St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NCB_5.0_UNICORTICAL_SCR_L=18MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007089
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB 5.0 UNICORTICAL SCR L=20MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006907
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB 5.0 UNICORTICAL SCR L=20MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006907
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB_5.0_UNICORTICAL_SCR_L=20MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007090
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB_5.0_UNICORTICAL_SCR_L=20MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007090
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB BLIND SCREW INSERT

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006898
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB BLIND SCREW INSERT

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006898
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB CAN.CANC.SCREW 4.5 THR L=55

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007220
Hospital Revenue Code	278
Min. Negotiated Rate	$200.24
Max. Negotiated Rate	$200.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24

NCB CAN.CANC.SCREW 4.5 THR L=55

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007220
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.28
Rate for Payer: EmblemHealth Commercial	$200.24
Rate for Payer: Fidelis Medicare Advantage	$420.50
Rate for Payer: Group Health Inc Commercial	$200.24
Rate for Payer: Group Health Inc Medicare	$140.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.31

NCB CAN.CANC.SCREW X4.5 THR L=30

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007209
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.28
Rate for Payer: EmblemHealth Commercial	$200.24
Rate for Payer: Fidelis Medicare Advantage	$420.50
Rate for Payer: Group Health Inc Commercial	$200.24
Rate for Payer: Group Health Inc Medicare	$140.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.31

NCB CAN.CANC.SCREW X4.5 THR L=30

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007209
Hospital Revenue Code	278
Min. Negotiated Rate	$200.24
Max. Negotiated Rate	$200.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24

NCB CAN.CANC.SCREW X4.5 THR L=32

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007210
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.28
Rate for Payer: EmblemHealth Commercial	$200.24
Rate for Payer: Fidelis Medicare Advantage	$420.50
Rate for Payer: Group Health Inc Commercial	$200.24
Rate for Payer: Group Health Inc Medicare	$140.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.31

NCB CAN.CANC.SCREW X4.5 THR L=32

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007210
Hospital Revenue Code	278
Min. Negotiated Rate	$200.24
Max. Negotiated Rate	$200.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24

NCB CAN.CANC.SCREW X4.5 THR L=34

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007211
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.28
Rate for Payer: EmblemHealth Commercial	$200.24
Rate for Payer: Fidelis Medicare Advantage	$420.50
Rate for Payer: Group Health Inc Commercial	$200.24
Rate for Payer: Group Health Inc Medicare	$140.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.31

NCB CAN.CANC.SCREW X4.5 THR L=34

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007211
Hospital Revenue Code	278
Min. Negotiated Rate	$200.24
Max. Negotiated Rate	$200.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24

NCB CAN.CANC.SCREW X4.5 THR L=36

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007212
Hospital Revenue Code	278
Min. Negotiated Rate	$200.24
Max. Negotiated Rate	$200.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24

NCB CAN.CANC.SCREW X4.5 THR L=36

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007212
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.28
Rate for Payer: EmblemHealth Commercial	$200.24
Rate for Payer: Fidelis Medicare Advantage	$420.50
Rate for Payer: Group Health Inc Commercial	$200.24
Rate for Payer: Group Health Inc Medicare	$140.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.31

NCB CAN.CANC.SCREW X4.5 THR L=38

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007213
Hospital Revenue Code	278
Min. Negotiated Rate	$200.24
Max. Negotiated Rate	$200.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24

NCB CAN.CANC.SCREW X4.5 THR L=38

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007213
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.28
Rate for Payer: EmblemHealth Commercial	$200.24
Rate for Payer: Fidelis Medicare Advantage	$420.50
Rate for Payer: Group Health Inc Commercial	$200.24
Rate for Payer: Group Health Inc Medicare	$140.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.31

NCB CAN.CANC.SCREW X4.5 THR L=40

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007214
Hospital Revenue Code	278
Min. Negotiated Rate	$200.24
Max. Negotiated Rate	$200.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24

NCB CAN.CANC.SCREW X4.5 THR L=40

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007214
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.28
Rate for Payer: EmblemHealth Commercial	$200.24
Rate for Payer: Fidelis Medicare Advantage	$420.50
Rate for Payer: Group Health Inc Commercial	$200.24
Rate for Payer: Group Health Inc Medicare	$140.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.31

NCB CAN.CANC.SCREW X4.5 THR L=42

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007215
Hospital Revenue Code	278
Min. Negotiated Rate	$200.24
Max. Negotiated Rate	$200.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24

NCB CAN.CANC.SCREW X4.5 THR L=42

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007215
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.28
Rate for Payer: EmblemHealth Commercial	$200.24
Rate for Payer: Fidelis Medicare Advantage	$420.50
Rate for Payer: Group Health Inc Commercial	$200.24
Rate for Payer: Group Health Inc Medicare	$140.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.31

NCB CAN.CANC.SCREW X4.5 THR L=44

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007216
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.28
Rate for Payer: EmblemHealth Commercial	$200.24
Rate for Payer: Fidelis Medicare Advantage	$420.50
Rate for Payer: Group Health Inc Commercial	$200.24
Rate for Payer: Group Health Inc Medicare	$140.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.31

NCB CAN.CANC.SCREW X4.5 THR L=44

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007216
Hospital Revenue Code	278
Min. Negotiated Rate	$200.24
Max. Negotiated Rate	$200.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.24
Rate for Payer: Hamaspik Choice Inc Medicare	$200.24

Know your out-of-pocket cost for care.

All Charges