St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW CRANIAL TI 1.5MM

Facility OP

$687.50

Service Code	HCPCS C1713
Hospital Charge Code	64901320
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$721.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$378.12
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	$343.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$395.31
Rate for Payer: Fidelis Medicare Advantage	$721.88
Rate for Payer: Group Health Inc Commercial	$343.75
Rate for Payer: Group Health Inc Medicare	$240.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$343.75
Rate for Payer: Hamaspik Choice Inc Medicare	$343.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$446.88

SCREW CRANIAL TI 1.5MM

Facility IP

$687.50

Service Code	HCPCS C1713
Hospital Charge Code	64901320
Hospital Revenue Code	278
Min. Negotiated Rate	$343.75
Max. Negotiated Rate	$343.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$343.75
Rate for Payer: Hamaspik Choice Inc Medicare	$343.75

SCREW CRS SELF DRILL 1.2X10MM

Facility IP

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906598
Hospital Revenue Code	278
Min. Negotiated Rate	$53.24
Max. Negotiated Rate	$53.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24

SCREW CRS SELF DRILL 1.2X10MM

Facility OP

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906598
Hospital Revenue Code	278
Min. Negotiated Rate	$37.27
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.56
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	$53.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.23
Rate for Payer: Fidelis Medicare Advantage	$111.80
Rate for Payer: Group Health Inc Commercial	$53.24
Rate for Payer: Group Health Inc Medicare	$37.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$69.21

SCREW CRS SELF DRILL 1.2X12MM

Facility OP

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906599
Hospital Revenue Code	278
Min. Negotiated Rate	$37.27
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.56
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	$53.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.23
Rate for Payer: Fidelis Medicare Advantage	$111.80
Rate for Payer: Group Health Inc Commercial	$53.24
Rate for Payer: Group Health Inc Medicare	$37.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$69.21

SCREW CRS SELF DRILL 1.2X12MM

Facility IP

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906599
Hospital Revenue Code	278
Min. Negotiated Rate	$53.24
Max. Negotiated Rate	$53.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24

SCREW CRS SELF DRILL 1.2X8MM

Facility IP

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906597
Hospital Revenue Code	278
Min. Negotiated Rate	$53.24
Max. Negotiated Rate	$53.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24

SCREW CRS SELF DRILL 1.2X8MM

Facility OP

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906597
Hospital Revenue Code	278
Min. Negotiated Rate	$37.27
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.56
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	$53.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.23
Rate for Payer: Fidelis Medicare Advantage	$111.80
Rate for Payer: Group Health Inc Commercial	$53.24
Rate for Payer: Group Health Inc Medicare	$37.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$69.21

SCREW CRT LPR TM SS 3.5X14MM

Facility IP

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	64906362
Hospital Revenue Code	278
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50

SCREW CRT LPR TM SS 3.5X14MM

Facility OP

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	64906362
Hospital Revenue Code	278
Min. Negotiated Rate	$12.25
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.25
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	$17.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.12
Rate for Payer: Fidelis Medicare Advantage	$36.75
Rate for Payer: Group Health Inc Commercial	$17.50
Rate for Payer: Group Health Inc Medicare	$12.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.75

SCREW CRTX 4.5X38MM HEX FT ST

Facility OP

$33.60

Service Code	HCPCS C1713
Hospital Charge Code	40205456
Hospital Revenue Code	278
Min. Negotiated Rate	$11.76
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.48
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	$16.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.32
Rate for Payer: Fidelis Medicare Advantage	$35.28
Rate for Payer: Group Health Inc Commercial	$16.80
Rate for Payer: Group Health Inc Medicare	$11.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.80
Rate for Payer: Hamaspik Choice Inc Medicare	$16.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.84

SCREW CRTX 4.5X38MM HEX FT ST

Facility IP

$33.60

Service Code	HCPCS C1713
Hospital Charge Code	40205456
Hospital Revenue Code	278
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.80
Rate for Payer: Hamaspik Choice Inc Medicare	$16.80

SCREW CRTX LO PRO 26MM

Facility IP

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903583
Hospital Revenue Code	278
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$61.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88

SCREW CRTX LO PRO 26MM

Facility OP

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903583
Hospital Revenue Code	278
Min. Negotiated Rate	$43.31
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.06
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	$61.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.16
Rate for Payer: Fidelis Medicare Advantage	$129.94
Rate for Payer: Group Health Inc Commercial	$61.88
Rate for Payer: Group Health Inc Medicare	$43.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.44

SCREW CRTX LO PRO 28MM

Facility IP

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903587
Hospital Revenue Code	278
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$61.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88

SCREW CRTX LO PRO 28MM

Facility OP

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903587
Hospital Revenue Code	278
Min. Negotiated Rate	$43.31
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.06
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	$61.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.16
Rate for Payer: Fidelis Medicare Advantage	$129.94
Rate for Payer: Group Health Inc Commercial	$61.88
Rate for Payer: Group Health Inc Medicare	$43.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.44

SCREW CRTX LO PRO 34MM

Facility OP

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903585
Hospital Revenue Code	278
Min. Negotiated Rate	$43.31
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.06
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	$61.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.16
Rate for Payer: Fidelis Medicare Advantage	$129.94
Rate for Payer: Group Health Inc Commercial	$61.88
Rate for Payer: Group Health Inc Medicare	$43.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.44

SCREW CRTX LO PRO 34MM

Facility IP

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903585
Hospital Revenue Code	278
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$61.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88

SCREW DF MINI 2.0X5MM

Facility IP

$108.00

Service Code	HCPCS C1776
Hospital Charge Code	40202401
Hospital Revenue Code	278
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.00
Rate for Payer: Hamaspik Choice Inc Medicare	$54.00

SCREW DF MINI 2.0X5MM

Facility OP

$108.00

Service Code	HCPCS C1776
Hospital Charge Code	40202401
Hospital Revenue Code	278
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.40
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	$54.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$62.10
Rate for Payer: Fidelis Medicare Advantage	$113.40
Rate for Payer: Group Health Inc Commercial	$54.00
Rate for Payer: Group Health Inc Medicare	$37.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.00
Rate for Payer: Hamaspik Choice Inc Medicare	$54.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.20

SCREW DF MINI 2.0X7MM

Facility IP

$104.00

Service Code	HCPCS C1769
Hospital Charge Code	40202402
Hospital Revenue Code	278
Min. Negotiated Rate	$52.00
Max. Negotiated Rate	$52.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00

SCREW DF MINI 2.0X7MM

Facility OP

$104.00

Service Code	HCPCS C1769
Hospital Charge Code	40202402
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$109.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.80
Rate for Payer: Fidelis Medicare Advantage	$109.20
Rate for Payer: Group Health Inc Commercial	$52.00
Rate for Payer: Group Health Inc Medicare	$36.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$67.60

SCREW DIS ARCOS REV 301000

Facility IP

$2,352.00

Service Code	HCPCS C1713
Hospital Charge Code	64906710
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.00
Max. Negotiated Rate	$1,176.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,176.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,176.00

SCREW DIS ARCOS REV 301000

Facility OP

$2,352.00

Service Code	HCPCS C1713
Hospital Charge Code	64906710
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,469.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,293.60
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	$1,176.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,352.40
Rate for Payer: Fidelis Medicare Advantage	$2,469.60
Rate for Payer: Group Health Inc Commercial	$1,176.00
Rate for Payer: Group Health Inc Medicare	$823.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,176.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,176.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,528.80

SCREW DRILL 3.5 X 12

Facility IP

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64904765
Hospital Revenue Code	278
Min. Negotiated Rate	$556.25
Max. Negotiated Rate	$556.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25

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