St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW 120MM L

Facility

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64904878
Hospital Revenue Code	278
Min. Negotiated Rate	$641.06
Max. Negotiated Rate	$641.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$641.06
Rate for Payer: Hamaspik Choice Inc Medicare	$641.06

SCREW 120MM L

Facility

$1,282.13

Service Code	HCPCS C1713
Hospital Charge Code	64904878
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,346.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$705.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$769.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$641.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$737.22
Rate for Payer: EmblemHealth Commercial	$641.06
Rate for Payer: Fidelis Medicare Advantage	$1,346.24
Rate for Payer: Group Health Inc Commercial	$641.06
Rate for Payer: Group Health Inc Medicare	$448.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$641.06
Rate for Payer: Hamaspik Choice Inc Medicare	$641.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$833.38

SCREW 1.2 X 3MM SELF DRILL

Facility

$149.15

Service Code	HCPCS C1713
Hospital Charge Code	64901550
Hospital Revenue Code	278
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$156.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$89.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$74.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.76
Rate for Payer: EmblemHealth Commercial	$74.58
Rate for Payer: Fidelis Medicare Advantage	$156.61
Rate for Payer: Group Health Inc Commercial	$74.58
Rate for Payer: Group Health Inc Medicare	$52.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.58
Rate for Payer: Hamaspik Choice Inc Medicare	$74.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.95

SCREW 1.2 X 3MM SELF DRILL

Facility

$149.15

Service Code	HCPCS C1713
Hospital Charge Code	64901550
Hospital Revenue Code	278
Min. Negotiated Rate	$74.58
Max. Negotiated Rate	$74.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.58
Rate for Payer: Hamaspik Choice Inc Medicare	$74.58

SCREW 1.2 X 3MM SELF TAP

Facility

$133.10

Service Code	HCPCS C1713
Hospital Charge Code	64901546
Hospital Revenue Code	278
Min. Negotiated Rate	$66.55
Max. Negotiated Rate	$66.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.55
Rate for Payer: Hamaspik Choice Inc Medicare	$66.55

SCREW 1.2 X 3MM SELF TAP

Facility

$133.10

Service Code	HCPCS C1713
Hospital Charge Code	64901546
Hospital Revenue Code	278
Min. Negotiated Rate	$46.58
Max. Negotiated Rate	$139.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$73.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$79.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.53
Rate for Payer: EmblemHealth Commercial	$66.55
Rate for Payer: Fidelis Medicare Advantage	$139.76
Rate for Payer: Group Health Inc Commercial	$66.55
Rate for Payer: Group Health Inc Medicare	$46.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.55
Rate for Payer: Hamaspik Choice Inc Medicare	$66.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$86.52

SCREW1.2X4MM CRS PIN SLF TAPP

Facility

$117.08

Service Code	HCPCS C1713
Hospital Charge Code	40200747
Hospital Revenue Code	278
Min. Negotiated Rate	$58.54
Max. Negotiated Rate	$58.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.54
Rate for Payer: Hamaspik Choice Inc Medicare	$58.54

SCREW1.2X4MM CRS PIN SLF TAPP

Facility

$117.08

Service Code	HCPCS C1713
Hospital Charge Code	40200747
Hospital Revenue Code	278
Min. Negotiated Rate	$40.98
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$64.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$70.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$58.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$67.32
Rate for Payer: EmblemHealth Commercial	$58.54
Rate for Payer: Fidelis Medicare Advantage	$122.93
Rate for Payer: Group Health Inc Commercial	$58.54
Rate for Payer: Group Health Inc Medicare	$40.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.54
Rate for Payer: Hamaspik Choice Inc Medicare	$58.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$76.10

SCREW 1.2 X 4MM SELF TAP

Facility

$133.10

Service Code	HCPCS C1713
Hospital Charge Code	64901547
Hospital Revenue Code	278
Min. Negotiated Rate	$46.58
Max. Negotiated Rate	$139.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$73.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$79.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.53
Rate for Payer: EmblemHealth Commercial	$66.55
Rate for Payer: Fidelis Medicare Advantage	$139.76
Rate for Payer: Group Health Inc Commercial	$66.55
Rate for Payer: Group Health Inc Medicare	$46.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.55
Rate for Payer: Hamaspik Choice Inc Medicare	$66.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$86.52

SCREW 1.2 X 4MM SELF TAP

Facility

$133.10

Service Code	HCPCS C1713
Hospital Charge Code	64901547
Hospital Revenue Code	278
Min. Negotiated Rate	$66.55
Max. Negotiated Rate	$66.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.55
Rate for Payer: Hamaspik Choice Inc Medicare	$66.55

SCREW 1.2 X 4MM SLF DRILL

Facility

$149.15

Service Code	HCPCS C1713
Hospital Charge Code	64901392
Hospital Revenue Code	278
Min. Negotiated Rate	$52.20
Max. Negotiated Rate	$156.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$89.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$74.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.76
Rate for Payer: EmblemHealth Commercial	$74.58
Rate for Payer: Fidelis Medicare Advantage	$156.61
Rate for Payer: Group Health Inc Commercial	$74.58
Rate for Payer: Group Health Inc Medicare	$52.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.58
Rate for Payer: Hamaspik Choice Inc Medicare	$74.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.95

