St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

COUNTER SINK 2.012.4

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40202305
Hospital Revenue Code	278
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00

COUNTERSINK CANN 2.0 TO 2.5MM

Facility

$848.00

Service Code	HCPCS C1713
Hospital Charge Code	40005929
Hospital Revenue Code	278
Min. Negotiated Rate	$424.00
Max. Negotiated Rate	$424.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$424.00
Rate for Payer: Hamaspik Choice Inc Medicare	$424.00

COUNTERSINK CANN 2.0 TO 2.5MM

Facility

$848.00

Service Code	HCPCS C1713
Hospital Charge Code	40005929
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$890.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$466.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$508.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$424.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$487.60
Rate for Payer: EmblemHealth Commercial	$424.00
Rate for Payer: Fidelis Medicare Advantage	$890.40
Rate for Payer: Group Health Inc Commercial	$424.00
Rate for Payer: Group Health Inc Medicare	$296.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$424.00
Rate for Payer: Hamaspik Choice Inc Medicare	$424.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$551.20

COUNTERSINK CANNUL 2.0 2.5MM

Facility

$1,060.00

Service Code	HCPCS C1713
Hospital Charge Code	64905614
Hospital Revenue Code	278
Min. Negotiated Rate	$530.00
Max. Negotiated Rate	$530.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$530.00
Rate for Payer: Hamaspik Choice Inc Medicare	$530.00

COUNTERSINK CANNUL 2.0 2.5MM

Facility

$1,060.00

Service Code	HCPCS C1713
Hospital Charge Code	64905614
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,113.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$583.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$636.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$530.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$609.50
Rate for Payer: EmblemHealth Commercial	$530.00
Rate for Payer: Fidelis Medicare Advantage	$1,113.00
Rate for Payer: Group Health Inc Commercial	$530.00
Rate for Payer: Group Health Inc Medicare	$371.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$530.00
Rate for Payer: Hamaspik Choice Inc Medicare	$530.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$689.00

COUNTERSINK SCREW CANN 2X24MM

Facility

$925.00

Service Code	HCPCS C1713
Hospital Charge Code	64901622
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$971.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$508.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$555.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$462.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$531.88
Rate for Payer: EmblemHealth Commercial	$462.50
Rate for Payer: Fidelis Medicare Advantage	$971.25
Rate for Payer: Group Health Inc Commercial	$462.50
Rate for Payer: Group Health Inc Medicare	$323.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$462.50
Rate for Payer: Hamaspik Choice Inc Medicare	$462.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$601.25

COUNTERSINK SCREW CANN 2X24MM

Facility

$925.00

Service Code	HCPCS C1713
Hospital Charge Code	64901622
Hospital Revenue Code	278
Min. Negotiated Rate	$462.50
Max. Negotiated Rate	$462.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$462.50
Rate for Payer: Hamaspik Choice Inc Medicare	$462.50

COUNTERSINK SURGICAL 5.0MM DIA

Facility

$1,172.50

Service Code	HCPCS C1713
Hospital Charge Code	64904558
Hospital Revenue Code	278
Min. Negotiated Rate	$586.25
Max. Negotiated Rate	$586.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$586.25
Rate for Payer: Hamaspik Choice Inc Medicare	$586.25

COUNTERSINK SURGICAL 5.0MM DIA

Facility

$1,172.50

Service Code	HCPCS C1713
Hospital Charge Code	64904558
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,231.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$644.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$703.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$586.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$674.19
Rate for Payer: EmblemHealth Commercial	$586.25
Rate for Payer: Fidelis Medicare Advantage	$1,231.12
Rate for Payer: Group Health Inc Commercial	$586.25
Rate for Payer: Group Health Inc Medicare	$410.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$586.25
Rate for Payer: Hamaspik Choice Inc Medicare	$586.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$762.12

COUPING MULTIPLANR PINRD-42991025

Facility

$1,095.64

Service Code	HCPCS C1713
Hospital Charge Code	64906396
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,150.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$602.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$657.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$547.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$629.99
Rate for Payer: EmblemHealth Commercial	$547.82
Rate for Payer: Fidelis Medicare Advantage	$1,150.42
Rate for Payer: Group Health Inc Commercial	$547.82
Rate for Payer: Group Health Inc Medicare	$383.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$547.82
Rate for Payer: Hamaspik Choice Inc Medicare	$547.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$712.17

COUPING MULTIPLANR PINRD-42991025

Facility

$1,095.64

Service Code	HCPCS C1713
Hospital Charge Code	64906396
Hospital Revenue Code	278
Min. Negotiated Rate	$547.82
Max. Negotiated Rate	$547.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$547.82
Rate for Payer: Hamaspik Choice Inc Medicare	$547.82

COUPLE ANASTO 2.5MM RED

Facility

$645.83

Hospital Charge Code	64905471
Hospital Revenue Code	270
Min. Negotiated Rate	$226.04
Max. Negotiated Rate	$516.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$355.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$322.92
Rate for Payer: Aetna Government	$322.92
Rate for Payer: Brighton Health Commercial	$484.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$516.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$439.16
Rate for Payer: Group Health Inc Commercial	$322.92
Rate for Payer: Group Health Inc Medicare	$226.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$322.92
Rate for Payer: Hamaspik Choice Inc Medicare	$322.92

COUPLER ANASTOMOSIS 2.5MM DIA

Facility

$2,237.50

Hospital Charge Code	64904455
Hospital Revenue Code	270
Min. Negotiated Rate	$783.12
Max. Negotiated Rate	$1,790.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,230.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,118.75
Rate for Payer: Aetna Government	$1,118.75
Rate for Payer: Brighton Health Commercial	$1,678.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,790.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,521.50
Rate for Payer: Group Health Inc Commercial	$1,118.75
Rate for Payer: Group Health Inc Medicare	$783.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,118.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,118.75

