St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW BONE 6.5X30 SELF TAP

Facility IP

$368.00

Service Code	HCPCS C1776
Hospital Charge Code	40204647
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 IP

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64905855
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 6.5X30 SELF-TAP

Facility OP

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64905855
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 6.5X95

Facility OP

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64903847
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$644.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$337.84
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	$307.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$353.19
Rate for Payer: Fidelis Medicare Advantage	$644.96
Rate for Payer: Group Health Inc Commercial	$307.12
Rate for Payer: Group Health Inc Medicare	$214.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$399.26

SCREW BONE 6.5X95

Facility IP

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64903847
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 BONE .7 X 16

Facility OP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64904525
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 .7 X 16

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64904525
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 8MM/3MM/4.5MM DIA H

Facility OP

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902724
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 8MM/3MM/4.5MM DIA H

Facility IP

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902724
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 8MM/3MM/6.5MM DIA H

Facility OP

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64902340
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 8MM/3MM/6.5MM DIA H

Facility IP

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64902340
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 8MM DIA 14.5MML

Facility IP

$409.50

Service Code	HCPCS C1713
Hospital Charge Code	64905566
Hospital Revenue Code	278
Min. Negotiated Rate	$204.75
Max. Negotiated Rate	$204.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.75
Rate for Payer: Hamaspik Choice Inc Medicare	$204.75

SCREW BONE 8MM DIA 14.5MML

Facility OP

$409.50

Service Code	HCPCS C1713
Hospital Charge Code	64905566
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$429.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$225.22
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	$204.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$235.46
Rate for Payer: Fidelis Medicare Advantage	$429.98
Rate for Payer: Group Health Inc Commercial	$204.75
Rate for Payer: Group Health Inc Medicare	$143.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.75
Rate for Payer: Hamaspik Choice Inc Medicare	$204.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$266.18

SCREW BONE 8MM DIA 17.5MML TT

Facility OP

$458.25

Service Code	HCPCS C1713
Hospital Charge Code	64902187
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$481.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$252.04
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	$229.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$263.49
Rate for Payer: Fidelis Medicare Advantage	$481.16
Rate for Payer: Group Health Inc Commercial	$229.12
Rate for Payer: Group Health Inc Medicare	$160.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$229.12
Rate for Payer: Hamaspik Choice Inc Medicare	$229.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$297.86

SCREW BONE 8MM DIA 17.5MML TT

Facility IP

$458.25

Service Code	HCPCS C1713
Hospital Charge Code	64902187
Hospital Revenue Code	278
Min. Negotiated Rate	$229.12
Max. Negotiated Rate	$229.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$229.12
Rate for Payer: Hamaspik Choice Inc Medicare	$229.12

SCREW BONE AXS

Facility IP

$172.13

Service Code	HCPCS C1713
Hospital Charge Code	64907474
Hospital Revenue Code	278
Min. Negotiated Rate	$86.06
Max. Negotiated Rate	$86.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.06
Rate for Payer: Hamaspik Choice Inc Medicare	$86.06

SCREW BONE AXS

Facility OP

$172.13

Service Code	HCPCS C1713
Hospital Charge Code	64907474
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$180.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.67
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	$86.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$98.97
Rate for Payer: Fidelis Medicare Advantage	$180.74
Rate for Payer: Group Health Inc Commercial	$86.06
Rate for Payer: Group Health Inc Medicare	$60.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.06
Rate for Payer: Hamaspik Choice Inc Medicare	$86.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.88

SCREW BONE AXS 1.2

Facility IP

$155.55

Service Code	HCPCS C1713
Hospital Charge Code	64907449
Hospital Revenue Code	278
Min. Negotiated Rate	$77.78
Max. Negotiated Rate	$77.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.78
Rate for Payer: Hamaspik Choice Inc Medicare	$77.78

SCREW BONE AXS 1.2

Facility OP

$155.55

Service Code	HCPCS C1713
Hospital Charge Code	64907449
Hospital Revenue Code	278
Min. Negotiated Rate	$54.44
Max. Negotiated Rate	$163.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.55
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	$77.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$89.44
Rate for Payer: Fidelis Medicare Advantage	$163.33
Rate for Payer: Group Health Inc Commercial	$77.78
Rate for Payer: Group Health Inc Medicare	$54.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.78
Rate for Payer: Hamaspik Choice Inc Medicare	$77.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$101.11

SCREW BONE AXS 1.7

Facility IP

$138.98

Service Code	HCPCS C1713
Hospital Charge Code	64907450
Hospital Revenue Code	278
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$69.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.49
Rate for Payer: Hamaspik Choice Inc Medicare	$69.49

SCREW BONE AXS 1.7

Facility OP

$138.98

Service Code	HCPCS C1713
Hospital Charge Code	64907450
Hospital Revenue Code	278
Min. Negotiated Rate	$48.64
Max. Negotiated Rate	$145.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$76.44
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	$69.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$79.91
Rate for Payer: Fidelis Medicare Advantage	$145.93
Rate for Payer: Group Health Inc Commercial	$69.49
Rate for Payer: Group Health Inc Medicare	$48.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.49
Rate for Payer: Hamaspik Choice Inc Medicare	$69.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$90.34

SCREW BONE CANCELL 4.0MM

Facility OP

$112.93

Service Code	HCPCS C1713
Hospital Charge Code	40202404
Hospital Revenue Code	278
Min. Negotiated Rate	$39.53
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.11
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	$56.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.93
Rate for Payer: Fidelis Medicare Advantage	$118.58
Rate for Payer: Group Health Inc Commercial	$56.46
Rate for Payer: Group Health Inc Medicare	$39.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.46
Rate for Payer: Hamaspik Choice Inc Medicare	$56.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$73.40

SCREW BONE CANCELL 4.0MM

Facility IP

$112.93

Service Code	HCPCS C1713
Hospital Charge Code	40202404
Hospital Revenue Code	278
Min. Negotiated Rate	$56.46
Max. Negotiated Rate	$56.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.46
Rate for Payer: Hamaspik Choice Inc Medicare	$56.46

SCREW BONE CANCELL 4.0MM /36MM

Facility OP

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	64905436
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 BONE CANCELL 4.0MM /36MM

Facility IP

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	64905436
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

Price Transparency.

All Charges