St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NCB CAN.CANC.SCREW X4.5 THR L=46

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007217
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=46

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007217
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=48

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007218
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=48

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007218
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=50

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007219
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=50

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007219
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=60

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007221
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=60

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007221
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=65

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007222
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=65

Facility

$400.48

Service Code	HCPCS C1713
Hospital Charge Code	40007222
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 CANCELLOUS SCREW 5.0 L=90

Facility

$304.06

Service Code	HCPCS C1713
Hospital Charge Code	40006916
Hospital Revenue Code	278
Min. Negotiated Rate	$152.03
Max. Negotiated Rate	$152.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$152.03
Rate for Payer: Hamaspik Choice Inc Medicare	$152.03

NCB CANCELLOUS SCREW 5.0 L=90

Facility

$304.06

Service Code	HCPCS C1713
Hospital Charge Code	40006916
Hospital Revenue Code	278
Min. Negotiated Rate	$106.42
Max. Negotiated Rate	$319.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$167.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$182.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$152.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$174.83
Rate for Payer: EmblemHealth Commercial	$152.03
Rate for Payer: Fidelis Medicare Advantage	$319.26
Rate for Payer: Group Health Inc Commercial	$152.03
Rate for Payer: Group Health Inc Medicare	$106.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$152.03
Rate for Payer: Hamaspik Choice Inc Medicare	$152.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$197.64

NCB CANC SCREW 4.5 X 30MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007146
Hospital Revenue Code	278
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$280.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$160.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$133.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.51
Rate for Payer: EmblemHealth Commercial	$133.49
Rate for Payer: Fidelis Medicare Advantage	$280.33
Rate for Payer: Group Health Inc Commercial	$133.49
Rate for Payer: Group Health Inc Medicare	$93.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$173.54

NCB CANC SCREW 4.5 X 30MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007146
Hospital Revenue Code	278
Min. Negotiated Rate	$133.49
Max. Negotiated Rate	$133.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49

NCB CANC SCREW 4.5 X 32MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007147
Hospital Revenue Code	278
Min. Negotiated Rate	$133.49
Max. Negotiated Rate	$133.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49

NCB CANC SCREW 4.5 X 32MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007147
Hospital Revenue Code	278
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$280.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$160.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$133.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.51
Rate for Payer: EmblemHealth Commercial	$133.49
Rate for Payer: Fidelis Medicare Advantage	$280.33
Rate for Payer: Group Health Inc Commercial	$133.49
Rate for Payer: Group Health Inc Medicare	$93.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$173.54

NCB CANC SCREW 4.5 X 34MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007148
Hospital Revenue Code	278
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$280.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$160.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$133.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.51
Rate for Payer: EmblemHealth Commercial	$133.49
Rate for Payer: Fidelis Medicare Advantage	$280.33
Rate for Payer: Group Health Inc Commercial	$133.49
Rate for Payer: Group Health Inc Medicare	$93.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$173.54

NCB CANC SCREW 4.5 X 34MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007148
Hospital Revenue Code	278
Min. Negotiated Rate	$133.49
Max. Negotiated Rate	$133.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49

NCB CANC SCREW 4.5 X 36MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007149
Hospital Revenue Code	278
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$280.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$160.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$133.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.51
Rate for Payer: EmblemHealth Commercial	$133.49
Rate for Payer: Fidelis Medicare Advantage	$280.33
Rate for Payer: Group Health Inc Commercial	$133.49
Rate for Payer: Group Health Inc Medicare	$93.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$173.54

NCB CANC SCREW 4.5 X 36MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007149
Hospital Revenue Code	278
Min. Negotiated Rate	$133.49
Max. Negotiated Rate	$133.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49

NCB CANC SCREW 4.5 X 38MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007150
Hospital Revenue Code	278
Min. Negotiated Rate	$133.49
Max. Negotiated Rate	$133.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49

NCB CANC SCREW 4.5 X 38MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007150
Hospital Revenue Code	278
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$280.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$160.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$133.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.51
Rate for Payer: EmblemHealth Commercial	$133.49
Rate for Payer: Fidelis Medicare Advantage	$280.33
Rate for Payer: Group Health Inc Commercial	$133.49
Rate for Payer: Group Health Inc Medicare	$93.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$173.54

NCB CANC SCREW 4.5 X 40MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007151
Hospital Revenue Code	278
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$280.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$160.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$133.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.51
Rate for Payer: EmblemHealth Commercial	$133.49
Rate for Payer: Fidelis Medicare Advantage	$280.33
Rate for Payer: Group Health Inc Commercial	$133.49
Rate for Payer: Group Health Inc Medicare	$93.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$173.54

NCB CANC SCREW 4.5 X 40MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007151
Hospital Revenue Code	278
Min. Negotiated Rate	$133.49
Max. Negotiated Rate	$133.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49

NCB CANC SCREW 4.5 X 42MM

Facility

$266.98

Service Code	HCPCS C1713
Hospital Charge Code	40007152
Hospital Revenue Code	278
Min. Negotiated Rate	$93.44
Max. Negotiated Rate	$280.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$160.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$133.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$153.51
Rate for Payer: EmblemHealth Commercial	$133.49
Rate for Payer: Fidelis Medicare Advantage	$280.33
Rate for Payer: Group Health Inc Commercial	$133.49
Rate for Payer: Group Health Inc Medicare	$93.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.49
Rate for Payer: Hamaspik Choice Inc Medicare	$133.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$173.54

Know your out-of-pocket cost for care.

All Charges