St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW 3.5MM CORTICAL LKG 22MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905631
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 32MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905632
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 32MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905632
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 38MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905633
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 38MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905633
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 40MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905634
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 40MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905634
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 44MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905635
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 44MM

Facility

$357.50

Service Code	HCPCS C1713
Hospital Charge Code	64905635
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 LOCKING 18MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40204632
Hospital Revenue Code	278
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$300.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$171.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$143.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$164.45
Rate for Payer: EmblemHealth Commercial	$143.00
Rate for Payer: Fidelis Medicare Advantage	$300.30
Rate for Payer: Group Health Inc Commercial	$143.00
Rate for Payer: Group Health Inc Medicare	$100.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.90

SCREW 3.5MM CORTICAL LOCKING 18MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40007551
Hospital Revenue Code	278
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$300.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$171.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$143.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$164.45
Rate for Payer: EmblemHealth Commercial	$143.00
Rate for Payer: Fidelis Medicare Advantage	$300.30
Rate for Payer: Group Health Inc Commercial	$143.00
Rate for Payer: Group Health Inc Medicare	$100.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.90

SCREW 3.5MM CORTICAL LOCKING 18MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40204632
Hospital Revenue Code	278
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00

SCREW 3.5MM CORTICAL LOCKING 18MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40007551
Hospital Revenue Code	278
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00

SCREW 3.5MM CORTICAL LOCKING 20MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40204633
Hospital Revenue Code	278
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00

SCREW 3.5MM CORTICAL LOCKING 20MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40007552
Hospital Revenue Code	278
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$300.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$171.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$143.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$164.45
Rate for Payer: EmblemHealth Commercial	$143.00
Rate for Payer: Fidelis Medicare Advantage	$300.30
Rate for Payer: Group Health Inc Commercial	$143.00
Rate for Payer: Group Health Inc Medicare	$100.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.90

SCREW 3.5MM CORTICAL LOCKING 20MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40007552
Hospital Revenue Code	278
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00

SCREW 3.5MM CORTICAL LOCKING 20MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40204633
Hospital Revenue Code	278
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$300.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$171.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$143.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$164.45
Rate for Payer: EmblemHealth Commercial	$143.00
Rate for Payer: Fidelis Medicare Advantage	$300.30
Rate for Payer: Group Health Inc Commercial	$143.00
Rate for Payer: Group Health Inc Medicare	$100.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.90

SCREW 3.5MM CORTICAL LOCKING 22MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40204634
Hospital Revenue Code	278
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00

SCREW 3.5MM CORTICAL LOCKING 22MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40204634
Hospital Revenue Code	278
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$300.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$171.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$143.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$164.45
Rate for Payer: EmblemHealth Commercial	$143.00
Rate for Payer: Fidelis Medicare Advantage	$300.30
Rate for Payer: Group Health Inc Commercial	$143.00
Rate for Payer: Group Health Inc Medicare	$100.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.90

SCREW 3.5MM CORTICAL LOCKING 32MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40007554
Hospital Revenue Code	278
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00

SCREW 3.5MM CORTICAL LOCKING 32MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40007554
Hospital Revenue Code	278
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$300.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$171.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$143.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$164.45
Rate for Payer: EmblemHealth Commercial	$143.00
Rate for Payer: Fidelis Medicare Advantage	$300.30
Rate for Payer: Group Health Inc Commercial	$143.00
Rate for Payer: Group Health Inc Medicare	$100.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.90

SCREW 3.5MM CORTICAL LOCKING 32MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40204635
Hospital Revenue Code	278
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$300.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$171.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$143.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$164.45
Rate for Payer: EmblemHealth Commercial	$143.00
Rate for Payer: Fidelis Medicare Advantage	$300.30
Rate for Payer: Group Health Inc Commercial	$143.00
Rate for Payer: Group Health Inc Medicare	$100.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.90

SCREW 3.5MM CORTICAL LOCKING 32MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40204635
Hospital Revenue Code	278
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00

SCREW 3.5MM CORTICAL LOCKING 38MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40007555
Hospital Revenue Code	278
Min. Negotiated Rate	$100.10
Max. Negotiated Rate	$300.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$171.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$143.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$164.45
Rate for Payer: EmblemHealth Commercial	$143.00
Rate for Payer: Fidelis Medicare Advantage	$300.30
Rate for Payer: Group Health Inc Commercial	$143.00
Rate for Payer: Group Health Inc Medicare	$100.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.90

SCREW 3.5MM CORTICAL LOCKING 38MM

Facility

$286.00

Service Code	HCPCS C1713
Hospital Charge Code	40204636
Hospital Revenue Code	278
Min. Negotiated Rate	$143.00
Max. Negotiated Rate	$143.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.00
Rate for Payer: Hamaspik Choice Inc Medicare	$143.00

Know your out-of-pocket cost for care.

All Charges