St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW BONE 23MM 26MML

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64905462
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 BONE 2.3MM DIA 10MML TT

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64901983
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 BONE 2.3MM DIA 10MML TT

Facility OP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64901983
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 BONE 2.3MM DIA 14MML TT

Facility OP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64904987
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 BONE 2.3MM DIA 14MML TT

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64904987
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 BONE 2.3MM DIA 20MML TT

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64901985
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 BONE 2.3MM DIA 20MML TT

Facility OP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64901985
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 BONE 2.3MM DIA 8MML TTA

Facility OP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64904083
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 BONE 2.3MM DIA 8MML TTA

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64904083
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 BONE 2.3MM X 12MM

Facility OP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64901982
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 BONE 2.3MM X 12MM

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64901982
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 BONE 2.3 X 10MM

Facility OP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64903036
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 BONE 2.3 X 10MM

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64903036
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 BONE 2.3 X 10MM CROSS PIN

Facility IP

$134.58

Service Code	HCPCS C1713
Hospital Charge Code	64901401
Hospital Revenue Code	278
Min. Negotiated Rate	$67.29
Max. Negotiated Rate	$67.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.29
Rate for Payer: Hamaspik Choice Inc Medicare	$67.29

SCREW BONE 2.3 X 10MM CROSS PIN

Facility OP

$134.58

Service Code	HCPCS C1713
Hospital Charge Code	64901401
Hospital Revenue Code	278
Min. Negotiated Rate	$47.10
Max. Negotiated Rate	$141.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.02
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	$67.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.38
Rate for Payer: Fidelis Medicare Advantage	$141.31
Rate for Payer: Group Health Inc Commercial	$67.29
Rate for Payer: Group Health Inc Medicare	$47.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.29
Rate for Payer: Hamaspik Choice Inc Medicare	$67.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$87.48

SCREW BONE 2.3 X 11MM

Facility OP

$124.00

Service Code	HCPCS C1776
Hospital Charge Code	40202433
Hospital Revenue Code	278
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.20
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	$62.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.30
Rate for Payer: Fidelis Medicare Advantage	$130.20
Rate for Payer: Group Health Inc Commercial	$62.00
Rate for Payer: Group Health Inc Medicare	$43.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.00
Rate for Payer: Hamaspik Choice Inc Medicare	$62.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.60

SCREW BONE 2.3 X 11MM

Facility IP

$124.00

Service Code	HCPCS C1776
Hospital Charge Code	40202433
Hospital Revenue Code	278
Min. Negotiated Rate	$62.00
Max. Negotiated Rate	$62.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.00
Rate for Payer: Hamaspik Choice Inc Medicare	$62.00

SCREW BONE 2.3X13MM

Facility IP

$124.00

Service Code	HCPCS C1776
Hospital Charge Code	40205087
Hospital Revenue Code	278
Min. Negotiated Rate	$62.00
Max. Negotiated Rate	$62.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.00
Rate for Payer: Hamaspik Choice Inc Medicare	$62.00

SCREW BONE 2.3X13MM

Facility OP

$124.00

Service Code	HCPCS C1776
Hospital Charge Code	40205087
Hospital Revenue Code	278
Min. Negotiated Rate	$43.40
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.20
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	$62.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.30
Rate for Payer: Fidelis Medicare Advantage	$130.20
Rate for Payer: Group Health Inc Commercial	$62.00
Rate for Payer: Group Health Inc Medicare	$43.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.00
Rate for Payer: Hamaspik Choice Inc Medicare	$62.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.60

SCREW BONE 2.3X20

Facility IP

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64903710
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25

SCREW BONE 2.3X20

Facility OP

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64903710
Hospital Revenue Code	278
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$275.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.38
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	$131.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.94
Rate for Payer: Fidelis Medicare Advantage	$275.62
Rate for Payer: Group Health Inc Commercial	$131.25
Rate for Payer: Group Health Inc Medicare	$91.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.62

SCREW BONE 2.3X6MM CROSS

Facility OP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64905838
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 BONE 2.3X6MM CROSS

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64905838
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 BONE 2.3 X 6MM CROSS PIN

Facility IP

$131.18

Service Code	HCPCS C1713
Hospital Charge Code	64901399
Hospital Revenue Code	278
Min. Negotiated Rate	$65.59
Max. Negotiated Rate	$65.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.59
Rate for Payer: Hamaspik Choice Inc Medicare	$65.59

SCREW BONE 2.3 X 6MM CROSS PIN

Facility OP

$131.18

Service Code	HCPCS C1713
Hospital Charge Code	64901399
Hospital Revenue Code	278
Min. Negotiated Rate	$45.91
Max. Negotiated Rate	$137.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$72.15
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	$65.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$75.43
Rate for Payer: Fidelis Medicare Advantage	$137.74
Rate for Payer: Group Health Inc Commercial	$65.59
Rate for Payer: Group Health Inc Medicare	$45.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.59
Rate for Payer: Hamaspik Choice Inc Medicare	$65.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$85.27

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