St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW ASNIS III SS CAN 6.5X95MM

Facility IP

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64905791
Hospital Revenue Code	278
Min. Negotiated Rate	$307.12
Max. Negotiated Rate	$307.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12

SCREW ASNIS III SS CANN 8.0X110MM

Facility OP

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005922
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$510.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$267.41
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	$243.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$279.56
Rate for Payer: Fidelis Medicare Advantage	$510.51
Rate for Payer: Group Health Inc Commercial	$243.10
Rate for Payer: Group Health Inc Medicare	$170.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$316.03

SCREW ASNIS III SS CANN 8.0X110MM

Facility IP

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005922
Hospital Revenue Code	278
Min. Negotiated Rate	$243.10
Max. Negotiated Rate	$243.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10

SCREW ASNIS III SS CANN 8.0X115MM

Facility IP

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005923
Hospital Revenue Code	278
Min. Negotiated Rate	$243.10
Max. Negotiated Rate	$243.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10

SCREW ASNIS III SS CANN 8.0X115MM

Facility OP

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005923
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$510.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$267.41
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	$243.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$279.56
Rate for Payer: Fidelis Medicare Advantage	$510.51
Rate for Payer: Group Health Inc Commercial	$243.10
Rate for Payer: Group Health Inc Medicare	$170.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$316.03

SCREW ASNIS III SS CANN 8.0X120MM

Facility OP

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005924
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$510.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$267.41
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	$243.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$279.56
Rate for Payer: Fidelis Medicare Advantage	$510.51
Rate for Payer: Group Health Inc Commercial	$243.10
Rate for Payer: Group Health Inc Medicare	$170.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$316.03

SCREW ASNIS III SS CANN 8.0X120MM

Facility IP

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005924
Hospital Revenue Code	278
Min. Negotiated Rate	$243.10
Max. Negotiated Rate	$243.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10

SCREW ASNIS TT 4.0X32

Facility IP

$1,472.50

Service Code	HCPCS C1713
Hospital Charge Code	64905125
Hospital Revenue Code	278
Min. Negotiated Rate	$736.25
Max. Negotiated Rate	$736.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$736.25
Rate for Payer: Hamaspik Choice Inc Medicare	$736.25

SCREW ASNIS TT 4.0X32

Facility OP

$1,472.50

Service Code	HCPCS C1713
Hospital Charge Code	64905125
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,546.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$809.88
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	$736.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$846.69
Rate for Payer: Fidelis Medicare Advantage	$1,546.12
Rate for Payer: Group Health Inc Commercial	$736.25
Rate for Payer: Group Health Inc Medicare	$515.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$736.25
Rate for Payer: Hamaspik Choice Inc Medicare	$736.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$957.12

SCREW ASNIS TT 4.0X36

Facility IP

$1,472.50

Service Code	HCPCS C1713
Hospital Charge Code	64905127
Hospital Revenue Code	278
Min. Negotiated Rate	$736.25
Max. Negotiated Rate	$736.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$736.25
Rate for Payer: Hamaspik Choice Inc Medicare	$736.25

SCREW ASNIS TT 4.0X36

Facility OP

$1,472.50

Service Code	HCPCS C1713
Hospital Charge Code	64905127
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,546.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$809.88
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	$736.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$846.69
Rate for Payer: Fidelis Medicare Advantage	$1,546.12
Rate for Payer: Group Health Inc Commercial	$736.25
Rate for Payer: Group Health Inc Medicare	$515.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$736.25
Rate for Payer: Hamaspik Choice Inc Medicare	$736.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$957.12

SCREW AUTOFX CMPR MOD T7 DR2.5X25

Facility IP

$858.00

Service Code	HCPCS C1713
Hospital Charge Code	40005930
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$429.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$429.00
Rate for Payer: Hamaspik Choice Inc Medicare	$429.00

SCREW AUTOFX CMPR MOD T7 DR2.5X25

Facility OP

$858.00

Service Code	HCPCS C1713
Hospital Charge Code	40005930
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$900.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$471.90
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	$429.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$493.35
Rate for Payer: Fidelis Medicare Advantage	$900.90
Rate for Payer: Group Health Inc Commercial	$429.00
Rate for Payer: Group Health Inc Medicare	$300.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$429.00
Rate for Payer: Hamaspik Choice Inc Medicare	$429.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$557.70

