St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW 2.3X8 HEX ST COMMAND

Facility OP

$81.00

Service Code	HCPCS C1713
Hospital Charge Code	40202383
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 2.3 X 9 NL

Facility OP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64904085
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 2.3 X 9 NL

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64904085
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 2.5 X 20MM

Facility IP

$712.50

Service Code	HCPCS C1713
Hospital Charge Code	64904047
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$356.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$356.25
Rate for Payer: Hamaspik Choice Inc Medicare	$356.25

SCREW 2.5 X 20MM

Facility OP

$712.50

Service Code	HCPCS C1713
Hospital Charge Code	64904047
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$748.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$391.88
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	$356.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$409.69
Rate for Payer: Fidelis Medicare Advantage	$748.12
Rate for Payer: Group Health Inc Commercial	$356.25
Rate for Payer: Group Health Inc Medicare	$249.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$356.25
Rate for Payer: Hamaspik Choice Inc Medicare	$356.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$463.12

SCREW 2.7 X 26MM

Facility IP

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64903188
Hospital Revenue Code	278
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$28.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.44
Rate for Payer: Hamaspik Choice Inc Medicare	$28.44

SCREW 2.7 X 26MM

Facility OP

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64903188
Hospital Revenue Code	278
Min. Negotiated Rate	$19.91
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.28
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	$28.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.71
Rate for Payer: Fidelis Medicare Advantage	$59.72
Rate for Payer: Group Health Inc Commercial	$28.44
Rate for Payer: Group Health Inc Medicare	$19.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.44
Rate for Payer: Hamaspik Choice Inc Medicare	$28.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.97

SCREW 3.0

Facility OP

$437.50

Service Code	HCPCS C1713
Hospital Charge Code	64907158
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$459.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$240.62
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	$218.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$251.56
Rate for Payer: Fidelis Medicare Advantage	$459.38
Rate for Payer: Group Health Inc Commercial	$218.75
Rate for Payer: Group Health Inc Medicare	$153.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$218.75
Rate for Payer: Hamaspik Choice Inc Medicare	$218.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$284.38

SCREW 3.0

Facility IP

$437.50

Service Code	HCPCS C1713
Hospital Charge Code	64907158
Hospital Revenue Code	278
Min. Negotiated Rate	$218.75
Max. Negotiated Rate	$218.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$218.75
Rate for Payer: Hamaspik Choice Inc Medicare	$218.75

SCREW 300-999

Facility OP

$867.40

Service Code	HCPCS C1713
Hospital Charge Code	40203070
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$910.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$477.07
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	$433.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$498.76
Rate for Payer: Fidelis Medicare Advantage	$910.77
Rate for Payer: Group Health Inc Commercial	$433.70
Rate for Payer: Group Health Inc Medicare	$303.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$433.70
Rate for Payer: Hamaspik Choice Inc Medicare	$433.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$563.81

SCREW 300-999

Facility IP

$867.40

Service Code	HCPCS C1713
Hospital Charge Code	40203070
Hospital Revenue Code	278
Min. Negotiated Rate	$433.70
Max. Negotiated Rate	$433.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$433.70
Rate for Payer: Hamaspik Choice Inc Medicare	$433.70

SCREW 3.0MM ASNIS MCR CANN 5/6 ST

Facility IP

$360.10

Service Code	HCPCS C1713
Hospital Charge Code	40005921
Hospital Revenue Code	278
Min. Negotiated Rate	$180.05
Max. Negotiated Rate	$180.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$180.05
Rate for Payer: Hamaspik Choice Inc Medicare	$180.05

SCREW 3.0MM ASNIS MCR CANN 5/6 ST

Facility OP

$360.10

Service Code	HCPCS C1713
Hospital Charge Code	40005921
Hospital Revenue Code	278
Min. Negotiated Rate	$126.04
Max. Negotiated Rate	$378.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$198.06
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	$180.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$207.06
Rate for Payer: Fidelis Medicare Advantage	$378.10
Rate for Payer: Group Health Inc Commercial	$180.05
Rate for Payer: Group Health Inc Medicare	$126.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$180.05
Rate for Payer: Hamaspik Choice Inc Medicare	$180.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$234.06

SCREW 3.0 X 16 MM

Facility IP

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64904043
Hospital Revenue Code	278
Min. Negotiated Rate	$368.75
Max. Negotiated Rate	$368.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75

SCREW 3.0 X 16 MM

Facility OP

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64904043
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$774.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$405.62
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	$368.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$424.06
Rate for Payer: Fidelis Medicare Advantage	$774.38
Rate for Payer: Group Health Inc Commercial	$368.75
Rate for Payer: Group Health Inc Medicare	$258.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$479.38

SCREW 3.0 X 18 MM

Facility OP

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64904045
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$774.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$405.62
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	$368.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$424.06
Rate for Payer: Fidelis Medicare Advantage	$774.38
Rate for Payer: Group Health Inc Commercial	$368.75
Rate for Payer: Group Health Inc Medicare	$258.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$479.38

SCREW 3.0 X 18 MM

Facility IP

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64904045
Hospital Revenue Code	278
Min. Negotiated Rate	$368.75
Max. Negotiated Rate	$368.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75

SCREW 3.0 X 22MM

Facility IP

$1,012.50

Service Code	HCPCS C1713
Hospital Charge Code	64906984
Hospital Revenue Code	278
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$506.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$506.25
Rate for Payer: Hamaspik Choice Inc Medicare	$506.25

SCREW 3.0 X 22MM

Facility OP

$1,012.50

Service Code	HCPCS C1713
Hospital Charge Code	64906984
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,063.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$556.88
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	$506.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$582.19
Rate for Payer: Fidelis Medicare Advantage	$1,063.12
Rate for Payer: Group Health Inc Commercial	$506.25
Rate for Payer: Group Health Inc Medicare	$354.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$506.25
Rate for Payer: Hamaspik Choice Inc Medicare	$506.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$658.12

SCREW 3.5 38MML

Facility OP

$80.00

Service Code	HCPCS C1713
Hospital Charge Code	64904059
Hospital Revenue Code	278
Min. Negotiated Rate	$28.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.00
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	$40.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.00
Rate for Payer: Fidelis Medicare Advantage	$84.00
Rate for Payer: Group Health Inc Commercial	$40.00
Rate for Payer: Group Health Inc Medicare	$28.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.00

SCREW 3.5 38MML

Facility IP

$80.00

Service Code	HCPCS C1713
Hospital Charge Code	64904059
Hospital Revenue Code	278
Min. Negotiated Rate	$40.00
Max. Negotiated Rate	$40.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00

SCREW 35MM

Facility IP

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202428
Hospital Revenue Code	278
Min. Negotiated Rate	$159.00
Max. Negotiated Rate	$159.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00
Rate for Payer: Hamaspik Choice Inc Medicare	$159.00

SCREW 35MM

Facility OP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901233
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$450.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.95
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	$214.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.68
Rate for Payer: Fidelis Medicare Advantage	$450.45
Rate for Payer: Group Health Inc Commercial	$214.50
Rate for Payer: Group Health Inc Medicare	$150.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$278.85

SCREW 35MM

Facility IP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901233
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50

SCREW 35MM

Facility OP

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202428
Hospital Revenue Code	278
Min. Negotiated Rate	$111.30
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.90
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	$159.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.85
Rate for Payer: Fidelis Medicare Advantage	$333.90
Rate for Payer: Group Health Inc Commercial	$159.00
Rate for Payer: Group Health Inc Medicare	$111.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00
Rate for Payer: Hamaspik Choice Inc Medicare	$159.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.70

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