St. Barnabas Hospital

All Charges

Charge

Type

Price

FEMORAL TIBIAL BYPASS

Facility OP

$5,171.19

Service Code	HCPCS 35566
Hospital Charge Code	40031910
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

FEMORO FEMORAL BYPASS

Facility OP

$3,913.69

Service Code	HCPCS 35558
Hospital Charge Code	40031915
Hospital Revenue Code	360
Min. Negotiated Rate	$1,369.79
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,152.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,405.28
Rate for Payer: Aetna Government	$1,405.28
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	$1,408.68
Rate for Payer: Group Health Inc Commercial	$1,956.84
Rate for Payer: Group Health Inc Medicare	$1,369.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,956.84
Rate for Payer: Hamaspik Choice Inc Medicare	$1,956.84
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,565.20

FEM POST TRI AUG

Facility IP

$4,271.25

Service Code	HCPCS C1776
Hospital Charge Code	64907217
Hospital Revenue Code	278
Min. Negotiated Rate	$2,135.62
Max. Negotiated Rate	$2,135.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,135.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,135.62

FEM POST TRI AUG

Facility OP

$4,271.25

Service Code	HCPCS C1776
Hospital Charge Code	64907217
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,484.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,349.19
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	$2,135.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,455.97
Rate for Payer: Fidelis Medicare Advantage	$4,484.81
Rate for Payer: Group Health Inc Commercial	$2,135.62
Rate for Payer: Group Health Inc Medicare	$1,494.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,135.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,135.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,776.31

FEMRL COMPONENT 3 R CEMENTED

Facility OP

$688.00

Service Code	HCPCS C1776
Hospital Charge Code	40209704
Hospital Revenue Code	278
Min. Negotiated Rate	$240.80
Max. Negotiated Rate	$722.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$378.40
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	$344.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$395.60
Rate for Payer: Fidelis Medicare Advantage	$722.40
Rate for Payer: Group Health Inc Commercial	$344.00
Rate for Payer: Group Health Inc Medicare	$240.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$344.00
Rate for Payer: Hamaspik Choice Inc Medicare	$344.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$447.20

FEMRL COMPONENT 3 R CEMENTED

Facility IP

$688.00

Service Code	HCPCS C1776
Hospital Charge Code	40209704
Hospital Revenue Code	278
Min. Negotiated Rate	$344.00
Max. Negotiated Rate	$344.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$344.00
Rate for Payer: Hamaspik Choice Inc Medicare	$344.00

FEM STEM MRS

Facility IP

$13,018.12

Service Code	HCPCS C1776
Hospital Charge Code	64907280
Hospital Revenue Code	278
Min. Negotiated Rate	$6,509.06
Max. Negotiated Rate	$6,509.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,509.06
Rate for Payer: Hamaspik Choice Inc Medicare	$6,509.06

FEM STEM MRS

Facility OP

$13,018.12

Service Code	HCPCS C1776
Hospital Charge Code	64907280
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$13,669.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,159.97
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	$6,509.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,485.42
Rate for Payer: Fidelis Medicare Advantage	$13,669.03
Rate for Payer: Group Health Inc Commercial	$6,509.06
Rate for Payer: Group Health Inc Medicare	$4,556.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,509.06
Rate for Payer: Hamaspik Choice Inc Medicare	$6,509.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,461.78

FEM STM MRS W/O BD

Facility OP

$9,429.38

Service Code	HCPCS C1776
Hospital Charge Code	64907281
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,900.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,186.16
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	$4,714.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,421.89
Rate for Payer: Fidelis Medicare Advantage	$9,900.85
Rate for Payer: Group Health Inc Commercial	$4,714.69
Rate for Payer: Group Health Inc Medicare	$3,300.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,714.69
Rate for Payer: Hamaspik Choice Inc Medicare	$4,714.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,129.10

FEM STM MRS W/O BD

Facility IP

$9,429.38

Service Code	HCPCS C1776
Hospital Charge Code	64907281
Hospital Revenue Code	278
Min. Negotiated Rate	$4,714.69
Max. Negotiated Rate	$4,714.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,714.69
Rate for Payer: Hamaspik Choice Inc Medicare	$4,714.69

FEM STM W/FEM TAPER

Facility IP

$8,608.12

Service Code	HCPCS C1776
Hospital Charge Code	64907282
Hospital Revenue Code	278
Min. Negotiated Rate	$4,304.06
Max. Negotiated Rate	$4,304.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,304.06
Rate for Payer: Hamaspik Choice Inc Medicare	$4,304.06

FEM STM W/FEM TAPER

Facility OP

$8,608.12

Service Code	HCPCS C1776
Hospital Charge Code	64907282
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,038.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,734.47
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	$4,304.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,949.67
Rate for Payer: Fidelis Medicare Advantage	$9,038.53
Rate for Payer: Group Health Inc Commercial	$4,304.06
Rate for Payer: Group Health Inc Medicare	$3,012.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,304.06
Rate for Payer: Hamaspik Choice Inc Medicare	$4,304.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,595.28

