St. Barnabas Hospital

All Charges

Charge

Type

Price

2.0 K-WIRE

Facility OP

$189.00

Hospital Charge Code	40202759
Hospital Revenue Code	272
Min. Negotiated Rate	$66.15
Max. Negotiated Rate	$151.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$103.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$94.50
Rate for Payer: Aetna Government	$94.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$151.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.52
Rate for Payer: Group Health Inc Commercial	$94.50
Rate for Payer: Group Health Inc Medicare	$66.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.50
Rate for Payer: Hamaspik Choice Inc Medicare	$94.50

2.0 LOCKING FRACTURE PLT 4 HOLE

Facility OP

$748.00

Service Code	HCPCS C1713
Hospital Charge Code	40209987
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$785.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$411.40
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	$374.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$430.10
Rate for Payer: Fidelis Medicare Advantage	$785.40
Rate for Payer: Group Health Inc Commercial	$374.00
Rate for Payer: Group Health Inc Medicare	$261.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$374.00
Rate for Payer: Hamaspik Choice Inc Medicare	$374.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$486.20

2.0 LOCKING FRACTURE PLT 4 HOLE

Facility IP

$748.00

Service Code	HCPCS C1713
Hospital Charge Code	40209987
Hospital Revenue Code	278
Min. Negotiated Rate	$374.00
Max. Negotiated Rate	$374.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$374.00
Rate for Payer: Hamaspik Choice Inc Medicare	$374.00

20% MANNITOL IN WATER - 500CC

Facility OP

$48.55

Hospital Charge Code	40501781
Hospital Revenue Code	260
Min. Negotiated Rate	$16.99
Max. Negotiated Rate	$38.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.28
Rate for Payer: Aetna Government	$24.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.01
Rate for Payer: Group Health Inc Commercial	$24.28
Rate for Payer: Group Health Inc Medicare	$16.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.28
Rate for Payer: Hamaspik Choice Inc Medicare	$24.28

2.0 MATRIX 12MM SCREW

Facility OP

$172.00

Service Code	HCPCS C1713
Hospital Charge Code	40200143
Hospital Revenue Code	278
Min. Negotiated Rate	$60.20
Max. Negotiated Rate	$180.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.60
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	$86.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$98.90
Rate for Payer: Fidelis Medicare Advantage	$180.60
Rate for Payer: Group Health Inc Commercial	$86.00
Rate for Payer: Group Health Inc Medicare	$60.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.00
Rate for Payer: Hamaspik Choice Inc Medicare	$86.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.80

2.0 MATRIX 12MM SCREW

Facility IP

$172.00

Service Code	HCPCS C1713
Hospital Charge Code	40200143
Hospital Revenue Code	278
Min. Negotiated Rate	$86.00
Max. Negotiated Rate	$86.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.00
Rate for Payer: Hamaspik Choice Inc Medicare	$86.00

20MM LOCKING SCREW 212.106

Facility OP

$270.00

Service Code	HCPCS C1713
Hospital Charge Code	40202752
Hospital Revenue Code	278
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$283.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$148.50
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	$135.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$155.25
Rate for Payer: Fidelis Medicare Advantage	$283.50
Rate for Payer: Group Health Inc Commercial	$135.00
Rate for Payer: Group Health Inc Medicare	$94.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.00
Rate for Payer: Hamaspik Choice Inc Medicare	$135.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$175.50

20MM LOCKING SCREW 212.106

Facility IP

$270.00

Service Code	HCPCS C1713
Hospital Charge Code	40202752
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$135.00
Rate for Payer: Hamaspik Choice Inc Medicare	$135.00

2.0MM SMOOTH WIRE

Facility OP

$496.00

Hospital Charge Code	40203553
Hospital Revenue Code	272
Min. Negotiated Rate	$173.60
Max. Negotiated Rate	$396.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$272.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$248.00
Rate for Payer: Aetna Government	$248.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$396.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$337.28
Rate for Payer: Group Health Inc Commercial	$248.00
Rate for Payer: Group Health Inc Medicare	$173.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.00
Rate for Payer: Hamaspik Choice Inc Medicare	$248.00

2.0X24MM CROSS-LAG SCREW

Facility IP

$148.00

Service Code	HCPCS C1781
Hospital Charge Code	40209819
Hospital Revenue Code	278
Min. Negotiated Rate	$74.00
Max. Negotiated Rate	$74.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.00
Rate for Payer: Hamaspik Choice Inc Medicare	$74.00

2.0X24MM CROSS-LAG SCREW

Facility OP

$148.00

Service Code	HCPCS C1781
Hospital Charge Code	40209819
Hospital Revenue Code	278
Min. Negotiated Rate	$51.80
Max. Negotiated Rate	$155.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$74.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.10
Rate for Payer: Fidelis Medicare Advantage	$155.40
Rate for Payer: Group Health Inc Commercial	$74.00
Rate for Payer: Group Health Inc Medicare	$51.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.00
Rate for Payer: Hamaspik Choice Inc Medicare	$74.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.20

2.0X27MM CROSS-LAG SCREW

Facility IP

$148.00

Service Code	HCPCS C1781
Hospital Charge Code	40209820
Hospital Revenue Code	278
Min. Negotiated Rate	$74.00
Max. Negotiated Rate	$74.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.00
Rate for Payer: Hamaspik Choice Inc Medicare	$74.00

