St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

LOCKING SCREW 4.0X 24MM

Facility

$190.00

Service Code	HCPCS C1713
Hospital Charge Code	40201207
Hospital Revenue Code	278
Min. Negotiated Rate	$95.00
Max. Negotiated Rate	$95.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$95.00
Rate for Payer: Hamaspik Choice Inc Medicare	$95.00

LOCKING SCREW 4.0 X 28 MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005315
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 X 28 MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005315
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 X 40MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005319
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 X 40MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005319
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 X 46MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005320
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 X 46MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005320
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 X 55 MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005314
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 X 55 MM

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40005314
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 FT 2.4MM / L12MM

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	64904402
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 FT 2.4MM / L12MM

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	64904402
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 SCREW FT 2.4MM / L16MM

Facility

$656.25

Service Code	HCPCS C1713
Hospital Charge Code	64904404
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$689.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$360.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$393.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$328.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$377.34
Rate for Payer: EmblemHealth Commercial	$328.12
Rate for Payer: Fidelis Medicare Advantage	$689.06
Rate for Payer: Group Health Inc Commercial	$328.12
Rate for Payer: Group Health Inc Medicare	$229.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$328.12
Rate for Payer: Hamaspik Choice Inc Medicare	$328.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$426.56

LOCKING SCREW FT 2.4MM / L16MM

Facility

$656.25

Service Code	HCPCS C1713
Hospital Charge Code	64904404
Hospital Revenue Code	278
Min. Negotiated Rate	$328.12
Max. Negotiated Rate	$328.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$328.12
Rate for Payer: Hamaspik Choice Inc Medicare	$328.12

LOCKING SCREW FT 2.4MM / L18MM

Facility

$314.82

Service Code	HCPCS C1713
Hospital Charge Code	64904406
Hospital Revenue Code	278
Min. Negotiated Rate	$110.19
Max. Negotiated Rate	$330.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$173.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$188.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$157.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$181.02
Rate for Payer: EmblemHealth Commercial	$157.41
Rate for Payer: Fidelis Medicare Advantage	$330.56
Rate for Payer: Group Health Inc Commercial	$157.41
Rate for Payer: Group Health Inc Medicare	$110.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$157.41
Rate for Payer: Hamaspik Choice Inc Medicare	$157.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$204.63

LOCKING SCREW FT 2.4MM / L18MM

Facility

$314.82

Service Code	HCPCS C1713
Hospital Charge Code	64904406
Hospital Revenue Code	278
Min. Negotiated Rate	$157.41
Max. Negotiated Rate	$157.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$157.41
Rate for Payer: Hamaspik Choice Inc Medicare	$157.41

LOCKING SCREW FT 2.4MM / L20MM

Facility

$566.25

Service Code	HCPCS C1713
Hospital Charge Code	64904422
Hospital Revenue Code	278
Min. Negotiated Rate	$283.12
Max. Negotiated Rate	$283.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$283.12
Rate for Payer: Hamaspik Choice Inc Medicare	$283.12

LOCKING SCREW FT 2.4MM / L20MM

Facility

$566.25

Service Code	HCPCS C1713
Hospital Charge Code	64904422
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$594.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$311.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$339.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$283.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$325.59
Rate for Payer: EmblemHealth Commercial	$283.12
Rate for Payer: Fidelis Medicare Advantage	$594.56
Rate for Payer: Group Health Inc Commercial	$283.12
Rate for Payer: Group Health Inc Medicare	$198.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$283.12
Rate for Payer: Hamaspik Choice Inc Medicare	$283.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$368.06

LOCKING SCREW FT 2.4MM / L22MM

Facility

$563.13

Service Code	HCPCS C1713
Hospital Charge Code	64904474
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 SCREW FT 2.4MM / L22MM

Facility

$563.13

Service Code	HCPCS C1713
Hospital Charge Code	64904474
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 SCREW FT 2.4MM / L24MM

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	64904476
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 FT 2.4MM / L24MM

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	64904476
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 SCREW FT 2.7MM / L10MM

Facility

$563.13

Service Code	HCPCS C1713
Hospital Charge Code	64904773
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 SCREW FT 2.7MM / L10MM

Facility

$563.13

Service Code	HCPCS C1713
Hospital Charge Code	64904773
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 SCREW FT 2.7MM / L12MM

Facility

$566.25

Service Code	HCPCS C1713
Hospital Charge Code	64904410
Hospital Revenue Code	278
Min. Negotiated Rate	$283.12
Max. Negotiated Rate	$283.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$283.12
Rate for Payer: Hamaspik Choice Inc Medicare	$283.12

LOCKING SCREW FT 2.7MM / L12MM

Facility

$566.25

Service Code	HCPCS C1713
Hospital Charge Code	64904410
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$594.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$311.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$339.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$283.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$325.59
Rate for Payer: EmblemHealth Commercial	$283.12
Rate for Payer: Fidelis Medicare Advantage	$594.56
Rate for Payer: Group Health Inc Commercial	$283.12
Rate for Payer: Group Health Inc Medicare	$198.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$283.12
Rate for Payer: Hamaspik Choice Inc Medicare	$283.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$368.06

Know your out-of-pocket cost for care.

All Charges