St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

FIRST-METRONIDAZOLE 50 MG/ML PO SUSR [166740]

Facility

$0.60

Service Code	NDC 65628020205
Hospital Charge Code	65628020205
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Brighton Health Commercial	$0.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.41
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.39

FIRST PLUS BED

Facility

$200.00

Hospital Charge Code	40209304
Hospital Revenue Code	270
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$160.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$100.00
Rate for Payer: Aetna Government	$100.00
Rate for Payer: Brighton Health Commercial	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

FIRST SELECT BED

Facility

$200.00

Hospital Charge Code	40209308
Hospital Revenue Code	270
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$160.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$100.00
Rate for Payer: Aetna Government	$100.00
Rate for Payer: Brighton Health Commercial	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

FIRST STEP HEAVY DUTY BED

Facility

$200.00

Hospital Charge Code	40209300
Hospital Revenue Code	270
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$160.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$100.00
Rate for Payer: Aetna Government	$100.00
Rate for Payer: Brighton Health Commercial	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

Fissurectomy, including sphincterotomy, when performed

Facility

$3,311.93

Service Code	CPT 46200
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.00
Max. Negotiated Rate	$3,311.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,246.99
Rate for Payer: Aetna Government	$3,246.99
Rate for Payer: Affinity Essential Plan 1&2	$2,272.89
Rate for Payer: Affinity Essential Plan 3&4	$2,272.89
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,272.89
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,246.99
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	$3,246.99
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$2,759.94
Rate for Payer: Fidelis Essential Plan QHP	$2,889.82
Rate for Payer: Fidelis Medicare Advantage	$3,246.99
Rate for Payer: Fidelis Qualified Health Plan	$2,889.82
Rate for Payer: Group Health Inc Commercial	$3,246.99
Rate for Payer: Group Health Inc Medicare	$3,246.99
Rate for Payer: Hamaspik Choice Inc Medicare	$3,246.99
Rate for Payer: Healthfirst Medicare Advantage	$2,759.94
Rate for Payer: Healthfirst QHP	$3,246.99
Rate for Payer: Humana Medicare	$3,311.93
Rate for Payer: Senior Whole Health Medicare Advantage	$3,246.99
Rate for Payer: United Healthcare Commercial	$1,468.00
Rate for Payer: United Healthcare Medicare Advantage	$3,246.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,246.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,597.59
Rate for Payer: Wellcare Medicare	$3,084.64

FISTULA PLUG

Facility

$2,825.00

Service Code	HCPCS C1760
Hospital Charge Code	41300008
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$2,966.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,553.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.50
Rate for Payer: Aetna Government	$73.50
Rate for Payer: Brighton Health Commercial	$1,695.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,412.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,624.38
Rate for Payer: EmblemHealth Commercial	$1,412.50
Rate for Payer: Fidelis Medicare Advantage	$2,966.25
Rate for Payer: Group Health Inc Commercial	$1,412.50
Rate for Payer: Group Health Inc Medicare	$988.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,412.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,412.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,836.25

FISTULA PLUG

Facility

$2,825.00

Service Code	HCPCS C1760
Hospital Charge Code	41300008
Hospital Revenue Code	278
Min. Negotiated Rate	$1,412.50
Max. Negotiated Rate	$1,412.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,412.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,412.50

