St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW 300-999

Facility

$867.40

Service Code	HCPCS C1713
Hospital Charge Code	40203070
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$910.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$477.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$520.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$433.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$498.76
Rate for Payer: EmblemHealth Commercial	$433.70
Rate for Payer: Fidelis Medicare Advantage	$910.77
Rate for Payer: Group Health Inc Commercial	$433.70
Rate for Payer: Group Health Inc Medicare	$303.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$433.70
Rate for Payer: Hamaspik Choice Inc Medicare	$433.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$563.81

SCREW 300-999

Facility

$867.40

Service Code	HCPCS C1713
Hospital Charge Code	40203070
Hospital Revenue Code	278
Min. Negotiated Rate	$433.70
Max. Negotiated Rate	$433.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$433.70
Rate for Payer: Hamaspik Choice Inc Medicare	$433.70

SCREW 3.0MM ASNIS MCR CANN 5/6 ST

Facility

$360.10

Service Code	HCPCS C1713
Hospital Charge Code	40005921
Hospital Revenue Code	278
Min. Negotiated Rate	$180.05
Max. Negotiated Rate	$180.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$180.05
Rate for Payer: Hamaspik Choice Inc Medicare	$180.05

SCREW 3.0MM ASNIS MCR CANN 5/6 ST

Facility

$360.10

Service Code	HCPCS C1713
Hospital Charge Code	40005921
Hospital Revenue Code	278
Min. Negotiated Rate	$126.04
Max. Negotiated Rate	$378.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$198.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$216.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$180.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$207.06
Rate for Payer: EmblemHealth Commercial	$180.05
Rate for Payer: Fidelis Medicare Advantage	$378.10
Rate for Payer: Group Health Inc Commercial	$180.05
Rate for Payer: Group Health Inc Medicare	$126.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$180.05
Rate for Payer: Hamaspik Choice Inc Medicare	$180.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$234.06

SCREW 3.0 X 16 MM

Facility

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64904043
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$774.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$405.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$442.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$368.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$424.06
Rate for Payer: EmblemHealth Commercial	$368.75
Rate for Payer: Fidelis Medicare Advantage	$774.38
Rate for Payer: Group Health Inc Commercial	$368.75
Rate for Payer: Group Health Inc Medicare	$258.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$479.38

SCREW 3.0 X 16 MM

Facility

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64904043
Hospital Revenue Code	278
Min. Negotiated Rate	$368.75
Max. Negotiated Rate	$368.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75

SCREW 3.0 X 18 MM

Facility

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64904045
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$774.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$405.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$442.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$368.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$424.06
Rate for Payer: EmblemHealth Commercial	$368.75
Rate for Payer: Fidelis Medicare Advantage	$774.38
Rate for Payer: Group Health Inc Commercial	$368.75
Rate for Payer: Group Health Inc Medicare	$258.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$479.38

SCREW 3.0 X 18 MM

Facility

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64904045
Hospital Revenue Code	278
Min. Negotiated Rate	$368.75
Max. Negotiated Rate	$368.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75

SCREW 3.0 X 22MM

Facility

$1,012.50

Service Code	HCPCS C1713
Hospital Charge Code	64906984
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: Brighton Health Commercial	$607.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$506.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$582.19
Rate for Payer: EmblemHealth Commercial	$506.25
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 3.0 X 22MM

Facility

$1,012.50

Service Code	HCPCS C1713
Hospital Charge Code	64906984
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 3.5 38MML

Facility

$80.00

Service Code	HCPCS C1713
Hospital Charge Code	64904059
Hospital Revenue Code	278
Min. Negotiated Rate	$40.00
Max. Negotiated Rate	$40.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00

SCREW 3.5 38MML

Facility

$80.00

Service Code	HCPCS C1713
Hospital Charge Code	64904059
Hospital Revenue Code	278
Min. Negotiated Rate	$28.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$48.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.00
Rate for Payer: EmblemHealth Commercial	$40.00
Rate for Payer: Fidelis Medicare Advantage	$84.00
Rate for Payer: Group Health Inc Commercial	$40.00
Rate for Payer: Group Health Inc Medicare	$28.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.00

SCREW 35MM

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901233
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 35MM

Facility

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202428
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 35MM

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901233
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: Brighton Health Commercial	$257.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$214.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.68
Rate for Payer: EmblemHealth Commercial	$214.50
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 35MM

