St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HEAD FEM STD 26MM COBALT V-40

Facility

$2,184.00

Service Code	HCPCS C1776
Hospital Charge Code	40202431
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,293.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,201.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,310.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,092.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,255.80
Rate for Payer: EmblemHealth Commercial	$1,092.00
Rate for Payer: Fidelis Medicare Advantage	$2,293.20
Rate for Payer: Group Health Inc Commercial	$1,092.00
Rate for Payer: Group Health Inc Medicare	$764.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,092.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,092.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,419.60

HEAD FEM STD 26MM COBALT V-40

Facility

$2,731.50

Service Code	HCPCS C1713
Hospital Charge Code	64901455
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,868.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,502.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,638.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,365.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,570.61
Rate for Payer: EmblemHealth Commercial	$1,365.75
Rate for Payer: Fidelis Medicare Advantage	$2,868.08
Rate for Payer: Group Health Inc Commercial	$1,365.75
Rate for Payer: Group Health Inc Medicare	$956.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,365.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,365.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,775.48

HEAD FEMUR ACCL

Facility

$7,250.00

Service Code	HCPCS C1776
Hospital Charge Code	64907203
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,612.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,987.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,350.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,625.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,168.75
Rate for Payer: EmblemHealth Commercial	$3,625.00
Rate for Payer: Fidelis Medicare Advantage	$7,612.50
Rate for Payer: Group Health Inc Commercial	$3,625.00
Rate for Payer: Group Health Inc Medicare	$2,537.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,625.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,625.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,712.50

HEAD FEMUR ACCL

Facility

$7,250.00

Service Code	HCPCS C1776
Hospital Charge Code	64907203
Hospital Revenue Code	278
Min. Negotiated Rate	$3,625.00
Max. Negotiated Rate	$3,625.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,625.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,625.00

HEAD FEM V40 26MM LFIT MD-NK

Facility

$2,731.50

Service Code	HCPCS C1713
Hospital Charge Code	64902601
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,868.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,502.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,638.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,365.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,570.61
Rate for Payer: EmblemHealth Commercial	$1,365.75
Rate for Payer: Fidelis Medicare Advantage	$2,868.08
Rate for Payer: Group Health Inc Commercial	$1,365.75
Rate for Payer: Group Health Inc Medicare	$956.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,365.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,365.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,775.48

HEAD FEM V40 26MM LFIT MD-NK

Facility

$2,731.50

Service Code	HCPCS C1713
Hospital Charge Code	64902601
Hospital Revenue Code	278
Min. Negotiated Rate	$1,365.75
Max. Negotiated Rate	$1,365.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,365.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,365.75

HEAD FM BLX D 40/7 XL 12/14

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	64906548
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,725.00
Rate for Payer: EmblemHealth Commercial	$1,500.00
Rate for Payer: Fidelis Medicare Advantage	$3,150.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,950.00

HEAD FM BLX D 40/7 XL 12/14

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	64906548
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

HEAD FM BLX DL 40/0 M 12/14

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	64906547
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

HEAD FM BLX DL 40/0 M 12/14

Facility

$3,000.00

Service Code	HCPCS C1776
Hospital Charge Code	64906547
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,725.00
Rate for Payer: EmblemHealth Commercial	$1,500.00
Rate for Payer: Fidelis Medicare Advantage	$3,150.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,950.00

HEAD HUMERAL CONCENTRIC 45MM

Facility

$4,472.00

Service Code	HCPCS C1713
Hospital Charge Code	64903608
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,695.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,459.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,683.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,236.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,571.40
Rate for Payer: EmblemHealth Commercial	$2,236.00
Rate for Payer: Fidelis Medicare Advantage	$4,695.60
Rate for Payer: Group Health Inc Commercial	$2,236.00
Rate for Payer: Group Health Inc Medicare	$1,565.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,236.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,236.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,906.80

HEAD HUMERAL CONCENTRIC 45MM

Facility

$4,472.00

Service Code	HCPCS C1713
Hospital Charge Code	64903608
Hospital Revenue Code	278
Min. Negotiated Rate	$2,236.00
Max. Negotiated Rate	$2,236.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,236.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,236.00

