St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW 3.5 X 18 MM

Facility OP

$762.50

Service Code	HCPCS C1713
Hospital Charge Code	64904049
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$800.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$419.38
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	$381.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$438.44
Rate for Payer: Fidelis Medicare Advantage	$800.62
Rate for Payer: Group Health Inc Commercial	$381.25
Rate for Payer: Group Health Inc Medicare	$266.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$381.25
Rate for Payer: Hamaspik Choice Inc Medicare	$381.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$495.62

SCREW 3.5 X 18MM

Facility OP

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905057
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,168.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$611.88
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	$556.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$639.69
Rate for Payer: Fidelis Medicare Advantage	$1,168.12
Rate for Payer: Group Health Inc Commercial	$556.25
Rate for Payer: Group Health Inc Medicare	$389.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$723.12

SCREW 3.5 X 18MM

Facility IP

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905057
Hospital Revenue Code	278
Min. Negotiated Rate	$556.25
Max. Negotiated Rate	$556.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25

SCREW - 371318

Facility IP

$186.00

Service Code	HCPCS C1713
Hospital Charge Code	40203579
Hospital Revenue Code	278
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.00
Rate for Payer: Hamaspik Choice Inc Medicare	$93.00

SCREW - 371318

Facility OP

$186.00

Service Code	HCPCS C1713
Hospital Charge Code	40203579
Hospital Revenue Code	278
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$195.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$102.30
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	$93.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$106.95
Rate for Payer: Fidelis Medicare Advantage	$195.30
Rate for Payer: Group Health Inc Commercial	$93.00
Rate for Payer: Group Health Inc Medicare	$65.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.00
Rate for Payer: Hamaspik Choice Inc Medicare	$93.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$120.90

SCREW 40MM

Facility OP

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202490
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

SCREW 40MM

Facility IP

$300.00

Service Code	HCPCS C1776
Hospital Charge Code	40202424
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

SCREW 40MM

Facility IP

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202490
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 40MM

Facility OP

$300.00

Service Code	HCPCS C1776
Hospital Charge Code	40202424
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
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	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.50
Rate for Payer: Fidelis Medicare Advantage	$315.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$195.00

SCREW 4.0 X 12MM

Facility OP

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905105
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,168.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$611.88
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	$556.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$639.69
Rate for Payer: Fidelis Medicare Advantage	$1,168.12
Rate for Payer: Group Health Inc Commercial	$556.25
Rate for Payer: Group Health Inc Medicare	$389.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$723.12

SCREW 4.0 X 12MM

Facility IP

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905105
Hospital Revenue Code	278
Min. Negotiated Rate	$556.25
Max. Negotiated Rate	$556.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25

SCREW 4.0 X 35

Facility OP

$4,912.80

Service Code	HCPCS C1713
Hospital Charge Code	64904435
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,158.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,702.04
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	$2,456.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,824.86
Rate for Payer: Fidelis Medicare Advantage	$5,158.44
Rate for Payer: Group Health Inc Commercial	$2,456.40
Rate for Payer: Group Health Inc Medicare	$1,719.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,456.40
Rate for Payer: Hamaspik Choice Inc Medicare	$2,456.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,193.32

SCREW 4.0 X 35

Facility IP

$4,912.80

Service Code	HCPCS C1713
Hospital Charge Code	64904435
Hospital Revenue Code	278
Min. Negotiated Rate	$2,456.40
Max. Negotiated Rate	$2,456.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,456.40
Rate for Payer: Hamaspik Choice Inc Medicare	$2,456.40

SCREW 45MM

Facility IP

$317.80

Service Code	HCPCS C1776
Hospital Charge Code	40202418
Hospital Revenue Code	278
Min. Negotiated Rate	$158.90
Max. Negotiated Rate	$158.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.90
Rate for Payer: Hamaspik Choice Inc Medicare	$158.90

SCREW 45MM

Facility OP

$317.80

Service Code	HCPCS C1776
Hospital Charge Code	40202418
Hospital Revenue Code	278
Min. Negotiated Rate	$111.23
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.79
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	$158.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.74
Rate for Payer: Fidelis Medicare Advantage	$333.69
Rate for Payer: Group Health Inc Commercial	$158.90
Rate for Payer: Group Health Inc Medicare	$111.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.90
Rate for Payer: Hamaspik Choice Inc Medicare	$158.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.57

