St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW LAG TTN 10.5X85MM L

Facility IP

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64901444
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 LCK 2.3MMD X 16MML CRS-PN

Facility OP

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64901460
Hospital Revenue Code	278
Min. Negotiated Rate	$78.83
Max. Negotiated Rate	$236.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.88
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	$112.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.51
Rate for Payer: Fidelis Medicare Advantage	$236.49
Rate for Payer: Group Health Inc Commercial	$112.62
Rate for Payer: Group Health Inc Medicare	$78.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.62
Rate for Payer: Hamaspik Choice Inc Medicare	$112.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$146.40

SCREW LCK 2.3MMD X 16MML CRS-PN

Facility IP

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64901460
Hospital Revenue Code	278
Min. Negotiated Rate	$112.62
Max. Negotiated Rate	$112.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.62
Rate for Payer: Hamaspik Choice Inc Medicare	$112.62

SCREW LCKING 5MX5.0MXL60M-661160

Facility OP

$216.58

Service Code	HCPCS C1713
Hospital Charge Code	64906440
Hospital Revenue Code	278
Min. Negotiated Rate	$75.80
Max. Negotiated Rate	$227.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$119.12
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	$108.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$124.53
Rate for Payer: Fidelis Medicare Advantage	$227.41
Rate for Payer: Group Health Inc Commercial	$108.29
Rate for Payer: Group Health Inc Medicare	$75.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.29
Rate for Payer: Hamaspik Choice Inc Medicare	$108.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$140.78

SCREW LCKING 5MX5.0MXL60M-661160

Facility IP

$216.58

Service Code	HCPCS C1713
Hospital Charge Code	64906440
Hospital Revenue Code	278
Min. Negotiated Rate	$108.29
Max. Negotiated Rate	$108.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.29
Rate for Payer: Hamaspik Choice Inc Medicare	$108.29

SCREW LCKING PERIPRO 5.0MM L10MM

Facility OP

$274.00

Service Code	HCPCS C1713
Hospital Charge Code	64906483
Hospital Revenue Code	278
Min. Negotiated Rate	$95.90
Max. Negotiated Rate	$287.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$150.70
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	$137.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$157.55
Rate for Payer: Fidelis Medicare Advantage	$287.70
Rate for Payer: Group Health Inc Commercial	$137.00
Rate for Payer: Group Health Inc Medicare	$95.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.00
Rate for Payer: Hamaspik Choice Inc Medicare	$137.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$178.10

SCREW LCKING PERIPRO 5.0MM L10MM

Facility IP

$274.00

Service Code	HCPCS C1713
Hospital Charge Code	64906483
Hospital Revenue Code	278
Min. Negotiated Rate	$137.00
Max. Negotiated Rate	$137.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.00
Rate for Payer: Hamaspik Choice Inc Medicare	$137.00

SCREW LCKING T8FTHRD 2.7MM,L26MM

Facility OP

$205.00

Service Code	HCPCS C1713
Hospital Charge Code	64906297
Hospital Revenue Code	278
Min. Negotiated Rate	$71.75
Max. Negotiated Rate	$215.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$112.75
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	$102.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$117.88
Rate for Payer: Fidelis Medicare Advantage	$215.25
Rate for Payer: Group Health Inc Commercial	$102.50
Rate for Payer: Group Health Inc Medicare	$71.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$102.50
Rate for Payer: Hamaspik Choice Inc Medicare	$102.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$133.25

SCREW LCKING T8FTHRD 2.7MM,L26MM

Facility IP

$205.00

Service Code	HCPCS C1713
Hospital Charge Code	64906297
Hospital Revenue Code	278
Min. Negotiated Rate	$102.50
Max. Negotiated Rate	$102.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$102.50
Rate for Payer: Hamaspik Choice Inc Medicare	$102.50

SCREW LCKNG CROSS PIN 2.0X10MM

Facility OP

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	64901509
Hospital Revenue Code	278
Min. Negotiated Rate	$68.42
Max. Negotiated Rate	$205.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.51
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	$97.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.40
Rate for Payer: Fidelis Medicare Advantage	$205.25
Rate for Payer: Group Health Inc Commercial	$97.74
Rate for Payer: Group Health Inc Medicare	$68.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.74
Rate for Payer: Hamaspik Choice Inc Medicare	$97.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.06

SCREW LCKNG CROSS PIN 2.0X10MM

Facility IP

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	64901509
Hospital Revenue Code	278
Min. Negotiated Rate	$97.74
Max. Negotiated Rate	$97.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.74
Rate for Payer: Hamaspik Choice Inc Medicare	$97.74

SCREW LCKNG CROSS PIN 2.0X12MM

Facility OP

$195.55

Service Code	HCPCS C1713
Hospital Charge Code	64901511
Hospital Revenue Code	278
Min. Negotiated Rate	$68.44
Max. Negotiated Rate	$205.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.55
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	$97.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.44
Rate for Payer: Fidelis Medicare Advantage	$205.33
Rate for Payer: Group Health Inc Commercial	$97.78
Rate for Payer: Group Health Inc Medicare	$68.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.78
Rate for Payer: Hamaspik Choice Inc Medicare	$97.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.11