HEAD HUM REUNION TSA

Facility

$3,125.00

Service Code	HCPCS C1889
Hospital Charge Code	64907488
Hospital Revenue Code	278
Min. Negotiated Rate	$1,093.75
Max. Negotiated Rate	$3,281.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,718.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,562.50
Rate for Payer: Aetna Government	$1,562.50
Rate for Payer: Brighton Health Commercial	$1,875.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,562.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,796.88
Rate for Payer: EmblemHealth Commercial	$1,562.50
Rate for Payer: Fidelis Medicare Advantage	$3,281.25
Rate for Payer: Group Health Inc Commercial	$1,562.50
Rate for Payer: Group Health Inc Medicare	$1,093.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,562.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,562.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,031.25

HEAD HUM REUNION TSA

Facility

$3,125.00

Service Code	HCPCS C1889
Hospital Charge Code	64907488
Hospital Revenue Code	278
Min. Negotiated Rate	$1,562.50
Max. Negotiated Rate	$1,562.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,562.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,562.50

HEAD L2L RADIAL 20MM, 10MM

Facility

$6,320.00

Hospital Charge Code	64906693
Hospital Revenue Code	279
Min. Negotiated Rate	$2,212.00
Max. Negotiated Rate	$5,056.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,476.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,160.00
Rate for Payer: Aetna Government	$3,160.00
Rate for Payer: Brighton Health Commercial	$4,740.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,056.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,297.60
Rate for Payer: Group Health Inc Commercial	$3,160.00
Rate for Payer: Group Health Inc Medicare	$2,212.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,160.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,160.00

HEADLESS COMPRESSION SCREW 4.0M

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904961
Hospital Revenue Code	278
Min. Negotiated Rate	$687.50
Max. Negotiated Rate	$687.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50

HEADLESS COMPRESSION SCREW 4.0M

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904961
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,443.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$756.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$825.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$687.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$790.62
Rate for Payer: EmblemHealth Commercial	$687.50
Rate for Payer: Fidelis Medicare Advantage	$1,443.75
Rate for Payer: Group Health Inc Commercial	$687.50
Rate for Payer: Group Health Inc Medicare	$481.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$893.75

HEADLESS COMP SCREW 4MM X L36MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905140
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,443.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$756.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$825.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$687.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$790.62
Rate for Payer: EmblemHealth Commercial	$687.50
Rate for Payer: Fidelis Medicare Advantage	$1,443.75
Rate for Payer: Group Health Inc Commercial	$687.50
Rate for Payer: Group Health Inc Medicare	$481.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$893.75

HEADLESS COMP SCREW 4MM X L36MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905140
Hospital Revenue Code	278
Min. Negotiated Rate	$687.50
Max. Negotiated Rate	$687.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50

HEADLESS COMP SCREW 4MM X L60MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905142
Hospital Revenue Code	278
Min. Negotiated Rate	$687.50
Max. Negotiated Rate	$687.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50

HEADLESS COMP SCREW 4MM X L60MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905142
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,443.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$756.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$825.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$687.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$790.62
Rate for Payer: EmblemHealth Commercial	$687.50
Rate for Payer: Fidelis Medicare Advantage	$1,443.75
Rate for Payer: Group Health Inc Commercial	$687.50
Rate for Payer: Group Health Inc Medicare	$481.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$893.75

HEADLESS COMP SCREW 4MM X L70MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905143
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,443.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$756.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$825.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$687.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$790.62
Rate for Payer: EmblemHealth Commercial	$687.50
Rate for Payer: Fidelis Medicare Advantage	$1,443.75
Rate for Payer: Group Health Inc Commercial	$687.50
Rate for Payer: Group Health Inc Medicare	$481.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$893.75

HEADLESS COMP SCREW 4MM X L70MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905143
Hospital Revenue Code	278
Min. Negotiated Rate	$687.50
Max. Negotiated Rate	$687.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50

HEADLESS COMP SCREW 5.0MM/L50MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905644
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,443.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$756.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$825.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$687.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$790.62
Rate for Payer: EmblemHealth Commercial	$687.50
Rate for Payer: Fidelis Medicare Advantage	$1,443.75
Rate for Payer: Group Health Inc Commercial	$687.50
Rate for Payer: Group Health Inc Medicare	$481.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$893.75

HEADLESS COMP SCREW 5.0MM/L50MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905644
Hospital Revenue Code	278
Min. Negotiated Rate	$687.50
Max. Negotiated Rate	$687.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50

Know your out-of-pocket cost for care.

All Charges