St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE 3.5 X 16MM B

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902244
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 3.5 X 18

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64904657
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 3.5 X 18

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64904657
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 3.5 X 18MM A

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902222
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 3.5 X 18MM A

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902222
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 X 18MM B

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902261
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 3.5 X 18MM B

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902261
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 X 20MM A

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902154
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 X 20MM A

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902154
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 3.5 X 20MM B

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902166
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 3.5 X 20MM B

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902166
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 X 22

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64904659
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 3.5 X 22

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64904659
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 3.5 X 22MM A

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902158
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 3.5 X 22MM A

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902158
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 X 22MM B

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902367
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 3.5 X 22MM B

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902367
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 X 24

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64902907
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 3.5 X 24

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64902907
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 3.5 X 24MM A

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902172
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 3.5 X 24MM A

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902172
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 X 24MM B

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902263
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 3.5 X 24MM B

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902263
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 X 26

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64904914
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 3.5 X 26

Facility

$525.00

Service Code	HCPCS C1713
Hospital Charge Code	64904914
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

Know your out-of-pocket cost for care.

All Charges