St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HEAD MODULAR 36MM TYPE-1 TAPER

Facility

$1,830.00

Service Code	HCPCS C1713
Hospital Charge Code	64902287
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,921.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,006.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,098.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,052.25
Rate for Payer: EmblemHealth Commercial	$915.00
Rate for Payer: Fidelis Medicare Advantage	$1,921.50
Rate for Payer: Group Health Inc Commercial	$915.00
Rate for Payer: Group Health Inc Medicare	$640.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$915.00
Rate for Payer: Hamaspik Choice Inc Medicare	$915.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,189.50

HEAD MODULAR 36MM TYPE-1 TAPER

Facility

$1,830.00

Service Code	HCPCS C1713
Hospital Charge Code	64902287
Hospital Revenue Code	278
Min. Negotiated Rate	$915.00
Max. Negotiated Rate	$915.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$915.00
Rate for Payer: Hamaspik Choice Inc Medicare	$915.00

HEAD MODULAR COMP

Facility

$2,385.00

Service Code	HCPCS C1776
Hospital Charge Code	64907135
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,504.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,311.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,431.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,192.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,371.38
Rate for Payer: EmblemHealth Commercial	$1,192.50
Rate for Payer: Fidelis Medicare Advantage	$2,504.25
Rate for Payer: Group Health Inc Commercial	$1,192.50
Rate for Payer: Group Health Inc Medicare	$834.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,192.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,192.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,550.25

HEAD MODULAR COMP

Facility

$2,385.00

Service Code	HCPCS C1776
Hospital Charge Code	64907135
Hospital Revenue Code	278
Min. Negotiated Rate	$1,192.50
Max. Negotiated Rate	$1,192.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,192.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,192.50

HEAD MODULAR COMP 28MM DIA

Facility

$702.00

Service Code	HCPCS C1776
Hospital Charge Code	40209669
Hospital Revenue Code	278
Min. Negotiated Rate	$351.00
Max. Negotiated Rate	$351.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$351.00
Rate for Payer: Hamaspik Choice Inc Medicare	$351.00

HEAD MODULAR COMP 28MM DIA

Facility

$702.00

Service Code	HCPCS C1776
Hospital Charge Code	40209669
Hospital Revenue Code	278
Min. Negotiated Rate	$245.70
Max. Negotiated Rate	$737.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$386.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$421.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$351.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$403.65
Rate for Payer: EmblemHealth Commercial	$351.00
Rate for Payer: Fidelis Medicare Advantage	$737.10
Rate for Payer: Group Health Inc Commercial	$351.00
Rate for Payer: Group Health Inc Medicare	$245.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$351.00
Rate for Payer: Hamaspik Choice Inc Medicare	$351.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$456.30

HEAD RADIAL

Facility

$6,715.00

Service Code	HCPCS C1776
Hospital Charge Code	64907154
Hospital Revenue Code	278
Min. Negotiated Rate	$3,357.50
Max. Negotiated Rate	$3,357.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,357.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,357.50

HEAD RADIAL

Facility

$6,715.00

Service Code	HCPCS C1776
Hospital Charge Code	64907154
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,050.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,693.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,029.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,357.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,861.12
Rate for Payer: EmblemHealth Commercial	$3,357.50
Rate for Payer: Fidelis Medicare Advantage	$7,050.75
Rate for Payer: Group Health Inc Commercial	$3,357.50
Rate for Payer: Group Health Inc Medicare	$2,350.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,357.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3,357.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,364.75

HEAD REMOVAL 28MM 4

Facility

$1,680.25

Service Code	HCPCS C1776
Hospital Charge Code	64905357
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,764.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$924.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,008.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$840.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$966.14
Rate for Payer: EmblemHealth Commercial	$840.12
Rate for Payer: Fidelis Medicare Advantage	$1,764.26
Rate for Payer: Group Health Inc Commercial	$840.12
Rate for Payer: Group Health Inc Medicare	$588.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$840.12
Rate for Payer: Hamaspik Choice Inc Medicare	$840.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,092.16

HEAD REMOVAL 28MM 4

Facility

$1,680.25

Service Code	HCPCS C1776
Hospital Charge Code	64905357
Hospital Revenue Code	278
Min. Negotiated Rate	$840.12
Max. Negotiated Rate	$840.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$840.12
Rate for Payer: Hamaspik Choice Inc Medicare	$840.12

HEADREST PAD POSTING GEL

Facility

$2,022.50

Hospital Charge Code	64907531
Hospital Revenue Code	270
Min. Negotiated Rate	$707.88
Max. Negotiated Rate	$1,618.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,112.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,011.25
Rate for Payer: Aetna Government	$1,011.25
Rate for Payer: Brighton Health Commercial	$1,516.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,618.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,375.30
Rate for Payer: Group Health Inc Commercial	$1,011.25
Rate for Payer: Group Health Inc Medicare	$707.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,011.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,011.25

HEAD SCREW REF SPHER 25MM

Facility

$251.45

Service Code	HCPCS C1713
Hospital Charge Code	64905216
Hospital Revenue Code	278
Min. Negotiated Rate	$88.01
Max. Negotiated Rate	$264.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$150.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$125.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.58
Rate for Payer: EmblemHealth Commercial	$125.72
Rate for Payer: Fidelis Medicare Advantage	$264.02
Rate for Payer: Group Health Inc Commercial	$125.72
Rate for Payer: Group Health Inc Medicare	$88.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$125.72
Rate for Payer: Hamaspik Choice Inc Medicare	$125.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.44

HEAD SCREW REF SPHER 25MM

Facility

$251.45

Service Code	HCPCS C1713
Hospital Charge Code	64905216
Hospital Revenue Code	278
Min. Negotiated Rate	$125.72
Max. Negotiated Rate	$125.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$125.72
Rate for Payer: Hamaspik Choice Inc Medicare	$125.72

