St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW 14MM IMF

Facility OP

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	40202376
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.00
Rate for Payer: Fidelis Medicare Advantage	$126.00
Rate for Payer: Group Health Inc Commercial	$60.00
Rate for Payer: Group Health Inc Medicare	$42.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$78.00

SCREW 14MM IMF

Facility IP

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	40202376
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00

SCREW 1.4 X 5MM ER C-P S-T

Facility OP

$165.48

Service Code	HCPCS C1713
Hospital Charge Code	64901553
Hospital Revenue Code	278
Min. Negotiated Rate	$57.92
Max. Negotiated Rate	$173.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$91.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$82.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.15
Rate for Payer: Fidelis Medicare Advantage	$173.75
Rate for Payer: Group Health Inc Commercial	$82.74
Rate for Payer: Group Health Inc Medicare	$57.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.74
Rate for Payer: Hamaspik Choice Inc Medicare	$82.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$107.56

SCREW 1.4 X 5MM ER C-P S-T

Facility IP

$165.48

Service Code	HCPCS C1713
Hospital Charge Code	64901553
Hospital Revenue Code	278
Min. Negotiated Rate	$82.74
Max. Negotiated Rate	$82.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.74
Rate for Payer: Hamaspik Choice Inc Medicare	$82.74

SCREW 1.5MM TIT CORT S/T 11MM

Facility IP

$67.50

Service Code	HCPCS C1776
Hospital Charge Code	40205214
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.75
Rate for Payer: Hamaspik Choice Inc Medicare	$33.75

SCREW 1.5MM TIT CORT S/T 11MM

Facility OP

$67.50

Service Code	HCPCS C1776
Hospital Charge Code	40205214
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.81
Rate for Payer: Fidelis Medicare Advantage	$70.88
Rate for Payer: Group Health Inc Commercial	$33.75
Rate for Payer: Group Health Inc Medicare	$23.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.75
Rate for Payer: Hamaspik Choice Inc Medicare	$33.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.88

SCREW 1.7 7MM

Facility IP

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903232
Hospital Revenue Code	278
Min. Negotiated Rate	$114.56
Max. Negotiated Rate	$114.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56

SCREW 1.7 7MM

Facility OP

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903232
Hospital Revenue Code	278
Min. Negotiated Rate	$80.20
Max. Negotiated Rate	$240.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.75
Rate for Payer: Fidelis Medicare Advantage	$240.59
Rate for Payer: Group Health Inc Commercial	$114.56
Rate for Payer: Group Health Inc Medicare	$80.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.93

SCREW 1.7 X 12MM

Facility OP

$113.30

Service Code	HCPCS C1713
Hospital Charge Code	64901395
Hospital Revenue Code	278
Min. Negotiated Rate	$39.66
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$65.15
Rate for Payer: Fidelis Medicare Advantage	$118.96
Rate for Payer: Group Health Inc Commercial	$56.65
Rate for Payer: Group Health Inc Medicare	$39.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.65
Rate for Payer: Hamaspik Choice Inc Medicare	$56.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$73.64

SCREW 1.7 X 12MM

Facility IP

$113.30

Service Code	HCPCS C1713
Hospital Charge Code	64901395
Hospital Revenue Code	278
Min. Negotiated Rate	$56.65
Max. Negotiated Rate	$56.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.65
Rate for Payer: Hamaspik Choice Inc Medicare	$56.65

SCREW 1.7X14MM LOCKING CROSS

Facility OP

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64905641
Hospital Revenue Code	278
Min. Negotiated Rate	$80.20
Max. Negotiated Rate	$240.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.75
Rate for Payer: Fidelis Medicare Advantage	$240.59
Rate for Payer: Group Health Inc Commercial	$114.56
Rate for Payer: Group Health Inc Medicare	$80.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.93

SCREW 1.7X14MM LOCKING CROSS

Facility IP

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64905641
Hospital Revenue Code	278
Min. Negotiated Rate	$114.56
Max. Negotiated Rate	$114.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56

SCREW 1.7X3MM CRSS PIN SLF TAP

Facility IP

$113.30

Service Code	HCPCS C1713
Hospital Charge Code	64901596
Hospital Revenue Code	278
Min. Negotiated Rate	$56.65
Max. Negotiated Rate	$56.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.65
Rate for Payer: Hamaspik Choice Inc Medicare	$56.65

