St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW LOCKING 2.3X16

Facility IP

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64903712
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25

SCREW LOCKING 2.3X16

Facility OP

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64903712
Hospital Revenue Code	278
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$275.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.38
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	$131.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.94
Rate for Payer: Fidelis Medicare Advantage	$275.62
Rate for Payer: Group Health Inc Commercial	$131.25
Rate for Payer: Group Health Inc Medicare	$91.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.62

SCREW LOCKING 2.3 X 16MM

Facility IP

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64902399
Hospital Revenue Code	278
Min. Negotiated Rate	$122.50
Max. Negotiated Rate	$122.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50

SCREW LOCKING 2.3 X 16MM

Facility OP

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64902399
Hospital Revenue Code	278
Min. Negotiated Rate	$85.75
Max. Negotiated Rate	$257.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$134.75
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	$122.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$140.88
Rate for Payer: Fidelis Medicare Advantage	$257.25
Rate for Payer: Group Health Inc Commercial	$122.50
Rate for Payer: Group Health Inc Medicare	$85.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$159.25

SCREW LOCKING 2.3 X 18MM

Facility OP

$216.00

Service Code	HCPCS C1713
Hospital Charge Code	64906840
Hospital Revenue Code	278
Min. Negotiated Rate	$75.60
Max. Negotiated Rate	$226.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$118.80
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	$108.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$124.20
Rate for Payer: Fidelis Medicare Advantage	$226.80
Rate for Payer: Group Health Inc Commercial	$108.00
Rate for Payer: Group Health Inc Medicare	$75.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.00
Rate for Payer: Hamaspik Choice Inc Medicare	$108.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$140.40

SCREW LOCKING 2.3 X 18MM

Facility IP

$216.00

Service Code	HCPCS C1713
Hospital Charge Code	64906840
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.00
Rate for Payer: Hamaspik Choice Inc Medicare	$108.00

SCREW LOCKING 2.3 X 20

Facility OP

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64903707
Hospital Revenue Code	278
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$275.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.38
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	$131.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.94
Rate for Payer: Fidelis Medicare Advantage	$275.62
Rate for Payer: Group Health Inc Commercial	$131.25
Rate for Payer: Group Health Inc Medicare	$91.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.62

SCREW LOCKING 2.3 X 20

Facility IP

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64903707
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25

SCREW LOCKING 2.3 X 22

Facility OP

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64903708
Hospital Revenue Code	278
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$275.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.38
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	$131.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.94
Rate for Payer: Fidelis Medicare Advantage	$275.62
Rate for Payer: Group Health Inc Commercial	$131.25
Rate for Payer: Group Health Inc Medicare	$91.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.62

SCREW LOCKING 2.3 X 22

Facility IP

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64903708
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25

SCREW LOCKING 2.3 X 24 MM

Facility OP

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64902757
Hospital Revenue Code	278
Min. Negotiated Rate	$85.75
Max. Negotiated Rate	$257.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$134.75
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	$122.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$140.88
Rate for Payer: Fidelis Medicare Advantage	$257.25
Rate for Payer: Group Health Inc Commercial	$122.50
Rate for Payer: Group Health Inc Medicare	$85.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$159.25

SCREW LOCKING 2.3 X 24 MM

Facility IP

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64902757
Hospital Revenue Code	278
Min. Negotiated Rate	$122.50
Max. Negotiated Rate	$122.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50

SCREW LOCKING 2.3 X 26MM

Facility OP

$216.00

Service Code	HCPCS C1713
Hospital Charge Code	64906838
Hospital Revenue Code	278
Min. Negotiated Rate	$75.60
Max. Negotiated Rate	$226.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$118.80
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	$108.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$124.20
Rate for Payer: Fidelis Medicare Advantage	$226.80
Rate for Payer: Group Health Inc Commercial	$108.00
Rate for Payer: Group Health Inc Medicare	$75.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.00
Rate for Payer: Hamaspik Choice Inc Medicare	$108.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$140.40

SCREW LOCKING 2.3 X 26MM

Facility IP

$216.00

Service Code	HCPCS C1713
Hospital Charge Code	64906838
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.00
Rate for Payer: Hamaspik Choice Inc Medicare	$108.00

SCREW LOCKING 2.3 X 6

Facility IP

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64904414
Hospital Revenue Code	278
Min. Negotiated Rate	$122.50
Max. Negotiated Rate	$122.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50

SCREW LOCKING 2.3 X 6

Facility OP

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64904414
Hospital Revenue Code	278
Min. Negotiated Rate	$85.75
Max. Negotiated Rate	$257.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$134.75
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	$122.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$140.88
Rate for Payer: Fidelis Medicare Advantage	$257.25
Rate for Payer: Group Health Inc Commercial	$122.50
Rate for Payer: Group Health Inc Medicare	$85.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$159.25

SCREW LOCKING 2.3 X 9MM

Facility IP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64902827
Hospital Revenue Code	278
Min. Negotiated Rate	$89.38
Max. Negotiated Rate	$89.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38

SCREW LOCKING 2.3 X 9MM

Facility OP

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64902827
Hospital Revenue Code	278
Min. Negotiated Rate	$62.56
Max. Negotiated Rate	$187.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.31
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	$89.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.78
Rate for Payer: Fidelis Medicare Advantage	$187.69
Rate for Payer: Group Health Inc Commercial	$89.38
Rate for Payer: Group Health Inc Medicare	$62.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$116.19

SCREW LOCKING 2.4

Facility OP

$512.43

Service Code	HCPCS C1713
Hospital Charge Code	64907038
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$538.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$281.84
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	$256.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$294.65
Rate for Payer: Fidelis Medicare Advantage	$538.05
Rate for Payer: Group Health Inc Commercial	$256.22
Rate for Payer: Group Health Inc Medicare	$179.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.22
Rate for Payer: Hamaspik Choice Inc Medicare	$256.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$333.08

SCREW LOCKING 2.4

Facility IP

$512.43

Service Code	HCPCS C1713
Hospital Charge Code	64907038
Hospital Revenue Code	278
Min. Negotiated Rate	$256.22
Max. Negotiated Rate	$256.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.22
Rate for Payer: Hamaspik Choice Inc Medicare	$256.22

SCREW LOCKING 2.4 X 4MM

Facility IP

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	64901370
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 LOCKING 2.4 X 4MM

Facility OP

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	64901370
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 LOCKING 25MM

Facility OP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901330
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$450.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.95
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	$214.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.68
Rate for Payer: Fidelis Medicare Advantage	$450.45
Rate for Payer: Group Health Inc Commercial	$214.50
Rate for Payer: Group Health Inc Medicare	$150.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$278.85

SCREW LOCKING 25MM

Facility IP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901330
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50

SCREW LOCKING 27 14MM 882714

Facility IP

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	64906647
Hospital Revenue Code	278
Min. Negotiated Rate	$115.00
Max. Negotiated Rate	$115.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00

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