St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW ASNIS TT 4.0X36

Facility

$1,472.50

Service Code	HCPCS C1713
Hospital Charge Code	64905127
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

SCREW ASNIS TT 4.0X36

Facility

$1,472.50

Service Code	HCPCS C1713
Hospital Charge Code	64905127
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 AUTOFX CMPR MOD T7 DR2.5X25

Facility

$858.00

Service Code	HCPCS C1713
Hospital Charge Code	40005930
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$900.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$471.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$514.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$429.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$493.35
Rate for Payer: EmblemHealth Commercial	$429.00
Rate for Payer: Fidelis Medicare Advantage	$900.90
Rate for Payer: Group Health Inc Commercial	$429.00
Rate for Payer: Group Health Inc Medicare	$300.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$429.00
Rate for Payer: Hamaspik Choice Inc Medicare	$429.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$557.70

SCREW AUTOFX CMPR MOD T7 DR2.5X25

Facility

$858.00

Service Code	HCPCS C1713
Hospital Charge Code	40005930
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$429.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$429.00
Rate for Payer: Hamaspik Choice Inc Medicare	$429.00

SCREW AUTOFX CMPR MOD T7 DR2.5X29

Facility

$858.00

Service Code	HCPCS C1713
Hospital Charge Code	40005931
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$900.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$471.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$514.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$429.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$493.35
Rate for Payer: EmblemHealth Commercial	$429.00
Rate for Payer: Fidelis Medicare Advantage	$900.90
Rate for Payer: Group Health Inc Commercial	$429.00
Rate for Payer: Group Health Inc Medicare	$300.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$429.00
Rate for Payer: Hamaspik Choice Inc Medicare	$429.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$557.70

SCREW AUTOFX CMPR MOD T7 DR2.5X29

Facility

$858.00

Service Code	HCPCS C1713
Hospital Charge Code	40005931
Hospital Revenue Code	278
Min. Negotiated Rate	$429.00
Max. Negotiated Rate	$429.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$429.00
Rate for Payer: Hamaspik Choice Inc Medicare	$429.00

SCREW AUTO T7 DR 2.5 X 25MM

Facility

$1,072.50

Service Code	HCPCS C1713
Hospital Charge Code	64905615
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,126.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$589.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$643.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$536.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$616.69
Rate for Payer: EmblemHealth Commercial	$536.25
Rate for Payer: Fidelis Medicare Advantage	$1,126.12
Rate for Payer: Group Health Inc Commercial	$536.25
Rate for Payer: Group Health Inc Medicare	$375.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$536.25
Rate for Payer: Hamaspik Choice Inc Medicare	$536.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$697.12

SCREW AUTO T7 DR 2.5 X 25MM

Facility

$1,072.50

Service Code	HCPCS C1713
Hospital Charge Code	64905615
Hospital Revenue Code	278
Min. Negotiated Rate	$536.25
Max. Negotiated Rate	$536.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$536.25
Rate for Payer: Hamaspik Choice Inc Medicare	$536.25

SCREW AUTO T7 DR 2.5 X 29MM

Facility

$1,072.50

Service Code	HCPCS C1713
Hospital Charge Code	64905616
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,126.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$589.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$643.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$536.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$616.69
Rate for Payer: EmblemHealth Commercial	$536.25
Rate for Payer: Fidelis Medicare Advantage	$1,126.12
Rate for Payer: Group Health Inc Commercial	$536.25
Rate for Payer: Group Health Inc Medicare	$375.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$536.25
Rate for Payer: Hamaspik Choice Inc Medicare	$536.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$697.12

SCREW AUTO T7 DR 2.5 X 29MM

Facility

$1,072.50

Service Code	HCPCS C1713
Hospital Charge Code	64905616
Hospital Revenue Code	278
Min. Negotiated Rate	$536.25
Max. Negotiated Rate	$536.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$536.25
Rate for Payer: Hamaspik Choice Inc Medicare	$536.25

SCREW BIOCOMP INTERFER

Facility

$840.00

Service Code	HCPCS C1713
Hospital Charge Code	64903684
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$882.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$462.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$504.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$420.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$483.00
Rate for Payer: EmblemHealth Commercial	$420.00
Rate for Payer: Fidelis Medicare Advantage	$882.00
Rate for Payer: Group Health Inc Commercial	$420.00
Rate for Payer: Group Health Inc Medicare	$294.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$420.00
Rate for Payer: Hamaspik Choice Inc Medicare	$420.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$546.00

SCREW BIOCOMP INTERFER

Facility

$840.00

Service Code	HCPCS C1713
Hospital Charge Code	64903684
Hospital Revenue Code	278
Min. Negotiated Rate	$420.00
Max. Negotiated Rate	$420.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$420.00
Rate for Payer: Hamaspik Choice Inc Medicare	$420.00

