St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE 4.5MM DIA 52MML

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902390
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 52MML

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902390
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 54MML

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902211
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 54MML

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902211
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 55MML TT

Facility

$115.00

Service Code	HCPCS C1713
Hospital Charge Code	64903838
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

SCREW BONE 4.5MM DIA 55MML TT

Facility

$115.00

Service Code	HCPCS C1713
Hospital Charge Code	64903838
Hospital Revenue Code	278
Min. Negotiated Rate	$57.50
Max. Negotiated Rate	$57.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.50
Rate for Payer: Hamaspik Choice Inc Medicare	$57.50

SCREW BONE 4.5MM DIA 58MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902392
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 58MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902392
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 60MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902214
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 60MML STA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902214
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 60MML TT

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64904981
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 BONE 4.5MM DIA 60MML TT

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64904981
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 BONE 4.5MM DIA 75MML TT

Facility

$115.00

Service Code	HCPCS C1713
Hospital Charge Code	64903869
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

SCREW BONE 4.5MM DIA 75MML TT

Facility

$115.00

Service Code	HCPCS C1713
Hospital Charge Code	64903869
Hospital Revenue Code	278
Min. Negotiated Rate	$57.50
Max. Negotiated Rate	$57.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.50
Rate for Payer: Hamaspik Choice Inc Medicare	$57.50

SCREW BONE 4.5MM DIA 95MML TT

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64904036
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 BONE 4.5MM DIA 95MML TT

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64904036
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 BONE 4MM DIA 16MML TTAN

Facility

$58.50

Service Code	HCPCS C1713
Hospital Charge Code	64904193
Hospital Revenue Code	278
Min. Negotiated Rate	$20.48
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$35.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.64
Rate for Payer: EmblemHealth Commercial	$29.25
Rate for Payer: Fidelis Medicare Advantage	$61.42
Rate for Payer: Group Health Inc Commercial	$29.25
Rate for Payer: Group Health Inc Medicare	$20.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.25
Rate for Payer: Hamaspik Choice Inc Medicare	$29.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$38.02

SCREW BONE 4MM DIA 16MML TTAN

Facility

$58.50

Service Code	HCPCS C1713
Hospital Charge Code	64904193
Hospital Revenue Code	278
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$29.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.25
Rate for Payer: Hamaspik Choice Inc Medicare	$29.25

SCREW BONE 4MM DIA 60MML LOCKING

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64905001
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 4MM DIA 60MML LOCKING

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64905001
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 4MM DIA 75MML LOCKING

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64903318
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 4MM DIA 75MML LOCKING

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64903318
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 5.0MM X 36MM

Facility

$496.00

Service Code	HCPCS C1713
Hospital Charge Code	40003340
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$520.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$272.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$297.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$248.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$285.20
Rate for Payer: EmblemHealth Commercial	$248.00
Rate for Payer: Fidelis Medicare Advantage	$520.80
Rate for Payer: Group Health Inc Commercial	$248.00
Rate for Payer: Group Health Inc Medicare	$173.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.00
Rate for Payer: Hamaspik Choice Inc Medicare	$248.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$322.40

SCREW BONE 5.0MM X 36MM

Facility

$496.00

Service Code	HCPCS C1713
Hospital Charge Code	40003340
Hospital Revenue Code	278
Min. Negotiated Rate	$248.00
Max. Negotiated Rate	$248.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.00
Rate for Payer: Hamaspik Choice Inc Medicare	$248.00

SCREW BONE 55 DIA 3.5MML

Facility

$89.25

Service Code	HCPCS C1713
Hospital Charge Code	64905468
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