St. Barnabas Hospital

All Charges

Charge

Type

Price

FEMORAL COMPONENT SZ E LFT

Facility IP

$6,907.10

Service Code	HCPCS C1776
Hospital Charge Code	40200250
Hospital Revenue Code	278
Min. Negotiated Rate	$3,453.55
Max. Negotiated Rate	$3,453.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,453.55
Rate for Payer: Hamaspik Choice Inc Medicare	$3,453.55

FEMORAL COMPONENT SZ E RIGHT

Facility IP

$6,547.00

Service Code	HCPCS C1776
Hospital Charge Code	40202107
Hospital Revenue Code	278
Min. Negotiated Rate	$3,273.50
Max. Negotiated Rate	$3,273.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,273.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,273.50

FEMORAL COMPONENT SZ E RIGHT

Facility OP

$6,547.00

Service Code	HCPCS C1776
Hospital Charge Code	40202107
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,874.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,600.85
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	$3,273.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,764.52
Rate for Payer: Fidelis Medicare Advantage	$6,874.35
Rate for Payer: Group Health Inc Commercial	$3,273.50
Rate for Payer: Group Health Inc Medicare	$2,291.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,273.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,273.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,255.55

FEMORAL COM P SZ F RGHT

Facility IP

$8,374.20

Service Code	HCPCS C1776
Hospital Charge Code	40205128
Hospital Revenue Code	278
Min. Negotiated Rate	$4,187.10
Max. Negotiated Rate	$4,187.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,187.10
Rate for Payer: Hamaspik Choice Inc Medicare	$4,187.10

FEMORAL COM P SZ F RGHT

Facility OP

$8,374.20

Service Code	HCPCS C1776
Hospital Charge Code	40205128
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,792.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,605.81
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	$4,187.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,815.16
Rate for Payer: Fidelis Medicare Advantage	$8,792.91
Rate for Payer: Group Health Inc Commercial	$4,187.10
Rate for Payer: Group Health Inc Medicare	$2,930.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,187.10
Rate for Payer: Hamaspik Choice Inc Medicare	$4,187.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,443.23

FEMORAL COMPT POROUS SZD LT

Facility OP

$6,730.00

Service Code	HCPCS C1713
Hospital Charge Code	40009109
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$7,066.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,701.50
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	$3,365.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,869.75
Rate for Payer: Fidelis Medicare Advantage	$7,066.50
Rate for Payer: Group Health Inc Commercial	$3,365.00
Rate for Payer: Group Health Inc Medicare	$2,355.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,365.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,365.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,374.50

FEMORAL COMPT POROUS SZD LT

Facility IP

$6,730.00

Service Code	HCPCS C1713
Hospital Charge Code	40009109
Hospital Revenue Code	278
Min. Negotiated Rate	$3,365.00
Max. Negotiated Rate	$3,365.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,365.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,365.00

FEMORAL COMPT POROUS SZE RT

Facility OP

$6,730.00

Service Code	HCPCS C1713
Hospital Charge Code	40009108
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$7,066.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,701.50
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	$3,365.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,869.75
Rate for Payer: Fidelis Medicare Advantage	$7,066.50
Rate for Payer: Group Health Inc Commercial	$3,365.00
Rate for Payer: Group Health Inc Medicare	$2,355.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,365.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,365.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,374.50

FEMORAL COMPT POROUS SZE RT

Facility IP

$6,730.00

Service Code	HCPCS C1713
Hospital Charge Code	40009108
Hospital Revenue Code	278
Min. Negotiated Rate	$3,365.00
Max. Negotiated Rate	$3,365.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,365.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,365.00

FEMORAL COMPT POROUS SZF LT

Facility IP

$6,730.00

Service Code	HCPCS C1713
Hospital Charge Code	40009110
Hospital Revenue Code	278
Min. Negotiated Rate	$3,365.00
Max. Negotiated Rate	$3,365.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,365.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,365.00

FEMORAL COMPT POROUS SZF LT

Facility OP

$6,730.00

Service Code	HCPCS C1713
Hospital Charge Code	40009110
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$7,066.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,701.50
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	$3,365.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,869.75
Rate for Payer: Fidelis Medicare Advantage	$7,066.50
Rate for Payer: Group Health Inc Commercial	$3,365.00
Rate for Payer: Group Health Inc Medicare	$2,355.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,365.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,365.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,374.50

FEMORAL CRUCIATE RETAIN SZ5 RIGHT

Facility IP

$5,625.00

Service Code	HCPCS C1776
Hospital Charge Code	64905238
Hospital Revenue Code	278
Min. Negotiated Rate	$2,812.50
Max. Negotiated Rate	$2,812.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,812.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,812.50

