St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW 4.0 X 12MM

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905105
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 4.0 X 12MM

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64905105
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 4.0 X 35

Facility

$4,912.80

Service Code	HCPCS C1713
Hospital Charge Code	64904435
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: Brighton Health Commercial	$2,947.68
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: EmblemHealth Commercial	$2,456.40
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 4.0 X 35

Facility

$4,912.80

Service Code	HCPCS C1713
Hospital Charge Code	64904435
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 45MM

Facility

$317.80

Service Code	HCPCS C1776
Hospital Charge Code	40202418
Hospital Revenue Code	278
Min. Negotiated Rate	$111.23
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$190.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$158.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.74
Rate for Payer: EmblemHealth Commercial	$158.90
Rate for Payer: Fidelis Medicare Advantage	$333.69
Rate for Payer: Group Health Inc Commercial	$158.90
Rate for Payer: Group Health Inc Medicare	$111.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.90
Rate for Payer: Hamaspik Choice Inc Medicare	$158.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.57

SCREW 45MM

Facility

$317.80

Service Code	HCPCS C1776
Hospital Charge Code	40202418
Hospital Revenue Code	278
Min. Negotiated Rate	$158.90
Max. Negotiated Rate	$158.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.90
Rate for Payer: Hamaspik Choice Inc Medicare	$158.90

SCREW 4MM CAN BONE PT-THRD 40MM

Facility

$33.00

Service Code	HCPCS C1713
Hospital Charge Code	40205029
Hospital Revenue Code	278
Min. Negotiated Rate	$16.50
Max. Negotiated Rate	$16.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50
Rate for Payer: Hamaspik Choice Inc Medicare	$16.50

SCREW 4MM CAN BONE PT-THRD 40MM

Facility

$43.75

Service Code	HCPCS C1713
Hospital Charge Code	64901213
Hospital Revenue Code	278
Min. Negotiated Rate	$21.88
Max. Negotiated Rate	$21.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.88
Rate for Payer: Hamaspik Choice Inc Medicare	$21.88

SCREW 4MM CAN BONE PT-THRD 40MM

Facility

$33.00

Service Code	HCPCS C1713
Hospital Charge Code	40205029
Hospital Revenue Code	278
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$19.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.98
Rate for Payer: EmblemHealth Commercial	$16.50
Rate for Payer: Fidelis Medicare Advantage	$34.65
Rate for Payer: Group Health Inc Commercial	$16.50
Rate for Payer: Group Health Inc Medicare	$11.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.50
Rate for Payer: Hamaspik Choice Inc Medicare	$16.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.45

SCREW 4MM CAN BONE PT-THRD 40MM

Facility

$43.75

Service Code	HCPCS C1713
Hospital Charge Code	64901213
Hospital Revenue Code	278
Min. Negotiated Rate	$15.31
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$26.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.16
Rate for Payer: EmblemHealth Commercial	$21.88
Rate for Payer: Fidelis Medicare Advantage	$45.94
Rate for Payer: Group Health Inc Commercial	$21.88
Rate for Payer: Group Health Inc Medicare	$15.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.88
Rate for Payer: Hamaspik Choice Inc Medicare	$21.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.44

SCREW 4MM X 1.2 SQ FIT

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	64901217
Hospital Revenue Code	278
Min. Negotiated Rate	$77.50
Max. Negotiated Rate	$77.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50

SCREW 4MM X 1.2 SQ FIT

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	64901217
Hospital Revenue Code	278
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$162.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$93.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$77.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$89.12
Rate for Payer: EmblemHealth Commercial	$77.50
Rate for Payer: Fidelis Medicare Advantage	$162.75
Rate for Payer: Group Health Inc Commercial	$77.50
Rate for Payer: Group Health Inc Medicare	$54.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.75

SCREW 4X14X3

Facility

$26.83

Service Code	HCPCS C1713
Hospital Charge Code	64905922
Hospital Revenue Code	278
Min. Negotiated Rate	$9.39
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$16.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.43
Rate for Payer: EmblemHealth Commercial	$13.42
Rate for Payer: Fidelis Medicare Advantage	$28.17
Rate for Payer: Group Health Inc Commercial	$13.42
Rate for Payer: Group Health Inc Medicare	$9.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.42
Rate for Payer: Hamaspik Choice Inc Medicare	$13.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$17.44

