St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW HFN LAG 10.5MM X 95MM

Facility IP

$2,120.00

Service Code	HCPCS C1713
Hospital Charge Code	64905501
Hospital Revenue Code	278
Min. Negotiated Rate	$1,060.00
Max. Negotiated Rate	$1,060.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,060.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,060.00

SCREW HFN LAG 10.5MM X 95MM

Facility OP

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40003339
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,780.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$932.80
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	$848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$975.20
Rate for Payer: Fidelis Medicare Advantage	$1,780.80
Rate for Payer: Group Health Inc Commercial	$848.00
Rate for Payer: Group Health Inc Medicare	$593.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,102.40

SCREW HFN LAG 10.5MM X 95MM

Facility IP

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40003339
Hospital Revenue Code	278
Min. Negotiated Rate	$848.00
Max. Negotiated Rate	$848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00

SCREW HFN LAG 10.5MMX95MM

Facility OP

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40204589
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,780.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$932.80
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	$848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$975.20
Rate for Payer: Fidelis Medicare Advantage	$1,780.80
Rate for Payer: Group Health Inc Commercial	$848.00
Rate for Payer: Group Health Inc Medicare	$593.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,102.40

SCREW HFN LAG 10.5MMX95MM

Facility IP

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40204589
Hospital Revenue Code	278
Min. Negotiated Rate	$848.00
Max. Negotiated Rate	$848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00

SCREW HFN LAG 10.MM X 95MM

Facility OP

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40007508
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,780.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$932.80
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	$848.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$975.20
Rate for Payer: Fidelis Medicare Advantage	$1,780.80
Rate for Payer: Group Health Inc Commercial	$848.00
Rate for Payer: Group Health Inc Medicare	$593.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,102.40

SCREW HFN LAG 10.MM X 95MM

Facility IP

$1,696.00

Service Code	HCPCS C1713
Hospital Charge Code	40007508
Hospital Revenue Code	278
Min. Negotiated Rate	$848.00
Max. Negotiated Rate	$848.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$848.00
Rate for Payer: Hamaspik Choice Inc Medicare	$848.00

SCREW HMMF 2.0 X 6MM A

Facility IP

$315.00

Service Code	HCPCS C1713
Hospital Charge Code	64905464
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$157.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$157.50
Rate for Payer: Hamaspik Choice Inc Medicare	$157.50

SCREW HMMF 2.0 X 6MM A

Facility OP

$315.00

Service Code	HCPCS C1713
Hospital Charge Code	64905464
Hospital Revenue Code	278
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$330.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$173.25
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	$157.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$181.12
Rate for Payer: Fidelis Medicare Advantage	$330.75
Rate for Payer: Group Health Inc Commercial	$157.50
Rate for Payer: Group Health Inc Medicare	$110.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$157.50
Rate for Payer: Hamaspik Choice Inc Medicare	$157.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$204.75

SCREW HMMF 2.0 X 6MM B

Facility IP

$315.00

Service Code	HCPCS C1713
Hospital Charge Code	64905465
Hospital Revenue Code	278
Min. Negotiated Rate	$157.50
Max. Negotiated Rate	$157.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$157.50
Rate for Payer: Hamaspik Choice Inc Medicare	$157.50

SCREW HMMF 2.0 X 6MM B

Facility OP

$315.00

Service Code	HCPCS C1713
Hospital Charge Code	64905465
Hospital Revenue Code	278
Min. Negotiated Rate	$110.25
Max. Negotiated Rate	$330.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$173.25
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	$157.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$181.12
Rate for Payer: Fidelis Medicare Advantage	$330.75
Rate for Payer: Group Health Inc Commercial	$157.50
Rate for Payer: Group Health Inc Medicare	$110.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$157.50
Rate for Payer: Hamaspik Choice Inc Medicare	$157.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$204.75

SCREW IMF 12MM

Facility OP

$253.45

Service Code	HCPCS C1713
Hospital Charge Code	64901373
Hospital Revenue Code	278
Min. Negotiated Rate	$88.71
Max. Negotiated Rate	$266.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$139.40
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	$126.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$145.73
Rate for Payer: Fidelis Medicare Advantage	$266.12
Rate for Payer: Group Health Inc Commercial	$126.72
Rate for Payer: Group Health Inc Medicare	$88.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.72
Rate for Payer: Hamaspik Choice Inc Medicare	$126.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$164.74

SCREW IMF 12MM

Facility IP

$253.45

Service Code	HCPCS C1713
Hospital Charge Code	64901373
Hospital Revenue Code	278
Min. Negotiated Rate	$126.72
Max. Negotiated Rate	$126.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.72
Rate for Payer: Hamaspik Choice Inc Medicare	$126.72

