St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

OSTEOMED AUTO DRVE SCRW 5MMX2.0MM

Facility

$104.00

Service Code	HCPCS C1776
Hospital Charge Code	40205058
Hospital Revenue Code	278
Min. Negotiated Rate	$52.00
Max. Negotiated Rate	$52.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00

OSTEOMED CHIN PLATE 2MM

Facility

$414.00

Service Code	HCPCS C1713
Hospital Charge Code	40209364
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$434.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$248.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$207.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$238.05
Rate for Payer: EmblemHealth Commercial	$207.00
Rate for Payer: Fidelis Medicare Advantage	$434.70
Rate for Payer: Group Health Inc Commercial	$207.00
Rate for Payer: Group Health Inc Medicare	$144.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.00
Rate for Payer: Hamaspik Choice Inc Medicare	$207.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$269.10

OSTEOMED CHIN PLATE 2MM

Facility

$414.00

Service Code	HCPCS C1713
Hospital Charge Code	40209364
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$207.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.00
Rate for Payer: Hamaspik Choice Inc Medicare	$207.00

OSTEOMED FRACTURE PLATE 4HOLE

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	40209992
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$724.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$379.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$414.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$345.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$396.75
Rate for Payer: EmblemHealth Commercial	$345.00
Rate for Payer: Fidelis Medicare Advantage	$724.50
Rate for Payer: Group Health Inc Commercial	$345.00
Rate for Payer: Group Health Inc Medicare	$241.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$345.00
Rate for Payer: Hamaspik Choice Inc Medicare	$345.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$448.50

OSTEOMED FRACTURE PLATE 4HOLE

Facility

$690.00

Service Code	HCPCS C1713
Hospital Charge Code	40209992
Hospital Revenue Code	278
Min. Negotiated Rate	$345.00
Max. Negotiated Rate	$345.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$345.00
Rate for Payer: Hamaspik Choice Inc Medicare	$345.00

OSTEOMED M4 RGD FIX SCRW 2.0

Facility

$94.00

Service Code	HCPCS C1776
Hospital Charge Code	40205123
Hospital Revenue Code	278
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$51.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$56.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$54.05
Rate for Payer: EmblemHealth Commercial	$47.00
Rate for Payer: Fidelis Medicare Advantage	$98.70
Rate for Payer: Group Health Inc Commercial	$47.00
Rate for Payer: Group Health Inc Medicare	$32.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.00
Rate for Payer: Hamaspik Choice Inc Medicare	$47.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$61.10

OSTEOMED M4 RGD FIX SCRW 2.0

Facility

$94.00

Service Code	HCPCS C1776
Hospital Charge Code	40205123
Hospital Revenue Code	278
Min. Negotiated Rate	$47.00
Max. Negotiated Rate	$47.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.00
Rate for Payer: Hamaspik Choice Inc Medicare	$47.00

OSTEOMED M4 RGD FIX SCRW 2.0 X6MM

Facility

$116.00

Service Code	HCPCS C1776
Hospital Charge Code	40205124
Hospital Revenue Code	278
Min. Negotiated Rate	$58.00
Max. Negotiated Rate	$58.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.00
Rate for Payer: Hamaspik Choice Inc Medicare	$58.00

OSTEOMED M4 RGD FIX SCRW 2.0 X6MM

Facility

$116.00

Service Code	HCPCS C1776
Hospital Charge Code	40205124
Hospital Revenue Code	278
Min. Negotiated Rate	$40.60
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$69.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$58.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.70
Rate for Payer: EmblemHealth Commercial	$58.00
Rate for Payer: Fidelis Medicare Advantage	$121.80
Rate for Payer: Group Health Inc Commercial	$58.00
Rate for Payer: Group Health Inc Medicare	$40.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.00
Rate for Payer: Hamaspik Choice Inc Medicare	$58.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$75.40

OSTEOMED M4 RIGID FIX SCRW 2.0

Facility

$116.00

Service Code	HCPCS C1713
Hospital Charge Code	40205355
Hospital Revenue Code	278
Min. Negotiated Rate	$58.00
Max. Negotiated Rate	$58.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.00
Rate for Payer: Hamaspik Choice Inc Medicare	$58.00

OSTEOMED M4 RIGID FIX SCRW 2.0

Facility

$116.00

Service Code	HCPCS C1713
Hospital Charge Code	40205355
Hospital Revenue Code	278
Min. Negotiated Rate	$40.60
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$69.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$58.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.70
Rate for Payer: EmblemHealth Commercial	$58.00
Rate for Payer: Fidelis Medicare Advantage	$121.80
Rate for Payer: Group Health Inc Commercial	$58.00
Rate for Payer: Group Health Inc Medicare	$40.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.00
Rate for Payer: Hamaspik Choice Inc Medicare	$58.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$75.40

OSTEOMED PLATE 1.6MM

Facility

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	40200166
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00

OSTEOMED PLATE 1.6MM

Facility

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	40200166
Hospital Revenue Code	278
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$147.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$84.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$70.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$80.50
Rate for Payer: EmblemHealth Commercial	$70.00
Rate for Payer: Fidelis Medicare Advantage	$147.00
Rate for Payer: Group Health Inc Commercial	$70.00
Rate for Payer: Group Health Inc Medicare	$49.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$91.00

