St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW 3.5MM LP CORTICAL 40MM

Facility

$162.50

Service Code	HCPCS C1713
Hospital Charge Code	64905625
Hospital Revenue Code	278
Min. Negotiated Rate	$81.25
Max. Negotiated Rate	$81.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.25
Rate for Payer: Hamaspik Choice Inc Medicare	$81.25

SCREW 3.5MM LP CORTICAL 50MM

Facility

$162.50

Service Code	HCPCS C1713
Hospital Charge Code	64905627
Hospital Revenue Code	278
Min. Negotiated Rate	$56.88
Max. Negotiated Rate	$170.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$97.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.44
Rate for Payer: EmblemHealth Commercial	$81.25
Rate for Payer: Fidelis Medicare Advantage	$170.62
Rate for Payer: Group Health Inc Commercial	$81.25
Rate for Payer: Group Health Inc Medicare	$56.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.25
Rate for Payer: Hamaspik Choice Inc Medicare	$81.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.62

SCREW 3.5MM LP CORTICAL 50MM

Facility

$162.50

Service Code	HCPCS C1713
Hospital Charge Code	64905627
Hospital Revenue Code	278
Min. Negotiated Rate	$81.25
Max. Negotiated Rate	$81.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.25
Rate for Payer: Hamaspik Choice Inc Medicare	$81.25

SCREW 35 NL X 10

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64903520
Hospital Revenue Code	278
Min. Negotiated Rate	$73.94
Max. Negotiated Rate	$73.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.94
Rate for Payer: Hamaspik Choice Inc Medicare	$73.94

SCREW 35 NL X 10

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64903520
Hospital Revenue Code	278
Min. Negotiated Rate	$51.76
Max. Negotiated Rate	$155.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$88.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$73.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.03
Rate for Payer: EmblemHealth Commercial	$73.94
Rate for Payer: Fidelis Medicare Advantage	$155.27
Rate for Payer: Group Health Inc Commercial	$73.94
Rate for Payer: Group Health Inc Medicare	$51.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.94
Rate for Payer: Hamaspik Choice Inc Medicare	$73.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.12

SCREW 3.5 X 12

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904116
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 3.5 X 12

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904156
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 3.5 X 12

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904156
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: Brighton Health Commercial	$2,098.50
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: EmblemHealth Commercial	$1,748.75
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 3.5 X 12

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904116
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: Brighton Health Commercial	$2,098.50
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: EmblemHealth Commercial	$1,748.75
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 3.5 X 12MM

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905104
Hospital Revenue Code	278
Min. Negotiated Rate	$556.25
Max. Negotiated Rate	$556.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25

SCREW 3.5 X 12MM

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905104
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,168.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$611.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$667.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$556.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$639.69
Rate for Payer: EmblemHealth Commercial	$556.25
Rate for Payer: Fidelis Medicare Advantage	$1,168.12
Rate for Payer: Group Health Inc Commercial	$556.25
Rate for Payer: Group Health Inc Medicare	$389.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$723.12

SCREW 3.5 X 14MM SELF

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64904839
Hospital Revenue Code	278
Min. Negotiated Rate	$556.25
Max. Negotiated Rate	$556.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25

SCREW 3.5 X 14MM SELF

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64904839
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,168.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$611.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$667.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$556.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$639.69
Rate for Payer: EmblemHealth Commercial	$556.25
Rate for Payer: Fidelis Medicare Advantage	$1,168.12
Rate for Payer: Group Health Inc Commercial	$556.25
Rate for Payer: Group Health Inc Medicare	$389.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$723.12

SCREW 3.5 X 16 MM SELF

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64904841
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,168.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$611.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$667.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$556.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$639.69
Rate for Payer: EmblemHealth Commercial	$556.25
Rate for Payer: Fidelis Medicare Advantage	$1,168.12
Rate for Payer: Group Health Inc Commercial	$556.25
Rate for Payer: Group Health Inc Medicare	$389.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$723.12

SCREW 3.5 X 16 MM SELF

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64904841
Hospital Revenue Code	278
Min. Negotiated Rate	$556.25
Max. Negotiated Rate	$556.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25

SCREW 3.5 X 18 MM

Facility

$762.50

Service Code	HCPCS C1713
Hospital Charge Code	64904049
Hospital Revenue Code	278
Min. Negotiated Rate	$381.25
Max. Negotiated Rate	$381.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$381.25
Rate for Payer: Hamaspik Choice Inc Medicare	$381.25

SCREW 3.5 X 18 MM

Facility

$762.50

Service Code	HCPCS C1713
Hospital Charge Code	64904049
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$800.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$419.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$457.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$381.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$438.44
Rate for Payer: EmblemHealth Commercial	$381.25
Rate for Payer: Fidelis Medicare Advantage	$800.62
Rate for Payer: Group Health Inc Commercial	$381.25
Rate for Payer: Group Health Inc Medicare	$266.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$381.25
Rate for Payer: Hamaspik Choice Inc Medicare	$381.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$495.62

SCREW 3.5 X 18MM

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905057
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,168.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$611.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$667.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$556.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$639.69
Rate for Payer: EmblemHealth Commercial	$556.25
Rate for Payer: Fidelis Medicare Advantage	$1,168.12
Rate for Payer: Group Health Inc Commercial	$556.25
Rate for Payer: Group Health Inc Medicare	$389.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$723.12

SCREW 3.5 X 18MM

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905057
Hospital Revenue Code	278
Min. Negotiated Rate	$556.25
Max. Negotiated Rate	$556.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25

SCREW - 371318

Facility

$186.00

Service Code	HCPCS C1713
Hospital Charge Code	40203579
Hospital Revenue Code	278
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$195.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$102.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$111.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$93.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$106.95
Rate for Payer: EmblemHealth Commercial	$93.00
Rate for Payer: Fidelis Medicare Advantage	$195.30
Rate for Payer: Group Health Inc Commercial	$93.00
Rate for Payer: Group Health Inc Medicare	$65.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.00
Rate for Payer: Hamaspik Choice Inc Medicare	$93.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$120.90

SCREW - 371318

Facility

$186.00

Service Code	HCPCS C1713
Hospital Charge Code	40203579
Hospital Revenue Code	278
Min. Negotiated Rate	$93.00
Max. Negotiated Rate	$93.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.00
Rate for Payer: Hamaspik Choice Inc Medicare	$93.00

SCREW 40MM

Facility

$300.00

Service Code	HCPCS C1776
Hospital Charge Code	40202424
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$180.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.50
Rate for Payer: EmblemHealth Commercial	$150.00
Rate for Payer: Fidelis Medicare Advantage	$315.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$195.00

SCREW 40MM

Facility

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202490
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 40MM

Facility

$300.00

Service Code	HCPCS C1776
Hospital Charge Code	40202424
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

SCREW 40MM

Facility

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202490
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

Know your out-of-pocket cost for care.

All Charges