SCREW BIO-COMP INTER FULL

Facility

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64905252
Hospital Revenue Code	278
Min. Negotiated Rate	$293.75
Max. Negotiated Rate	$293.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.75
Rate for Payer: Hamaspik Choice Inc Medicare	$293.75

SCREW BIO-COMP INTER FULL

Facility

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64905252
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$616.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$323.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$352.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$293.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$337.81
Rate for Payer: EmblemHealth Commercial	$293.75
Rate for Payer: Fidelis Medicare Advantage	$616.88
Rate for Payer: Group Health Inc Commercial	$293.75
Rate for Payer: Group Health Inc Medicare	$205.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.75
Rate for Payer: Hamaspik Choice Inc Medicare	$293.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$381.88

SCREW BIO-COMP INTER W DISP

Facility

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64905251
Hospital Revenue Code	278
Min. Negotiated Rate	$293.75
Max. Negotiated Rate	$293.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.75
Rate for Payer: Hamaspik Choice Inc Medicare	$293.75

SCREW BIO-COMP INTER W DISP

Facility

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64905251
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$616.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$323.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$352.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$293.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$337.81
Rate for Payer: EmblemHealth Commercial	$293.75
Rate for Payer: Fidelis Medicare Advantage	$616.88
Rate for Payer: Group Health Inc Commercial	$293.75
Rate for Payer: Group Health Inc Medicare	$205.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.75
Rate for Payer: Hamaspik Choice Inc Medicare	$293.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$381.88

SCREW BIOCOMPOSITE INTERFEREN

Facility

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64903003
Hospital Revenue Code	278
Min. Negotiated Rate	$293.75
Max. Negotiated Rate	$293.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.75
Rate for Payer: Hamaspik Choice Inc Medicare	$293.75

SCREW BIOCOMPOSITE INTERFEREN

Facility

$587.50

Service Code	HCPCS C1713
Hospital Charge Code	64903003
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$616.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$323.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$352.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$293.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$337.81
Rate for Payer: EmblemHealth Commercial	$293.75
Rate for Payer: Fidelis Medicare Advantage	$616.88
Rate for Payer: Group Health Inc Commercial	$293.75
Rate for Payer: Group Health Inc Medicare	$205.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.75
Rate for Payer: Hamaspik Choice Inc Medicare	$293.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$381.88

SCREW BIO COMP TENOD

Facility

$1,012.50

Service Code	HCPCS C1713
Hospital Charge Code	64907478
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,063.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$556.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$607.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$506.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$582.19
Rate for Payer: EmblemHealth Commercial	$506.25
Rate for Payer: Fidelis Medicare Advantage	$1,063.12
Rate for Payer: Group Health Inc Commercial	$506.25
Rate for Payer: Group Health Inc Medicare	$354.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$506.25
Rate for Payer: Hamaspik Choice Inc Medicare	$506.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$658.12

SCREW BIO COMP TENOD

Facility

$1,012.50

Service Code	HCPCS C1713
Hospital Charge Code	64907478
Hospital Revenue Code	278
Min. Negotiated Rate	$506.25
Max. Negotiated Rate	$506.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$506.25
Rate for Payer: Hamaspik Choice Inc Medicare	$506.25

SCREW BNE SLFTAP 6.5 X 15MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64907026
Hospital Revenue Code	278
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$362.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$189.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$207.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$172.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$198.38
Rate for Payer: EmblemHealth Commercial	$172.50
Rate for Payer: Fidelis Medicare Advantage	$362.25
Rate for Payer: Group Health Inc Commercial	$172.50
Rate for Payer: Group Health Inc Medicare	$120.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.50
Rate for Payer: Hamaspik Choice Inc Medicare	$172.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$224.25

SCREW BNE SLFTAP 6.5 X 15MM

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64907026
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.50
Rate for Payer: Hamaspik Choice Inc Medicare	$172.50

SCREW BNE T8 FTHRD 2.7MM,L40MM

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64906296
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$72.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.00
Rate for Payer: EmblemHealth Commercial	$60.00
Rate for Payer: Fidelis Medicare Advantage	$126.00
Rate for Payer: Group Health Inc Commercial	$60.00
Rate for Payer: Group Health Inc Medicare	$42.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$78.00

SCREW BNE T8 FTHRD 2.7MM,L40MM

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64906296
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00

SCREW BNE T8 FTHRD 2.7MM,L50MM

Facility

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906530
Hospital Revenue Code	278
Min. Negotiated Rate	$83.92
Max. Negotiated Rate	$251.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$131.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$143.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$119.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$137.87
Rate for Payer: EmblemHealth Commercial	$119.89
Rate for Payer: Fidelis Medicare Advantage	$251.77
Rate for Payer: Group Health Inc Commercial	$119.89
Rate for Payer: Group Health Inc Medicare	$83.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.89
Rate for Payer: Hamaspik Choice Inc Medicare	$119.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$155.86

Know your out-of-pocket cost for care.

All Charges