St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW BONE 4MM DIA 16MML TTAN

Facility IP

$58.50

Service Code	HCPCS C1713
Hospital Charge Code	64904193
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$29.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.25
Rate for Payer: Hamaspik Choice Inc Medicare	$29.25

SCREW BONE 4MM DIA 16MML TTAN

Facility OP

$58.50

Service Code	HCPCS C1713
Hospital Charge Code	64904193
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.18
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	$29.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.64
Rate for Payer: Fidelis Medicare Advantage	$61.42
Rate for Payer: Group Health Inc Commercial	$29.25
Rate for Payer: Group Health Inc Medicare	$20.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.25
Rate for Payer: Hamaspik Choice Inc Medicare	$29.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$38.02

SCREW BONE 4MM DIA 60MML LOCKING

Facility OP

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64905001
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$589.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$308.55
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	$280.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$322.58
Rate for Payer: Fidelis Medicare Advantage	$589.05
Rate for Payer: Group Health Inc Commercial	$280.50
Rate for Payer: Group Health Inc Medicare	$196.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$364.65

SCREW BONE 4MM DIA 60MML LOCKING

Facility IP

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64905001
Hospital Revenue Code	278
Min. Negotiated Rate	$280.50
Max. Negotiated Rate	$280.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50

SCREW BONE 4MM DIA 75MML LOCKING

Facility OP

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64903318
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$589.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$308.55
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	$280.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$322.58
Rate for Payer: Fidelis Medicare Advantage	$589.05
Rate for Payer: Group Health Inc Commercial	$280.50
Rate for Payer: Group Health Inc Medicare	$196.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$364.65

SCREW BONE 4MM DIA 75MML LOCKING

Facility IP

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64903318
Hospital Revenue Code	278
Min. Negotiated Rate	$280.50
Max. Negotiated Rate	$280.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50

SCREW BONE 5.0MM X 36MM

Facility OP

$496.00

Service Code	HCPCS C1713
Hospital Charge Code	40003340
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$520.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$272.80
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	$248.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$285.20
Rate for Payer: Fidelis Medicare Advantage	$520.80
Rate for Payer: Group Health Inc Commercial	$248.00
Rate for Payer: Group Health Inc Medicare	$173.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.00
Rate for Payer: Hamaspik Choice Inc Medicare	$248.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$322.40

SCREW BONE 5.0MM X 36MM

Facility IP

$496.00

Service Code	HCPCS C1713
Hospital Charge Code	40003340
Hospital Revenue Code	278
Min. Negotiated Rate	$248.00
Max. Negotiated Rate	$248.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.00
Rate for Payer: Hamaspik Choice Inc Medicare	$248.00

SCREW BONE 55 DIA 3.5MML

Facility IP

$89.25

Service Code	HCPCS C1713
Hospital Charge Code	64905468
Hospital Revenue Code	278
Min. Negotiated Rate	$44.62
Max. Negotiated Rate	$44.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.62
Rate for Payer: Hamaspik Choice Inc Medicare	$44.62

SCREW BONE 55 DIA 3.5MML

Facility OP

$89.25

Service Code	HCPCS C1713
Hospital Charge Code	64905468
Hospital Revenue Code	278
Min. Negotiated Rate	$31.24
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.09
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	$44.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.32
Rate for Payer: Fidelis Medicare Advantage	$93.71
Rate for Payer: Group Health Inc Commercial	$44.62
Rate for Payer: Group Health Inc Medicare	$31.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.62
Rate for Payer: Hamaspik Choice Inc Medicare	$44.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$58.01

SCREW BONE 5MM/1.9MM/2.7MM DIA

Facility IP

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64903773
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 BONE 5MM/1.9MM/2.7MM DIA

Facility OP

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64903773
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 BONE 5MM DIA 34MML LOCKING

Facility OP

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903126
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$735.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$385.00
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	$350.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$402.50
Rate for Payer: Fidelis Medicare Advantage	$735.00
Rate for Payer: Group Health Inc Commercial	$350.00
Rate for Payer: Group Health Inc Medicare	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$455.00

SCREW BONE 5MM DIA 34MML LOCKING

Facility IP

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903126
Hospital Revenue Code	278
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00

SCREW BONE 5MM DIA 38MML LOCKING

Facility OP

$667.50

Service Code	HCPCS C1713
Hospital Charge Code	64903245
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$700.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$367.12
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	$333.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$383.81
Rate for Payer: Fidelis Medicare Advantage	$700.88
Rate for Payer: Group Health Inc Commercial	$333.75
Rate for Payer: Group Health Inc Medicare	$233.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$333.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$433.88

SCREW BONE 5MM DIA 38MML LOCKING

Facility IP

$667.50

Service Code	HCPCS C1713
Hospital Charge Code	64903245
Hospital Revenue Code	278
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$333.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$333.75

SCREW BONE 5MM DIA 40MML LOCKING

Facility OP

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903130
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$735.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$385.00
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	$350.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$402.50
Rate for Payer: Fidelis Medicare Advantage	$735.00
Rate for Payer: Group Health Inc Commercial	$350.00
Rate for Payer: Group Health Inc Medicare	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$455.00

SCREW BONE 5MM DIA 40MML LOCKING

Facility IP

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903130
Hospital Revenue Code	278
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00

SCREW BONE 6.5MM DIA 50MML STA

Facility OP

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64904093
Hospital Revenue Code	278
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.69
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	$40.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.72
Rate for Payer: Fidelis Medicare Advantage	$85.31
Rate for Payer: Group Health Inc Commercial	$40.62
Rate for Payer: Group Health Inc Medicare	$28.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.62
Rate for Payer: Hamaspik Choice Inc Medicare	$40.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.81

SCREW BONE 6.5MM DIA 50MML STA

Facility IP

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64904093
Hospital Revenue Code	278
Min. Negotiated Rate	$40.62
Max. Negotiated Rate	$40.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.62
Rate for Payer: Hamaspik Choice Inc Medicare	$40.62

SCREW BONE 6.5X25 SELF TAP

Facility OP

$368.00

Service Code	HCPCS C1776
Hospital Charge Code	40204648
Hospital Revenue Code	278
Min. Negotiated Rate	$128.80
Max. Negotiated Rate	$386.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.40
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	$184.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$211.60
Rate for Payer: Fidelis Medicare Advantage	$386.40
Rate for Payer: Group Health Inc Commercial	$184.00
Rate for Payer: Group Health Inc Medicare	$128.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$239.20

SCREW BONE 6.5X25 SELF TAP

Facility IP

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64905657
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 BONE 6.5X25 SELF TAP

Facility OP

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64905657
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 BONE 6.5X25 SELF TAP

Facility IP

$368.00

Service Code	HCPCS C1776
Hospital Charge Code	40204648
Hospital Revenue Code	278
Min. Negotiated Rate	$184.00
Max. Negotiated Rate	$184.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00

SCREW BONE 6.5X30 SELF TAP

Facility OP

$368.00

Service Code	HCPCS C1776
Hospital Charge Code	40204647
Hospital Revenue Code	278
Min. Negotiated Rate	$128.80
Max. Negotiated Rate	$386.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.40
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	$184.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$211.60
Rate for Payer: Fidelis Medicare Advantage	$386.40
Rate for Payer: Group Health Inc Commercial	$184.00
Rate for Payer: Group Health Inc Medicare	$128.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$239.20

Price Transparency.

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