FISTULECTOMY

Facility

$7,099.93

Service Code	HCPCS 46270
Hospital Charge Code	40011350
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.00
Max. Negotiated Rate	$5,324.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,246.99
Rate for Payer: Aetna Government	$3,246.99
Rate for Payer: Affinity Essential Plan 1&2	$2,272.89
Rate for Payer: Affinity Essential Plan 3&4	$2,272.89
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,272.89
Rate for Payer: Brighton Health Commercial	$5,324.95
Rate for Payer: Cash Price	$3,246.99
Rate for Payer: Cash Price	$3,246.99
Rate for Payer: Cash Price	$3,246.99
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,246.99
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	$3,246.99
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$2,759.94
Rate for Payer: Fidelis Essential Plan QHP	$2,889.82
Rate for Payer: Fidelis Medicare Advantage	$3,246.99
Rate for Payer: Fidelis Qualified Health Plan	$2,889.82
Rate for Payer: Group Health Inc Commercial	$3,246.99
Rate for Payer: Group Health Inc Medicare	$3,246.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,549.96
Rate for Payer: Hamaspik Choice Inc Medicare	$3,246.99
Rate for Payer: Healthfirst Medicare Advantage	$2,759.94
Rate for Payer: Healthfirst QHP	$3,246.99
Rate for Payer: Humana Medicare	$3,311.93
Rate for Payer: Senior Whole Health Medicare Advantage	$3,246.99
Rate for Payer: United Healthcare Commercial	$1,468.00
Rate for Payer: United Healthcare Medicare Advantage	$3,246.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,246.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,597.59
Rate for Payer: Wellcare Medicare	$3,084.64

FISTULECTOMY

Facility

$7,099.93

Service Code	HCPCS 46270
Hospital Charge Code	40011350
Hospital Revenue Code	360
Rate for Payer: Cash Price	$3,246.99

Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery

Facility

$2,915.00

Service Code	CPT 66170
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,694.88
Rate for Payer: Aetna Government	$2,694.88
Rate for Payer: Affinity Essential Plan 1&2	$1,886.42
Rate for Payer: Affinity Essential Plan 3&4	$1,886.42
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,886.42
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,694.88
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	$2,694.88
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$2,290.65
Rate for Payer: Fidelis Essential Plan QHP	$2,398.44
Rate for Payer: Fidelis Medicare Advantage	$2,694.88
Rate for Payer: Fidelis Qualified Health Plan	$2,398.44
Rate for Payer: Group Health Inc Commercial	$2,694.88
Rate for Payer: Group Health Inc Medicare	$2,694.88
Rate for Payer: Hamaspik Choice Inc Medicare	$2,694.88
Rate for Payer: Healthfirst Medicare Advantage	$2,290.65
Rate for Payer: Healthfirst QHP	$2,694.88
Rate for Payer: Humana Medicare	$2,748.78
Rate for Payer: Senior Whole Health Medicare Advantage	$2,694.88
Rate for Payer: United Healthcare Commercial	$1,468.00
Rate for Payer: United Healthcare Medicare Advantage	$2,694.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,694.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,155.90
Rate for Payer: Wellcare Medicare	$2,560.14

FIT FLOSEAL HEMOSTATIC MATRIX

Facility

$367.00

Hospital Charge Code	40205974
Hospital Revenue Code	270
Min. Negotiated Rate	$128.45
Max. Negotiated Rate	$293.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$201.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$183.50
Rate for Payer: Aetna Government	$183.50
Rate for Payer: Brighton Health Commercial	$275.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$293.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$249.56
Rate for Payer: Group Health Inc Commercial	$183.50
Rate for Payer: Group Health Inc Medicare	$128.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$183.50
Rate for Payer: Hamaspik Choice Inc Medicare	$183.50

FITTING FRAME FIXATOR 4.2MM AO

Facility

$482.50

Hospital Charge Code	64906485
Hospital Revenue Code	270
Min. Negotiated Rate	$168.88
Max. Negotiated Rate	$386.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$265.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$241.25
Rate for Payer: Aetna Government	$241.25
Rate for Payer: Brighton Health Commercial	$361.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$386.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$328.10
Rate for Payer: Group Health Inc Commercial	$241.25
Rate for Payer: Group Health Inc Medicare	$168.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$241.25
Rate for Payer: Hamaspik Choice Inc Medicare	$241.25

FIXATION DEVICE

Facility

$1,564.55

Hospital Charge Code	64905137
Hospital Revenue Code	270
Min. Negotiated Rate	$547.59
Max. Negotiated Rate	$1,251.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$860.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$782.28
Rate for Payer: Aetna Government	$782.28
Rate for Payer: Brighton Health Commercial	$1,173.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,251.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,063.89
Rate for Payer: Group Health Inc Commercial	$782.28
Rate for Payer: Group Health Inc Medicare	$547.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$782.28
Rate for Payer: Hamaspik Choice Inc Medicare	$782.28