SCREW 1.2 X 4MM SLF DRILL

Facility

$149.15

Service Code	HCPCS C1713
Hospital Charge Code	64901392
Hospital Revenue Code	278
Min. Negotiated Rate	$74.58
Max. Negotiated Rate	$74.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.58
Rate for Payer: Hamaspik Choice Inc Medicare	$74.58

SCREW 1.2X6MM BONE XPNS ELFT

Facility

$154.38

Service Code	HCPCS C1713
Hospital Charge Code	64905648
Hospital Revenue Code	278
Min. Negotiated Rate	$54.03
Max. Negotiated Rate	$162.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$84.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$92.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$77.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$88.77
Rate for Payer: EmblemHealth Commercial	$77.19
Rate for Payer: Fidelis Medicare Advantage	$162.10
Rate for Payer: Group Health Inc Commercial	$77.19
Rate for Payer: Group Health Inc Medicare	$54.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.19
Rate for Payer: Hamaspik Choice Inc Medicare	$77.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.35

SCREW 1.2X6MM BONE XPNS ELFT

Facility

$154.38

Service Code	HCPCS C1713
Hospital Charge Code	64905648
Hospital Revenue Code	278
Min. Negotiated Rate	$77.19
Max. Negotiated Rate	$77.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.19
Rate for Payer: Hamaspik Choice Inc Medicare	$77.19

SCREW 1.2 X 6MM SELF TAP

Facility

$133.10

Service Code	HCPCS C1713
Hospital Charge Code	64901548
Hospital Revenue Code	278
Min. Negotiated Rate	$66.55
Max. Negotiated Rate	$66.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.55
Rate for Payer: Hamaspik Choice Inc Medicare	$66.55

SCREW 1.2 X 6MM SELF TAP

Facility

$133.10

Service Code	HCPCS C1713
Hospital Charge Code	64901548
Hospital Revenue Code	278
Min. Negotiated Rate	$46.58
Max. Negotiated Rate	$139.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$73.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$79.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.53
Rate for Payer: EmblemHealth Commercial	$66.55
Rate for Payer: Fidelis Medicare Advantage	$139.76
Rate for Payer: Group Health Inc Commercial	$66.55
Rate for Payer: Group Health Inc Medicare	$46.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.55
Rate for Payer: Hamaspik Choice Inc Medicare	$66.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$86.52

SCREW 14MM IMF

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	40202376
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00

SCREW 14MM IMF

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	40202376
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$72.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.00
Rate for Payer: EmblemHealth Commercial	$60.00
Rate for Payer: Fidelis Medicare Advantage	$126.00
Rate for Payer: Group Health Inc Commercial	$60.00
Rate for Payer: Group Health Inc Medicare	$42.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$78.00

SCREW 1.4 X 5MM ER C-P S-T

Facility

$165.48

Service Code	HCPCS C1713
Hospital Charge Code	64901553
Hospital Revenue Code	278
Min. Negotiated Rate	$57.92
Max. Negotiated Rate	$173.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$91.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$99.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$82.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.15
Rate for Payer: EmblemHealth Commercial	$82.74
Rate for Payer: Fidelis Medicare Advantage	$173.75
Rate for Payer: Group Health Inc Commercial	$82.74
Rate for Payer: Group Health Inc Medicare	$57.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.74
Rate for Payer: Hamaspik Choice Inc Medicare	$82.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$107.56

SCREW 1.4 X 5MM ER C-P S-T

Facility

$165.48

Service Code	HCPCS C1713
Hospital Charge Code	64901553
Hospital Revenue Code	278
Min. Negotiated Rate	$82.74
Max. Negotiated Rate	$82.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.74
Rate for Payer: Hamaspik Choice Inc Medicare	$82.74

SCREW 1.5MM TIT CORT S/T 11MM

Facility

$67.50

Service Code	HCPCS C1776
Hospital Charge Code	40205214
Hospital Revenue Code	278
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.75
Rate for Payer: Hamaspik Choice Inc Medicare	$33.75

SCREW 1.5MM TIT CORT S/T 11MM

Facility

$67.50

Service Code	HCPCS C1776
Hospital Charge Code	40205214
Hospital Revenue Code	278
Min. Negotiated Rate	$23.62
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$40.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.81
Rate for Payer: EmblemHealth Commercial	$33.75
Rate for Payer: Fidelis Medicare Advantage	$70.88
Rate for Payer: Group Health Inc Commercial	$33.75
Rate for Payer: Group Health Inc Medicare	$23.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.75
Rate for Payer: Hamaspik Choice Inc Medicare	$33.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$43.88

SCREW 1.7 7MM

Facility

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903232
Hospital Revenue Code	278
Min. Negotiated Rate	$80.20
Max. Negotiated Rate	$240.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$137.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.75
Rate for Payer: EmblemHealth Commercial	$114.56
Rate for Payer: Fidelis Medicare Advantage	$240.59
Rate for Payer: Group Health Inc Commercial	$114.56
Rate for Payer: Group Health Inc Medicare	$80.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.93

SCREW 1.7 7MM

Facility

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903232
Hospital Revenue Code	278
Min. Negotiated Rate	$114.56
Max. Negotiated Rate	$114.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56

SCREW 1.7 X 12MM

Facility

$113.30

Service Code	HCPCS C1713
Hospital Charge Code	64901395
Hospital Revenue Code	278
Min. Negotiated Rate	$56.65
Max. Negotiated Rate	$56.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.65
Rate for Payer: Hamaspik Choice Inc Medicare	$56.65

Know your out-of-pocket cost for care.

All Charges