St. Barnabas Hospital

All Charges

Charge

Type

Price

SCREW PARTIAL THREAD 207.040

Facility OP

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	40205516
Hospital Revenue Code	278
Min. Negotiated Rate	$12.25
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.25
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	$17.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.12
Rate for Payer: Fidelis Medicare Advantage	$36.75
Rate for Payer: Group Health Inc Commercial	$17.50
Rate for Payer: Group Health Inc Medicare	$12.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.75

SCREW PEEK INTERF

Facility OP

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64907432
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$656.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.75
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	$312.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$359.38
Rate for Payer: Fidelis Medicare Advantage	$656.25
Rate for Payer: Group Health Inc Commercial	$312.50
Rate for Payer: Group Health Inc Medicare	$218.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$406.25

SCREW PEEK INTERF

Facility IP

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64907432
Hospital Revenue Code	278
Min. Negotiated Rate	$312.50
Max. Negotiated Rate	$312.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50

SCREW PERIPRO LOCKING 5

Facility IP

$498.12

Service Code	HCPCS C1713
Hospital Charge Code	64906889
Hospital Revenue Code	278
Min. Negotiated Rate	$249.06
Max. Negotiated Rate	$249.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$249.06
Rate for Payer: Hamaspik Choice Inc Medicare	$249.06

SCREW PERIPRO LOCKING 5

Facility OP

$498.12

Service Code	HCPCS C1713
Hospital Charge Code	64906889
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$523.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$273.97
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	$249.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$286.42
Rate for Payer: Fidelis Medicare Advantage	$523.03
Rate for Payer: Group Health Inc Commercial	$249.06
Rate for Payer: Group Health Inc Medicare	$174.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$249.06
Rate for Payer: Hamaspik Choice Inc Medicare	$249.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$323.78

SCREW PLYX NO LOCK

Facility IP

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64907327
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$142.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50

SCREW PLYX NO LOCK

Facility OP

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64907327
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$299.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$156.75
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	$142.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.88
Rate for Payer: Fidelis Medicare Advantage	$299.25
Rate for Payer: Group Health Inc Commercial	$142.50
Rate for Payer: Group Health Inc Medicare	$99.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.25

SCREW POLY 3.5 X 10

Facility IP

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904827
Hospital Revenue Code	278
Min. Negotiated Rate	$1,748.75
Max. Negotiated Rate	$1,748.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,748.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,748.75

SCREW POLY 3.5 X 10

Facility OP

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904827
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,672.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,923.62
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	$1,748.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,011.06
Rate for Payer: Fidelis Medicare Advantage	$3,672.38
Rate for Payer: Group Health Inc Commercial	$1,748.75
Rate for Payer: Group Health Inc Medicare	$1,224.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,748.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,748.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,273.38

SCREW POLY 5.0 X 35

Facility IP

$4,912.80

Service Code	HCPCS C1713
Hospital Charge Code	64904040
Hospital Revenue Code	278
Min. Negotiated Rate	$2,456.40
Max. Negotiated Rate	$2,456.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,456.40
Rate for Payer: Hamaspik Choice Inc Medicare	$2,456.40

SCREW POLY 5.0 X 35

Facility OP

$4,912.80

Service Code	HCPCS C1713
Hospital Charge Code	64904040
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,158.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,702.04
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	$2,456.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,824.86
Rate for Payer: Fidelis Medicare Advantage	$5,158.44
Rate for Payer: Group Health Inc Commercial	$2,456.40
Rate for Payer: Group Health Inc Medicare	$1,719.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,456.40
Rate for Payer: Hamaspik Choice Inc Medicare	$2,456.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,193.32

SCREW POLYAXIAL 5.5 X 30

Facility IP

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904166
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.50
Max. Negotiated Rate	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50

SCREW POLYAXIAL 5.5 X 30

Facility OP

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904166
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,648.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,911.25
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	$1,737.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,998.12
Rate for Payer: Fidelis Medicare Advantage	$3,648.75
Rate for Payer: Group Health Inc Commercial	$1,737.50
Rate for Payer: Group Health Inc Medicare	$1,216.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,258.75

SCREW POLYAXIAL 5.5 X 35

Facility IP

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904164
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.50
Max. Negotiated Rate	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50

SCREW POLYAXIAL 5.5 X 35

Facility OP

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904164
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,648.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,911.25
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	$1,737.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,998.12
Rate for Payer: Fidelis Medicare Advantage	$3,648.75
Rate for Payer: Group Health Inc Commercial	$1,737.50
Rate for Payer: Group Health Inc Medicare	$1,216.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,258.75

SCREW POLYAXIAL 6.5 45

Facility IP

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904157
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.50
Max. Negotiated Rate	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50

SCREW POLYAXIAL 6.5 45

Facility OP

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904157
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,648.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,911.25
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	$1,737.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,998.12
Rate for Payer: Fidelis Medicare Advantage	$3,648.75
Rate for Payer: Group Health Inc Commercial	$1,737.50
Rate for Payer: Group Health Inc Medicare	$1,216.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,258.75

SCREW POLYAXIAL 6.5 X 35

Facility OP

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904162
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,648.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,911.25
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	$1,737.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,998.12
Rate for Payer: Fidelis Medicare Advantage	$3,648.75
Rate for Payer: Group Health Inc Commercial	$1,737.50
Rate for Payer: Group Health Inc Medicare	$1,216.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,258.75

SCREW POLYAXIAL 6.5 X 35

Facility IP

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904162
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.50
Max. Negotiated Rate	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50

SCREW POLYAXIAL 6.5 X 40

Facility OP

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904161
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,648.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,911.25
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	$1,737.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,998.12
Rate for Payer: Fidelis Medicare Advantage	$3,648.75
Rate for Payer: Group Health Inc Commercial	$1,737.50
Rate for Payer: Group Health Inc Medicare	$1,216.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,258.75

SCREW POLYAXIAL 6.5 X 40

Facility IP

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904161
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.50
Max. Negotiated Rate	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50

SCREW POLYAXIAL SRTO 5.0X35MM

Facility OP

$2,332.79

Service Code	HCPCS C1713
Hospital Charge Code	64906398
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,449.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,283.03
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	$1,166.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,341.35
Rate for Payer: Fidelis Medicare Advantage	$2,449.43
Rate for Payer: Group Health Inc Commercial	$1,166.40
Rate for Payer: Group Health Inc Medicare	$816.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.40
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,516.31

SCREW POLYAXIAL SRTO 5.0X35MM

Facility IP

$2,332.79

Service Code	HCPCS C1713
Hospital Charge Code	64906398
Hospital Revenue Code	278
Min. Negotiated Rate	$1,166.40
Max. Negotiated Rate	$1,166.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.40
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.40

SCREW POLYAX SERRATO 6.5X40MM

Facility IP

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	64906684
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.79
Max. Negotiated Rate	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicare	$2,332.79

SCREW POLYAX SERRATO 6.5X40MM

Facility OP

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	64906684
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,898.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,566.07
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	$2,332.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,682.71
Rate for Payer: Fidelis Medicare Advantage	$4,898.86
Rate for Payer: Group Health Inc Commercial	$2,332.79
Rate for Payer: Group Health Inc Medicare	$1,632.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicare	$2,332.79
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,032.63

Price Transparency.

All Charges