St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW 2.0 X 12

Facility OP

$107.10

Service Code	HCPCS C1713
Hospital Charge Code	64901381
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.90
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	$53.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.58
Rate for Payer: Fidelis Medicare Advantage	$112.46
Rate for Payer: Group Health Inc Commercial	$53.55
Rate for Payer: Group Health Inc Medicare	$37.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.55
Rate for Payer: Hamaspik Choice Inc Medicare	$53.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$69.62

SCREW 2.0 X 12

Facility IP

$107.10

Service Code	HCPCS C1713
Hospital Charge Code	64901381
Hospital Revenue Code	278
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$53.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.55
Rate for Payer: Hamaspik Choice Inc Medicare	$53.55

SCREW 2.0 X 12MM

Facility IP

$912.50

Service Code	HCPCS C1713
Hospital Charge Code	64901311
Hospital Revenue Code	278
Min. Negotiated Rate	$456.25
Max. Negotiated Rate	$456.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.25
Rate for Payer: Hamaspik Choice Inc Medicare	$456.25

SCREW 2.0 X 12MM

Facility OP

$912.50

Service Code	HCPCS C1713
Hospital Charge Code	64901311
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$958.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$501.88
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	$456.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$524.69
Rate for Payer: Fidelis Medicare Advantage	$958.12
Rate for Payer: Group Health Inc Commercial	$456.25
Rate for Payer: Group Health Inc Medicare	$319.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.25
Rate for Payer: Hamaspik Choice Inc Medicare	$456.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$593.12

SCREW 2.0 X 13MM

Facility IP

$353.00

Service Code	HCPCS C1776
Hospital Charge Code	40202435
Hospital Revenue Code	278
Min. Negotiated Rate	$176.50
Max. Negotiated Rate	$176.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$176.50
Rate for Payer: Hamaspik Choice Inc Medicare	$176.50

SCREW 2.0 X 13MM

Facility OP

$353.00

Service Code	HCPCS C1776
Hospital Charge Code	40202435
Hospital Revenue Code	278
Min. Negotiated Rate	$123.55
Max. Negotiated Rate	$370.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$194.15
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	$176.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$202.98
Rate for Payer: Fidelis Medicare Advantage	$370.65
Rate for Payer: Group Health Inc Commercial	$176.50
Rate for Payer: Group Health Inc Medicare	$123.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$176.50
Rate for Payer: Hamaspik Choice Inc Medicare	$176.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$229.45

SCREW 2.0 X 13 TWIST OFF

Facility IP

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904673
Hospital Revenue Code	278
Min. Negotiated Rate	$692.50
Max. Negotiated Rate	$692.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50

SCREW 2.0 X 13 TWIST OFF

Facility OP

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904673
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,454.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$761.75
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	$692.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$796.38
Rate for Payer: Fidelis Medicare Advantage	$1,454.25
Rate for Payer: Group Health Inc Commercial	$692.50
Rate for Payer: Group Health Inc Medicare	$484.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$900.25

SCREW 2.0 X 14MM

Facility OP

$195.55

Service Code	HCPCS C1713
Hospital Charge Code	64901385
Hospital Revenue Code	278
Min. Negotiated Rate	$68.44
Max. Negotiated Rate	$205.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.55
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	$97.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.44
Rate for Payer: Fidelis Medicare Advantage	$205.33
Rate for Payer: Group Health Inc Commercial	$97.78
Rate for Payer: Group Health Inc Medicare	$68.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.78
Rate for Payer: Hamaspik Choice Inc Medicare	$97.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.11

SCREW 2.0 X 14MM

Facility IP

$195.55

Service Code	HCPCS C1713
Hospital Charge Code	64901385
Hospital Revenue Code	278
Min. Negotiated Rate	$97.78
Max. Negotiated Rate	$97.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.78
Rate for Payer: Hamaspik Choice Inc Medicare	$97.78

SCREW 2.0 X 14 TWIST OFF

Facility OP

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904671
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,454.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$761.75
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	$692.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$796.38
Rate for Payer: Fidelis Medicare Advantage	$1,454.25
Rate for Payer: Group Health Inc Commercial	$692.50
Rate for Payer: Group Health Inc Medicare	$484.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$900.25

SCREW 2.0 X 14 TWIST OFF

Facility IP

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904671
Hospital Revenue Code	278
Min. Negotiated Rate	$692.50
Max. Negotiated Rate	$692.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50

