St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NCB CORT SCREW 4.0X75MM SELF-TAP

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40007142
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB CORT SCREW 4.0X75MM SELF-TAP

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40007142
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$111.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24

NCB CORT SCREW 4.0X80MM SELF-TAP

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40007143
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB CORT SCREW 4.0X80MM SELF-TAP

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40007143
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$111.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24

NCB CORT SCREW 4.0X85MM SELF-TAP

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40007144
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB CORT SCREW 4.0X85MM SELF-TAP

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40007144
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$111.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24

NCB CORT SCREW 4.0X90MM SELF-TAP

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40007145
Hospital Revenue Code	278
Min. Negotiated Rate	$111.24
Max. Negotiated Rate	$111.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24

NCB CORT SCREW 4.0X90MM SELF-TAP

Facility

$222.48

Service Code	HCPCS C1713
Hospital Charge Code	40007145
Hospital Revenue Code	278
Min. Negotiated Rate	$77.87
Max. Negotiated Rate	$233.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$133.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.93
Rate for Payer: EmblemHealth Commercial	$111.24
Rate for Payer: Fidelis Medicare Advantage	$233.60
Rate for Payer: Group Health Inc Commercial	$111.24
Rate for Payer: Group Health Inc Medicare	$77.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.24
Rate for Payer: Hamaspik Choice Inc Medicare	$111.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$144.61

NCB CORT SCREW 5.0X14MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007054
Hospital Revenue Code	278
Min. Negotiated Rate	$122.00
Max. Negotiated Rate	$365.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$209.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.42
Rate for Payer: EmblemHealth Commercial	$174.28
Rate for Payer: Fidelis Medicare Advantage	$365.99
Rate for Payer: Group Health Inc Commercial	$174.28
Rate for Payer: Group Health Inc Medicare	$122.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.56

NCB CORT SCREW 5.0X14MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007054
Hospital Revenue Code	278
Min. Negotiated Rate	$174.28
Max. Negotiated Rate	$174.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28

NCB CORT SCREW 5.0X16MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007055
Hospital Revenue Code	278
Min. Negotiated Rate	$122.00
Max. Negotiated Rate	$365.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$209.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.42
Rate for Payer: EmblemHealth Commercial	$174.28
Rate for Payer: Fidelis Medicare Advantage	$365.99
Rate for Payer: Group Health Inc Commercial	$174.28
Rate for Payer: Group Health Inc Medicare	$122.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.56

NCB CORT SCREW 5.0X16MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007055
Hospital Revenue Code	278
Min. Negotiated Rate	$174.28
Max. Negotiated Rate	$174.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28

NCB CORT SCREW 5.0X18MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007056
Hospital Revenue Code	278
Min. Negotiated Rate	$174.28
Max. Negotiated Rate	$174.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28

NCB CORT SCREW 5.0X18MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007056
Hospital Revenue Code	278
Min. Negotiated Rate	$122.00
Max. Negotiated Rate	$365.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$209.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.42
Rate for Payer: EmblemHealth Commercial	$174.28
Rate for Payer: Fidelis Medicare Advantage	$365.99
Rate for Payer: Group Health Inc Commercial	$174.28
Rate for Payer: Group Health Inc Medicare	$122.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.56

NCB CORT SCREW 5.0X20MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007057
Hospital Revenue Code	278
Min. Negotiated Rate	$174.28
Max. Negotiated Rate	$174.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28

NCB CORT SCREW 5.0X20MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007057
Hospital Revenue Code	278
Min. Negotiated Rate	$122.00
Max. Negotiated Rate	$365.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$209.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.42
Rate for Payer: EmblemHealth Commercial	$174.28
Rate for Payer: Fidelis Medicare Advantage	$365.99
Rate for Payer: Group Health Inc Commercial	$174.28
Rate for Payer: Group Health Inc Medicare	$122.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.56

NCB CORT SCREW 5.0X22MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007058
Hospital Revenue Code	278
Min. Negotiated Rate	$174.28
Max. Negotiated Rate	$174.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28

NCB CORT SCREW 5.0X22MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007058
Hospital Revenue Code	278
Min. Negotiated Rate	$122.00
Max. Negotiated Rate	$365.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$209.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.42
Rate for Payer: EmblemHealth Commercial	$174.28
Rate for Payer: Fidelis Medicare Advantage	$365.99
Rate for Payer: Group Health Inc Commercial	$174.28
Rate for Payer: Group Health Inc Medicare	$122.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.56

NCB CORT SCREW 5.0X24MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007059
Hospital Revenue Code	278
Min. Negotiated Rate	$174.28
Max. Negotiated Rate	$174.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28

NCB CORT SCREW 5.0X24MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007059
Hospital Revenue Code	278
Min. Negotiated Rate	$122.00
Max. Negotiated Rate	$365.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$209.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.42
Rate for Payer: EmblemHealth Commercial	$174.28
Rate for Payer: Fidelis Medicare Advantage	$365.99
Rate for Payer: Group Health Inc Commercial	$174.28
Rate for Payer: Group Health Inc Medicare	$122.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.56

NCB CORT SCREW 5.0X26MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007060
Hospital Revenue Code	278
Min. Negotiated Rate	$174.28
Max. Negotiated Rate	$174.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28

NCB CORT SCREW 5.0X26MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007060
Hospital Revenue Code	278
Min. Negotiated Rate	$122.00
Max. Negotiated Rate	$365.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$209.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.42
Rate for Payer: EmblemHealth Commercial	$174.28
Rate for Payer: Fidelis Medicare Advantage	$365.99
Rate for Payer: Group Health Inc Commercial	$174.28
Rate for Payer: Group Health Inc Medicare	$122.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.56

NCB CORT SCREW 5.0X28MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007061
Hospital Revenue Code	278
Min. Negotiated Rate	$122.00
Max. Negotiated Rate	$365.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$209.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$174.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$200.42
Rate for Payer: EmblemHealth Commercial	$174.28
Rate for Payer: Fidelis Medicare Advantage	$365.99
Rate for Payer: Group Health Inc Commercial	$174.28
Rate for Payer: Group Health Inc Medicare	$122.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$226.56

NCB CORT SCREW 5.0X28MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007061
Hospital Revenue Code	278
Min. Negotiated Rate	$174.28
Max. Negotiated Rate	$174.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28

NCB CORT SCREW 5.0X30MM SELF-TAP

Facility

$348.56

Service Code	HCPCS C1713
Hospital Charge Code	40007062
Hospital Revenue Code	278
Min. Negotiated Rate	$174.28
Max. Negotiated Rate	$174.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.28
Rate for Payer: Hamaspik Choice Inc Medicare	$174.28

Know your out-of-pocket cost for care.

All Charges