FEM TRI TS

Facility IP

$23,640.00

Service Code	HCPCS C1776
Hospital Charge Code	64907208
Hospital Revenue Code	278
Min. Negotiated Rate	$11,820.00
Max. Negotiated Rate	$11,820.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,820.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11,820.00

FEM TRI TS

Facility OP

$23,640.00

Service Code	HCPCS C1776
Hospital Charge Code	64907208
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$24,822.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13,002.00
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	$11,820.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13,593.00
Rate for Payer: Fidelis Medicare Advantage	$24,822.00
Rate for Payer: Group Health Inc Commercial	$11,820.00
Rate for Payer: Group Health Inc Medicare	$8,274.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,820.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11,820.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15,366.00

FEMUR, CEMENT PER STD SZ7 L

Facility OP

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	64905511
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,662.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,537.50
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	$4,125.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,743.75
Rate for Payer: Fidelis Medicare Advantage	$8,662.50
Rate for Payer: Group Health Inc Commercial	$4,125.00
Rate for Payer: Group Health Inc Medicare	$2,887.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,125.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,362.50

FEMUR, CEMENT PER STD SZ7 L

Facility IP

$8,250.00

Service Code	HCPCS C1713
Hospital Charge Code	64905511
Hospital Revenue Code	278
Min. Negotiated Rate	$4,125.00
Max. Negotiated Rate	$4,125.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,125.00

FEMUR, CEMENT PS SZ4 L

Facility OP

$7,750.00

Service Code	HCPCS C1713
Hospital Charge Code	64905517
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,137.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,262.50
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	$3,875.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,456.25
Rate for Payer: Fidelis Medicare Advantage	$8,137.50
Rate for Payer: Group Health Inc Commercial	$3,875.00
Rate for Payer: Group Health Inc Medicare	$2,712.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,875.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,037.50

FEMUR, CEMENT PS SZ4 L

Facility IP

$7,750.00

Service Code	HCPCS C1713
Hospital Charge Code	64905517
Hospital Revenue Code	278
Min. Negotiated Rate	$3,875.00
Max. Negotiated Rate	$3,875.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,875.00

FEMUR CEMENT RIGHT SZ5

Facility OP

$8,250.00

Service Code	HCPCS C1776
Hospital Charge Code	64905313
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,662.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,537.50
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	$4,125.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,743.75
Rate for Payer: Fidelis Medicare Advantage	$8,662.50
Rate for Payer: Group Health Inc Commercial	$4,125.00
Rate for Payer: Group Health Inc Medicare	$2,887.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,125.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,362.50

FEMUR CEMENT RIGHT SZ5

Facility IP

$8,250.00

Service Code	HCPCS C1776
Hospital Charge Code	64905313
Hospital Revenue Code	278
Min. Negotiated Rate	$4,125.00
Max. Negotiated Rate	$4,125.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,125.00

FEMUR CMNTD PS CMT CCR NRW SZ4 L

Facility IP

$6,600.00

Service Code	HCPCS C1776
Hospital Charge Code	40204602
Hospital Revenue Code	278
Min. Negotiated Rate	$3,300.00
Max. Negotiated Rate	$3,300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,300.00

FEMUR CMNTD PS CMT CCR NRW SZ4 L

Facility OP

$6,600.00

Service Code	HCPCS C1776
Hospital Charge Code	40204602
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,930.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,630.00
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	$3,300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,795.00
Rate for Payer: Fidelis Medicare Advantage	$6,930.00
Rate for Payer: Group Health Inc Commercial	$3,300.00
Rate for Payer: Group Health Inc Medicare	$2,310.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,290.00

FEMUR CMNT PS RIGHT SZ10

Facility IP

$7,750.00

Service Code	HCPCS C1713
Hospital Charge Code	64905454
Hospital Revenue Code	278
Min. Negotiated Rate	$3,875.00
Max. Negotiated Rate	$3,875.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,875.00

FEMUR CMNT PS RIGHT SZ10

Facility OP

$7,750.00

Service Code	HCPCS C1713
Hospital Charge Code	64905454
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,137.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,262.50
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	$3,875.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,456.25
Rate for Payer: Fidelis Medicare Advantage	$8,137.50
Rate for Payer: Group Health Inc Commercial	$3,875.00
Rate for Payer: Group Health Inc Medicare	$2,712.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,875.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,037.50

FEMUR, CMTD, PS CMT CCR NRW SZ4 L

Facility IP

$6,600.00

Service Code	HCPCS C1776
Hospital Charge Code	40007521
Hospital Revenue Code	278
Min. Negotiated Rate	$3,300.00
Max. Negotiated Rate	$3,300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,300.00

Price Transparency.

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