St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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

SCREW BONE 5MM/1.9MM/2.7MM DIA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64903773
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 5MM/1.9MM/2.7MM DIA

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64903773
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 5MM DIA 34MML LOCKING

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903126
Hospital Revenue Code	278
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00

SCREW BONE 5MM DIA 34MML LOCKING

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903126
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$735.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$385.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$420.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$350.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$402.50
Rate for Payer: EmblemHealth Commercial	$350.00
Rate for Payer: Fidelis Medicare Advantage	$735.00
Rate for Payer: Group Health Inc Commercial	$350.00
Rate for Payer: Group Health Inc Medicare	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$455.00

SCREW BONE 5MM DIA 38MML LOCKING

Facility

$667.50

Service Code	HCPCS C1713
Hospital Charge Code	64903245
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$700.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$367.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$400.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$333.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$383.81
Rate for Payer: EmblemHealth Commercial	$333.75
Rate for Payer: Fidelis Medicare Advantage	$700.88
Rate for Payer: Group Health Inc Commercial	$333.75
Rate for Payer: Group Health Inc Medicare	$233.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$333.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$433.88

SCREW BONE 5MM DIA 38MML LOCKING

Facility

$667.50

Service Code	HCPCS C1713
Hospital Charge Code	64903245
Hospital Revenue Code	278
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$333.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$333.75

SCREW BONE 5MM DIA 40MML LOCKING

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903130
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$735.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$385.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$420.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$350.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$402.50
Rate for Payer: EmblemHealth Commercial	$350.00
Rate for Payer: Fidelis Medicare Advantage	$735.00
Rate for Payer: Group Health Inc Commercial	$350.00
Rate for Payer: Group Health Inc Medicare	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$455.00

SCREW BONE 5MM DIA 40MML LOCKING

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903130
Hospital Revenue Code	278
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00

SCREW BONE 6.5MM DIA 50MML STA

Facility

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64904093
Hospital Revenue Code	278
Min. Negotiated Rate	$40.62
Max. Negotiated Rate	$40.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.62
Rate for Payer: Hamaspik Choice Inc Medicare	$40.62

SCREW BONE 6.5MM DIA 50MML STA

Facility

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64904093
Hospital Revenue Code	278
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$48.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.72
Rate for Payer: EmblemHealth Commercial	$40.62
Rate for Payer: Fidelis Medicare Advantage	$85.31
Rate for Payer: Group Health Inc Commercial	$40.62
Rate for Payer: Group Health Inc Medicare	$28.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.62
Rate for Payer: Hamaspik Choice Inc Medicare	$40.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.81

SCREW BONE 6.5X25 SELF TAP

Facility

$368.00

Service Code	HCPCS C1776
Hospital Charge Code	40204648
Hospital Revenue Code	278
Min. Negotiated Rate	$128.80
Max. Negotiated Rate	$386.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$220.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$184.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$211.60
Rate for Payer: EmblemHealth Commercial	$184.00
Rate for Payer: Fidelis Medicare Advantage	$386.40
Rate for Payer: Group Health Inc Commercial	$184.00
Rate for Payer: Group Health Inc Medicare	$128.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$239.20

SCREW BONE 6.5X25 SELF TAP

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64905657
Hospital Revenue Code	278
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$362.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$189.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$207.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$172.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$198.38
Rate for Payer: EmblemHealth Commercial	$172.50
Rate for Payer: Fidelis Medicare Advantage	$362.25
Rate for Payer: Group Health Inc Commercial	$172.50
Rate for Payer: Group Health Inc Medicare	$120.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.50
Rate for Payer: Hamaspik Choice Inc Medicare	$172.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$224.25

SCREW BONE 6.5X25 SELF TAP

Facility

$368.00

Service Code	HCPCS C1776
Hospital Charge Code	40204648
Hospital Revenue Code	278
Min. Negotiated Rate	$184.00
Max. Negotiated Rate	$184.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00

SCREW BONE 6.5X25 SELF TAP

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64905657
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.50
Rate for Payer: Hamaspik Choice Inc Medicare	$172.50

SCREW BONE 6.5X30 SELF TAP

Facility

$368.00

Service Code	HCPCS C1776
Hospital Charge Code	40204647
Hospital Revenue Code	278
Min. Negotiated Rate	$184.00
Max. Negotiated Rate	$184.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00

SCREW BONE 6.5X30 SELF TAP

Facility

$368.00

Service Code	HCPCS C1776
Hospital Charge Code	40204647
Hospital Revenue Code	278
Min. Negotiated Rate	$128.80
Max. Negotiated Rate	$386.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$220.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$184.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$211.60
Rate for Payer: EmblemHealth Commercial	$184.00
Rate for Payer: Fidelis Medicare Advantage	$386.40
Rate for Payer: Group Health Inc Commercial	$184.00
Rate for Payer: Group Health Inc Medicare	$128.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$239.20

SCREW BONE 6.5X30 SELF-TAP

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64905855
Hospital Revenue Code	278
Min. Negotiated Rate	$172.50
Max. Negotiated Rate	$172.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.50
Rate for Payer: Hamaspik Choice Inc Medicare	$172.50

SCREW BONE 6.5X30 SELF-TAP

Facility

$345.00

Service Code	HCPCS C1713
Hospital Charge Code	64905855
Hospital Revenue Code	278
Min. Negotiated Rate	$120.75
Max. Negotiated Rate	$362.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$189.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$207.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$172.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$198.38
Rate for Payer: EmblemHealth Commercial	$172.50
Rate for Payer: Fidelis Medicare Advantage	$362.25
Rate for Payer: Group Health Inc Commercial	$172.50
Rate for Payer: Group Health Inc Medicare	$120.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$172.50
Rate for Payer: Hamaspik Choice Inc Medicare	$172.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$224.25

SCREW BONE 6.5X95

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64903847
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$644.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$337.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$368.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$307.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$353.19
Rate for Payer: EmblemHealth Commercial	$307.12
Rate for Payer: Fidelis Medicare Advantage	$644.96
Rate for Payer: Group Health Inc Commercial	$307.12
Rate for Payer: Group Health Inc Medicare	$214.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$399.26

SCREW BONE 6.5X95

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64903847
Hospital Revenue Code	278
Min. Negotiated Rate	$307.12
Max. Negotiated Rate	$307.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12

SCREW BONE .7 X 16

Facility

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64904525
Hospital Revenue Code	278
Min. Negotiated Rate	$62.56
Max. Negotiated Rate	$187.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$107.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$89.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.78
Rate for Payer: EmblemHealth Commercial	$89.38
Rate for Payer: Fidelis Medicare Advantage	$187.69
Rate for Payer: Group Health Inc Commercial	$89.38
Rate for Payer: Group Health Inc Medicare	$62.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$116.19

SCREW BONE .7 X 16

Facility

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64904525
Hospital Revenue Code	278
Min. Negotiated Rate	$89.38
Max. Negotiated Rate	$89.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38

SCREW BONE 8MM/3MM/4.5MM DIA H

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902724
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 8MM/3MM/4.5MM DIA H

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902724
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

Know your out-of-pocket cost for care.

All Charges