St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW ARM15T 8.5X50MM POLY

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64904077
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 ARTHRO 2.5

Facility

$2,077.50

Service Code	HCPCS C1713
Hospital Charge Code	64907505
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,181.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,142.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,246.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,038.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,194.56
Rate for Payer: EmblemHealth Commercial	$1,038.75
Rate for Payer: Fidelis Medicare Advantage	$2,181.38
Rate for Payer: Group Health Inc Commercial	$1,038.75
Rate for Payer: Group Health Inc Medicare	$727.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,038.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,038.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,350.38

SCREW ARTHRO 2.5

Facility

$2,077.50

Service Code	HCPCS C1713
Hospital Charge Code	64907505
Hospital Revenue Code	278
Min. Negotiated Rate	$1,038.75
Max. Negotiated Rate	$1,038.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,038.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,038.75

SCREW ARTM15T 6.5X40 POL

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903888
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 ARTM15T 6.5X40 POL

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903888
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 ARTM15T 6.5X55 POL

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903890
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 ARTM15T 6.5X55 POL

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903890
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 ASNIS 3.0

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64903119
Hospital Revenue Code	278
Min. Negotiated Rate	$225.06
Max. Negotiated Rate	$225.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.06
Rate for Payer: Hamaspik Choice Inc Medicare	$225.06

SCREW ASNIS 3.0

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64903119
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$472.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$247.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$270.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$225.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$258.82
Rate for Payer: EmblemHealth Commercial	$225.06
Rate for Payer: Fidelis Medicare Advantage	$472.64
Rate for Payer: Group Health Inc Commercial	$225.06
Rate for Payer: Group Health Inc Medicare	$157.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.06
Rate for Payer: Hamaspik Choice Inc Medicare	$225.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$292.58

SCREW ASNIS 3.0 X 30

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64903260
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$472.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$247.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$270.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$225.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$258.82
Rate for Payer: EmblemHealth Commercial	$225.06
Rate for Payer: Fidelis Medicare Advantage	$472.64
Rate for Payer: Group Health Inc Commercial	$225.06
Rate for Payer: Group Health Inc Medicare	$157.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.06
Rate for Payer: Hamaspik Choice Inc Medicare	$225.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$292.58

SCREW ASNIS 3.0 X 30

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64903260
Hospital Revenue Code	278
Min. Negotiated Rate	$225.06
Max. Negotiated Rate	$225.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.06
Rate for Payer: Hamaspik Choice Inc Medicare	$225.06

SCREW ASNIS III 6.5X140MM-606140

Facility

$223.58

Service Code	HCPCS C1713
Hospital Charge Code	64906388
Hospital Revenue Code	278
Min. Negotiated Rate	$111.79
Max. Negotiated Rate	$111.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.79
Rate for Payer: Hamaspik Choice Inc Medicare	$111.79

SCREW ASNIS III 6.5X140MM-606140

Facility

$223.58

Service Code	HCPCS C1713
Hospital Charge Code	64906388
Hospital Revenue Code	278
Min. Negotiated Rate	$78.25
Max. Negotiated Rate	$234.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$122.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$134.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$111.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$128.56
Rate for Payer: EmblemHealth Commercial	$111.79
Rate for Payer: Fidelis Medicare Advantage	$234.76
Rate for Payer: Group Health Inc Commercial	$111.79
Rate for Payer: Group Health Inc Medicare	$78.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$111.79
Rate for Payer: Hamaspik Choice Inc Medicare	$111.79
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$145.33

SCREW ASNIS III SS CAN 6.5X80MM

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64905793
Hospital Revenue Code	278
Min. Negotiated Rate	$307.12
Max. Negotiated Rate	$307.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12

SCREW ASNIS III SS CAN 6.5X80MM

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64905793
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$644.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$337.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$368.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$307.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$353.19
Rate for Payer: EmblemHealth Commercial	$307.12
Rate for Payer: Fidelis Medicare Advantage	$644.96
Rate for Payer: Group Health Inc Commercial	$307.12
Rate for Payer: Group Health Inc Medicare	$214.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$399.26

SCREW ASNIS III SS CAN 6.5X95MM

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64905791
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$644.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$337.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$368.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$307.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$353.19
Rate for Payer: EmblemHealth Commercial	$307.12
Rate for Payer: Fidelis Medicare Advantage	$644.96
Rate for Payer: Group Health Inc Commercial	$307.12
Rate for Payer: Group Health Inc Medicare	$214.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$399.26

SCREW ASNIS III SS CAN 6.5X95MM

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64905791
Hospital Revenue Code	278
Min. Negotiated Rate	$307.12
Max. Negotiated Rate	$307.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12

SCREW ASNIS III SS CANN 8.0X110MM

Facility

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005922
Hospital Revenue Code	278
Min. Negotiated Rate	$243.10
Max. Negotiated Rate	$243.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10

SCREW ASNIS III SS CANN 8.0X110MM

Facility

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005922
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$510.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$267.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$291.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$243.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$279.56
Rate for Payer: EmblemHealth Commercial	$243.10
Rate for Payer: Fidelis Medicare Advantage	$510.51
Rate for Payer: Group Health Inc Commercial	$243.10
Rate for Payer: Group Health Inc Medicare	$170.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$316.03

SCREW ASNIS III SS CANN 8.0X115MM

Facility

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005923
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$510.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$267.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$291.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$243.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$279.56
Rate for Payer: EmblemHealth Commercial	$243.10
Rate for Payer: Fidelis Medicare Advantage	$510.51
Rate for Payer: Group Health Inc Commercial	$243.10
Rate for Payer: Group Health Inc Medicare	$170.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$316.03

SCREW ASNIS III SS CANN 8.0X115MM

Facility

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005923
Hospital Revenue Code	278
Min. Negotiated Rate	$243.10
Max. Negotiated Rate	$243.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10

SCREW ASNIS III SS CANN 8.0X120MM

Facility

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005924
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$510.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$267.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$291.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$243.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$279.56
Rate for Payer: EmblemHealth Commercial	$243.10
Rate for Payer: Fidelis Medicare Advantage	$510.51
Rate for Payer: Group Health Inc Commercial	$243.10
Rate for Payer: Group Health Inc Medicare	$170.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$316.03

SCREW ASNIS III SS CANN 8.0X120MM

Facility

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40005924
Hospital Revenue Code	278
Min. Negotiated Rate	$243.10
Max. Negotiated Rate	$243.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10

SCREW ASNIS TT 4.0X32

Facility

$1,472.50

Service Code	HCPCS C1713
Hospital Charge Code	64905125
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,546.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$809.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$883.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$736.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$846.69
Rate for Payer: EmblemHealth Commercial	$736.25
Rate for Payer: Fidelis Medicare Advantage	$1,546.12
Rate for Payer: Group Health Inc Commercial	$736.25
Rate for Payer: Group Health Inc Medicare	$515.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$736.25
Rate for Payer: Hamaspik Choice Inc Medicare	$736.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$957.12

SCREW ASNIS TT 4.0X32

Facility

$1,472.50

Service Code	HCPCS C1713
Hospital Charge Code	64905125
Hospital Revenue Code	278
Min. Negotiated Rate	$736.25
Max. Negotiated Rate	$736.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$736.25
Rate for Payer: Hamaspik Choice Inc Medicare	$736.25

Know your out-of-pocket cost for care.

All Charges