FEMORAL CRUCIATE RETAIN SZ5 RIGHT

Facility OP

$5,625.00

Service Code	HCPCS C1776
Hospital Charge Code	64905238
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,906.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,093.75
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	$2,812.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,234.38
Rate for Payer: Fidelis Medicare Advantage	$5,906.25
Rate for Payer: Group Health Inc Commercial	$2,812.50
Rate for Payer: Group Health Inc Medicare	$1,968.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,812.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,812.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,656.25

FEMORAL CRUC RETAIN SZ5 RT

Facility OP

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	40005150
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,725.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,475.00
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	$2,250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,587.50
Rate for Payer: Fidelis Medicare Advantage	$4,725.00
Rate for Payer: Group Health Inc Commercial	$2,250.00
Rate for Payer: Group Health Inc Medicare	$1,575.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,925.00

FEMORAL CRUC RETAIN SZ5 RT

Facility IP

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	40005150
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$2,250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,250.00

FEMORAL DIST BLK SZ E 5MM

Facility IP

$7,900.00

Service Code	HCPCS L1690
Hospital Charge Code	64905885
Hospital Revenue Code	278
Min. Negotiated Rate	$3,950.00
Max. Negotiated Rate	$3,950.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,950.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,950.00

FEMORAL DIST BLK SZ E 5MM

Facility OP

$7,900.00

Service Code	HCPCS L1690
Hospital Charge Code	64905885
Hospital Revenue Code	278
Min. Negotiated Rate	$989.62
Max. Negotiated Rate	$8,295.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,345.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$989.62
Rate for Payer: Aetna Government	$989.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,950.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,542.50
Rate for Payer: Fidelis Medicare Advantage	$8,295.00
Rate for Payer: Group Health Inc Commercial	$3,950.00
Rate for Payer: Group Health Inc Medicare	$2,765.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,950.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,950.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,135.00

FEMORAL HD 12/14 40MM 10.5

Facility IP

$2,385.00

Service Code	HCPCS C1776
Hospital Charge Code	64905597
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$1,192.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,192.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,192.50

FEMORAL HD 12/14 40MM 10.5

Facility OP

$2,385.00

Service Code	HCPCS C1776
Hospital Charge Code	64905597
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,504.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,311.75
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	$1,192.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,371.38
Rate for Payer: Fidelis Medicare Advantage	$2,504.25
Rate for Payer: Group Health Inc Commercial	$1,192.50
Rate for Payer: Group Health Inc Medicare	$834.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,192.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,192.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,550.25

FEMORAL HEAD CCHROME 22MM

Facility OP

$1,680.25

Service Code	HCPCS C1776
Hospital Charge Code	64905051
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,764.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$924.14
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	$840.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$966.14
Rate for Payer: Fidelis Medicare Advantage	$1,764.26
Rate for Payer: Group Health Inc Commercial	$840.12
Rate for Payer: Group Health Inc Medicare	$588.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$840.12
Rate for Payer: Hamaspik Choice Inc Medicare	$840.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,092.16

FEMORAL HEAD CCHROME 22MM

Facility IP

$1,680.25

Service Code	HCPCS C1776
Hospital Charge Code	64905051
Hospital Revenue Code	278
Min. Negotiated Rate	$840.12
Max. Negotiated Rate	$840.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$840.12
Rate for Payer: Hamaspik Choice Inc Medicare	$840.12

FEMORAL HEAD/COMPONENT > 2000

Facility OP

$8,646.03

Service Code	HCPCS C1776
Hospital Charge Code	40203093
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,078.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,755.32
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	$4,323.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,971.47
Rate for Payer: Fidelis Medicare Advantage	$9,078.33
Rate for Payer: Group Health Inc Commercial	$4,323.02
Rate for Payer: Group Health Inc Medicare	$3,026.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,323.02
Rate for Payer: Hamaspik Choice Inc Medicare	$4,323.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,619.92

FEMORAL HEAD/COMPONENT > 2000

Facility IP

$8,646.03

Service Code	HCPCS C1776
Hospital Charge Code	40203093
Hospital Revenue Code	278
Min. Negotiated Rate	$4,323.02
Max. Negotiated Rate	$4,323.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,323.02
Rate for Payer: Hamaspik Choice Inc Medicare	$4,323.02

FEMORAL HEAD LONG 8X26

Facility IP

$2,228.00

Service Code	HCPCS C1776
Hospital Charge Code	40205370
Hospital Revenue Code	278
Min. Negotiated Rate	$1,114.00
Max. Negotiated Rate	$1,114.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,114.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,114.00

FEMORAL HEAD LONG 8X26

Facility OP

$2,228.00

Service Code	HCPCS C1776
Hospital Charge Code	40205370
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,339.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,225.40
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	$1,114.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,281.10
Rate for Payer: Fidelis Medicare Advantage	$2,339.40
Rate for Payer: Group Health Inc Commercial	$1,114.00
Rate for Payer: Group Health Inc Medicare	$779.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,114.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,114.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,448.20

Price Transparency.

All Charges