2.0X27MM CROSS-LAG SCREW

Facility OP

$148.00

Service Code	HCPCS C1781
Hospital Charge Code	40209820
Hospital Revenue Code	278
Min. Negotiated Rate	$51.80
Max. Negotiated Rate	$155.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$74.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.10
Rate for Payer: Fidelis Medicare Advantage	$155.40
Rate for Payer: Group Health Inc Commercial	$74.00
Rate for Payer: Group Health Inc Medicare	$51.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.00
Rate for Payer: Hamaspik Choice Inc Medicare	$74.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.20

2.0X33MM CROSS-LAG SCREW

Facility IP

$148.00

Service Code	HCPCS C1781
Hospital Charge Code	40209821
Hospital Revenue Code	278
Min. Negotiated Rate	$74.00
Max. Negotiated Rate	$74.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.00
Rate for Payer: Hamaspik Choice Inc Medicare	$74.00

2.0X33MM CROSS-LAG SCREW

Facility OP

$148.00

Service Code	HCPCS C1781
Hospital Charge Code	40209821
Hospital Revenue Code	278
Min. Negotiated Rate	$51.80
Max. Negotiated Rate	$155.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$74.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.10
Rate for Payer: Fidelis Medicare Advantage	$155.40
Rate for Payer: Group Health Inc Commercial	$74.00
Rate for Payer: Group Health Inc Medicare	$51.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.00
Rate for Payer: Hamaspik Choice Inc Medicare	$74.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.20

2.0X36MM CROSS-LAG SCREW

Facility IP

$148.00

Service Code	HCPCS C1781
Hospital Charge Code	40209822
Hospital Revenue Code	278
Min. Negotiated Rate	$74.00
Max. Negotiated Rate	$74.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.00
Rate for Payer: Hamaspik Choice Inc Medicare	$74.00

2.0X36MM CROSS-LAG SCREW

Facility OP

$148.00

Service Code	HCPCS C1781
Hospital Charge Code	40209822
Hospital Revenue Code	278
Min. Negotiated Rate	$51.80
Max. Negotiated Rate	$155.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$69.35
Rate for Payer: Aetna Government	$69.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$74.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.10
Rate for Payer: Fidelis Medicare Advantage	$155.40
Rate for Payer: Group Health Inc Commercial	$74.00
Rate for Payer: Group Health Inc Medicare	$51.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.00
Rate for Payer: Hamaspik Choice Inc Medicare	$74.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.20

210MM FOOT RING

Facility OP

$1,118.00

Hospital Charge Code	40200592
Hospital Revenue Code	270
Min. Negotiated Rate	$391.30
Max. Negotiated Rate	$894.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$614.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$559.00
Rate for Payer: Aetna Government	$559.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$894.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$760.24
Rate for Payer: Group Health Inc Commercial	$559.00
Rate for Payer: Group Health Inc Medicare	$391.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$559.00
Rate for Payer: Hamaspik Choice Inc Medicare	$559.00

210 OPEN RING

Facility OP

$906.00

Hospital Charge Code	40200591
Hospital Revenue Code	270
Min. Negotiated Rate	$317.10
Max. Negotiated Rate	$724.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$498.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$453.00
Rate for Payer: Aetna Government	$453.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$724.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$616.08
Rate for Payer: Group Health Inc Commercial	$453.00
Rate for Payer: Group Health Inc Medicare	$317.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$453.00
Rate for Payer: Hamaspik Choice Inc Medicare	$453.00

2 1/2 DEXTROSE IN WATR-1000CC

Facility OP

$10.28

Hospital Charge Code	40501000
Hospital Revenue Code	260
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$8.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.14
Rate for Payer: Aetna Government	$5.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.99
Rate for Payer: Group Health Inc Commercial	$5.14
Rate for Payer: Group Health Inc Medicare	$3.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.14
Rate for Payer: Hamaspik Choice Inc Medicare	$5.14

2.2MMDRILLBIT JLATCH10MMSTOP135MM

Facility OP

$300.00

Hospital Charge Code	40209521
Hospital Revenue Code	270
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$240.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$150.00
Rate for Payer: Aetna Government	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$204.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

2.2MMDRILLBIT JLATCH12MMSTOP135MM

Facility OP

$300.00

Hospital Charge Code	40209522
Hospital Revenue Code	270
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$240.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$150.00
Rate for Payer: Aetna Government	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$204.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

2.2MMDRILLBIT JLATCH14MMSTOP135MM

Facility OP

$300.00

Hospital Charge Code	40209523
Hospital Revenue Code	270
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$240.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$150.00
Rate for Payer: Aetna Government	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$204.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

2.2MM DRILLBIT JLATCH6MMSTOP135MM

Facility OP

$300.00

Hospital Charge Code	40209519
Hospital Revenue Code	270
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$240.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$150.00
Rate for Payer: Aetna Government	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$204.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

2.2MM DRILLBIT JLATCH8MMSTOP135MM

Facility OP

$300.00

Hospital Charge Code	40209520
Hospital Revenue Code	270
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$240.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$150.00
Rate for Payer: Aetna Government	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$240.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$204.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

Price Transparency.

All Charges