St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW BIOCOMPOSITE INTERFEREN

Facility IP

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64903003
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 BIOCOMPOSITE INTERFEREN

Facility OP

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64903003
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 TENOD

Facility OP

$1,012.50

Service Code	HCPCS C1713
Hospital Charge Code	64907478
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 BIO COMP TENOD

Facility IP

$1,012.50

Service Code	HCPCS C1713
Hospital Charge Code	64907478
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 BNE SLFTAP 6.5 X 15MM

Facility OP

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64907026
Hospital Revenue Code	278
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$362.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$189.75
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	$172.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$198.38
Rate for Payer: Fidelis Medicare Advantage	$362.25
Rate for Payer: Group Health Inc Commercial	$172.50
Rate for Payer: Group Health Inc Medicare	$120.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.50
Rate for Payer: Hamaspik Choice Inc Medicare	$172.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$224.25

SCREW BNE SLFTAP 6.5 X 15MM

Facility IP

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64907026
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.50
Rate for Payer: Hamaspik Choice Inc Medicare	$172.50

SCREW BNE T8 FTHRD 2.7MM,L40MM

Facility IP

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64906296
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 BNE T8 FTHRD 2.7MM,L40MM

Facility OP

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64906296
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 BNE T8 FTHRD 2.7MM,L50MM

Facility IP

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906530
Hospital Revenue Code	278
Min. Negotiated Rate	$119.89
Max. Negotiated Rate	$119.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.89
Rate for Payer: Hamaspik Choice Inc Medicare	$119.89

SCREW BNE T8 FTHRD 2.7MM,L50MM

Facility OP

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906530
Hospital Revenue Code	278
Min. Negotiated Rate	$83.92
Max. Negotiated Rate	$251.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$131.88
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	$119.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$137.87
Rate for Payer: Fidelis Medicare Advantage	$251.77
Rate for Payer: Group Health Inc Commercial	$119.89
Rate for Payer: Group Health Inc Medicare	$83.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.89
Rate for Payer: Hamaspik Choice Inc Medicare	$119.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$155.86

SCREW BNE T8 FTHRD2.7MMXL45MM

Facility IP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906420
Hospital Revenue Code	278
Min. Negotiated Rate	$59.94
Max. Negotiated Rate	$59.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.94
Rate for Payer: Hamaspik Choice Inc Medicare	$59.94

SCREW BNE T8 FTHRD2.7MMXL45MM

Facility OP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906420
Hospital Revenue Code	278
Min. Negotiated Rate	$41.96
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$65.94
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	$59.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.94
Rate for Payer: Fidelis Medicare Advantage	$125.88
Rate for Payer: Group Health Inc Commercial	$59.94
Rate for Payer: Group Health Inc Medicare	$41.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.94
Rate for Payer: Hamaspik Choice Inc Medicare	$59.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$77.93

SCREW BN T10 FL THRD 2.7MM,28MML

Facility IP

$136.00

Service Code	HCPCS C1713
Hospital Charge Code	64906498
Hospital Revenue Code	278
Min. Negotiated Rate	$68.00
Max. Negotiated Rate	$68.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.00
Rate for Payer: Hamaspik Choice Inc Medicare	$68.00

SCREW BN T10 FL THRD 2.7MM,28MML

Facility OP

$136.00

Service Code	HCPCS C1713
Hospital Charge Code	64906498
Hospital Revenue Code	278
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$142.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.80
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	$68.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.20
Rate for Payer: Fidelis Medicare Advantage	$142.80
Rate for Payer: Group Health Inc Commercial	$68.00
Rate for Payer: Group Health Inc Medicare	$47.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.00
Rate for Payer: Hamaspik Choice Inc Medicare	$68.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$88.40

SCREW BN T10 FULL THREAD 27X22MM

Facility IP

$260.00

Service Code	HCPCS C1713
Hospital Charge Code	40008276
Hospital Revenue Code	278
Min. Negotiated Rate	$130.00
Max. Negotiated Rate	$130.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00

SCREW BN T10 FULL THREAD 27X22MM

Facility OP

$260.00

Service Code	HCPCS C1713
Hospital Charge Code	40008276
Hospital Revenue Code	278
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$273.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.00
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	$130.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$149.50
Rate for Payer: Fidelis Medicare Advantage	$273.00
Rate for Payer: Group Health Inc Commercial	$130.00
Rate for Payer: Group Health Inc Medicare	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.00
Rate for Payer: Hamaspik Choice Inc Medicare	$130.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$169.00