SCREW AUTOFX CMPR MOD T7 DR2.5X29

Facility OP

$858.00

Service Code	HCPCS C1713
Hospital Charge Code	40005931
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$900.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$471.90
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	$429.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$493.35
Rate for Payer: Fidelis Medicare Advantage	$900.90
Rate for Payer: Group Health Inc Commercial	$429.00
Rate for Payer: Group Health Inc Medicare	$300.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$429.00
Rate for Payer: Hamaspik Choice Inc Medicare	$429.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$557.70

SCREW AUTOFX CMPR MOD T7 DR2.5X29

Facility IP

$858.00

Service Code	HCPCS C1713
Hospital Charge Code	40005931
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$429.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$429.00
Rate for Payer: Hamaspik Choice Inc Medicare	$429.00

SCREW AUTO T7 DR 2.5 X 25MM

Facility IP

$1,072.50

Service Code	HCPCS C1713
Hospital Charge Code	64905615
Hospital Revenue Code	278
Min. Negotiated Rate	$536.25
Max. Negotiated Rate	$536.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$536.25
Rate for Payer: Hamaspik Choice Inc Medicare	$536.25

SCREW AUTO T7 DR 2.5 X 25MM

Facility OP

$1,072.50

Service Code	HCPCS C1713
Hospital Charge Code	64905615
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,126.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$589.88
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	$536.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$616.69
Rate for Payer: Fidelis Medicare Advantage	$1,126.12
Rate for Payer: Group Health Inc Commercial	$536.25
Rate for Payer: Group Health Inc Medicare	$375.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$536.25
Rate for Payer: Hamaspik Choice Inc Medicare	$536.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$697.12

SCREW AUTO T7 DR 2.5 X 29MM

Facility OP

$1,072.50

Service Code	HCPCS C1713
Hospital Charge Code	64905616
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,126.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$589.88
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	$536.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$616.69
Rate for Payer: Fidelis Medicare Advantage	$1,126.12
Rate for Payer: Group Health Inc Commercial	$536.25
Rate for Payer: Group Health Inc Medicare	$375.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$536.25
Rate for Payer: Hamaspik Choice Inc Medicare	$536.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$697.12

SCREW AUTO T7 DR 2.5 X 29MM

Facility IP

$1,072.50

Service Code	HCPCS C1713
Hospital Charge Code	64905616
Hospital Revenue Code	278
Min. Negotiated Rate	$536.25
Max. Negotiated Rate	$536.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$536.25
Rate for Payer: Hamaspik Choice Inc Medicare	$536.25

SCREW BIOCOMP INTERFER

Facility IP

$840.00

Service Code	HCPCS C1713
Hospital Charge Code	64903684
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$420.00
Rate for Payer: Hamaspik Choice Inc Medicare	$420.00

SCREW BIOCOMP INTERFER

Facility OP

$840.00

Service Code	HCPCS C1713
Hospital Charge Code	64903684
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$882.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$462.00
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	$420.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$483.00
Rate for Payer: Fidelis Medicare Advantage	$882.00
Rate for Payer: Group Health Inc Commercial	$420.00
Rate for Payer: Group Health Inc Medicare	$294.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$420.00
Rate for Payer: Hamaspik Choice Inc Medicare	$420.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$546.00

SCREW BIO-COMP INTER FULL

Facility OP

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64905252
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$616.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$323.12
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	$293.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$337.81
Rate for Payer: Fidelis Medicare Advantage	$616.88
Rate for Payer: Group Health Inc Commercial	$293.75
Rate for Payer: Group Health Inc Medicare	$205.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.75
Rate for Payer: Hamaspik Choice Inc Medicare	$293.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$381.88

SCREW BIO-COMP INTER FULL

Facility IP

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64905252
Hospital Revenue Code	278
Min. Negotiated Rate	$293.75
Max. Negotiated Rate	$293.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.75
Rate for Payer: Hamaspik Choice Inc Medicare	$293.75

SCREW BIO-COMP INTER W DISP

Facility OP

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64905251
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$616.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$323.12
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	$293.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$337.81
Rate for Payer: Fidelis Medicare Advantage	$616.88
Rate for Payer: Group Health Inc Commercial	$293.75
Rate for Payer: Group Health Inc Medicare	$205.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.75
Rate for Payer: Hamaspik Choice Inc Medicare	$293.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$381.88

SCREW BIO-COMP INTER W DISP

Facility IP

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64905251
Hospital Revenue Code	278
Min. Negotiated Rate	$293.75
Max. Negotiated Rate	$293.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.75
Rate for Payer: Hamaspik Choice Inc Medicare	$293.75

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