COUPLER ANASTOMOSIS 2MM DIA PO

Facility

$2,237.50

Hospital Charge Code	64904453
Hospital Revenue Code	279
Min. Negotiated Rate	$783.12
Max. Negotiated Rate	$1,790.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,230.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,118.75
Rate for Payer: Aetna Government	$1,118.75
Rate for Payer: Brighton Health Commercial	$1,678.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,790.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,521.50
Rate for Payer: Group Health Inc Commercial	$1,118.75
Rate for Payer: Group Health Inc Medicare	$783.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,118.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,118.75

COUPLER ANASTOMOSIS 3MM DIA PO

Facility

$2,237.50

Hospital Charge Code	64904457
Hospital Revenue Code	279
Min. Negotiated Rate	$783.12
Max. Negotiated Rate	$1,790.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,230.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,118.75
Rate for Payer: Aetna Government	$1,118.75
Rate for Payer: Brighton Health Commercial	$1,678.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,790.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,521.50
Rate for Payer: Group Health Inc Commercial	$1,118.75
Rate for Payer: Group Health Inc Medicare	$783.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,118.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,118.75

COUPLER FEMORAL STEMMED 4MM D

Facility

$4,593.25

Hospital Charge Code	64905991
Hospital Revenue Code	270
Min. Negotiated Rate	$1,607.64
Max. Negotiated Rate	$3,674.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,526.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,296.62
Rate for Payer: Aetna Government	$2,296.62
Rate for Payer: Brighton Health Commercial	$3,444.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,674.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,123.41
Rate for Payer: Group Health Inc Commercial	$2,296.62
Rate for Payer: Group Health Inc Medicare	$1,607.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,296.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,296.62

COUPLING EXT FIXATION 11MM

Facility

$1,655.75

Service Code	HCPCS C1713
Hospital Charge Code	64903113
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,738.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$910.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$993.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$827.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$952.06
Rate for Payer: EmblemHealth Commercial	$827.88
Rate for Payer: Fidelis Medicare Advantage	$1,738.54
Rate for Payer: Group Health Inc Commercial	$827.88
Rate for Payer: Group Health Inc Medicare	$579.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$827.88
Rate for Payer: Hamaspik Choice Inc Medicare	$827.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,076.24

COUPLING EXT FIXATION 11MM

Facility

$1,655.75

Service Code	HCPCS C1713
Hospital Charge Code	64903113
Hospital Revenue Code	278
Min. Negotiated Rate	$827.88
Max. Negotiated Rate	$827.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$827.88
Rate for Payer: Hamaspik Choice Inc Medicare	$827.88

COUPLING EXT FIXATION 3MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Charge Code	64901691
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$846.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$443.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$483.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$403.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$463.45
Rate for Payer: EmblemHealth Commercial	$403.00
Rate for Payer: Fidelis Medicare Advantage	$846.30
Rate for Payer: Group Health Inc Commercial	$403.00
Rate for Payer: Group Health Inc Medicare	$282.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$403.00
Rate for Payer: Hamaspik Choice Inc Medicare	$403.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$523.90

COUPLING EXT FIXATION 3MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Charge Code	64901691
Hospital Revenue Code	278
Min. Negotiated Rate	$403.00
Max. Negotiated Rate	$403.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$403.00
Rate for Payer: Hamaspik Choice Inc Medicare	$403.00

COUPLING EXT FIXATION 5MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Charge Code	64901689
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$846.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$443.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$483.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$403.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$463.45
Rate for Payer: EmblemHealth Commercial	$403.00
Rate for Payer: Fidelis Medicare Advantage	$846.30
Rate for Payer: Group Health Inc Commercial	$403.00
Rate for Payer: Group Health Inc Medicare	$282.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$403.00
Rate for Payer: Hamaspik Choice Inc Medicare	$403.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$523.90

COUPLING EXT FIXATION 5MM

Facility

$806.00

Service Code	HCPCS C1713
Hospital Charge Code	64901689
Hospital Revenue Code	278
Min. Negotiated Rate	$403.00
Max. Negotiated Rate	$403.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$403.00
Rate for Payer: Hamaspik Choice Inc Medicare	$403.00

COUPLING EXT FIXATION 90MM

Facility

$1,630.23

Service Code	HCPCS C1713
Hospital Charge Code	64902730
Hospital Revenue Code	278
Min. Negotiated Rate	$815.12
Max. Negotiated Rate	$815.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$815.12
Rate for Payer: Hamaspik Choice Inc Medicare	$815.12

COUPLING EXT FIXATION 90MM

Facility

$1,630.23

Service Code	HCPCS C1713
Hospital Charge Code	64902730
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,711.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$896.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$978.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$815.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$937.38
Rate for Payer: EmblemHealth Commercial	$815.12
Rate for Payer: Fidelis Medicare Advantage	$1,711.74
Rate for Payer: Group Health Inc Commercial	$815.12
Rate for Payer: Group Health Inc Medicare	$570.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$815.12
Rate for Payer: Hamaspik Choice Inc Medicare	$815.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,059.65

COUPLING EXT FIXATION HOLE

Facility

$943.25

Service Code	HCPCS C1713
Hospital Charge Code	64901247
Hospital Revenue Code	278
Min. Negotiated Rate	$471.62
Max. Negotiated Rate	$471.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$471.62
Rate for Payer: Hamaspik Choice Inc Medicare	$471.62

Know your out-of-pocket cost for care.

All Charges