St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE 2.7MM DIA 12MML TT

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902831
Hospital Revenue Code	278
Min. Negotiated Rate	$67.44
Max. Negotiated Rate	$67.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44

SCREW BONE 2.7MM DIA 14MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901925
Hospital Revenue Code	278
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$28.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.44
Rate for Payer: Hamaspik Choice Inc Medicare	$28.44

SCREW BONE 2.7MM DIA 14MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901925
Hospital Revenue Code	278
Min. Negotiated Rate	$19.91
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$34.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.71
Rate for Payer: EmblemHealth Commercial	$28.44
Rate for Payer: Fidelis Medicare Advantage	$59.72
Rate for Payer: Group Health Inc Commercial	$28.44
Rate for Payer: Group Health Inc Medicare	$19.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.44
Rate for Payer: Hamaspik Choice Inc Medicare	$28.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.97

SCREW BONE 2.7MM DIA 14MML TT

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902295
Hospital Revenue Code	278
Min. Negotiated Rate	$67.44
Max. Negotiated Rate	$67.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44

SCREW BONE 2.7MM DIA 14MML TT

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902295
Hospital Revenue Code	278
Min. Negotiated Rate	$47.21
Max. Negotiated Rate	$141.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$80.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.56
Rate for Payer: EmblemHealth Commercial	$67.44
Rate for Payer: Fidelis Medicare Advantage	$141.62
Rate for Payer: Group Health Inc Commercial	$67.44
Rate for Payer: Group Health Inc Medicare	$47.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$87.67

SCREW BONE 2.7MM DIA 16MML STA

Facility

$50.00

Service Code	HCPCS C1713
Hospital Charge Code	64901927
Hospital Revenue Code	278
Min. Negotiated Rate	$25.00
Max. Negotiated Rate	$25.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.00
Rate for Payer: Hamaspik Choice Inc Medicare	$25.00

SCREW BONE 2.7MM DIA 16MML STA

Facility

$50.00

Service Code	HCPCS C1713
Hospital Charge Code	64901927
Hospital Revenue Code	278
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$30.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.75
Rate for Payer: EmblemHealth Commercial	$25.00
Rate for Payer: Fidelis Medicare Advantage	$52.50
Rate for Payer: Group Health Inc Commercial	$25.00
Rate for Payer: Group Health Inc Medicare	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.00
Rate for Payer: Hamaspik Choice Inc Medicare	$25.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$32.50

SCREW BONE 2.7MM DIA 16MML TT

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902308
Hospital Revenue Code	278
Min. Negotiated Rate	$67.44
Max. Negotiated Rate	$67.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44

SCREW BONE 2.7MM DIA 16MML TT

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902308
Hospital Revenue Code	278
Min. Negotiated Rate	$47.21
Max. Negotiated Rate	$141.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$80.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.56
Rate for Payer: EmblemHealth Commercial	$67.44
Rate for Payer: Fidelis Medicare Advantage	$141.62
Rate for Payer: Group Health Inc Commercial	$67.44
Rate for Payer: Group Health Inc Medicare	$47.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$87.67

SCREW BONE 2.7MM DIA 18MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902902
Hospital Revenue Code	278
Min. Negotiated Rate	$19.91
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$34.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.71
Rate for Payer: EmblemHealth Commercial	$28.44
Rate for Payer: Fidelis Medicare Advantage	$59.72
Rate for Payer: Group Health Inc Commercial	$28.44
Rate for Payer: Group Health Inc Medicare	$19.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.44
Rate for Payer: Hamaspik Choice Inc Medicare	$28.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.97

SCREW BONE 2.7MM DIA 18MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902902
Hospital Revenue Code	278
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$28.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.44
Rate for Payer: Hamaspik Choice Inc Medicare	$28.44

SCREW BONE 2.7MM DIA 18MML TT

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64901888
Hospital Revenue Code	278
Min. Negotiated Rate	$100.45
Max. Negotiated Rate	$301.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$172.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$143.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$165.02
Rate for Payer: EmblemHealth Commercial	$143.50
Rate for Payer: Fidelis Medicare Advantage	$301.35
Rate for Payer: Group Health Inc Commercial	$143.50
Rate for Payer: Group Health Inc Medicare	$100.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.50
Rate for Payer: Hamaspik Choice Inc Medicare	$143.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$186.55