SCREW 4MM CAN BONE PT-THRD 40MM

Facility OP

$33.00

Service Code	HCPCS C1713
Hospital Charge Code	40205029
Hospital Revenue Code	278
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.15
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	$16.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.98
Rate for Payer: Fidelis Medicare Advantage	$34.65
Rate for Payer: Group Health Inc Commercial	$16.50
Rate for Payer: Group Health Inc Medicare	$11.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50
Rate for Payer: Hamaspik Choice Inc Medicare	$16.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.45

SCREW 4MM CAN BONE PT-THRD 40MM

Facility OP

$43.75

Service Code	HCPCS C1713
Hospital Charge Code	64901213
Hospital Revenue Code	278
Min. Negotiated Rate	$15.31
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.06
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	$21.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.16
Rate for Payer: Fidelis Medicare Advantage	$45.94
Rate for Payer: Group Health Inc Commercial	$21.88
Rate for Payer: Group Health Inc Medicare	$15.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.88
Rate for Payer: Hamaspik Choice Inc Medicare	$21.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.44

SCREW 4MM CAN BONE PT-THRD 40MM

Facility IP

$33.00

Service Code	HCPCS C1713
Hospital Charge Code	40205029
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50
Rate for Payer: Hamaspik Choice Inc Medicare	$16.50

SCREW 4MM CAN BONE PT-THRD 40MM

Facility IP

$43.75

Service Code	HCPCS C1713
Hospital Charge Code	64901213
Hospital Revenue Code	278
Min. Negotiated Rate	$21.88
Max. Negotiated Rate	$21.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.88
Rate for Payer: Hamaspik Choice Inc Medicare	$21.88

SCREW 4MM X 1.2 SQ FIT

Facility IP

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	64901217
Hospital Revenue Code	278
Min. Negotiated Rate	$77.50
Max. Negotiated Rate	$77.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50

SCREW 4MM X 1.2 SQ FIT

Facility OP

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	64901217
Hospital Revenue Code	278
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$162.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.25
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	$77.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$89.12
Rate for Payer: Fidelis Medicare Advantage	$162.75
Rate for Payer: Group Health Inc Commercial	$77.50
Rate for Payer: Group Health Inc Medicare	$54.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.75

SCREW 4X14X3

Facility OP

$26.83

Service Code	HCPCS C1713
Hospital Charge Code	64905922
Hospital Revenue Code	278
Min. Negotiated Rate	$9.39
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.76
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	$13.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.43
Rate for Payer: Fidelis Medicare Advantage	$28.17
Rate for Payer: Group Health Inc Commercial	$13.42
Rate for Payer: Group Health Inc Medicare	$9.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.42
Rate for Payer: Hamaspik Choice Inc Medicare	$13.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.44

SCREW 4X14X3

Facility IP

$26.83

Service Code	HCPCS C1713
Hospital Charge Code	64905922
Hospital Revenue Code	278
Min. Negotiated Rate	$13.42
Max. Negotiated Rate	$13.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.42
Rate for Payer: Hamaspik Choice Inc Medicare	$13.42

SCREW 5.0 X 48

Facility IP

$947.50

Service Code	HCPCS C1713
Hospital Charge Code	64904808
Hospital Revenue Code	278
Min. Negotiated Rate	$473.75
Max. Negotiated Rate	$473.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$473.75
Rate for Payer: Hamaspik Choice Inc Medicare	$473.75

SCREW 5.0 X 48

Facility OP

$947.50

Service Code	HCPCS C1713
Hospital Charge Code	64904808
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$994.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$521.12
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	$473.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$544.81
Rate for Payer: Fidelis Medicare Advantage	$994.88
Rate for Payer: Group Health Inc Commercial	$473.75
Rate for Payer: Group Health Inc Medicare	$331.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$473.75
Rate for Payer: Hamaspik Choice Inc Medicare	$473.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$615.88

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