SCREW, 2.0X7MM

Facility OP

$147.60

Service Code	HCPCS C1713
Hospital Charge Code	64905713
Hospital Revenue Code	278
Min. Negotiated Rate	$51.66
Max. Negotiated Rate	$154.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.18
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	$73.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.87
Rate for Payer: Fidelis Medicare Advantage	$154.98
Rate for Payer: Group Health Inc Commercial	$73.80
Rate for Payer: Group Health Inc Medicare	$51.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.80
Rate for Payer: Hamaspik Choice Inc Medicare	$73.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$95.94

SCREW, 2.0X7MM

Facility IP

$147.60

Service Code	HCPCS C1713
Hospital Charge Code	64905713
Hospital Revenue Code	278
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$73.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.80
Rate for Payer: Hamaspik Choice Inc Medicare	$73.80

SCREW 23 8M

Facility IP

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64903645
Hospital Revenue Code	278
Min. Negotiated Rate	$122.50
Max. Negotiated Rate	$122.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50

SCREW 23 8M

Facility OP

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64903645
Hospital Revenue Code	278
Min. Negotiated Rate	$85.75
Max. Negotiated Rate	$257.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$134.75
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	$122.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$140.88
Rate for Payer: Fidelis Medicare Advantage	$257.25
Rate for Payer: Group Health Inc Commercial	$122.50
Rate for Payer: Group Health Inc Medicare	$85.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$159.25

SCREW 23 9MM

Facility OP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64903226
Hospital Revenue Code	278
Min. Negotiated Rate	$62.56
Max. Negotiated Rate	$187.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.31
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	$89.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.78
Rate for Payer: Fidelis Medicare Advantage	$187.69
Rate for Payer: Group Health Inc Commercial	$89.38
Rate for Payer: Group Health Inc Medicare	$62.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$116.19

SCREW 23 9MM

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64903226
Hospital Revenue Code	278
Min. Negotiated Rate	$89.38
Max. Negotiated Rate	$89.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38

SCREW 2.3X10 HEX ST COMMAND

Facility IP

$81.00

Service Code	HCPCS C1713
Hospital Charge Code	40202379
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.50
Rate for Payer: Hamaspik Choice Inc Medicare	$40.50

SCREW 2.3X10 HEX ST COMMAND

Facility OP

$81.00

Service Code	HCPCS C1713
Hospital Charge Code	40202379
Hospital Revenue Code	278
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.55
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	$40.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.58
Rate for Payer: Fidelis Medicare Advantage	$85.05
Rate for Payer: Group Health Inc Commercial	$40.50
Rate for Payer: Group Health Inc Medicare	$28.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.50
Rate for Payer: Hamaspik Choice Inc Medicare	$40.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.65

SCREW 2.3X12 HEX ST COMMAND

Facility IP

$81.00

Service Code	HCPCS C1713
Hospital Charge Code	40202380
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.50
Rate for Payer: Hamaspik Choice Inc Medicare	$40.50

SCREW 2.3X12 HEX ST COMMAND

Facility OP

$81.00

Service Code	HCPCS C1713
Hospital Charge Code	40202380
Hospital Revenue Code	278
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.55
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	$40.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.58
Rate for Payer: Fidelis Medicare Advantage	$85.05
Rate for Payer: Group Health Inc Commercial	$40.50
Rate for Payer: Group Health Inc Medicare	$28.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.50
Rate for Payer: Hamaspik Choice Inc Medicare	$40.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.65

SCREW 2.3X14 HEX ST COMMAND

Facility IP

$81.00

Service Code	HCPCS C1713
Hospital Charge Code	40202381
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.50
Rate for Payer: Hamaspik Choice Inc Medicare	$40.50

SCREW 2.3X14 HEX ST COMMAND

Facility OP

$81.00

Service Code	HCPCS C1713
Hospital Charge Code	40202381
Hospital Revenue Code	278
Min. Negotiated Rate	$28.35
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.55
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	$40.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.58
Rate for Payer: Fidelis Medicare Advantage	$85.05
Rate for Payer: Group Health Inc Commercial	$40.50
Rate for Payer: Group Health Inc Medicare	$28.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.50
Rate for Payer: Hamaspik Choice Inc Medicare	$40.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.65

SCREW 2.3X8 HEX ST COMMAND

Facility IP

$81.00

Service Code	HCPCS C1713
Hospital Charge Code	40202383
Hospital Revenue Code	278
Min. Negotiated Rate	$40.50
Max. Negotiated Rate	$40.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.50
Rate for Payer: Hamaspik Choice Inc Medicare	$40.50

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All Charges