SCREW 1.7X3MM CRSS PIN SLF TAP

Facility OP

$113.30

Service Code	HCPCS C1713
Hospital Charge Code	64901596
Hospital Revenue Code	278
Min. Negotiated Rate	$39.66
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$65.15
Rate for Payer: Fidelis Medicare Advantage	$118.96
Rate for Payer: Group Health Inc Commercial	$56.65
Rate for Payer: Group Health Inc Medicare	$39.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.65
Rate for Payer: Hamaspik Choice Inc Medicare	$56.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$73.64

SCREW 1.7X3MM EMERGENCY SLF DRL

Facility IP

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	40200753
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

SCREW 1.7X3MM EMERGENCY SLF DRL

Facility OP

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	40200753
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: Cigna HMO/Network Benefit Plan/Open Access	$70.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$80.50
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

SCREW 1.7X3MM W/NEW TH

Facility IP

$127.33

Service Code	HCPCS C1713
Hospital Charge Code	64904959
Hospital Revenue Code	278
Min. Negotiated Rate	$63.66
Max. Negotiated Rate	$63.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.66
Rate for Payer: Hamaspik Choice Inc Medicare	$63.66

SCREW 1.7X3MM W/NEW TH

Facility OP

$127.33

Service Code	HCPCS C1713
Hospital Charge Code	64904959
Hospital Revenue Code	278
Min. Negotiated Rate	$44.57
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.21
Rate for Payer: Fidelis Medicare Advantage	$133.70
Rate for Payer: Group Health Inc Commercial	$63.66
Rate for Payer: Group Health Inc Medicare	$44.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.66
Rate for Payer: Hamaspik Choice Inc Medicare	$63.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$82.76

SCREW 1.7 X 4 EMR

Facility IP

$124.05

Service Code	HCPCS C1713
Hospital Charge Code	64904353
Hospital Revenue Code	278
Min. Negotiated Rate	$62.02
Max. Negotiated Rate	$62.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.02
Rate for Payer: Hamaspik Choice Inc Medicare	$62.02

SCREW 1.7 X 4 EMR

Facility OP

$124.05

Service Code	HCPCS C1713
Hospital Charge Code	64904353
Hospital Revenue Code	278
Min. Negotiated Rate	$43.42
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$62.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.33
Rate for Payer: Fidelis Medicare Advantage	$130.25
Rate for Payer: Group Health Inc Commercial	$62.02
Rate for Payer: Group Health Inc Medicare	$43.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.02
Rate for Payer: Hamaspik Choice Inc Medicare	$62.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.63

SCREW 1.7 X 4MM

Facility OP

$113.30

Service Code	HCPCS C1713
Hospital Charge Code	64901393
Hospital Revenue Code	278
Min. Negotiated Rate	$39.66
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$65.15
Rate for Payer: Fidelis Medicare Advantage	$118.96
Rate for Payer: Group Health Inc Commercial	$56.65
Rate for Payer: Group Health Inc Medicare	$39.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.65
Rate for Payer: Hamaspik Choice Inc Medicare	$56.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$73.64

SCREW 1.7 X 4MM

Facility IP

$113.30

Service Code	HCPCS C1713
Hospital Charge Code	64901393
Hospital Revenue Code	278
Min. Negotiated Rate	$56.65
Max. Negotiated Rate	$56.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.65
Rate for Payer: Hamaspik Choice Inc Medicare	$56.65

SCREW 1.7X4MM CRS PIN SLF DRL

Facility IP

$127.33

Service Code	HCPCS C1713
Hospital Charge Code	64901597
Hospital Revenue Code	278
Min. Negotiated Rate	$63.66
Max. Negotiated Rate	$63.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.66
Rate for Payer: Hamaspik Choice Inc Medicare	$63.66

SCREW 1.7X4MM CRS PIN SLF DRL

Facility OP

$127.33

Service Code	HCPCS C1713
Hospital Charge Code	64901597
Hospital Revenue Code	278
Min. Negotiated Rate	$44.57
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$70.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$73.21
Rate for Payer: Fidelis Medicare Advantage	$133.70
Rate for Payer: Group Health Inc Commercial	$63.66
Rate for Payer: Group Health Inc Medicare	$44.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.66
Rate for Payer: Hamaspik Choice Inc Medicare	$63.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$82.76

SCREW 1.7X4MM LOCKING CRSS PIN

Facility OP

$149.15

Service Code	HCPCS C1713
Hospital Charge Code	64901603
Hospital Revenue Code	278
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$156.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$74.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.76
Rate for Payer: Fidelis Medicare Advantage	$156.61
Rate for Payer: Group Health Inc Commercial	$74.58
Rate for Payer: Group Health Inc Medicare	$52.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.58
Rate for Payer: Hamaspik Choice Inc Medicare	$74.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.95

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