St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW BONE T8 F-THRD 2.7MMX30MML

Facility IP

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906528
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 BONE T8 FULL 2.4 L26

Facility IP

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64905007
Hospital Revenue Code	278
Min. Negotiated Rate	$193.75
Max. Negotiated Rate	$193.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75

SCREW BONE T8 FULL 2.4 L26

Facility OP

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64905007
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$406.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$213.12
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	$193.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.81
Rate for Payer: Fidelis Medicare Advantage	$406.88
Rate for Payer: Group Health Inc Commercial	$193.75
Rate for Payer: Group Health Inc Medicare	$135.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$251.88

SCREW BONE T8 FULL 2.7 L26

Facility OP

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64905009
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$406.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$213.12
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	$193.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.81
Rate for Payer: Fidelis Medicare Advantage	$406.88
Rate for Payer: Group Health Inc Commercial	$193.75
Rate for Payer: Group Health Inc Medicare	$135.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$251.88

SCREW BONE T8 FULL 2.7 L26

Facility IP

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64905009
Hospital Revenue Code	278
Min. Negotiated Rate	$193.75
Max. Negotiated Rate	$193.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75

SCREW BONE T8 FUL THRD 2.4,L30MM

Facility IP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906313
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 BONE T8 FUL THRD 2.4,L30MM

Facility OP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906313
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 BONE T8 FUL THRD 2.4,L34MM

Facility IP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906314
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 BONE T8 FUL THRD 2.4,L34MM

Facility OP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906314
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 BONE T8 FUL THRD 2.4,L36MM

Facility IP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906312
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 BONE T8 FUL THRD 2.4,L36MM

Facility OP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906312
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 BONE T8 FUL THRD 2.7,L28MM

Facility OP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906311
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 BONE T8 FUL THRD 2.7,L28MM

Facility IP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906311
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 BONE THRD

Facility OP

$116.03

Service Code	HCPCS C1713
Hospital Charge Code	64907247
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.82
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	$58.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.72
Rate for Payer: Fidelis Medicare Advantage	$121.83
Rate for Payer: Group Health Inc Commercial	$58.02
Rate for Payer: Group Health Inc Medicare	$40.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.02
Rate for Payer: Hamaspik Choice Inc Medicare	$58.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$75.42

SCREW BONE THRD

Facility IP

$116.03

Service Code	HCPCS C1713
Hospital Charge Code	64907247
Hospital Revenue Code	278
Min. Negotiated Rate	$58.02
Max. Negotiated Rate	$58.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.02
Rate for Payer: Hamaspik Choice Inc Medicare	$58.02

SCREW BON T8 FL THD CRT 3.4X38MM

Facility OP

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906533
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 BON T8 FL THD CRT 3.4X38MM

Facility IP

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906533
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 CALCANAIL

Facility OP

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64907152
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$656.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.75
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	$312.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$359.38
Rate for Payer: Fidelis Medicare Advantage	$656.25
Rate for Payer: Group Health Inc Commercial	$312.50
Rate for Payer: Group Health Inc Medicare	$218.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$406.25

SCREW CALCANAIL

Facility IP

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64907152
Hospital Revenue Code	278
Min. Negotiated Rate	$312.50
Max. Negotiated Rate	$312.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50

SCREW CALCANAIL CNLTD268325

Facility OP

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64907378
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$656.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.75
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	$312.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$359.38
Rate for Payer: Fidelis Medicare Advantage	$656.25
Rate for Payer: Group Health Inc Commercial	$312.50
Rate for Payer: Group Health Inc Medicare	$218.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$406.25

SCREW CALCANAIL CNLTD268325

Facility IP

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64907378
Hospital Revenue Code	278
Min. Negotiated Rate	$312.50
Max. Negotiated Rate	$312.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50

SCREW CAL CANNLTD 5X45 326

Facility IP

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	64906741
Hospital Revenue Code	278
Min. Negotiated Rate	$250.00
Max. Negotiated Rate	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00

SCREW CAL CANNLTD 5X45 326

Facility OP

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	64906741
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$525.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
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	$250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$287.50
Rate for Payer: Fidelis Medicare Advantage	$525.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$325.00

SCREW CAL CANNLTD 5X65 330

Facility OP

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	64906742
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$525.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
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	$250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$287.50
Rate for Payer: Fidelis Medicare Advantage	$525.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$325.00

SCREW CAL CANNLTD 5X65 330

Facility IP

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	64906742
Hospital Revenue Code	278
Min. Negotiated Rate	$250.00
Max. Negotiated Rate	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00

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