SCREW LCKNG CROSS PIN 2.0X12MM

Facility IP

$195.55

Service Code	HCPCS C1713
Hospital Charge Code	64901511
Hospital Revenue Code	278
Min. Negotiated Rate	$97.78
Max. Negotiated Rate	$97.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.78
Rate for Payer: Hamaspik Choice Inc Medicare	$97.78

SCREW LCKNG CROSS PIN 2.0X16MM

Facility IP

$195.55

Service Code	HCPCS C1713
Hospital Charge Code	64901513
Hospital Revenue Code	278
Min. Negotiated Rate	$97.78
Max. Negotiated Rate	$97.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.78
Rate for Payer: Hamaspik Choice Inc Medicare	$97.78

SCREW LCKNG CROSS PIN 2.0X16MM

Facility OP

$195.55

Service Code	HCPCS C1713
Hospital Charge Code	64901513
Hospital Revenue Code	278
Min. Negotiated Rate	$68.44
Max. Negotiated Rate	$205.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.55
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	$97.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.44
Rate for Payer: Fidelis Medicare Advantage	$205.33
Rate for Payer: Group Health Inc Commercial	$97.78
Rate for Payer: Group Health Inc Medicare	$68.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.78
Rate for Payer: Hamaspik Choice Inc Medicare	$97.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.11

SCREW LCKNG CROSS PIN 2.0X6MM

Facility OP

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	64901505
Hospital Revenue Code	278
Min. Negotiated Rate	$68.42
Max. Negotiated Rate	$205.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.51
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	$97.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.40
Rate for Payer: Fidelis Medicare Advantage	$205.25
Rate for Payer: Group Health Inc Commercial	$97.74
Rate for Payer: Group Health Inc Medicare	$68.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.74
Rate for Payer: Hamaspik Choice Inc Medicare	$97.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.06

SCREW LCKNG CROSS PIN 2.0X6MM

Facility IP

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	64901505
Hospital Revenue Code	278
Min. Negotiated Rate	$97.74
Max. Negotiated Rate	$97.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.74
Rate for Payer: Hamaspik Choice Inc Medicare	$97.74

SCREW LCKNG CROSS PIN 2.0X8MM

Facility IP

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	64901507
Hospital Revenue Code	278
Min. Negotiated Rate	$97.74
Max. Negotiated Rate	$97.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.74
Rate for Payer: Hamaspik Choice Inc Medicare	$97.74

SCREW LCKNG CROSS PIN 2.0X8MM

Facility OP

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	64901507
Hospital Revenue Code	278
Min. Negotiated Rate	$68.42
Max. Negotiated Rate	$205.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.51
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	$97.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.40
Rate for Payer: Fidelis Medicare Advantage	$205.25
Rate for Payer: Group Health Inc Commercial	$97.74
Rate for Payer: Group Health Inc Medicare	$68.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.74
Rate for Payer: Hamaspik Choice Inc Medicare	$97.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.06

SCREW LCKNG CROSS PIN 2.3X10MM

Facility IP

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64901491
Hospital Revenue Code	278
Min. Negotiated Rate	$112.62
Max. Negotiated Rate	$112.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.62
Rate for Payer: Hamaspik Choice Inc Medicare	$112.62

SCREW LCKNG CROSS PIN 2.3X10MM

Facility OP

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64901491
Hospital Revenue Code	278
Min. Negotiated Rate	$78.83
Max. Negotiated Rate	$236.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.88
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	$112.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.51
Rate for Payer: Fidelis Medicare Advantage	$236.49
Rate for Payer: Group Health Inc Commercial	$112.62
Rate for Payer: Group Health Inc Medicare	$78.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.62
Rate for Payer: Hamaspik Choice Inc Medicare	$112.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$146.40

SCREW LCKNG CROSS PIN 2.3X12MM

Facility IP

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64901493
Hospital Revenue Code	278
Min. Negotiated Rate	$112.62
Max. Negotiated Rate	$112.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.62
Rate for Payer: Hamaspik Choice Inc Medicare	$112.62

SCREW LCKNG CROSS PIN 2.3X12MM

Facility OP

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64901493
Hospital Revenue Code	278
Min. Negotiated Rate	$78.83
Max. Negotiated Rate	$236.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.88
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	$112.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.51
Rate for Payer: Fidelis Medicare Advantage	$236.49
Rate for Payer: Group Health Inc Commercial	$112.62
Rate for Payer: Group Health Inc Medicare	$78.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.62
Rate for Payer: Hamaspik Choice Inc Medicare	$112.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$146.40

SCREW LCKNG CROSS PIN 2.3X14NN

Facility IP

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64901497
Hospital Revenue Code	278
Min. Negotiated Rate	$112.62
Max. Negotiated Rate	$112.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.62
Rate for Payer: Hamaspik Choice Inc Medicare	$112.62

SCREW LCKNG CROSS PIN 2.3X14NN

Facility OP

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64901497
Hospital Revenue Code	278
Min. Negotiated Rate	$78.83
Max. Negotiated Rate	$236.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.88
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	$112.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.51
Rate for Payer: Fidelis Medicare Advantage	$236.49
Rate for Payer: Group Health Inc Commercial	$112.62
Rate for Payer: Group Health Inc Medicare	$78.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.62
Rate for Payer: Hamaspik Choice Inc Medicare	$112.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$146.40

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