SCREW BONE 2.7MM DIA 18MML TT

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64901888
Hospital Revenue Code	278
Min. Negotiated Rate	$143.50
Max. Negotiated Rate	$143.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.50
Rate for Payer: Hamaspik Choice Inc Medicare	$143.50

SCREW BONE 2.7MM DIA 30MML TT

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64903968
Hospital Revenue Code	278
Min. Negotiated Rate	$67.44
Max. Negotiated Rate	$67.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44

SCREW BONE 2.7MM DIA 30MML TT

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64903968
Hospital Revenue Code	278
Min. Negotiated Rate	$47.21
Max. Negotiated Rate	$141.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$80.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.56
Rate for Payer: EmblemHealth Commercial	$67.44
Rate for Payer: Fidelis Medicare Advantage	$141.62
Rate for Payer: Group Health Inc Commercial	$67.44
Rate for Payer: Group Health Inc Medicare	$47.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$87.67

SCREW BONE 2.7MM DIA 38MML TT

Facility

$406.00

Service Code	HCPCS C1713
Hospital Charge Code	64902926
Hospital Revenue Code	278
Min. Negotiated Rate	$203.00
Max. Negotiated Rate	$203.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.00
Rate for Payer: Hamaspik Choice Inc Medicare	$203.00

SCREW BONE 2.7MM DIA 38MML TT

Facility

$406.00

Service Code	HCPCS C1713
Hospital Charge Code	64902926
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$426.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$223.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$243.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$203.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$233.45
Rate for Payer: EmblemHealth Commercial	$203.00
Rate for Payer: Fidelis Medicare Advantage	$426.30
Rate for Payer: Group Health Inc Commercial	$203.00
Rate for Payer: Group Health Inc Medicare	$142.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.00
Rate for Payer: Hamaspik Choice Inc Medicare	$203.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$263.90

SCREW BONE 2.7MM DIA 8MML TT

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64903111
Hospital Revenue Code	278
Min. Negotiated Rate	$47.21
Max. Negotiated Rate	$141.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$80.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.56
Rate for Payer: EmblemHealth Commercial	$67.44
Rate for Payer: Fidelis Medicare Advantage	$141.62
Rate for Payer: Group Health Inc Commercial	$67.44
Rate for Payer: Group Health Inc Medicare	$47.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$87.67

SCREW BONE 2.7MM DIA 8MML TT

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64903111
Hospital Revenue Code	278
Min. Negotiated Rate	$67.44
Max. Negotiated Rate	$67.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44

SCREW BONE 2.7 X 12MM B

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902293
Hospital Revenue Code	278
Min. Negotiated Rate	$67.44
Max. Negotiated Rate	$67.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44

SCREW BONE 2.7 X 12MM B

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902293
Hospital Revenue Code	278
Min. Negotiated Rate	$47.21
Max. Negotiated Rate	$141.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$80.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.56
Rate for Payer: EmblemHealth Commercial	$67.44
Rate for Payer: Fidelis Medicare Advantage	$141.62
Rate for Payer: Group Health Inc Commercial	$67.44
Rate for Payer: Group Health Inc Medicare	$47.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$87.67

SCREW BONE 2.7 X 14MM

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902607
Hospital Revenue Code	278
Min. Negotiated Rate	$67.44
Max. Negotiated Rate	$67.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44

SCREW BONE 2.7 X 14MM

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902607
Hospital Revenue Code	278
Min. Negotiated Rate	$47.21
Max. Negotiated Rate	$141.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$80.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.56
Rate for Payer: EmblemHealth Commercial	$67.44
Rate for Payer: Fidelis Medicare Advantage	$141.62
Rate for Payer: Group Health Inc Commercial	$67.44
Rate for Payer: Group Health Inc Medicare	$47.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$87.67

SCREW BONE 2.7 X 16 MM

Facility

$160.00

Service Code	HCPCS C1713
Hospital Charge Code	40201316
Hospital Revenue Code	278
Min. Negotiated Rate	$80.00
Max. Negotiated Rate	$80.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00

SCREW BONE 2.7 X 16 MM

Facility

$160.00

Service Code	HCPCS C1713
Hospital Charge Code	40201316
Hospital Revenue Code	278
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$96.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$92.00
Rate for Payer: EmblemHealth Commercial	$80.00
Rate for Payer: Fidelis Medicare Advantage	$168.00
Rate for Payer: Group Health Inc Commercial	$80.00
Rate for Payer: Group Health Inc Medicare	$56.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$104.00

Know your out-of-pocket cost for care.

All Charges