SCREW BONE 1.2 16

Facility OP

$154.38

Service Code	HCPCS C1713
Hospital Charge Code	64904375
Hospital Revenue Code	278
Min. Negotiated Rate	$54.03
Max. Negotiated Rate	$162.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$84.91
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	$77.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$88.77
Rate for Payer: Fidelis Medicare Advantage	$162.10
Rate for Payer: Group Health Inc Commercial	$77.19
Rate for Payer: Group Health Inc Medicare	$54.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.19
Rate for Payer: Hamaspik Choice Inc Medicare	$77.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.35

SCREW BONE 1.2 16

Facility IP

$154.38

Service Code	HCPCS C1713
Hospital Charge Code	64904375
Hospital Revenue Code	278
Min. Negotiated Rate	$77.19
Max. Negotiated Rate	$77.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.19
Rate for Payer: Hamaspik Choice Inc Medicare	$77.19

SCREW BONE 1.2 18

Facility OP

$154.38

Service Code	HCPCS C1713
Hospital Charge Code	64904377
Hospital Revenue Code	278
Min. Negotiated Rate	$54.03
Max. Negotiated Rate	$162.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$84.91
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	$77.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$88.77
Rate for Payer: Fidelis Medicare Advantage	$162.10
Rate for Payer: Group Health Inc Commercial	$77.19
Rate for Payer: Group Health Inc Medicare	$54.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.19
Rate for Payer: Hamaspik Choice Inc Medicare	$77.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.35

SCREW BONE 1.2 18

Facility IP

$154.38

Service Code	HCPCS C1713
Hospital Charge Code	64904377
Hospital Revenue Code	278
Min. Negotiated Rate	$77.19
Max. Negotiated Rate	$77.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.19
Rate for Payer: Hamaspik Choice Inc Medicare	$77.19

SCREW BONE 1.2 X 10 ING

Facility IP

$154.38

Service Code	HCPCS C1713
Hospital Charge Code	64904947
Hospital Revenue Code	278
Min. Negotiated Rate	$77.19
Max. Negotiated Rate	$77.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.19
Rate for Payer: Hamaspik Choice Inc Medicare	$77.19

SCREW BONE 1.2 X 10 ING

Facility OP

$154.38

Service Code	HCPCS C1713
Hospital Charge Code	64904947
Hospital Revenue Code	278
Min. Negotiated Rate	$54.03
Max. Negotiated Rate	$162.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$84.91
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	$77.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$88.77
Rate for Payer: Fidelis Medicare Advantage	$162.10
Rate for Payer: Group Health Inc Commercial	$77.19
Rate for Payer: Group Health Inc Medicare	$54.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.19
Rate for Payer: Hamaspik Choice Inc Medicare	$77.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.35

SCREW BONE 1.2X12MM CROSSPIN

Facility OP

$154.38

Service Code	HCPCS C1713
Hospital Charge Code	64905477
Hospital Revenue Code	278
Min. Negotiated Rate	$54.03
Max. Negotiated Rate	$162.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$84.91
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	$77.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$88.77
Rate for Payer: Fidelis Medicare Advantage	$162.10
Rate for Payer: Group Health Inc Commercial	$77.19
Rate for Payer: Group Health Inc Medicare	$54.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.19
Rate for Payer: Hamaspik Choice Inc Medicare	$77.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.35

SCREW BONE 1.2X12MM CROSSPIN

Facility IP

$154.38

Service Code	HCPCS C1713
Hospital Charge Code	64905477
Hospital Revenue Code	278
Min. Negotiated Rate	$77.19
Max. Negotiated Rate	$77.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.19
Rate for Payer: Hamaspik Choice Inc Medicare	$77.19

SCREW,BONE,1.2X12MM CRSSPIN SELFT

Facility OP

$123.50

Service Code	HCPCS C1713
Hospital Charge Code	40005903
Hospital Revenue Code	278
Min. Negotiated Rate	$43.22
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$67.92
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	$61.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.01
Rate for Payer: Fidelis Medicare Advantage	$129.68
Rate for Payer: Group Health Inc Commercial	$61.75
Rate for Payer: Group Health Inc Medicare	$43.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.75
Rate for Payer: Hamaspik Choice Inc Medicare	$61.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.28

Price Transparency.

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