OSTEOMED PLATE 4HOLE

Facility

$478.00

Service Code	HCPCS C1713
Hospital Charge Code	40209357
Hospital Revenue Code	278
Min. Negotiated Rate	$239.00
Max. Negotiated Rate	$239.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$239.00
Rate for Payer: Hamaspik Choice Inc Medicare	$239.00

OSTEOMED PLATE 4HOLE

Facility

$478.00

Service Code	HCPCS C1713
Hospital Charge Code	40209357
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$501.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$262.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$286.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$239.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$274.85
Rate for Payer: EmblemHealth Commercial	$239.00
Rate for Payer: Fidelis Medicare Advantage	$501.90
Rate for Payer: Group Health Inc Commercial	$239.00
Rate for Payer: Group Health Inc Medicare	$167.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$239.00
Rate for Payer: Hamaspik Choice Inc Medicare	$239.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$310.70

OSTEOMED SAFETY SCREW

Facility

$60.00

Service Code	HCPCS C1713
Hospital Charge Code	40205054
Hospital Revenue Code	278
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$30.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00

OSTEOMED SAFETY SCREW

Facility

$60.00

Service Code	HCPCS C1713
Hospital Charge Code	40205054
Hospital Revenue Code	278
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$36.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$34.50
Rate for Payer: EmblemHealth Commercial	$30.00
Rate for Payer: Fidelis Medicare Advantage	$63.00
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$39.00

OSTEOMED SCREW 10MM

Facility

$160.00

Service Code	HCPCS C1713
Hospital Charge Code	40203656
Hospital Revenue Code	278
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$96.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$92.00
Rate for Payer: EmblemHealth Commercial	$80.00
Rate for Payer: Fidelis Medicare Advantage	$168.00
Rate for Payer: Group Health Inc Commercial	$80.00
Rate for Payer: Group Health Inc Medicare	$56.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$104.00

OSTEOMED SCREW 10MM

Facility

$160.00

Service Code	HCPCS C1713
Hospital Charge Code	40203656
Hospital Revenue Code	278
Min. Negotiated Rate	$80.00
Max. Negotiated Rate	$80.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00

OSTEOMED SCREW 1.2MMX10MM ST

Facility

$124.00

Service Code	HCPCS C1713
Hospital Charge Code	40205419
Hospital Revenue Code	278
Min. Negotiated Rate	$62.00
Max. Negotiated Rate	$62.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.00
Rate for Payer: Hamaspik Choice Inc Medicare	$62.00

OSTEOMED SCREW 1.2MMX10MM ST

Facility

$124.00

Service Code	HCPCS C1713
Hospital Charge Code	40205419
Hospital Revenue Code	278
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$74.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$62.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.30
Rate for Payer: EmblemHealth Commercial	$62.00
Rate for Payer: Fidelis Medicare Advantage	$130.20
Rate for Payer: Group Health Inc Commercial	$62.00
Rate for Payer: Group Health Inc Medicare	$43.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.00
Rate for Payer: Hamaspik Choice Inc Medicare	$62.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.60

OSTEOMED SCREW 1.2MMX8MM ST

Facility

$124.00

Service Code	HCPCS C1713
Hospital Charge Code	40205420
Hospital Revenue Code	278
Min. Negotiated Rate	$62.00
Max. Negotiated Rate	$62.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.00
Rate for Payer: Hamaspik Choice Inc Medicare	$62.00

OSTEOMED SCREW 1.2MMX8MM ST

Facility

$124.00

Service Code	HCPCS C1713
Hospital Charge Code	40205420
Hospital Revenue Code	278
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$74.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$62.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.30
Rate for Payer: EmblemHealth Commercial	$62.00
Rate for Payer: Fidelis Medicare Advantage	$130.20
Rate for Payer: Group Health Inc Commercial	$62.00
Rate for Payer: Group Health Inc Medicare	$43.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.00
Rate for Payer: Hamaspik Choice Inc Medicare	$62.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.60

OSTEOMED SCREW 2.0X5MM

Facility

$158.00

Service Code	HCPCS C1713
Hospital Charge Code	40203653
Hospital Revenue Code	278
Min. Negotiated Rate	$79.00
Max. Negotiated Rate	$79.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.00
Rate for Payer: Hamaspik Choice Inc Medicare	$79.00

OSTEOMED SCREW 2.0X5MM

Facility

$158.00

Service Code	HCPCS C1713
Hospital Charge Code	40203653
Hospital Revenue Code	278
Min. Negotiated Rate	$55.30
Max. Negotiated Rate	$165.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$86.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$94.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$90.85
Rate for Payer: EmblemHealth Commercial	$79.00
Rate for Payer: Fidelis Medicare Advantage	$165.90
Rate for Payer: Group Health Inc Commercial	$79.00
Rate for Payer: Group Health Inc Medicare	$55.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$79.00
Rate for Payer: Hamaspik Choice Inc Medicare	$79.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$102.70

Know your out-of-pocket cost for care.

All Charges