St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW LAG 10.5 X 100MM

Facility OP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901650
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 X 100MM

Facility IP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901650
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 X 110MM

Facility IP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901999
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 X 110MM

Facility OP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901999
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 X 150MM

Facility IP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901854
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 X 150MM

Facility OP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901854
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 10.5X90MM GAM3

Facility IP

$908.60

Service Code	HCPCS C1713
Hospital Charge Code	40205081
Hospital Revenue Code	278
Min. Negotiated Rate	$454.30
Max. Negotiated Rate	$454.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$454.30
Rate for Payer: Hamaspik Choice Inc Medicare	$454.30

SCREW LAG 10.5X90MM GAM3

Facility OP

$908.60

Service Code	HCPCS C1713
Hospital Charge Code	40205081
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$954.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$499.73
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	$454.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$522.44
Rate for Payer: Fidelis Medicare Advantage	$954.03
Rate for Payer: Group Health Inc Commercial	$454.30
Rate for Payer: Group Health Inc Medicare	$318.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$454.30
Rate for Payer: Hamaspik Choice Inc Medicare	$454.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$590.59

SCREW LAG 10.5X90MM GAM3

Facility IP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901446
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 10.5X90MM GAM3

Facility OP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901446
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 X 95MM

Facility OP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901737
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 X 95MM

Facility IP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901737
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 6.5 X 90MM

Facility IP

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64901648
Hospital Revenue Code	278
Min. Negotiated Rate	$277.88
Max. Negotiated Rate	$277.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88

SCREW LAG 6.5 X 90MM

Facility OP

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64901648
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$583.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$305.66
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	$277.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$319.56
Rate for Payer: Fidelis Medicare Advantage	$583.54
Rate for Payer: Group Health Inc Commercial	$277.88
Rate for Payer: Group Health Inc Medicare	$194.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$361.24

SCREW LAG CANN 2.4 X 14MM

Facility OP

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	64901623
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$498.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$261.25
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	$237.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$273.12
Rate for Payer: Fidelis Medicare Advantage	$498.75
Rate for Payer: Group Health Inc Commercial	$237.50
Rate for Payer: Group Health Inc Medicare	$166.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$237.50
Rate for Payer: Hamaspik Choice Inc Medicare	$237.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$308.75

SCREW LAG CANN 2.4 X 14MM

Facility IP

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	64901623
Hospital Revenue Code	278
Min. Negotiated Rate	$237.50
Max. Negotiated Rate	$237.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$237.50
Rate for Payer: Hamaspik Choice Inc Medicare	$237.50

SCREW LAG CANNLTD

Facility IP

$512.50

Service Code	HCPCS C1713
Hospital Charge Code	64907009
Hospital Revenue Code	278
Min. Negotiated Rate	$256.25
Max. Negotiated Rate	$256.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.25
Rate for Payer: Hamaspik Choice Inc Medicare	$256.25

SCREW LAG CANNLTD

Facility OP

$512.50

Service Code	HCPCS C1713
Hospital Charge Code	64907009
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$538.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$281.88
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	$256.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$294.69
Rate for Payer: Fidelis Medicare Advantage	$538.12
Rate for Payer: Group Health Inc Commercial	$256.25
Rate for Payer: Group Health Inc Medicare	$179.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.25
Rate for Payer: Hamaspik Choice Inc Medicare	$256.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$333.12

SCREW LAG GAMMA3 10.5X125MM

Facility IP

$466.69

Service Code	HCPCS C1713
Hospital Charge Code	64906319
Hospital Revenue Code	278
Min. Negotiated Rate	$233.34
Max. Negotiated Rate	$233.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.34
Rate for Payer: Hamaspik Choice Inc Medicare	$233.34

SCREW LAG GAMMA3 10.5X125MM

Facility OP

$466.69

Service Code	HCPCS C1713
Hospital Charge Code	64906319
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$490.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$256.68
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	$233.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$268.35
Rate for Payer: Fidelis Medicare Advantage	$490.02
Rate for Payer: Group Health Inc Commercial	$233.34
Rate for Payer: Group Health Inc Medicare	$163.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.34
Rate for Payer: Hamaspik Choice Inc Medicare	$233.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$303.35

SCREW LAG HIP 13MM DIA 130

Facility OP

$729.63

Service Code	HCPCS C1713
Hospital Charge Code	64903529
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$766.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$401.30
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	$364.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$419.54
Rate for Payer: Fidelis Medicare Advantage	$766.11
Rate for Payer: Group Health Inc Commercial	$364.82
Rate for Payer: Group Health Inc Medicare	$255.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$364.82
Rate for Payer: Hamaspik Choice Inc Medicare	$364.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$474.26

SCREW LAG HIP 13MM DIA 130

Facility IP

$729.63

Service Code	HCPCS C1713
Hospital Charge Code	64903529
Hospital Revenue Code	278
Min. Negotiated Rate	$364.82
Max. Negotiated Rate	$364.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$364.82
Rate for Payer: Hamaspik Choice Inc Medicare	$364.82

SCREW LAG TIT 10.5X85MM L

Facility IP

$1,282.13

Service Code	HCPCS C1776
Hospital Charge Code	40202413
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 TIT 10.5X85MM L

Facility OP

$1,282.13

Service Code	HCPCS C1776
Hospital Charge Code	40202413
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,346.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$705.17
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	$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 TTN 10.5X85MM L

Facility OP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901444
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

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