St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW LOCKING 5 X 50MM

Facility OP

$693.00

Service Code	HCPCS C1713
Hospital Charge Code	64906876
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$727.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$381.15
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	$346.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$398.48
Rate for Payer: Fidelis Medicare Advantage	$727.65
Rate for Payer: Group Health Inc Commercial	$346.50
Rate for Payer: Group Health Inc Medicare	$242.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$346.50
Rate for Payer: Hamaspik Choice Inc Medicare	$346.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$450.45

SCREW LOCKING 5 X 50MM FT T2

Facility OP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901236
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 5 X 50MM FT T2

Facility IP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901236
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 5 X 55MM FT T2

Facility OP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901238
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 5 X 55MM FT T2

Facility IP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901238
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 5 X 60MM FT T2

Facility IP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901239
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 5 X 60MM FT T2

Facility OP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901239
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 5 X 65MM FT T2

Facility IP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901279
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 5 X 65MM FT T2

Facility OP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901279
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 5 X 70MM FT T2

Facility IP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901267
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 5 X 70MM FT T2

Facility OP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901267
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 5 X 75MM FT T2

Facility IP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901241
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 5 X 75MM FT T2

Facility OP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901241
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 5 X 80MM FT T2

Facility OP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901273
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 5 X 80MM FT T2

Facility IP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901273
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 5 X 85MM FT T2

Facility OP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901242
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 5 X 85MM FT T2

Facility IP

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901242
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 5 X 90MM FT T2

Facility OP

$462.00

Service Code	HCPCS C1713
Hospital Charge Code	64901953
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$485.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$254.10
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	$231.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$265.65
Rate for Payer: Fidelis Medicare Advantage	$485.10
Rate for Payer: Group Health Inc Commercial	$231.00
Rate for Payer: Group Health Inc Medicare	$161.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$231.00
Rate for Payer: Hamaspik Choice Inc Medicare	$231.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$300.30

SCREW LOCKING 5 X 90MM FT T2

Facility IP

$462.00

Service Code	HCPCS C1713
Hospital Charge Code	64901953
Hospital Revenue Code	278
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$231.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$231.00
Rate for Payer: Hamaspik Choice Inc Medicare	$231.00

SCREW LOCKING 60MM

Facility IP

$317.80

Service Code	HCPCS C1776
Hospital Charge Code	40202416
Hospital Revenue Code	278
Min. Negotiated Rate	$158.90
Max. Negotiated Rate	$158.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.90
Rate for Payer: Hamaspik Choice Inc Medicare	$158.90

SCREW LOCKING 60MM

Facility OP

$317.80

Service Code	HCPCS C1776
Hospital Charge Code	40202416
Hospital Revenue Code	278
Min. Negotiated Rate	$111.23
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.79
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	$158.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.74
Rate for Payer: Fidelis Medicare Advantage	$333.69
Rate for Payer: Group Health Inc Commercial	$158.90
Rate for Payer: Group Health Inc Medicare	$111.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.90
Rate for Payer: Hamaspik Choice Inc Medicare	$158.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.57

SCREW LOCKING 70MM T2 F/T

Facility OP

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202427
Hospital Revenue Code	278
Min. Negotiated Rate	$111.30
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.90
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	$159.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.85
Rate for Payer: Fidelis Medicare Advantage	$333.90
Rate for Payer: Group Health Inc Commercial	$159.00
Rate for Payer: Group Health Inc Medicare	$111.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00
Rate for Payer: Hamaspik Choice Inc Medicare	$159.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.70

SCREW LOCKING 70MM T2 F/T

Facility IP

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202427
Hospital Revenue Code	278
Min. Negotiated Rate	$159.00
Max. Negotiated Rate	$159.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00
Rate for Payer: Hamaspik Choice Inc Medicare	$159.00

SCREW LOCKING ANCHOR 3.5X24MM

Facility OP

$762.50

Service Code	HCPCS C1713
Hospital Charge Code	64905677
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$800.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$419.38
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	$381.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$438.44
Rate for Payer: Fidelis Medicare Advantage	$800.62
Rate for Payer: Group Health Inc Commercial	$381.25
Rate for Payer: Group Health Inc Medicare	$266.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$381.25
Rate for Payer: Hamaspik Choice Inc Medicare	$381.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$495.62

SCREW LOCKING ANCHOR 3.5X24MM

Facility IP

$762.50

Service Code	HCPCS C1713
Hospital Charge Code	64905677
Hospital Revenue Code	278
Min. Negotiated Rate	$381.25
Max. Negotiated Rate	$381.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$381.25
Rate for Payer: Hamaspik Choice Inc Medicare	$381.25

Price Transparency.

All Charges