St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE 4.0 X 34MM

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64905075
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$589.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$308.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$336.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$280.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$322.58
Rate for Payer: EmblemHealth Commercial	$280.50
Rate for Payer: Fidelis Medicare Advantage	$589.05
Rate for Payer: Group Health Inc Commercial	$280.50
Rate for Payer: Group Health Inc Medicare	$196.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$364.65

SCREW BONE 4.0 X 34MM

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64905075
Hospital Revenue Code	278
Min. Negotiated Rate	$280.50
Max. Negotiated Rate	$280.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50

SCREW BONE 4.0 X 38MM

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64905076
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$589.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$308.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$336.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$280.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$322.58
Rate for Payer: EmblemHealth Commercial	$280.50
Rate for Payer: Fidelis Medicare Advantage	$589.05
Rate for Payer: Group Health Inc Commercial	$280.50
Rate for Payer: Group Health Inc Medicare	$196.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$364.65

SCREW BONE 4.0 X 38MM

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64905076
Hospital Revenue Code	278
Min. Negotiated Rate	$280.50
Max. Negotiated Rate	$280.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50

SCREW BONE 4.0 X 48MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	64905078
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$693.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$363.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$396.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$330.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$379.50
Rate for Payer: EmblemHealth Commercial	$330.00
Rate for Payer: Fidelis Medicare Advantage	$693.00
Rate for Payer: Group Health Inc Commercial	$330.00
Rate for Payer: Group Health Inc Medicare	$231.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$429.00

SCREW BONE 4.0 X 48MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	64905078
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$330.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00

SCREW BONE 4.0 X 65MM SELF

Facility

$278.10

Service Code	HCPCS C1713
Hospital Charge Code	64905812
Hospital Revenue Code	278
Min. Negotiated Rate	$97.34
Max. Negotiated Rate	$292.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$166.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$139.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.91
Rate for Payer: EmblemHealth Commercial	$139.05
Rate for Payer: Fidelis Medicare Advantage	$292.00
Rate for Payer: Group Health Inc Commercial	$139.05
Rate for Payer: Group Health Inc Medicare	$97.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$139.05
Rate for Payer: Hamaspik Choice Inc Medicare	$139.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$180.76

SCREW BONE 4.0 X 65MM SELF

Facility

$278.10

Service Code	HCPCS C1713
Hospital Charge Code	64905812
Hospital Revenue Code	278
Min. Negotiated Rate	$139.05
Max. Negotiated Rate	$139.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$139.05
Rate for Payer: Hamaspik Choice Inc Medicare	$139.05

SCREW BONE 4.5MM DIA 20MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64903733
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 4.5MM DIA 20MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64903733
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 4.5MM DIA 24MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901809
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 4.5MM DIA 24MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901809
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 4.5MM DIA 26MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901811
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 4.5MM DIA 26MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901811
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 4.5MM DIA 28MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902517
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 4.5MM DIA 28MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902517
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 4.5MM DIA 30MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902341
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 4.5MM DIA 30MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902341
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 4.5MM DIA 32MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901855
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 4.5MM DIA 32MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901855
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 4.5MM DIA 34MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901671
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 4.5MM DIA 34MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901671
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 4.5MM DIA 36MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901763
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 4.5MM DIA 36MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901763
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 4.5MM DIA 36MML TT

Facility

$115.00

Service Code	HCPCS C1713
Hospital Charge Code	64903836
Hospital Revenue Code	278
Min. Negotiated Rate	$40.25
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$69.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$57.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.12
Rate for Payer: EmblemHealth Commercial	$57.50
Rate for Payer: Fidelis Medicare Advantage	$120.75
Rate for Payer: Group Health Inc Commercial	$57.50
Rate for Payer: Group Health Inc Medicare	$40.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.50
Rate for Payer: Hamaspik Choice Inc Medicare	$57.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$74.75

Know your out-of-pocket cost for care.

All Charges