St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

COROENT LO 12X10X40MM 5 DG

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64904079
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$11,025.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,775.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$6,300.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,037.50
Rate for Payer: EmblemHealth Commercial	$5,250.00
Rate for Payer: Fidelis Medicare Advantage	$11,025.00
Rate for Payer: Group Health Inc Commercial	$5,250.00
Rate for Payer: Group Health Inc Medicare	$3,675.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,825.00

COROENTLO 8X10X30 5DEG

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64903921
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$11,025.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,775.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$6,300.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,037.50
Rate for Payer: EmblemHealth Commercial	$5,250.00
Rate for Payer: Fidelis Medicare Advantage	$11,025.00
Rate for Payer: Group Health Inc Commercial	$5,250.00
Rate for Payer: Group Health Inc Medicare	$3,675.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,825.00

COROENTLO 8X10X30 5DEG

Facility

$10,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64903921
Hospital Revenue Code	278
Min. Negotiated Rate	$5,250.00
Max. Negotiated Rate	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,250.00

COROENT SI SCREW, 4X12MM SELFT

Facility

$917.50

Service Code	HCPCS C1713
Hospital Charge Code	64905277
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$963.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$504.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$550.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$458.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$527.56
Rate for Payer: EmblemHealth Commercial	$458.75
Rate for Payer: Fidelis Medicare Advantage	$963.38
Rate for Payer: Group Health Inc Commercial	$458.75
Rate for Payer: Group Health Inc Medicare	$321.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$458.75
Rate for Payer: Hamaspik Choice Inc Medicare	$458.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$596.38

COROENT SI SCREW, 4X12MM SELFT

Facility

$917.50

Service Code	HCPCS C1713
Hospital Charge Code	64905277
Hospital Revenue Code	278
Min. Negotiated Rate	$458.75
Max. Negotiated Rate	$458.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$458.75
Rate for Payer: Hamaspik Choice Inc Medicare	$458.75

COROENT SI SCREW, 4X14MM SELFT

Facility

$917.50

Service Code	HCPCS C1713
Hospital Charge Code	64905276
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$963.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$504.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$550.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$458.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$527.56
Rate for Payer: EmblemHealth Commercial	$458.75
Rate for Payer: Fidelis Medicare Advantage	$963.38
Rate for Payer: Group Health Inc Commercial	$458.75
Rate for Payer: Group Health Inc Medicare	$321.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$458.75
Rate for Payer: Hamaspik Choice Inc Medicare	$458.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$596.38

COROENT SI SCREW, 4X14MM SELFT

Facility

$917.50

Service Code	HCPCS C1713
Hospital Charge Code	64905276
Hospital Revenue Code	278
Min. Negotiated Rate	$458.75
Max. Negotiated Rate	$458.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$458.75
Rate for Payer: Hamaspik Choice Inc Medicare	$458.75

COROENT SMALL, 7X13X15MM LORDO

Facility

$4,142.50

Service Code	HCPCS C1713
Hospital Charge Code	64905574
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,349.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,278.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,485.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,071.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,381.94
Rate for Payer: EmblemHealth Commercial	$2,071.25
Rate for Payer: Fidelis Medicare Advantage	$4,349.62
Rate for Payer: Group Health Inc Commercial	$2,071.25
Rate for Payer: Group Health Inc Medicare	$1,449.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,071.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,071.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,692.62

COROENT SMALL, 7X13X15MM LORDO

Facility

$4,142.50

Service Code	HCPCS C1713
Hospital Charge Code	64905574
Hospital Revenue Code	278
Min. Negotiated Rate	$2,071.25
Max. Negotiated Rate	$2,071.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,071.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,071.25

COROENT SMALL, 8X13X15MM LORDO

Facility

$4,142.50

Service Code	HCPCS C1713
Hospital Charge Code	64905572
Hospital Revenue Code	278
Min. Negotiated Rate	$2,071.25
Max. Negotiated Rate	$2,071.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,071.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,071.25

COROENT SMALL, 8X13X15MM LORDO

Facility

$4,142.50

Service Code	HCPCS C1713
Hospital Charge Code	64905572
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,349.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,278.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,485.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,071.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,381.94
Rate for Payer: EmblemHealth Commercial	$2,071.25
Rate for Payer: Fidelis Medicare Advantage	$4,349.62
Rate for Payer: Group Health Inc Commercial	$2,071.25
Rate for Payer: Group Health Inc Medicare	$1,449.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,071.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,071.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,692.62

COROENT SM CONTOUR, M6

Facility

$4,142.50

Service Code	HCPCS C1713
Hospital Charge Code	64905423
Hospital Revenue Code	278
Min. Negotiated Rate	$2,071.25
Max. Negotiated Rate	$2,071.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,071.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,071.25

COROENT SM CONTOUR, M6

Facility

$4,142.50

Service Code	HCPCS C1713
Hospital Charge Code	64905423
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,349.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,278.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,485.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,071.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,381.94
Rate for Payer: EmblemHealth Commercial	$2,071.25
Rate for Payer: Fidelis Medicare Advantage	$4,349.62
Rate for Payer: Group Health Inc Commercial	$2,071.25
Rate for Payer: Group Health Inc Medicare	$1,449.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,071.25
Rate for Payer: Hamaspik Choice Inc Medicare	$2,071.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,692.62

