St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW AFIX COMP T7 2.0 X 18MM

Facility

$390.39

Service Code	HCPCS C1713
Hospital Charge Code	64906424
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$409.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$234.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$195.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.47
Rate for Payer: EmblemHealth Commercial	$195.20
Rate for Payer: Fidelis Medicare Advantage	$409.91
Rate for Payer: Group Health Inc Commercial	$195.20
Rate for Payer: Group Health Inc Medicare	$136.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.20
Rate for Payer: Hamaspik Choice Inc Medicare	$195.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$253.75

SCREW AFIX COMP T7 2.0 X 18MM

Facility

$390.39

Service Code	HCPCS C1713
Hospital Charge Code	64906424
Hospital Revenue Code	278
Min. Negotiated Rate	$195.20
Max. Negotiated Rate	$195.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.20
Rate for Payer: Hamaspik Choice Inc Medicare	$195.20

SCREW AFIX COMP T7 2.0 X 19MM

Facility

$390.39

Service Code	HCPCS C1713
Hospital Charge Code	64906428
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$409.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$234.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$195.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.47
Rate for Payer: EmblemHealth Commercial	$195.20
Rate for Payer: Fidelis Medicare Advantage	$409.91
Rate for Payer: Group Health Inc Commercial	$195.20
Rate for Payer: Group Health Inc Medicare	$136.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.20
Rate for Payer: Hamaspik Choice Inc Medicare	$195.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$253.75

SCREW AFIX COMP T7 2.0 X 19MM

Facility

$390.39

Service Code	HCPCS C1713
Hospital Charge Code	64906428
Hospital Revenue Code	278
Min. Negotiated Rate	$195.20
Max. Negotiated Rate	$195.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.20
Rate for Payer: Hamaspik Choice Inc Medicare	$195.20

SCREW AFIX COMP T7 2.0 X 22MM

Facility

$390.39

Service Code	HCPCS C1713
Hospital Charge Code	64906425
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$409.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$234.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$195.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.47
Rate for Payer: EmblemHealth Commercial	$195.20
Rate for Payer: Fidelis Medicare Advantage	$409.91
Rate for Payer: Group Health Inc Commercial	$195.20
Rate for Payer: Group Health Inc Medicare	$136.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.20
Rate for Payer: Hamaspik Choice Inc Medicare	$195.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$253.75

SCREW AFIX COMP T7 2.0 X 22MM

Facility

$390.39

Service Code	HCPCS C1713
Hospital Charge Code	64906425
Hospital Revenue Code	278
Min. Negotiated Rate	$195.20
Max. Negotiated Rate	$195.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.20
Rate for Payer: Hamaspik Choice Inc Medicare	$195.20

SCREW AFIX COMP T7 2.0 X 23MM

Facility

$390.39

Service Code	HCPCS C1713
Hospital Charge Code	64906426
Hospital Revenue Code	278
Min. Negotiated Rate	$195.20
Max. Negotiated Rate	$195.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.20
Rate for Payer: Hamaspik Choice Inc Medicare	$195.20

SCREW AFIX COMP T7 2.0 X 23MM

Facility

$390.39

Service Code	HCPCS C1713
Hospital Charge Code	64906426
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$409.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$234.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$195.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.47
Rate for Payer: EmblemHealth Commercial	$195.20
Rate for Payer: Fidelis Medicare Advantage	$409.91
Rate for Payer: Group Health Inc Commercial	$195.20
Rate for Payer: Group Health Inc Medicare	$136.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.20
Rate for Payer: Hamaspik Choice Inc Medicare	$195.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$253.75

SCREW ANCHOR L 20MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	64905082
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,083.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$567.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$619.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$516.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$593.40
Rate for Payer: EmblemHealth Commercial	$516.00
Rate for Payer: Fidelis Medicare Advantage	$1,083.60
Rate for Payer: Group Health Inc Commercial	$516.00
Rate for Payer: Group Health Inc Medicare	$361.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$516.00
Rate for Payer: Hamaspik Choice Inc Medicare	$516.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$670.80

SCREW ANCHOR L 20MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	64905082
Hospital Revenue Code	278
Min. Negotiated Rate	$516.00
Max. Negotiated Rate	$516.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$516.00
Rate for Payer: Hamaspik Choice Inc Medicare	$516.00

SCREW ANCHOR L 25MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	64905081
Hospital Revenue Code	278
Min. Negotiated Rate	$516.00
Max. Negotiated Rate	$516.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$516.00
Rate for Payer: Hamaspik Choice Inc Medicare	$516.00

SCREW ANCHOR L 25MM

Facility

$1,032.00

Service Code	HCPCS C1713
Hospital Charge Code	64905081
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,083.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$567.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$619.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$516.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$593.40
Rate for Payer: EmblemHealth Commercial	$516.00
Rate for Payer: Fidelis Medicare Advantage	$1,083.60
Rate for Payer: Group Health Inc Commercial	$516.00
Rate for Payer: Group Health Inc Medicare	$361.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$516.00
Rate for Payer: Hamaspik Choice Inc Medicare	$516.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$670.80

SCREW ANKLE DIST

Facility

$2,972.50

Service Code	HCPCS C1713
Hospital Charge Code	64907510
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,121.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,634.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,783.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,486.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,709.19
Rate for Payer: EmblemHealth Commercial	$1,486.25
Rate for Payer: Fidelis Medicare Advantage	$3,121.12
Rate for Payer: Group Health Inc Commercial	$1,486.25
Rate for Payer: Group Health Inc Medicare	$1,040.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,486.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,486.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,932.12

SCREW ANKLE DIST

Facility

$2,972.50

Service Code	HCPCS C1713
Hospital Charge Code	64907510
Hospital Revenue Code	278
Min. Negotiated Rate	$1,486.25
Max. Negotiated Rate	$1,486.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,486.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,486.25

SCREW AP 6.25 X 30

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904586
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 AP 6.25 X 30

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904586
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 AP 6.25 X 40

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904585
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 AP 6.25 X 40

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904585
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 ARM15T 6.5X45MM POLY

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903715
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

SCREW ARM15T 6.5X45MM POLY

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903715
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,725.00
Rate for Payer: EmblemHealth Commercial	$1,500.00
Rate for Payer: Fidelis Medicare Advantage	$3,150.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,950.00

SCREW ARM15T 6.5X50 MM POLY

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903527
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

SCREW ARM15T 6.5X50 MM POLY

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903527
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,725.00
Rate for Payer: EmblemHealth Commercial	$1,500.00
Rate for Payer: Fidelis Medicare Advantage	$3,150.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,950.00

SCREW ARM15T 7.5X50MM PA

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64904461
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,725.00
Rate for Payer: EmblemHealth Commercial	$1,500.00
Rate for Payer: Fidelis Medicare Advantage	$3,150.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,950.00

SCREW ARM15T 7.5X50MM PA

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64904461
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

SCREW ARM15T 8.5X50MM POLY

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64904077
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,725.00
Rate for Payer: EmblemHealth Commercial	$1,500.00
Rate for Payer: Fidelis Medicare Advantage	$3,150.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,950.00

Know your out-of-pocket cost for care.

All Charges