HEADSTRAP CONDUCT 4LOOPS ADLT

Facility

$33.93

Hospital Charge Code	64904153
Hospital Revenue Code	270
Min. Negotiated Rate	$11.88
Max. Negotiated Rate	$27.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.96
Rate for Payer: Aetna Government	$16.96
Rate for Payer: Brighton Health Commercial	$25.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.07
Rate for Payer: Group Health Inc Commercial	$16.96
Rate for Payer: Group Health Inc Medicare	$11.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.96
Rate for Payer: Hamaspik Choice Inc Medicare	$16.96

HEAD UNIPOL COMP

Facility

$2,799.90

Service Code	HCPCS C1889
Hospital Charge Code	64907485
Hospital Revenue Code	278
Min. Negotiated Rate	$1,399.95
Max. Negotiated Rate	$1,399.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,399.95
Rate for Payer: Hamaspik Choice Inc Medicare	$1,399.95

HEAD UNIPOL COMP

Facility

$2,799.90

Service Code	HCPCS C1889
Hospital Charge Code	64907485
Hospital Revenue Code	278
Min. Negotiated Rate	$979.96
Max. Negotiated Rate	$2,939.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,539.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,399.95
Rate for Payer: Aetna Government	$1,399.95
Rate for Payer: Brighton Health Commercial	$1,679.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,399.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,609.94
Rate for Payer: EmblemHealth Commercial	$1,399.95
Rate for Payer: Fidelis Medicare Advantage	$2,939.90
Rate for Payer: Group Health Inc Commercial	$1,399.95
Rate for Payer: Group Health Inc Medicare	$979.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,399.95
Rate for Payer: Hamaspik Choice Inc Medicare	$1,399.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,819.94

HEAD UNIV BIPOLAR 41 X 26MM

Facility

$36.90

Service Code	HCPCS C1713
Hospital Charge Code	64902417
Hospital Revenue Code	278
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.45
Rate for Payer: Hamaspik Choice Inc Medicare	$18.45

HEAD UNIV BIPOLAR 41 X 26MM

Facility

$36.90

Service Code	HCPCS C1713
Hospital Charge Code	64902417
Hospital Revenue Code	278
Min. Negotiated Rate	$12.92
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$22.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.22
Rate for Payer: EmblemHealth Commercial	$18.45
Rate for Payer: Fidelis Medicare Advantage	$38.74
Rate for Payer: Group Health Inc Commercial	$18.45
Rate for Payer: Group Health Inc Medicare	$12.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.45
Rate for Payer: Hamaspik Choice Inc Medicare	$18.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$23.98

HEAD UNIV BIPOLAR 42 X 26MM

Facility

$3,690.00

Service Code	HCPCS C1713
Hospital Charge Code	64902118
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,874.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,029.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,214.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,845.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,121.75
Rate for Payer: EmblemHealth Commercial	$1,845.00
Rate for Payer: Fidelis Medicare Advantage	$3,874.50
Rate for Payer: Group Health Inc Commercial	$1,845.00
Rate for Payer: Group Health Inc Medicare	$1,291.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,845.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,845.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,398.50

HEAD UNIV BIPOLAR 42 X 26MM

Facility

$3,690.00

Service Code	HCPCS C1713
Hospital Charge Code	64902118
Hospital Revenue Code	278
Min. Negotiated Rate	$1,845.00
Max. Negotiated Rate	$1,845.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,845.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,845.00

HEAD UNIV BIPOLAR 43 X 26MM

Facility

$2,062.50

Service Code	HCPCS C1713
Hospital Charge Code	64901819
Hospital Revenue Code	278
Min. Negotiated Rate	$1,031.25
Max. Negotiated Rate	$1,031.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,031.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,031.25

HEAD UNIV BIPOLAR 43 X 26MM

Facility

$2,062.50

Service Code	HCPCS C1713
Hospital Charge Code	64901819
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,165.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,134.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,237.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,031.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,185.94
Rate for Payer: EmblemHealth Commercial	$1,031.25
Rate for Payer: Fidelis Medicare Advantage	$2,165.62
Rate for Payer: Group Health Inc Commercial	$1,031.25
Rate for Payer: Group Health Inc Medicare	$721.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,031.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,031.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,340.62

HEAD UNIV BIPOLAR 44 X 26MM

Facility

$2,062.50

Service Code	HCPCS C1713
Hospital Charge Code	64901843
Hospital Revenue Code	278
Min. Negotiated Rate	$1,031.25
Max. Negotiated Rate	$1,031.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,031.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,031.25

HEAD UNIV BIPOLAR 44 X 26MM

Facility

$2,062.50

Service Code	HCPCS C1713
Hospital Charge Code	64901843
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,165.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,134.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,237.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,031.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,185.94
Rate for Payer: EmblemHealth Commercial	$1,031.25
Rate for Payer: Fidelis Medicare Advantage	$2,165.62
Rate for Payer: Group Health Inc Commercial	$1,031.25
Rate for Payer: Group Health Inc Medicare	$721.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,031.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,031.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,340.62

HEAD UNIV BIPOLAR 44 X 28MM

Facility

$4,100.00

Service Code	HCPCS C1713
Hospital Charge Code	64902383
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,305.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,255.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,460.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,050.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,357.50
Rate for Payer: EmblemHealth Commercial	$2,050.00
Rate for Payer: Fidelis Medicare Advantage	$4,305.00
Rate for Payer: Group Health Inc Commercial	$2,050.00
Rate for Payer: Group Health Inc Medicare	$1,435.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,050.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,050.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,665.00

Know your out-of-pocket cost for care.

All Charges