SCREW IMF 8MM

Facility IP

$253.00

Service Code	HCPCS C1713
Hospital Charge Code	64901371
Hospital Revenue Code	278
Min. Negotiated Rate	$126.50
Max. Negotiated Rate	$126.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.50
Rate for Payer: Hamaspik Choice Inc Medicare	$126.50

SCREW IMF 8MM

Facility OP

$253.00

Service Code	HCPCS C1713
Hospital Charge Code	64901371
Hospital Revenue Code	278
Min. Negotiated Rate	$88.55
Max. Negotiated Rate	$265.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$139.15
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	$126.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$145.48
Rate for Payer: Fidelis Medicare Advantage	$265.65
Rate for Payer: Group Health Inc Commercial	$126.50
Rate for Payer: Group Health Inc Medicare	$88.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.50
Rate for Payer: Hamaspik Choice Inc Medicare	$126.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$164.45

SCREW KLS 2.7MM REG#12

Facility IP

$160.00

Service Code	HCPCS C1713
Hospital Charge Code	40200392
Hospital Revenue Code	278
Min. Negotiated Rate	$80.00
Max. Negotiated Rate	$80.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00

SCREW KLS 2.7MM REG#12

Facility OP

$160.00

Service Code	HCPCS C1713
Hospital Charge Code	40200392
Hospital Revenue Code	278
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.00
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	$80.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$92.00
Rate for Payer: Fidelis Medicare Advantage	$168.00
Rate for Payer: Group Health Inc Commercial	$80.00
Rate for Payer: Group Health Inc Medicare	$56.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$104.00

SCREW KOTOFIX 2.0 X 14MM

Facility IP

$487.50

Service Code	HCPCS C1713
Hospital Charge Code	64901624
Hospital Revenue Code	278
Min. Negotiated Rate	$243.75
Max. Negotiated Rate	$243.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$243.75

SCREW KOTOFIX 2.0 X 14MM

Facility OP

$487.50

Service Code	HCPCS C1713
Hospital Charge Code	64901624
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$511.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.12
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	$243.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$280.31
Rate for Payer: Fidelis Medicare Advantage	$511.88
Rate for Payer: Group Health Inc Commercial	$243.75
Rate for Payer: Group Health Inc Medicare	$170.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$243.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$316.88

SCREW LAG

Facility OP

$477.50

Service Code	HCPCS C1713
Hospital Charge Code	64901158
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$501.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$262.62
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	$238.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$274.56
Rate for Payer: Fidelis Medicare Advantage	$501.38
Rate for Payer: Group Health Inc Commercial	$238.75
Rate for Payer: Group Health Inc Medicare	$167.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$238.75
Rate for Payer: Hamaspik Choice Inc Medicare	$238.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$310.38

SCREW LAG

Facility IP

$477.50

Service Code	HCPCS C1713
Hospital Charge Code	64901158
Hospital Revenue Code	278
Min. Negotiated Rate	$238.75
Max. Negotiated Rate	$238.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$238.75
Rate for Payer: Hamaspik Choice Inc Medicare	$238.75

SCREW LAG 10.5 115MM

Facility OP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901739
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,346.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$705.17
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	$641.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$737.22
Rate for Payer: Fidelis Medicare Advantage	$1,346.24
Rate for Payer: Group Health Inc Commercial	$641.06
Rate for Payer: Group Health Inc Medicare	$448.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$641.06
Rate for Payer: Hamaspik Choice Inc Medicare	$641.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$833.38

SCREW LAG 10.5 115MM

Facility IP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901739
Hospital Revenue Code	278
Min. Negotiated Rate	$641.06
Max. Negotiated Rate	$641.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$641.06
Rate for Payer: Hamaspik Choice Inc Medicare	$641.06

SCREW LAG 10.5 MM X 100MM

Facility IP

$1,477.00

Service Code	HCPCS C1713
Hospital Charge Code	64901773
Hospital Revenue Code	278
Min. Negotiated Rate	$738.50
Max. Negotiated Rate	$738.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$738.50
Rate for Payer: Hamaspik Choice Inc Medicare	$738.50

SCREW LAG 10.5 MM X 100MM

Facility OP

$1,477.00

Service Code	HCPCS C1713
Hospital Charge Code	64901773
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,550.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$812.35
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	$738.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$849.28
Rate for Payer: Fidelis Medicare Advantage	$1,550.85
Rate for Payer: Group Health Inc Commercial	$738.50
Rate for Payer: Group Health Inc Medicare	$516.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$738.50
Rate for Payer: Hamaspik Choice Inc Medicare	$738.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$960.05

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