St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE 2.7 X 16MM

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64901895
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 16MM

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64901895
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 18MM

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902292
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 18MM

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902292
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 34

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64903969
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 34

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64903969
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 36

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64904536
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 36

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64904536
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 3.0 X 14

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64903203
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$551.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$288.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$315.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$262.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$301.88
Rate for Payer: EmblemHealth Commercial	$262.50
Rate for Payer: Fidelis Medicare Advantage	$551.25
Rate for Payer: Group Health Inc Commercial	$262.50
Rate for Payer: Group Health Inc Medicare	$183.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$262.50
Rate for Payer: Hamaspik Choice Inc Medicare	$262.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$341.25

SCREW BONE 3.0 X 14

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64903203
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$262.50
Rate for Payer: Hamaspik Choice Inc Medicare	$262.50

SCREW BONE 3.0 X 2.0

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64904720
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$551.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$288.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$315.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$262.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$301.88
Rate for Payer: EmblemHealth Commercial	$262.50
Rate for Payer: Fidelis Medicare Advantage	$551.25
Rate for Payer: Group Health Inc Commercial	$262.50
Rate for Payer: Group Health Inc Medicare	$183.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$262.50
Rate for Payer: Hamaspik Choice Inc Medicare	$262.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$341.25

SCREW BONE 3.0 X 2.0

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64904720
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$262.50
Rate for Payer: Hamaspik Choice Inc Medicare	$262.50

SCREW BONE 35 48

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64903884
Hospital Revenue Code	278
Min. Negotiated Rate	$51.76
Max. Negotiated Rate	$155.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$88.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$73.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.03
Rate for Payer: EmblemHealth Commercial	$73.94
Rate for Payer: Fidelis Medicare Advantage	$155.27
Rate for Payer: Group Health Inc Commercial	$73.94
Rate for Payer: Group Health Inc Medicare	$51.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.94
Rate for Payer: Hamaspik Choice Inc Medicare	$73.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.12

SCREW BONE 35 48

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64903884
Hospital Revenue Code	278
Min. Negotiated Rate	$73.94
Max. Negotiated Rate	$73.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.94
Rate for Payer: Hamaspik Choice Inc Medicare	$73.94

SCREW BONE 3.5-50

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902893
Hospital Revenue Code	278
Min. Negotiated Rate	$73.94
Max. Negotiated Rate	$73.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.94
Rate for Payer: Hamaspik Choice Inc Medicare	$73.94

SCREW BONE 3.5-50

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902893
Hospital Revenue Code	278
Min. Negotiated Rate	$51.76
Max. Negotiated Rate	$155.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$88.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$73.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.03
Rate for Payer: EmblemHealth Commercial	$73.94
Rate for Payer: Fidelis Medicare Advantage	$155.27
Rate for Payer: Group Health Inc Commercial	$73.94
Rate for Payer: Group Health Inc Medicare	$51.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.94
Rate for Payer: Hamaspik Choice Inc Medicare	$73.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.12

SCREW BONE 3.5MM DIA 14MML TT

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901766
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 3.5MM DIA 14MML TT

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901766
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 3.5MM DIA 16MML TT

Facility

$56.75

Service Code	HCPCS C1713
Hospital Charge Code	64901767
Hospital Revenue Code	278
Min. Negotiated Rate	$19.86
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$34.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.63
Rate for Payer: EmblemHealth Commercial	$28.38
Rate for Payer: Fidelis Medicare Advantage	$59.59
Rate for Payer: Group Health Inc Commercial	$28.38
Rate for Payer: Group Health Inc Medicare	$19.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.38
Rate for Payer: Hamaspik Choice Inc Medicare	$28.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.89

SCREW BONE 3.5MM DIA 16MML TT

Facility

$56.75

Service Code	HCPCS C1713
Hospital Charge Code	64901767
Hospital Revenue Code	278
Min. Negotiated Rate	$28.38
Max. Negotiated Rate	$28.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.38
Rate for Payer: Hamaspik Choice Inc Medicare	$28.38

SCREW BONE 3.5MM DIA 26MML T

Facility

$77.05

Service Code	HCPCS C1713
Hospital Charge Code	64903658
Hospital Revenue Code	278
Min. Negotiated Rate	$26.97
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$42.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$46.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.30
Rate for Payer: EmblemHealth Commercial	$38.52
Rate for Payer: Fidelis Medicare Advantage	$80.90
Rate for Payer: Group Health Inc Commercial	$38.52
Rate for Payer: Group Health Inc Medicare	$26.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.52
Rate for Payer: Hamaspik Choice Inc Medicare	$38.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$50.08

SCREW BONE 3.5MM DIA 26MML T

Facility

$77.05

Service Code	HCPCS C1713
Hospital Charge Code	64903658
Hospital Revenue Code	278
Min. Negotiated Rate	$38.52
Max. Negotiated Rate	$38.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.52
Rate for Payer: Hamaspik Choice Inc Medicare	$38.52

SCREW BONE 3.5MM DIA 26MML TT

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902179
Hospital Revenue Code	278
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.55
Rate for Payer: EmblemHealth Commercial	$166.56
Rate for Payer: Fidelis Medicare Advantage	$349.79
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.53

SCREW BONE 3.5MM DIA 26MML TT

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902179
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

SCREW BONE 3.5MM DIA 28MML TT

Facility

$89.25

Service Code	HCPCS C1713
Hospital Charge Code	64903174
Hospital Revenue Code	278
Min. Negotiated Rate	$44.62
Max. Negotiated Rate	$44.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.62
Rate for Payer: Hamaspik Choice Inc Medicare	$44.62

Know your out-of-pocket cost for care.

All Charges