COROENT SM INTERLOCK 7X17X14 7

Facility

$7,105.00

Service Code	HCPCS C1713
Hospital Charge Code	64905274
Hospital Revenue Code	278
Min. Negotiated Rate	$3,552.50
Max. Negotiated Rate	$3,552.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,552.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,552.50

COROENT SM INTERLOCK 7X17X14 7

Facility

$7,105.00

Service Code	HCPCS C1713
Hospital Charge Code	64905274
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$7,460.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,907.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$4,263.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,552.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,085.38
Rate for Payer: EmblemHealth Commercial	$3,552.50
Rate for Payer: Fidelis Medicare Advantage	$7,460.25
Rate for Payer: Group Health Inc Commercial	$3,552.50
Rate for Payer: Group Health Inc Medicare	$2,486.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,552.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,552.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,618.25

COROENT SM INTERLOCK 8X17X14 7

Facility

$7,105.00

Service Code	HCPCS C1713
Hospital Charge Code	64905275
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$7,460.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,907.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$4,263.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,552.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,085.38
Rate for Payer: EmblemHealth Commercial	$3,552.50
Rate for Payer: Fidelis Medicare Advantage	$7,460.25
Rate for Payer: Group Health Inc Commercial	$3,552.50
Rate for Payer: Group Health Inc Medicare	$2,486.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,552.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,552.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,618.25

COROENT SM INTERLOCK 8X17X14 7

Facility

$7,105.00

Service Code	HCPCS C1713
Hospital Charge Code	64905275
Hospital Revenue Code	278
Min. Negotiated Rate	$3,552.50
Max. Negotiated Rate	$3,552.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,552.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,552.50

COROENT XL 10X18X45MM 10D

Facility

$12,305.00

Service Code	HCPCS C1713
Hospital Charge Code	64905335
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$12,920.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,767.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$7,383.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,152.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,075.38
Rate for Payer: EmblemHealth Commercial	$6,152.50
Rate for Payer: Fidelis Medicare Advantage	$12,920.25
Rate for Payer: Group Health Inc Commercial	$6,152.50
Rate for Payer: Group Health Inc Medicare	$4,306.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,152.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,152.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,998.25

COROENT XL 10X18X45MM 10D

Facility

$12,305.00

Service Code	HCPCS C1713
Hospital Charge Code	64905335
Hospital Revenue Code	278
Min. Negotiated Rate	$6,152.50
Max. Negotiated Rate	$6,152.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,152.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,152.50

COROENT XL 8X18X45MM

Facility

$11,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64903533
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$12,075.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,325.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$6,900.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,750.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,612.50
Rate for Payer: EmblemHealth Commercial	$5,750.00
Rate for Payer: Fidelis Medicare Advantage	$12,075.00
Rate for Payer: Group Health Inc Commercial	$5,750.00
Rate for Payer: Group Health Inc Medicare	$4,025.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,750.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,475.00

COROENT XL 8X18X45MM

Facility

$11,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64903533
Hospital Revenue Code	278
Min. Negotiated Rate	$5,750.00
Max. Negotiated Rate	$5,750.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,750.00

COROENT XLR 14X34X24 8D

Facility

$16,930.00

Service Code	HCPCS C1713
Hospital Charge Code	64905178
Hospital Revenue Code	278
Min. Negotiated Rate	$8,465.00
Max. Negotiated Rate	$8,465.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,465.00
Rate for Payer: Hamaspik Choice Inc Medicare	$8,465.00

COROENT XLR 14X34X24 8D

Facility

$16,930.00

Service Code	HCPCS C1713
Hospital Charge Code	64905178
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$17,776.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,311.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$10,158.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8,465.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,734.75
Rate for Payer: EmblemHealth Commercial	$8,465.00
Rate for Payer: Fidelis Medicare Advantage	$17,776.50
Rate for Payer: Group Health Inc Commercial	$8,465.00
Rate for Payer: Group Health Inc Medicare	$5,925.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,465.00
Rate for Payer: Hamaspik Choice Inc Medicare	$8,465.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11,004.50

COROENT XLR 16X38X28 8D

Facility

$16,930.00

Service Code	HCPCS C1713
Hospital Charge Code	64905180
Hospital Revenue Code	278
Min. Negotiated Rate	$8,465.00
Max. Negotiated Rate	$8,465.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,465.00
Rate for Payer: Hamaspik Choice Inc Medicare	$8,465.00

COROENT XLR 16X38X28 8D

Facility

$16,930.00

Service Code	HCPCS C1713
Hospital Charge Code	64905180
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$17,776.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,311.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$10,158.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8,465.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,734.75
Rate for Payer: EmblemHealth Commercial	$8,465.00
Rate for Payer: Fidelis Medicare Advantage	$17,776.50
Rate for Payer: Group Health Inc Commercial	$8,465.00
Rate for Payer: Group Health Inc Medicare	$5,925.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,465.00
Rate for Payer: Hamaspik Choice Inc Medicare	$8,465.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11,004.50

Know your out-of-pocket cost for care.

All Charges