SCREW 4X14X3

Facility

$26.83

Service Code	HCPCS C1713
Hospital Charge Code	64905922
Hospital Revenue Code	278
Min. Negotiated Rate	$13.42
Max. Negotiated Rate	$13.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.42
Rate for Payer: Hamaspik Choice Inc Medicare	$13.42

SCREW 5.0 X 48

Facility

$947.50

Service Code	HCPCS C1713
Hospital Charge Code	64904808
Hospital Revenue Code	278
Min. Negotiated Rate	$473.75
Max. Negotiated Rate	$473.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$473.75
Rate for Payer: Hamaspik Choice Inc Medicare	$473.75

SCREW 5.0 X 48

Facility

$947.50

Service Code	HCPCS C1713
Hospital Charge Code	64904808
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$994.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$521.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$568.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$473.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$544.81
Rate for Payer: EmblemHealth Commercial	$473.75
Rate for Payer: Fidelis Medicare Advantage	$994.88
Rate for Payer: Group Health Inc Commercial	$473.75
Rate for Payer: Group Health Inc Medicare	$331.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$473.75
Rate for Payer: Hamaspik Choice Inc Medicare	$473.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$615.88

SCREW 55MM

Facility

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40201512
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 55MM

Facility

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40201512
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 5.5 X .30 XIA

Facility

$3,032.50

Service Code	HCPCS C1713
Hospital Charge Code	64907534
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,184.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,667.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,819.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,516.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,743.69
Rate for Payer: EmblemHealth Commercial	$1,516.25
Rate for Payer: Fidelis Medicare Advantage	$3,184.12
Rate for Payer: Group Health Inc Commercial	$1,516.25
Rate for Payer: Group Health Inc Medicare	$1,061.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,516.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,516.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,971.12

SCREW 5.5 X .30 XIA

Facility

$3,032.50

Service Code	HCPCS C1713
Hospital Charge Code	64907534
Hospital Revenue Code	278
Min. Negotiated Rate	$1,516.25
Max. Negotiated Rate	$1,516.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,516.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,516.25

SCREW 5.5X50SH ES2

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64905226
Hospital Revenue Code	278
Min. Negotiated Rate	$4,276.35
Max. Negotiated Rate	$4,276.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,276.35
Rate for Payer: Hamaspik Choice Inc Medicare	$4,276.35

SCREW 5.5X50SH ES2

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64905226
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,980.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,703.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$5,131.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,276.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,917.80
Rate for Payer: EmblemHealth Commercial	$4,276.35
Rate for Payer: Fidelis Medicare Advantage	$8,980.34
Rate for Payer: Group Health Inc Commercial	$4,276.35
Rate for Payer: Group Health Inc Medicare	$2,993.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,276.35
Rate for Payer: Hamaspik Choice Inc Medicare	$4,276.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,559.26

SCREW 5MM X2.0MM

Facility

$116.00

Service Code	HCPCS C1776
Hospital Charge Code	40206058
Hospital Revenue Code	278
Min. Negotiated Rate	$58.00
Max. Negotiated Rate	$58.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.00
Rate for Payer: Hamaspik Choice Inc Medicare	$58.00

SCREW 5MM X2.0MM

Facility

$116.00

Service Code	HCPCS C1776
Hospital Charge Code	40206058
Hospital Revenue Code	278
Min. Negotiated Rate	$40.60
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$69.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$58.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.70
Rate for Payer: EmblemHealth Commercial	$58.00
Rate for Payer: Fidelis Medicare Advantage	$121.80
Rate for Payer: Group Health Inc Commercial	$58.00
Rate for Payer: Group Health Inc Medicare	$40.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.00
Rate for Payer: Hamaspik Choice Inc Medicare	$58.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$75.40

SCREW 5 X 52MM 5052S

Facility

$693.00

Service Code	HCPCS C1713
Hospital Charge Code	64906720
Hospital Revenue Code	278
Min. Negotiated Rate	$346.50
Max. Negotiated Rate	$346.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$346.50
Rate for Payer: Hamaspik Choice Inc Medicare	$346.50

Know your out-of-pocket cost for care.

All Charges