St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW LOCKING 4.0 X 28

Facility IP

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64903505
Hospital Revenue Code	278
Min. Negotiated Rate	$280.50
Max. Negotiated Rate	$280.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50

SCREW LOCKING 4.0 X 28

Facility OP

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64903505
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$589.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$308.55
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	$280.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$322.58
Rate for Payer: Fidelis Medicare Advantage	$589.05
Rate for Payer: Group Health Inc Commercial	$280.50
Rate for Payer: Group Health Inc Medicare	$196.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$364.65

SCREW LOCKING 4.0 X 28MM

Facility OP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902047
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
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	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 28MM

Facility IP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902047
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 30

Facility OP

$549.00

Service Code	HCPCS C1713
Hospital Charge Code	64903503
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$576.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$301.95
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	$274.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$315.68
Rate for Payer: Fidelis Medicare Advantage	$576.45
Rate for Payer: Group Health Inc Commercial	$274.50
Rate for Payer: Group Health Inc Medicare	$192.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.50
Rate for Payer: Hamaspik Choice Inc Medicare	$274.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$356.85

SCREW LOCKING 4.0 X 30

Facility IP

$549.00

Service Code	HCPCS C1713
Hospital Charge Code	64903503
Hospital Revenue Code	278
Min. Negotiated Rate	$274.50
Max. Negotiated Rate	$274.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.50
Rate for Payer: Hamaspik Choice Inc Medicare	$274.50

SCREW LOCKING 4.0 X 30MM

Facility OP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902032
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
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	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 30MM

Facility IP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902032
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 32MM

Facility OP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902035
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
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	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 32MM

Facility IP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902035
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 34MM

Facility OP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902036
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
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	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 34MM

Facility OP

$212.80

Service Code	HCPCS C1776
Hospital Charge Code	40206052
Hospital Revenue Code	278
Min. Negotiated Rate	$74.48
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$117.04
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	$106.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$122.36
Rate for Payer: Fidelis Medicare Advantage	$223.44
Rate for Payer: Group Health Inc Commercial	$106.40
Rate for Payer: Group Health Inc Medicare	$74.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.40
Rate for Payer: Hamaspik Choice Inc Medicare	$106.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$138.32

SCREW LOCKING 4.0 X 34MM

Facility IP

$212.80

Service Code	HCPCS C1776
Hospital Charge Code	40206052
Hospital Revenue Code	278
Min. Negotiated Rate	$106.40
Max. Negotiated Rate	$106.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.40
Rate for Payer: Hamaspik Choice Inc Medicare	$106.40

SCREW LOCKING 4.0 X 34MM

Facility IP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902036
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 36MM

Facility IP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902037
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 36MM

Facility OP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902037
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
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	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 38MM A

Facility IP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902034
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 38MM A

Facility OP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902034
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
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	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 4.0

Facility IP

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	64904204
Hospital Revenue Code	278
Min. Negotiated Rate	$251.00
Max. Negotiated Rate	$251.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00

SCREW LOCKING 4.0 X 4.0

Facility OP

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	64904204
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$527.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.10
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	$251.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.65
Rate for Payer: Fidelis Medicare Advantage	$527.10
Rate for Payer: Group Health Inc Commercial	$251.00
Rate for Payer: Group Health Inc Medicare	$175.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$326.30

SCREW LOCKING 4.0 X 40MM

Facility OP

$214.00

Service Code	HCPCS C1776
Hospital Charge Code	40202408
Hospital Revenue Code	278
Min. Negotiated Rate	$74.90
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$117.70
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	$107.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$123.05
Rate for Payer: Fidelis Medicare Advantage	$224.70
Rate for Payer: Group Health Inc Commercial	$107.00
Rate for Payer: Group Health Inc Medicare	$74.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$107.00
Rate for Payer: Hamaspik Choice Inc Medicare	$107.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$139.10

SCREW LOCKING 4.0 X 40MM

Facility IP

$214.00

Service Code	HCPCS C1776
Hospital Charge Code	40202408
Hospital Revenue Code	278
Min. Negotiated Rate	$107.00
Max. Negotiated Rate	$107.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$107.00
Rate for Payer: Hamaspik Choice Inc Medicare	$107.00

SCREW LOCKING 4.0 X 40MM

Facility OP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902094
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
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	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 40MM

Facility IP

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902094
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 44MM

Facility OP

$213.00

Service Code	HCPCS C1776
Hospital Charge Code	40202407
Hospital Revenue Code	278
Min. Negotiated Rate	$74.55
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$117.15
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	$106.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$122.48
Rate for Payer: Fidelis Medicare Advantage	$223.65
Rate for Payer: Group Health Inc Commercial	$106.50
Rate for Payer: Group Health Inc Medicare	$74.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.50
Rate for Payer: Hamaspik Choice Inc Medicare	$106.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$138.45

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