Facility

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202428
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: Brighton Health Commercial	$190.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.85
Rate for Payer: EmblemHealth Commercial	$159.00
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 3.5MM.CORTEX S-TAP 26MM

Facility

$68.13

Service Code	HCPCS C1713
Hospital Charge Code	64901162
Hospital Revenue Code	278
Min. Negotiated Rate	$34.06
Max. Negotiated Rate	$34.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.06
Rate for Payer: Hamaspik Choice Inc Medicare	$34.06

SCREW 3.5MM.CORTEX S-TAP 26MM

Facility

$68.13

Service Code	HCPCS C1713
Hospital Charge Code	64901162
Hospital Revenue Code	278
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$40.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.17
Rate for Payer: EmblemHealth Commercial	$34.06
Rate for Payer: Fidelis Medicare Advantage	$71.54
Rate for Payer: Group Health Inc Commercial	$34.06
Rate for Payer: Group Health Inc Medicare	$23.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.06
Rate for Payer: Hamaspik Choice Inc Medicare	$34.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$44.28

SCREW 3.5MM CORTEX S-TAP 55MM

Facility

$68.13

Service Code	HCPCS C1713
Hospital Charge Code	64901309
Hospital Revenue Code	278
Min. Negotiated Rate	$34.06
Max. Negotiated Rate	$34.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.06
Rate for Payer: Hamaspik Choice Inc Medicare	$34.06

SCREW 3.5MM CORTEX S-TAP 55MM

Facility

$68.13

Service Code	HCPCS C1713
Hospital Charge Code	64901309
Hospital Revenue Code	278
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$40.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.17
Rate for Payer: EmblemHealth Commercial	$34.06
Rate for Payer: Fidelis Medicare Advantage	$71.54
Rate for Payer: Group Health Inc Commercial	$34.06
Rate for Payer: Group Health Inc Medicare	$23.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.06
Rate for Payer: Hamaspik Choice Inc Medicare	$34.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$44.28

SCREW 3.5MM CORTICAL LKG 18MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905628
Hospital Revenue Code	278
Min. Negotiated Rate	$178.75
Max. Negotiated Rate	$178.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$178.75
Rate for Payer: Hamaspik Choice Inc Medicare	$178.75

SCREW 3.5MM CORTICAL LKG 18MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905628
Hospital Revenue Code	278
Min. Negotiated Rate	$125.12
Max. Negotiated Rate	$375.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$196.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$214.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$178.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$205.56
Rate for Payer: EmblemHealth Commercial	$178.75
Rate for Payer: Fidelis Medicare Advantage	$375.38
Rate for Payer: Group Health Inc Commercial	$178.75
Rate for Payer: Group Health Inc Medicare	$125.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$178.75
Rate for Payer: Hamaspik Choice Inc Medicare	$178.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$232.38

SCREW 3.5MM CORTICAL LKG 20MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905630
Hospital Revenue Code	278
Min. Negotiated Rate	$125.12
Max. Negotiated Rate	$375.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$196.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$214.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$178.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$205.56
Rate for Payer: EmblemHealth Commercial	$178.75
Rate for Payer: Fidelis Medicare Advantage	$375.38
Rate for Payer: Group Health Inc Commercial	$178.75
Rate for Payer: Group Health Inc Medicare	$125.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$178.75
Rate for Payer: Hamaspik Choice Inc Medicare	$178.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$232.38

SCREW 3.5MM CORTICAL LKG 20MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905630
Hospital Revenue Code	278
Min. Negotiated Rate	$178.75
Max. Negotiated Rate	$178.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$178.75
Rate for Payer: Hamaspik Choice Inc Medicare	$178.75

SCREW 3.5MM CORTICAL LKG 22MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905631
Hospital Revenue Code	278
Min. Negotiated Rate	$125.12
Max. Negotiated Rate	$375.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$196.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$214.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$178.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$205.56
Rate for Payer: EmblemHealth Commercial	$178.75
Rate for Payer: Fidelis Medicare Advantage	$375.38
Rate for Payer: Group Health Inc Commercial	$178.75
Rate for Payer: Group Health Inc Medicare	$125.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$178.75
Rate for Payer: Hamaspik Choice Inc Medicare	$178.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$232.38

Know your out-of-pocket cost for care.

All Charges