St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW, NON-LOCK PLATE 3.5X16MM

Facility OP

$320.49

Service Code	HCPCS C1713
Hospital Charge Code	40004426
Hospital Revenue Code	278
Min. Negotiated Rate	$112.17
Max. Negotiated Rate	$336.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$176.27
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	$160.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.28
Rate for Payer: Fidelis Medicare Advantage	$336.51
Rate for Payer: Group Health Inc Commercial	$160.24
Rate for Payer: Group Health Inc Medicare	$112.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.24
Rate for Payer: Hamaspik Choice Inc Medicare	$160.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$208.32

SCREW, NON-LOCK PLATE 3.5X16MM

Facility IP

$320.49

Service Code	HCPCS C1713
Hospital Charge Code	40004426
Hospital Revenue Code	278
Min. Negotiated Rate	$160.24
Max. Negotiated Rate	$160.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.24
Rate for Payer: Hamaspik Choice Inc Medicare	$160.24

SCREW OC 4.5Z14MM

Facility OP

$505.75

Service Code	HCPCS C1713
Hospital Charge Code	64906473
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$531.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$278.16
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	$252.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$290.81
Rate for Payer: Fidelis Medicare Advantage	$531.04
Rate for Payer: Group Health Inc Commercial	$252.88
Rate for Payer: Group Health Inc Medicare	$177.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$252.88
Rate for Payer: Hamaspik Choice Inc Medicare	$252.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$328.74

SCREW OC 4.5Z14MM

Facility IP

$505.75

Service Code	HCPCS C1713
Hospital Charge Code	64906473
Hospital Revenue Code	278
Min. Negotiated Rate	$252.88
Max. Negotiated Rate	$252.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$252.88
Rate for Payer: Hamaspik Choice Inc Medicare	$252.88

SCREW, OCCIPITAL 4.5X10MM

Facility OP

$1,264.38

Service Code	HCPCS C1713
Hospital Charge Code	64905602
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,327.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$695.41
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	$632.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$727.02
Rate for Payer: Fidelis Medicare Advantage	$1,327.60
Rate for Payer: Group Health Inc Commercial	$632.19
Rate for Payer: Group Health Inc Medicare	$442.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$632.19
Rate for Payer: Hamaspik Choice Inc Medicare	$632.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$821.85

SCREW, OCCIPITAL 4.5X10MM

Facility IP

$1,264.38

Service Code	HCPCS C1713
Hospital Charge Code	64905602
Hospital Revenue Code	278
Min. Negotiated Rate	$632.19
Max. Negotiated Rate	$632.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$632.19
Rate for Payer: Hamaspik Choice Inc Medicare	$632.19

SCREW OCCIPITAL 4.5 X 6

Facility OP

$1,264.38

Service Code	HCPCS C1713
Hospital Charge Code	64904823
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,327.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$695.41
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	$632.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$727.02
Rate for Payer: Fidelis Medicare Advantage	$1,327.60
Rate for Payer: Group Health Inc Commercial	$632.19
Rate for Payer: Group Health Inc Medicare	$442.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$632.19
Rate for Payer: Hamaspik Choice Inc Medicare	$632.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$821.85

SCREW OCCIPITAL 4.5 X 6

Facility IP

$1,264.38

Service Code	HCPCS C1713
Hospital Charge Code	64904823
Hospital Revenue Code	278
Min. Negotiated Rate	$632.19
Max. Negotiated Rate	$632.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$632.19
Rate for Payer: Hamaspik Choice Inc Medicare	$632.19

SCREW OCCIPITAL 4.5 X 8MM

Facility IP

$1,264.38

Service Code	HCPCS C1713
Hospital Charge Code	64904824
Hospital Revenue Code	278
Min. Negotiated Rate	$632.19
Max. Negotiated Rate	$632.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$632.19
Rate for Payer: Hamaspik Choice Inc Medicare	$632.19

SCREW OCCIPITAL 4.5 X 8MM

Facility OP

$1,264.38

Service Code	HCPCS C1713
Hospital Charge Code	64904824
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,327.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$695.41
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	$632.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$727.02
Rate for Payer: Fidelis Medicare Advantage	$1,327.60
Rate for Payer: Group Health Inc Commercial	$632.19
Rate for Payer: Group Health Inc Medicare	$442.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$632.19
Rate for Payer: Hamaspik Choice Inc Medicare	$632.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$821.85

SCREW, OCCIPITAL 5.25X10MM

Facility IP

$1,370.63

Service Code	HCPCS C1713
Hospital Charge Code	64905604
Hospital Revenue Code	278
Min. Negotiated Rate	$685.32
Max. Negotiated Rate	$685.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$685.32
Rate for Payer: Hamaspik Choice Inc Medicare	$685.32