FIXATION OF ANKLE JOINT

Facility

$8,291.05

Service Code	HCPCS 27860
Hospital Charge Code	40029644
Hospital Revenue Code	360
Rate for Payer: Cash Price	$3,743.15

FIXATION OF ANKLE JOINT

Facility

$8,291.05

Service Code	HCPCS 27860
Hospital Charge Code	40029644
Hospital Revenue Code	360
Min. Negotiated Rate	$1,409.00
Max. Negotiated Rate	$6,218.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,743.15
Rate for Payer: Aetna Government	$3,743.15
Rate for Payer: Affinity Essential Plan 1&2	$2,620.20
Rate for Payer: Affinity Essential Plan 3&4	$2,620.20
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,620.20
Rate for Payer: Brighton Health Commercial	$6,218.29
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,743.15
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	$3,743.15
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,181.68
Rate for Payer: Fidelis Essential Plan QHP	$3,331.40
Rate for Payer: Fidelis Medicare Advantage	$3,743.15
Rate for Payer: Fidelis Qualified Health Plan	$3,331.40
Rate for Payer: Group Health Inc Commercial	$3,743.15
Rate for Payer: Group Health Inc Medicare	$3,743.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,145.52
Rate for Payer: Hamaspik Choice Inc Medicare	$3,743.15
Rate for Payer: Healthfirst Medicare Advantage	$3,181.68
Rate for Payer: Healthfirst QHP	$3,743.15
Rate for Payer: Humana Medicare	$3,818.01
Rate for Payer: Senior Whole Health Medicare Advantage	$3,743.15
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$3,743.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,743.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,994.52
Rate for Payer: Wellcare Medicare	$3,555.99

FIXATION OF KNEE JOINT

Facility

$4,105.13

Service Code	HCPCS 27570
Hospital Charge Code	40024264
Hospital Revenue Code	360
Rate for Payer: Cash Price	$1,858.61

FIXATION OF KNEE JOINT

Facility

$4,105.13

Service Code	HCPCS 27570
Hospital Charge Code	40024264
Hospital Revenue Code	360
Min. Negotiated Rate	$1,301.03
Max. Negotiated Rate	$3,078.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,858.61
Rate for Payer: Aetna Government	$1,858.61
Rate for Payer: Affinity Essential Plan 1&2	$1,301.03
Rate for Payer: Affinity Essential Plan 3&4	$1,301.03
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,301.03
Rate for Payer: Brighton Health Commercial	$3,078.85
Rate for Payer: Cash Price	$1,858.61
Rate for Payer: Cash Price	$1,858.61
Rate for Payer: Cash Price	$1,858.61
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,858.61
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	$1,858.61
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$1,579.82
Rate for Payer: Fidelis Essential Plan QHP	$1,654.16
Rate for Payer: Fidelis Medicare Advantage	$1,858.61
Rate for Payer: Fidelis Qualified Health Plan	$1,654.16
Rate for Payer: Group Health Inc Commercial	$1,858.61
Rate for Payer: Group Health Inc Medicare	$1,858.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,052.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1,858.61
Rate for Payer: Healthfirst Medicare Advantage	$1,579.82
Rate for Payer: Healthfirst QHP	$1,858.61
Rate for Payer: Humana Medicare	$1,895.78
Rate for Payer: Senior Whole Health Medicare Advantage	$1,858.61
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$1,858.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,858.61
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,486.89
Rate for Payer: Wellcare Medicare	$1,765.68

FIXATION OF SHOULDER

Facility

$4,105.13

Service Code	HCPCS 23700
Hospital Charge Code	40029933
Hospital Revenue Code	360
Rate for Payer: Cash Price	$1,858.61

