St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

LOCK DISTAL FIB PLT

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64907458
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

LOCK DISTAL FIB PLT

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64907458
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

LOCKING 4.0 MM X 42 MM SCREW

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005318
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$527.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$301.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$251.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.65
Rate for Payer: EmblemHealth Commercial	$251.00
Rate for Payer: Fidelis Medicare Advantage	$527.10
Rate for Payer: Group Health Inc Commercial	$251.00
Rate for Payer: Group Health Inc Medicare	$175.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$326.30

LOCKING 4.0 MM X 42 MM SCREW

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005318
Hospital Revenue Code	278
Min. Negotiated Rate	$251.00
Max. Negotiated Rate	$251.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00

LOCKING CALCANEAL SHORT RIGHT

Facility

$1,232.00

Service Code	HCPCS C1713
Hospital Charge Code	40200097
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,293.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$677.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$739.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$616.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$708.40
Rate for Payer: EmblemHealth Commercial	$616.00
Rate for Payer: Fidelis Medicare Advantage	$1,293.60
Rate for Payer: Group Health Inc Commercial	$616.00
Rate for Payer: Group Health Inc Medicare	$431.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$616.00
Rate for Payer: Hamaspik Choice Inc Medicare	$616.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$800.80

LOCKING CALCANEAL SHORT RIGHT

Facility

$1,232.00

Service Code	HCPCS C1713
Hospital Charge Code	40200097
Hospital Revenue Code	278
Min. Negotiated Rate	$616.00
Max. Negotiated Rate	$616.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$616.00
Rate for Payer: Hamaspik Choice Inc Medicare	$616.00

LOCKING CANN SCREW 5.0MM

Facility

$398.68

Service Code	HCPCS C1713
Hospital Charge Code	40205701
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$418.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$219.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$239.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$199.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$229.24
Rate for Payer: EmblemHealth Commercial	$199.34
Rate for Payer: Fidelis Medicare Advantage	$418.61
Rate for Payer: Group Health Inc Commercial	$199.34
Rate for Payer: Group Health Inc Medicare	$139.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$199.34
Rate for Payer: Hamaspik Choice Inc Medicare	$199.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$259.14

LOCKING CANN SCREW 5.0MM

Facility

$398.68

Service Code	HCPCS C1713
Hospital Charge Code	40205701
Hospital Revenue Code	278
Min. Negotiated Rate	$199.34
Max. Negotiated Rate	$199.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$199.34
Rate for Payer: Hamaspik Choice Inc Medicare	$199.34

LOCKING COMPRSN PLATE 12HL

Facility

$543.90

Service Code	HCPCS C1713
Hospital Charge Code	40209354
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$571.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$299.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$326.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$271.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$312.74
Rate for Payer: EmblemHealth Commercial	$271.95
Rate for Payer: Fidelis Medicare Advantage	$571.10
Rate for Payer: Group Health Inc Commercial	$271.95
Rate for Payer: Group Health Inc Medicare	$190.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$271.95
Rate for Payer: Hamaspik Choice Inc Medicare	$271.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$353.54

LOCKING COMPRSN PLATE 12HL

Facility

$543.90

Service Code	HCPCS C1713
Hospital Charge Code	40209354
Hospital Revenue Code	278
Min. Negotiated Rate	$271.95
Max. Negotiated Rate	$271.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$271.95
Rate for Payer: Hamaspik Choice Inc Medicare	$271.95

LOCKING PEG 2.0MM / L16MM

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	64904771
Hospital Revenue Code	278
Min. Negotiated Rate	$331.25
Max. Negotiated Rate	$331.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$331.25
Rate for Payer: Hamaspik Choice Inc Medicare	$331.25

LOCKING PEG 2.0MM / L16MM

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	64904771
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$695.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$364.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$397.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$380.94
Rate for Payer: EmblemHealth Commercial	$331.25
Rate for Payer: Fidelis Medicare Advantage	$695.62
Rate for Payer: Group Health Inc Commercial	$331.25
Rate for Payer: Group Health Inc Medicare	$231.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$331.25
Rate for Payer: Hamaspik Choice Inc Medicare	$331.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$430.62

LOCKING PEG 2.0MM / L18MM

Facility

$563.13

Service Code	HCPCS C1713
Hospital Charge Code	64904757
Hospital Revenue Code	278
Min. Negotiated Rate	$281.56
Max. Negotiated Rate	$281.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.56
Rate for Payer: Hamaspik Choice Inc Medicare	$281.56

