St. Barnabas Hospital

All Charges

Charge

Type

Price

FEMORAL HEAD STANDARD NEC

Facility IP

$2,228.00

Service Code	HCPCS C1776
Hospital Charge Code	40200349
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 STANDARD NEC

Facility OP

$2,228.00

Service Code	HCPCS C1776
Hospital Charge Code	40200349
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

FEMORAL NAIL

Facility IP

$3,271.80

Service Code	HCPCS C1713
Hospital Charge Code	40203570
Hospital Revenue Code	278
Min. Negotiated Rate	$1,635.90
Max. Negotiated Rate	$1,635.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,635.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,635.90

FEMORAL NAIL

Facility OP

$3,271.80

Service Code	HCPCS C1713
Hospital Charge Code	40203570
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,435.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,799.49
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	$1,635.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,881.28
Rate for Payer: Fidelis Medicare Advantage	$3,435.39
Rate for Payer: Group Health Inc Commercial	$1,635.90
Rate for Payer: Group Health Inc Medicare	$1,145.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,635.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,635.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,126.67

FEMORAL NAIL, A/R, R1500

Facility OP

$2,648.00

Service Code	HCPCS C1713
Hospital Charge Code	40202357
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,780.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,456.40
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	$1,324.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,522.60
Rate for Payer: Fidelis Medicare Advantage	$2,780.40
Rate for Payer: Group Health Inc Commercial	$1,324.00
Rate for Payer: Group Health Inc Medicare	$926.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,324.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,324.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,721.20

FEMORAL NAIL, A/R, R1500

Facility IP

$2,648.00

Service Code	HCPCS C1713
Hospital Charge Code	40202357
Hospital Revenue Code	278
Min. Negotiated Rate	$1,324.00
Max. Negotiated Rate	$1,324.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,324.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,324.00

FEMORAL NAIL T2 11X380

Facility OP

$2,940.00

Service Code	HCPCS C1713
Hospital Charge Code	40209922
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,087.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,617.00
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	$1,470.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,690.50
Rate for Payer: Fidelis Medicare Advantage	$3,087.00
Rate for Payer: Group Health Inc Commercial	$1,470.00
Rate for Payer: Group Health Inc Medicare	$1,029.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,470.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,470.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,911.00

FEMORAL NAIL T2 11X380

Facility IP

$2,940.00

Service Code	HCPCS C1713
Hospital Charge Code	40209922
Hospital Revenue Code	278
Min. Negotiated Rate	$1,470.00
Max. Negotiated Rate	$1,470.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,470.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,470.00

FEMORAL NAIL T2 12 X 460

Facility OP

$2,070.00

Service Code	HCPCS C1713
Hospital Charge Code	40201343
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,173.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,138.50
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	$1,035.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,190.25
Rate for Payer: Fidelis Medicare Advantage	$2,173.50
Rate for Payer: Group Health Inc Commercial	$1,035.00
Rate for Payer: Group Health Inc Medicare	$724.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,035.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,035.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,345.50

FEMORAL NAIL T2 12 X 460

Facility IP

$2,070.00

Service Code	HCPCS C1713
Hospital Charge Code	40201343
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.00
Max. Negotiated Rate	$1,035.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,035.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,035.00

FEMORAL NAIL T2 14 X 420MM

Facility OP

$2,070.00

Service Code	HCPCS C1713
Hospital Charge Code	40201344
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,173.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,138.50
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	$1,035.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,190.25
Rate for Payer: Fidelis Medicare Advantage	$2,173.50
Rate for Payer: Group Health Inc Commercial	$1,035.00
Rate for Payer: Group Health Inc Medicare	$724.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,035.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,035.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,345.50

FEMORAL NAIL T2 14 X 420MM

Facility IP

$2,070.00

Service Code	HCPCS C1713
Hospital Charge Code	40201344
Hospital Revenue Code	278
Min. Negotiated Rate	$1,035.00
Max. Negotiated Rate	$1,035.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,035.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,035.00

FEMORAL NERVE,CONT INFUS

Facility OP

$2,459.50

Service Code	HCPCS 64448
Hospital Charge Code	30305040
Hospital Revenue Code	510
Min. Negotiated Rate	$75.42
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,054.06
Rate for Payer: Aetna Government	$1,054.06
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,054.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$1,054.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$75.42
Rate for Payer: Fidelis Essential Plan Aliesa	$895.95
Rate for Payer: Fidelis Essential Plan QHP	$938.11
Rate for Payer: Fidelis Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Qualified Health Plan	$938.11
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,229.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,054.06
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$83.80
Rate for Payer: Healthfirst Medicare Advantage	$895.95
Rate for Payer: Healthfirst QHP	$1,054.06
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$1,054.06
Rate for Payer: Senior Whole Health Medicare Advantage	$1,054.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,054.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$843.25
Rate for Payer: Wellcare Medicare	$1,001.36

