St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

DISTAL ANTERO LEFT 14H/L229MM

Facility

$6,597.50

Service Code	HCPCS C1776
Hospital Charge Code	64905444
Hospital Revenue Code	278
Min. Negotiated Rate	$3,298.75
Max. Negotiated Rate	$3,298.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,298.75
Rate for Payer: Hamaspik Choice Inc Medicare	$3,298.75

DISTAL ANTERO LEFT 14H/L229MM

Facility

$6,597.50

Service Code	HCPCS C1776
Hospital Charge Code	64905444
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,927.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,628.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,958.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,298.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,793.56
Rate for Payer: EmblemHealth Commercial	$3,298.75
Rate for Payer: Fidelis Medicare Advantage	$6,927.38
Rate for Payer: Group Health Inc Commercial	$3,298.75
Rate for Payer: Group Health Inc Medicare	$2,309.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,298.75
Rate for Payer: Hamaspik Choice Inc Medicare	$3,298.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,288.38

DISTAL, AUGMENT 10MM

Facility

$4,550.00

Hospital Charge Code	64905990
Hospital Revenue Code	270
Min. Negotiated Rate	$1,592.50
Max. Negotiated Rate	$3,640.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,502.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,275.00
Rate for Payer: Aetna Government	$2,275.00
Rate for Payer: Brighton Health Commercial	$3,412.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,640.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,094.00
Rate for Payer: Group Health Inc Commercial	$2,275.00
Rate for Payer: Group Health Inc Medicare	$1,592.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,275.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,275.00

DISTAL FIBULAR PLATE 02.112.148S

Facility

$1,528.20

Service Code	HCPCS C1713
Hospital Charge Code	40202748
Hospital Revenue Code	278
Min. Negotiated Rate	$764.10
Max. Negotiated Rate	$764.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$764.10
Rate for Payer: Hamaspik Choice Inc Medicare	$764.10

DISTAL FIBULAR PLATE 02.112.148S

Facility

$1,528.20

Service Code	HCPCS C1713
Hospital Charge Code	40202748
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,604.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$840.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$916.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$764.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$878.72
Rate for Payer: EmblemHealth Commercial	$764.10
Rate for Payer: Fidelis Medicare Advantage	$1,604.61
Rate for Payer: Group Health Inc Commercial	$764.10
Rate for Payer: Group Health Inc Medicare	$534.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$764.10
Rate for Payer: Hamaspik Choice Inc Medicare	$764.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$993.33

DISTAL FIBULAR PLATE 02.112.152S

Facility

$1,549.00

Service Code	HCPCS C1713
Hospital Charge Code	40202749
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,626.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$851.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$929.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$774.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$890.68
Rate for Payer: EmblemHealth Commercial	$774.50
Rate for Payer: Fidelis Medicare Advantage	$1,626.45
Rate for Payer: Group Health Inc Commercial	$774.50
Rate for Payer: Group Health Inc Medicare	$542.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$774.50
Rate for Payer: Hamaspik Choice Inc Medicare	$774.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,006.85

DISTAL FIBULAR PLATE 02.112.152S

Facility

$1,549.00

Service Code	HCPCS C1713
Hospital Charge Code	40202749
Hospital Revenue Code	278
Min. Negotiated Rate	$774.50
Max. Negotiated Rate	$774.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$774.50
Rate for Payer: Hamaspik Choice Inc Medicare	$774.50

DISTAL OR PROXIMAL WEDGE PROCEDUR

Facility

$461.00

Service Code	HCPCS D4274
Hospital Charge Code	42303312
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,018.19