FIXATION OF SHOULDER

Facility

$4,105.13

Service Code	HCPCS 23700
Hospital Charge Code	40029933
Hospital Revenue Code	360
Min. Negotiated Rate	$1,301.03
Max. Negotiated Rate	$3,078.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,858.61
Rate for Payer: Aetna Government	$1,858.61
Rate for Payer: Affinity Essential Plan 1&2	$1,301.03
Rate for Payer: Affinity Essential Plan 3&4	$1,301.03
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,301.03
Rate for Payer: Brighton Health Commercial	$3,078.85
Rate for Payer: Cash Price	$1,858.61
Rate for Payer: Cash Price	$1,858.61
Rate for Payer: Cash Price	$1,858.61
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,858.61
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	$1,858.61
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$1,579.82
Rate for Payer: Fidelis Essential Plan QHP	$1,654.16
Rate for Payer: Fidelis Medicare Advantage	$1,858.61
Rate for Payer: Fidelis Qualified Health Plan	$1,654.16
Rate for Payer: Group Health Inc Commercial	$1,858.61
Rate for Payer: Group Health Inc Medicare	$1,858.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,052.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1,858.61
Rate for Payer: Healthfirst Medicare Advantage	$1,579.82
Rate for Payer: Healthfirst QHP	$1,858.61
Rate for Payer: Humana Medicare	$1,895.78
Rate for Payer: Senior Whole Health Medicare Advantage	$1,858.61
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$1,858.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,858.61
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,486.89
Rate for Payer: Wellcare Medicare	$1,765.68

FIXATOR LG ADJUST LONG BONE

Facility

$6,072.00

Service Code	HCPCS C1776
Hospital Charge Code	40202328
Hospital Revenue Code	278
Min. Negotiated Rate	$3,036.00
Max. Negotiated Rate	$3,036.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,036.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,036.00

FIXATOR LG ADJUST LONG BONE

Facility

$6,072.00

Service Code	HCPCS C1776
Hospital Charge Code	40202328
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,375.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,339.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,643.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,036.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,491.40
Rate for Payer: EmblemHealth Commercial	$3,036.00
Rate for Payer: Fidelis Medicare Advantage	$6,375.60
Rate for Payer: Group Health Inc Commercial	$3,036.00
Rate for Payer: Group Health Inc Medicare	$2,125.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,036.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,036.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,946.80

FIXER SPECTRA 1 GAL

Facility

$29.38

Hospital Charge Code	64902309
Hospital Revenue Code	270
Min. Negotiated Rate	$10.28
Max. Negotiated Rate	$23.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.69
Rate for Payer: Aetna Government	$14.69
Rate for Payer: Brighton Health Commercial	$22.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.98
Rate for Payer: Group Health Inc Commercial	$14.69
Rate for Payer: Group Health Inc Medicare	$10.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.69
Rate for Payer: Hamaspik Choice Inc Medicare	$14.69

FIXOS 4.0 X 32

Facility

$1,168.75

Hospital Charge Code	64906007
Hospital Revenue Code	270
Min. Negotiated Rate	$409.06
Max. Negotiated Rate	$935.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$642.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$584.38
Rate for Payer: Aetna Government	$584.38
Rate for Payer: Brighton Health Commercial	$876.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$935.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$794.75
Rate for Payer: Group Health Inc Commercial	$584.38
Rate for Payer: Group Health Inc Medicare	$409.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$584.38
Rate for Payer: Hamaspik Choice Inc Medicare	$584.38

FIXOS-GUIDE WIRE 1.4 X 150 MM

Facility

$75.95

Service Code	HCPCS C1769
Hospital Charge Code	64906008
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$79.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$45.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$37.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$43.67
Rate for Payer: EmblemHealth Commercial	$37.98
Rate for Payer: Fidelis Medicare Advantage	$79.75
Rate for Payer: Group Health Inc Commercial	$37.98
Rate for Payer: Group Health Inc Medicare	$26.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.98
Rate for Payer: Hamaspik Choice Inc Medicare	$37.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$49.37

FIXOS-GUIDE WIRE 1.4 X 150 MM

Facility

$75.95

Service Code	HCPCS C1769
Hospital Charge Code	64906008
Hospital Revenue Code	278
Min. Negotiated Rate	$37.98
Max. Negotiated Rate	$37.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.98
Rate for Payer: Hamaspik Choice Inc Medicare	$37.98

Know your out-of-pocket cost for care.

All Charges