St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

DEPUY CONDUCT 50

Facility

$2,400.00

Hospital Charge Code	40029549
Hospital Revenue Code	279
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,920.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,200.00
Rate for Payer: Aetna Government	$1,200.00
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,920.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,632.00
Rate for Payer: Group Health Inc Commercial	$1,200.00
Rate for Payer: Group Health Inc Medicare	$840.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.00

DEPUY CONDUIT TCP 10CC

Facility

$1,200.00

Hospital Charge Code	40203374
Hospital Revenue Code	272
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$960.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$660.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$600.00
Rate for Payer: Aetna Government	$600.00
Rate for Payer: Brighton Health Commercial	$900.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$960.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$816.00
Rate for Payer: Group Health Inc Commercial	$600.00
Rate for Payer: Group Health Inc Medicare	$420.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00

DEPUY CONDUIT TCP 10CC

Facility

$1,200.00

Hospital Charge Code	40009358
Hospital Revenue Code	272
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$960.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$660.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$600.00
Rate for Payer: Aetna Government	$600.00
Rate for Payer: Brighton Health Commercial	$900.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$960.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$816.00
Rate for Payer: Group Health Inc Commercial	$600.00
Rate for Payer: Group Health Inc Medicare	$420.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$600.00
Rate for Payer: Hamaspik Choice Inc Medicare	$600.00

DEPUY EXTENDED BODY HOOK

Facility

$2,050.00

Hospital Charge Code	40024018
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: Brighton Health Commercial	$1,537.50
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 F/A SCREWS 14MM

Facility

$3,400.00

Service Code	HCPCS C1713
Hospital Charge Code	40200941
Hospital Revenue Code	278
Min. Negotiated Rate	$1,700.00
Max. Negotiated Rate	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00

DEPUY F/A SCREWS 14MM

Facility

$3,400.00

Service Code	HCPCS C1713
Hospital Charge Code	40200941
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,570.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,870.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,040.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,955.00
Rate for Payer: EmblemHealth Commercial	$1,700.00
Rate for Payer: Fidelis Medicare Advantage	$3,570.00
Rate for Payer: Group Health Inc Commercial	$1,700.00
Rate for Payer: Group Health Inc Medicare	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,700.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,700.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,210.00

DEPUY FEMORAL HEAD

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	40200942
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,675.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,925.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,100.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,750.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,012.50
Rate for Payer: EmblemHealth Commercial	$1,750.00
Rate for Payer: Fidelis Medicare Advantage	$3,675.00
Rate for Payer: Group Health Inc Commercial	$1,750.00
Rate for Payer: Group Health Inc Medicare	$1,225.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,750.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,275.00

DEPUY FEMORAL HEAD

Facility

$3,500.00

Service Code	HCPCS C1776
Hospital Charge Code	40200942
Hospital Revenue Code	278
Min. Negotiated Rate	$1,750.00
Max. Negotiated Rate	$1,750.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,750.00

DEPUY GRANLS CONDUIT TCP 30CC

Facility

$2,400.00

Hospital Charge Code	40029550
Hospital Revenue Code	279
Min. Negotiated Rate	$840.00
Max. Negotiated Rate	$1,920.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,320.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,200.00
Rate for Payer: Aetna Government	$1,200.00
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,920.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,632.00
Rate for Payer: Group Health Inc Commercial	$1,200.00
Rate for Payer: Group Health Inc Medicare	$840.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,200.00

DEPUY GRANULES CONDUIT TCP 30CC V

Facility

$2,310.00

Hospital Charge Code	40009351
Hospital Revenue Code	272
Min. Negotiated Rate	$808.50
Max. Negotiated Rate	$1,848.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,270.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,155.00
Rate for Payer: Aetna Government	$1,155.00
Rate for Payer: Brighton Health Commercial	$1,732.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,570.80
Rate for Payer: Group Health Inc Commercial	$1,155.00
Rate for Payer: Group Health Inc Medicare	$808.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,155.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,155.00

DEPUY GRANULES CONDUIT TCP 30CC V

Facility

$2,310.00

Hospital Charge Code	40203368
Hospital Revenue Code	272
Min. Negotiated Rate	$808.50
Max. Negotiated Rate	$1,848.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,270.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,155.00
Rate for Payer: Aetna Government	$1,155.00
Rate for Payer: Brighton Health Commercial	$1,732.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,570.80
Rate for Payer: Group Health Inc Commercial	$1,155.00
Rate for Payer: Group Health Inc Medicare	$808.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,155.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,155.00

DEPUY HOOK LAM ANG BLD 5.0 SS

Facility

$1,240.00

Hospital Charge Code	40029564
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: Brighton Health Commercial	$930.00
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 NRWBLD 5.0 SS 1745

Facility

$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: Brighton Health Commercial	$982.50
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

$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: Brighton Health Commercial	$930.00
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

$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: Brighton Health Commercial	$1,455.00
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

$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: Brighton Health Commercial	$930.00
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

$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: Brighton Health Commercial	$930.00
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

$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: Brighton Health Commercial	$1,455.00
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

$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: Brighton Health Commercial	$930.00
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

$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: Brighton Health Commercial	$126.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$105.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$120.75
Rate for Payer: EmblemHealth Commercial	$105.00
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

$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

$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: Brighton Health Commercial	$1,537.50
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

$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: Brighton Health Commercial	$142.50
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

$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: Brighton Health Commercial	$1,425.00
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

$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: Brighton Health Commercial	$423.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$353.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$405.95
Rate for Payer: EmblemHealth Commercial	$353.00
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

Know your out-of-pocket cost for care.

All Charges