DISTAL OR PROXIMAL WEDGE PROCEDUR

Facility

$461.00

Service Code	HCPCS D4274
Hospital Charge Code	42303312
Hospital Revenue Code	361
Min. Negotiated Rate	$230.50
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$253.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,018.19
Rate for Payer: Aetna Government	$1,018.19
Rate for Payer: Affinity Essential Plan 1&2	$712.73
Rate for Payer: Affinity Essential Plan 3&4	$712.73
Rate for Payer: Affinity Medicaid/CHP/HARP	$712.73
Rate for Payer: Brighton Health Commercial	$345.75
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,018.19
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	$1,018.19
Rate for Payer: EmblemHealth Commercial	$1,018.19
Rate for Payer: Fidelis Essential Plan Aliesa	$865.46
Rate for Payer: Fidelis Essential Plan QHP	$906.19
Rate for Payer: Fidelis Medicare Advantage	$1,018.19
Rate for Payer: Fidelis Qualified Health Plan	$906.19
Rate for Payer: Group Health Inc Commercial	$1,018.19
Rate for Payer: Group Health Inc Medicare	$1,018.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,018.19
Rate for Payer: Healthfirst Medicare Advantage	$865.46
Rate for Payer: Healthfirst QHP	$1,018.19
Rate for Payer: Humana Medicare	$1,038.55
Rate for Payer: Senior Whole Health Medicare Advantage	$1,018.19
Rate for Payer: United Healthcare Medicare Advantage	$1,018.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,018.19
Rate for Payer: Wellcare CHP/FHP/Medicaid	$814.55
Rate for Payer: Wellcare Medicare	$967.28

DISTAL POSTERIOR LATERAL HUMERU

Facility

$3,807.50

Service Code	HCPCS C1776
Hospital Charge Code	64904739
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,997.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,094.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,284.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,903.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,189.31
Rate for Payer: EmblemHealth Commercial	$1,903.75
Rate for Payer: Fidelis Medicare Advantage	$3,997.88
Rate for Payer: Group Health Inc Commercial	$1,903.75
Rate for Payer: Group Health Inc Medicare	$1,332.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,903.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,903.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,474.88

DISTAL POSTERIOR LATERAL HUMERU

Facility

$3,807.50

Service Code	HCPCS C1776
Hospital Charge Code	64904739
Hospital Revenue Code	278
Min. Negotiated Rate	$1,903.75
Max. Negotiated Rate	$1,903.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,903.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,903.75

DISTAL RADIUS LCKNG PLTS 2.5MMLFT

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	40202237
Hospital Revenue Code	278
Min. Negotiated Rate	$680.00
Max. Negotiated Rate	$680.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$680.00

DISTAL RADIUS LCKNG PLTS 2.5MMLFT

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	40202237
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,428.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$748.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$816.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$680.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$782.00
Rate for Payer: EmblemHealth Commercial	$680.00
Rate for Payer: Fidelis Medicare Advantage	$1,428.00
Rate for Payer: Group Health Inc Commercial	$680.00
Rate for Payer: Group Health Inc Medicare	$476.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$680.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$884.00

DISTAL RADIUS LCKNG PLTS 2.5MM RT

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	40202238
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,428.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$748.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$816.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$680.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$782.00
Rate for Payer: EmblemHealth Commercial	$680.00
Rate for Payer: Fidelis Medicare Advantage	$1,428.00
Rate for Payer: Group Health Inc Commercial	$680.00
Rate for Payer: Group Health Inc Medicare	$476.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$680.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$884.00

DISTAL RADIUS LCKNG PLTS 2.5MM RT

Facility

$1,360.00

Service Code	HCPCS C1713
Hospital Charge Code	40202238
Hospital Revenue Code	278
Min. Negotiated Rate	$680.00
Max. Negotiated Rate	$680.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$680.00

DISTAL SCREW DEPTH GAUGE

Facility

$1,376.00

Service Code	HCPCS C1713
Hospital Charge Code	40006145
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,444.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$756.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$825.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$688.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$791.20
Rate for Payer: EmblemHealth Commercial	$688.00
Rate for Payer: Fidelis Medicare Advantage	$1,444.80
Rate for Payer: Group Health Inc Commercial	$688.00
Rate for Payer: Group Health Inc Medicare	$481.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.00
Rate for Payer: Hamaspik Choice Inc Medicare	$688.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$894.40

DISTAL SCREW DEPTH GAUGE

Facility

$1,376.00

Service Code	HCPCS C1713
Hospital Charge Code	40006145
Hospital Revenue Code	278
Min. Negotiated Rate	$688.00
Max. Negotiated Rate	$688.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.00
Rate for Payer: Hamaspik Choice Inc Medicare	$688.00

DISTAL SCREW DRILL SLEEVE

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	40006144
Hospital Revenue Code	278
Min. Negotiated Rate	$360.00
Max. Negotiated Rate	$360.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$360.00
Rate for Payer: Hamaspik Choice Inc Medicare	$360.00