LOCKING PEG 2.0MM / L18MM

Facility

$563.13

Service Code	HCPCS C1713
Hospital Charge Code	64904757
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$591.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$337.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$281.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$323.80
Rate for Payer: EmblemHealth Commercial	$281.56
Rate for Payer: Fidelis Medicare Advantage	$591.29
Rate for Payer: Group Health Inc Commercial	$281.56
Rate for Payer: Group Health Inc Medicare	$197.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.56
Rate for Payer: Hamaspik Choice Inc Medicare	$281.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$366.03

LOCKING PEG 2.0MM / L20MM

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	64904522
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$695.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$364.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$397.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$380.94
Rate for Payer: EmblemHealth Commercial	$331.25
Rate for Payer: Fidelis Medicare Advantage	$695.62
Rate for Payer: Group Health Inc Commercial	$331.25
Rate for Payer: Group Health Inc Medicare	$231.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$331.25
Rate for Payer: Hamaspik Choice Inc Medicare	$331.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$430.62

LOCKING PEG 2.0MM / L20MM

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	64904522
Hospital Revenue Code	278
Min. Negotiated Rate	$331.25
Max. Negotiated Rate	$331.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$331.25
Rate for Payer: Hamaspik Choice Inc Medicare	$331.25

LOCKING SCREW

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64902879
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50

LOCKING SCREW

Facility

$478.80

Service Code	HCPCS C1713
Hospital Charge Code	40203568
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$502.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$263.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$287.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$239.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$275.31
Rate for Payer: EmblemHealth Commercial	$239.40
Rate for Payer: Fidelis Medicare Advantage	$502.74
Rate for Payer: Group Health Inc Commercial	$239.40
Rate for Payer: Group Health Inc Medicare	$167.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$239.40
Rate for Payer: Hamaspik Choice Inc Medicare	$239.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$311.22

LOCKING SCREW

Facility

$478.80

Service Code	HCPCS C1713
Hospital Charge Code	40203568
Hospital Revenue Code	278
Min. Negotiated Rate	$239.40
Max. Negotiated Rate	$239.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$239.40
Rate for Payer: Hamaspik Choice Inc Medicare	$239.40

LOCKING SCREW

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64902879
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$450.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$257.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$214.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.68
Rate for Payer: EmblemHealth Commercial	$214.50
Rate for Payer: Fidelis Medicare Advantage	$450.45
Rate for Payer: Group Health Inc Commercial	$214.50
Rate for Payer: Group Health Inc Medicare	$150.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$278.85

LOCKING SCREW 4.0 MM X 24 MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005316
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$527.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$301.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$251.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.65
Rate for Payer: EmblemHealth Commercial	$251.00
Rate for Payer: Fidelis Medicare Advantage	$527.10
Rate for Payer: Group Health Inc Commercial	$251.00
Rate for Payer: Group Health Inc Medicare	$175.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$326.30

LOCKING SCREW 4.0 MM X 24 MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005316
Hospital Revenue Code	278
Min. Negotiated Rate	$251.00
Max. Negotiated Rate	$251.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00

LOCKING SCREW 4.0 MM X 44 MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005321
Hospital Revenue Code	278
Min. Negotiated Rate	$251.00
Max. Negotiated Rate	$251.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00

LOCKING SCREW 4.0 MM X 44 MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005321
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$527.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$301.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$251.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.65
Rate for Payer: EmblemHealth Commercial	$251.00
Rate for Payer: Fidelis Medicare Advantage	$527.10
Rate for Payer: Group Health Inc Commercial	$251.00
Rate for Payer: Group Health Inc Medicare	$175.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$326.30

LOCKING SCREW 4.0X 24MM

Facility

$190.00

Service Code	HCPCS C1713
Hospital Charge Code	40201207
Hospital Revenue Code	278
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$199.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$114.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$95.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$109.25
Rate for Payer: EmblemHealth Commercial	$95.00
Rate for Payer: Fidelis Medicare Advantage	$199.50
Rate for Payer: Group Health Inc Commercial	$95.00
Rate for Payer: Group Health Inc Medicare	$66.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$95.00
Rate for Payer: Hamaspik Choice Inc Medicare	$95.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$123.50

Know your out-of-pocket cost for care.

All Charges