Price Transparency.

All Charges