St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW LOCKING ARMADA TI

Facility OP

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	64903524
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$630.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$330.00
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	$300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$345.00
Rate for Payer: Fidelis Medicare Advantage	$630.00
Rate for Payer: Group Health Inc Commercial	$300.00
Rate for Payer: Group Health Inc Medicare	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$390.00

SCREW LOCKING ARMADA TI

Facility IP

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	64903524
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00

SCREW LOCKING AXSOS 5.0MM

Facility IP

$256.25

Service Code	HCPCS C1713
Hospital Charge Code	64902744
Hospital Revenue Code	278
Min. Negotiated Rate	$128.12
Max. Negotiated Rate	$128.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.12
Rate for Payer: Hamaspik Choice Inc Medicare	$128.12

SCREW LOCKING AXSOS 5.0MM

Facility OP

$256.25

Service Code	HCPCS C1713
Hospital Charge Code	64902744
Hospital Revenue Code	278
Min. Negotiated Rate	$89.69
Max. Negotiated Rate	$269.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$140.94
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	$128.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$147.34
Rate for Payer: Fidelis Medicare Advantage	$269.06
Rate for Payer: Group Health Inc Commercial	$128.12
Rate for Payer: Group Health Inc Medicare	$89.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.12
Rate for Payer: Hamaspik Choice Inc Medicare	$128.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$166.56

SCREW LOCKING C PIN 2.0X5MM

Facility OP

$195.03

Service Code	HCPCS C1713
Hospital Charge Code	64902006
Hospital Revenue Code	278
Min. Negotiated Rate	$68.26
Max. Negotiated Rate	$204.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.27
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	$97.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.14
Rate for Payer: Fidelis Medicare Advantage	$204.78
Rate for Payer: Group Health Inc Commercial	$97.52
Rate for Payer: Group Health Inc Medicare	$68.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.52
Rate for Payer: Hamaspik Choice Inc Medicare	$97.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$126.77

SCREW LOCKING C PIN 2.0X5MM

Facility IP

$195.03

Service Code	HCPCS C1713
Hospital Charge Code	64902006
Hospital Revenue Code	278
Min. Negotiated Rate	$97.52
Max. Negotiated Rate	$97.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.52
Rate for Payer: Hamaspik Choice Inc Medicare	$97.52

SCREW LOCKING C PIN 2.3X4MM

Facility IP

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64902008
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 LOCKING C PIN 2.3X4MM

Facility OP

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64902008
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 LOCKING CROSS PIN 2.0MM

Facility OP

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	40200150
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 CROSS PIN 2.0MM

Facility IP

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	40200150
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 D5X32.5

Facility IP

$693.00

Service Code	HCPCS C1713
Hospital Charge Code	64906935
Hospital Revenue Code	278
Min. Negotiated Rate	$346.50
Max. Negotiated Rate	$346.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$346.50
Rate for Payer: Hamaspik Choice Inc Medicare	$346.50

SCREW LOCKING D5X32.5

Facility OP

$693.00

Service Code	HCPCS C1713
Hospital Charge Code	64906935
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 D5X35L (2360-5035S)

Facility IP

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906346
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$173.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25

SCREW LOCKING D5X35L (2360-5035S)

Facility OP

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906346
Hospital Revenue Code	278
Min. Negotiated Rate	$121.28
Max. Negotiated Rate	$363.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.58
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	$173.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$199.24
Rate for Payer: Fidelis Medicare Advantage	$363.82
Rate for Payer: Group Health Inc Commercial	$173.25
Rate for Payer: Group Health Inc Medicare	$121.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$225.22

SCREW LOCKING D5X40L (2360-5040S)

Facility IP

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906348
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$173.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25

SCREW LOCKING D5X40L (2360-5040S)

Facility OP

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906348
Hospital Revenue Code	278
Min. Negotiated Rate	$121.28
Max. Negotiated Rate	$363.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.58
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	$173.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$199.24
Rate for Payer: Fidelis Medicare Advantage	$363.82
Rate for Payer: Group Health Inc Commercial	$173.25
Rate for Payer: Group Health Inc Medicare	$121.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$225.22

SCREW LOCKING D5X45L (2360-5045S)

Facility OP

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906350
Hospital Revenue Code	278
Min. Negotiated Rate	$121.28
Max. Negotiated Rate	$363.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.58
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	$173.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$199.24
Rate for Payer: Fidelis Medicare Advantage	$363.82
Rate for Payer: Group Health Inc Commercial	$173.25
Rate for Payer: Group Health Inc Medicare	$121.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$225.22

SCREW LOCKING D5X45L (2360-5045S)

Facility IP

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906350
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$173.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25

SCREW LOCKING D5X50L(2360-5050S)

Facility IP

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906352
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$173.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25

SCREW LOCKING D5X50L(2360-5050S)

Facility OP

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906352
Hospital Revenue Code	278
Min. Negotiated Rate	$121.28
Max. Negotiated Rate	$363.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.58
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	$173.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$199.24
Rate for Payer: Fidelis Medicare Advantage	$363.82
Rate for Payer: Group Health Inc Commercial	$173.25
Rate for Payer: Group Health Inc Medicare	$121.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$225.22

SCREW LOCKING D5 X L45MM

Facility OP

$693.00

Service Code	HCPCS C1713
Hospital Charge Code	64906834
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 D5 X L45MM

Facility IP

$693.00

Service Code	HCPCS C1713
Hospital Charge Code	64906834
Hospital Revenue Code	278
Min. Negotiated Rate	$346.50
Max. Negotiated Rate	$346.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$346.50
Rate for Payer: Hamaspik Choice Inc Medicare	$346.50

SCREW LOCKING D5 X L85

Facility IP

$866.25

Service Code	HCPCS C1713
Hospital Charge Code	64907007
Hospital Revenue Code	278
Min. Negotiated Rate	$433.12
Max. Negotiated Rate	$433.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$433.12
Rate for Payer: Hamaspik Choice Inc Medicare	$433.12

SCREW LOCKING D5 X L85

Facility OP

$866.25

Service Code	HCPCS C1713
Hospital Charge Code	64907007
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$909.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$476.44
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	$433.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$498.09
Rate for Payer: Fidelis Medicare Advantage	$909.56
Rate for Payer: Group Health Inc Commercial	$433.12
Rate for Payer: Group Health Inc Medicare	$303.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$433.12
Rate for Payer: Hamaspik Choice Inc Medicare	$433.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$563.06

SCREW LOCKING FL THRD 2.7 L42

Facility IP

$456.36

Service Code	HCPCS C1713
Hospital Charge Code	64906859
Hospital Revenue Code	278
Min. Negotiated Rate	$228.18
Max. Negotiated Rate	$228.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$228.18
Rate for Payer: Hamaspik Choice Inc Medicare	$228.18

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