DISTAL SCREW DRILL SLEEVE

Facility

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	40006144
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$756.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$396.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$432.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$360.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$414.00
Rate for Payer: EmblemHealth Commercial	$360.00
Rate for Payer: Fidelis Medicare Advantage	$756.00
Rate for Payer: Group Health Inc Commercial	$360.00
Rate for Payer: Group Health Inc Medicare	$252.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$360.00
Rate for Payer: Hamaspik Choice Inc Medicare	$360.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$468.00

DISTAL SCREW SHEATH

Facility

$1,248.00

Service Code	HCPCS C1713
Hospital Charge Code	40006142
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,310.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$686.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$748.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$624.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$717.60
Rate for Payer: EmblemHealth Commercial	$624.00
Rate for Payer: Fidelis Medicare Advantage	$1,310.40
Rate for Payer: Group Health Inc Commercial	$624.00
Rate for Payer: Group Health Inc Medicare	$436.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$624.00
Rate for Payer: Hamaspik Choice Inc Medicare	$624.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$811.20

DISTAL SCREW SHEATH

Facility

$1,248.00

Service Code	HCPCS C1713
Hospital Charge Code	40006142
Hospital Revenue Code	278
Min. Negotiated Rate	$624.00
Max. Negotiated Rate	$624.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$624.00
Rate for Payer: Hamaspik Choice Inc Medicare	$624.00

DISTAL SCREW TROCHAR

Facility

$528.00

Service Code	HCPCS C1713
Hospital Charge Code	40006143
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$554.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$290.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$316.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$264.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$303.60
Rate for Payer: EmblemHealth Commercial	$264.00
Rate for Payer: Fidelis Medicare Advantage	$554.40
Rate for Payer: Group Health Inc Commercial	$264.00
Rate for Payer: Group Health Inc Medicare	$184.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$264.00
Rate for Payer: Hamaspik Choice Inc Medicare	$264.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$343.20

DISTAL SCREW TROCHAR

Facility

$528.00

Service Code	HCPCS C1713
Hospital Charge Code	40006143
Hospital Revenue Code	278
Min. Negotiated Rate	$264.00
Max. Negotiated Rate	$264.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$264.00
Rate for Payer: Hamaspik Choice Inc Medicare	$264.00

DISTAL SHOE SPACE-FIXED UNI PER Q

Facility

$290.00

Service Code	HCPCS D1575
Hospital Charge Code	42300717
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,018.19

DISTAL SHOE SPACE-FIXED UNI PER Q

Facility

$290.00

Service Code	HCPCS D1575
Hospital Charge Code	42300717
Hospital Revenue Code	361
Min. Negotiated Rate	$145.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$159.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,018.19
Rate for Payer: Aetna Government	$1,018.19
Rate for Payer: Affinity Essential Plan 1&2	$712.73
Rate for Payer: Affinity Essential Plan 3&4	$712.73
Rate for Payer: Affinity Medicaid/CHP/HARP	$712.73
Rate for Payer: Brighton Health Commercial	$217.50
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,018.19
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	$1,018.19
Rate for Payer: EmblemHealth Commercial	$1,018.19
Rate for Payer: Fidelis Essential Plan Aliesa	$865.46
Rate for Payer: Fidelis Essential Plan QHP	$906.19
Rate for Payer: Fidelis Medicare Advantage	$1,018.19
Rate for Payer: Fidelis Qualified Health Plan	$906.19
Rate for Payer: Group Health Inc Commercial	$1,018.19
Rate for Payer: Group Health Inc Medicare	$1,018.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$145.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,018.19
Rate for Payer: Healthfirst Medicare Advantage	$865.46
Rate for Payer: Healthfirst QHP	$1,018.19
Rate for Payer: Humana Medicare	$1,038.55
Rate for Payer: Senior Whole Health Medicare Advantage	$1,018.19
Rate for Payer: United Healthcare Medicare Advantage	$1,018.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,018.19
Rate for Payer: Wellcare CHP/FHP/Medicaid	$814.55
Rate for Payer: Wellcare Medicare	$967.28

Know your out-of-pocket cost for care.

All Charges