FEMORAL NERVE,SINGLE

Facility OP

$1,893.13

Service Code	HCPCS 64447
Hospital Charge Code	30305041
Hospital Revenue Code	510
Min. Negotiated Rate	$66.05
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$799.72
Rate for Payer: Aetna Government	$799.72
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$799.72
Rate for Payer: Cash Price	$799.72
Rate for Payer: Cash Price	$799.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$799.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$799.72
Rate for Payer: Fidelis CHP/HARP/Medicaid	$66.05
Rate for Payer: Fidelis Essential Plan Aliesa	$679.76
Rate for Payer: Fidelis Essential Plan QHP	$711.75
Rate for Payer: Fidelis Medicare Advantage	$799.72
Rate for Payer: Fidelis Qualified Health Plan	$711.75
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$946.56
Rate for Payer: Hamaspik Choice Inc Medicare	$799.72
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$73.39
Rate for Payer: Healthfirst Medicare Advantage	$679.76
Rate for Payer: Healthfirst QHP	$799.72
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$799.72
Rate for Payer: Senior Whole Health Medicare Advantage	$799.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$799.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$639.78
Rate for Payer: Wellcare Medicare	$759.73

FEMORAL NEXG LCCK SIZE D-LT

Facility IP

$24,600.00

Service Code	HCPCS C1776
Hospital Charge Code	64905869
Hospital Revenue Code	278
Min. Negotiated Rate	$12,300.00
Max. Negotiated Rate	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12,300.00

FEMORAL NEXG LCCK SIZE D-LT

Facility OP

$24,600.00

Service Code	HCPCS C1776
Hospital Charge Code	64905869
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$25,830.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13,530.00
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	$12,300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$14,145.00
Rate for Payer: Fidelis Medicare Advantage	$25,830.00
Rate for Payer: Group Health Inc Commercial	$12,300.00
Rate for Payer: Group Health Inc Medicare	$8,610.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12,300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15,990.00

FEMORAL NEXG LCCK SIZE E-LT

Facility OP

$24,600.00

Service Code	HCPCS C1776
Hospital Charge Code	64905878
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$25,830.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13,530.00
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	$12,300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$14,145.00
Rate for Payer: Fidelis Medicare Advantage	$25,830.00
Rate for Payer: Group Health Inc Commercial	$12,300.00
Rate for Payer: Group Health Inc Medicare	$8,610.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12,300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15,990.00

FEMORAL NEXG LCCK SIZE E-LT

Facility IP

$24,600.00

Service Code	HCPCS C1776
Hospital Charge Code	64905878
Hospital Revenue Code	278
Min. Negotiated Rate	$12,300.00
Max. Negotiated Rate	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12,300.00

FEMORAL PERONEAL BYPASS

Facility OP

$5,171.19

Service Code	HCPCS 35566
Hospital Charge Code	40031900
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,844.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,909.58
Rate for Payer: Aetna Government	$1,909.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,898.56
Rate for Payer: Group Health Inc Commercial	$2,585.60
Rate for Payer: Group Health Inc Medicare	$1,809.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,585.60
Rate for Payer: Hamaspik Choice Inc Medicare	$2,585.60
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2,109.51

FEMORAL POPLITEAL BYPASS

Facility OP

$4,177.74

Service Code	HCPCS 35556
Hospital Charge Code	40031905
Hospital Revenue Code	360
Min. Negotiated Rate	$1,462.21
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,297.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,599.34
Rate for Payer: Aetna Government	$1,599.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,591.09
Rate for Payer: Group Health Inc Commercial	$2,088.87
Rate for Payer: Group Health Inc Medicare	$1,462.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,088.87
Rate for Payer: Hamaspik Choice Inc Medicare	$2,088.87
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,767.88

FEMORAL POST BLK SZ E 5MM

Facility OP

$7,020.00

Service Code	HCPCS L1690
Hospital Charge Code	64905886
Hospital Revenue Code	278
Min. Negotiated Rate	$989.62
Max. Negotiated Rate	$7,371.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,861.00
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	$3,510.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,036.50
Rate for Payer: Fidelis Medicare Advantage	$7,371.00
Rate for Payer: Group Health Inc Commercial	$3,510.00
Rate for Payer: Group Health Inc Medicare	$2,457.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,510.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,510.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,563.00

FEMORAL POST BLK SZ E 5MM

Facility IP

$7,020.00

Service Code	HCPCS L1690
Hospital Charge Code	64905886
Hospital Revenue Code	278
Min. Negotiated Rate	$3,510.00
Max. Negotiated Rate	$3,510.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,510.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,510.00

FEMORAL PSN

Facility IP

$2,805.00

Service Code	HCPCS C1776
Hospital Charge Code	64907170
Hospital Revenue Code	278
Min. Negotiated Rate	$1,402.50
Max. Negotiated Rate	$1,402.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,402.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,402.50

FEMORAL PSN

Facility OP

$2,805.00

Service Code	HCPCS C1776
Hospital Charge Code	64907170
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,945.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,542.75
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	$1,402.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,612.88
Rate for Payer: Fidelis Medicare Advantage	$2,945.25
Rate for Payer: Group Health Inc Commercial	$1,402.50
Rate for Payer: Group Health Inc Medicare	$981.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,402.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,402.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,823.25

FEMORAL STEM

Facility OP

$1,403.68

Hospital Charge Code	40202170
Hospital Revenue Code	270
Min. Negotiated Rate	$491.29
Max. Negotiated Rate	$1,122.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$772.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$701.84
Rate for Payer: Aetna Government	$701.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,122.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$954.50
Rate for Payer: Group Health Inc Commercial	$701.84
Rate for Payer: Group Health Inc Medicare	$491.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$701.84
Rate for Payer: Hamaspik Choice Inc Medicare	$701.84

Price Transparency.

All Charges