SCREW, OCCIPITAL 5.25X10MM

Facility OP

$1,370.63

Service Code	HCPCS C1713
Hospital Charge Code	64905604
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,439.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$753.85
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	$685.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$788.11
Rate for Payer: Fidelis Medicare Advantage	$1,439.16
Rate for Payer: Group Health Inc Commercial	$685.32
Rate for Payer: Group Health Inc Medicare	$479.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$685.32
Rate for Payer: Hamaspik Choice Inc Medicare	$685.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$890.91

SCREW OCCIPITAL 5.25 X 6MM

Facility OP

$1,370.63

Service Code	HCPCS C1713
Hospital Charge Code	64905174
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,439.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$753.85
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	$685.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$788.11
Rate for Payer: Fidelis Medicare Advantage	$1,439.16
Rate for Payer: Group Health Inc Commercial	$685.32
Rate for Payer: Group Health Inc Medicare	$479.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$685.32
Rate for Payer: Hamaspik Choice Inc Medicare	$685.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$890.91

SCREW OCCIPITAL 5.25 X 6MM

Facility OP

$1,370.63

Service Code	HCPCS C1713
Hospital Charge Code	64904825
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,439.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$753.85
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	$685.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$788.11
Rate for Payer: Fidelis Medicare Advantage	$1,439.16
Rate for Payer: Group Health Inc Commercial	$685.32
Rate for Payer: Group Health Inc Medicare	$479.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$685.32
Rate for Payer: Hamaspik Choice Inc Medicare	$685.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$890.91

SCREW OCCIPITAL 5.25 X 6MM

Facility IP

$1,370.63

Service Code	HCPCS C1713
Hospital Charge Code	64905174
Hospital Revenue Code	278
Min. Negotiated Rate	$685.32
Max. Negotiated Rate	$685.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$685.32
Rate for Payer: Hamaspik Choice Inc Medicare	$685.32

SCREW OCCIPITAL 5.25 X 6MM

Facility IP

$1,370.63

Service Code	HCPCS C1713
Hospital Charge Code	64904825
Hospital Revenue Code	278
Min. Negotiated Rate	$685.32
Max. Negotiated Rate	$685.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$685.32
Rate for Payer: Hamaspik Choice Inc Medicare	$685.32

SCREW OCCIPITAL 5.25 X 8MM

Facility IP

$1,370.63

Service Code	HCPCS C1713
Hospital Charge Code	64905176
Hospital Revenue Code	278
Min. Negotiated Rate	$685.32
Max. Negotiated Rate	$685.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$685.32
Rate for Payer: Hamaspik Choice Inc Medicare	$685.32

SCREW OCCIPITAL 5.25 X 8MM

Facility OP

$1,370.63

Service Code	HCPCS C1713
Hospital Charge Code	64905176
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,439.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$753.85
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	$685.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$788.11
Rate for Payer: Fidelis Medicare Advantage	$1,439.16
Rate for Payer: Group Health Inc Commercial	$685.32
Rate for Payer: Group Health Inc Medicare	$479.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$685.32
Rate for Payer: Hamaspik Choice Inc Medicare	$685.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$890.91

SCREW ORTHO

Facility OP

$866.25

Service Code	HCPCS C1713
Hospital Charge Code	64907144
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 ORTHO

Facility IP

$866.25

Service Code	HCPCS C1713
Hospital Charge Code	64907144
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 ORTHO 4

Facility IP

$1,012.50

Service Code	HCPCS C1713
Hospital Charge Code	64907177
Hospital Revenue Code	278
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$506.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$506.25
Rate for Payer: Hamaspik Choice Inc Medicare	$506.25

SCREW ORTHO 4

Facility OP

$1,012.50

Service Code	HCPCS C1713
Hospital Charge Code	64907177
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,063.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$556.88
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	$506.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$582.19
Rate for Payer: Fidelis Medicare Advantage	$1,063.12
Rate for Payer: Group Health Inc Commercial	$506.25
Rate for Payer: Group Health Inc Medicare	$354.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$506.25
Rate for Payer: Hamaspik Choice Inc Medicare	$506.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$658.12

SCREW OVERDRILL AO 2.7X122MM

Facility OP

$241.15

Service Code	HCPCS C1713
Hospital Charge Code	64906304
Hospital Revenue Code	278
Min. Negotiated Rate	$84.40
Max. Negotiated Rate	$253.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.63
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	$120.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.66
Rate for Payer: Fidelis Medicare Advantage	$253.21
Rate for Payer: Group Health Inc Commercial	$120.58
Rate for Payer: Group Health Inc Medicare	$84.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.58
Rate for Payer: Hamaspik Choice Inc Medicare	$120.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.75

SCREW OVERDRILL AO 2.7X122MM

Facility IP

$241.15

Service Code	HCPCS C1713
Hospital Charge Code	64906304
Hospital Revenue Code	278
Min. Negotiated Rate	$120.58
Max. Negotiated Rate	$120.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.58
Rate for Payer: Hamaspik Choice Inc Medicare	$120.58

SCREW PARTIAL THREAD 207.040

Facility IP

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	40205516
Hospital Revenue Code	278
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50

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