St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE 8MM/3MM/6.5MM DIA H

Facility

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64902340
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 8MM/3MM/6.5MM DIA H

Facility

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64902340
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 8MM DIA 14.5MML

Facility

$409.50

Service Code	HCPCS C1713
Hospital Charge Code	64905566
Hospital Revenue Code	278
Min. Negotiated Rate	$204.75
Max. Negotiated Rate	$204.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.75
Rate for Payer: Hamaspik Choice Inc Medicare	$204.75

SCREW BONE 8MM DIA 14.5MML

Facility

$409.50

Service Code	HCPCS C1713
Hospital Charge Code	64905566
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$429.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$225.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$245.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$235.46
Rate for Payer: EmblemHealth Commercial	$204.75
Rate for Payer: Fidelis Medicare Advantage	$429.98
Rate for Payer: Group Health Inc Commercial	$204.75
Rate for Payer: Group Health Inc Medicare	$143.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.75
Rate for Payer: Hamaspik Choice Inc Medicare	$204.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$266.18

SCREW BONE 8MM DIA 17.5MML TT

Facility

$458.25

Service Code	HCPCS C1713
Hospital Charge Code	64902187
Hospital Revenue Code	278
Min. Negotiated Rate	$229.12
Max. Negotiated Rate	$229.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$229.12
Rate for Payer: Hamaspik Choice Inc Medicare	$229.12

SCREW BONE 8MM DIA 17.5MML TT

Facility

$458.25

Service Code	HCPCS C1713
Hospital Charge Code	64902187
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$481.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$252.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$274.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$229.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$263.49
Rate for Payer: EmblemHealth Commercial	$229.12
Rate for Payer: Fidelis Medicare Advantage	$481.16
Rate for Payer: Group Health Inc Commercial	$229.12
Rate for Payer: Group Health Inc Medicare	$160.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$229.12
Rate for Payer: Hamaspik Choice Inc Medicare	$229.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$297.86

SCREW BONE AXS

Facility

$172.13

Service Code	HCPCS C1713
Hospital Charge Code	64907474
Hospital Revenue Code	278
Min. Negotiated Rate	$86.06
Max. Negotiated Rate	$86.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.06
Rate for Payer: Hamaspik Choice Inc Medicare	$86.06

SCREW BONE AXS

Facility

$172.13

Service Code	HCPCS C1713
Hospital Charge Code	64907474
Hospital Revenue Code	278
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$180.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$103.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$86.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$98.97
Rate for Payer: EmblemHealth Commercial	$86.06
Rate for Payer: Fidelis Medicare Advantage	$180.74
Rate for Payer: Group Health Inc Commercial	$86.06
Rate for Payer: Group Health Inc Medicare	$60.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.06
Rate for Payer: Hamaspik Choice Inc Medicare	$86.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$111.88

SCREW BONE AXS 1.2

Facility

$155.55

Service Code	HCPCS C1713
Hospital Charge Code	64907449
Hospital Revenue Code	278
Min. Negotiated Rate	$54.44
Max. Negotiated Rate	$163.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$93.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$77.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$89.44
Rate for Payer: EmblemHealth Commercial	$77.78
Rate for Payer: Fidelis Medicare Advantage	$163.33
Rate for Payer: Group Health Inc Commercial	$77.78
Rate for Payer: Group Health Inc Medicare	$54.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.78
Rate for Payer: Hamaspik Choice Inc Medicare	$77.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$101.11

SCREW BONE AXS 1.2

Facility

$155.55

Service Code	HCPCS C1713
Hospital Charge Code	64907449
Hospital Revenue Code	278
Min. Negotiated Rate	$77.78
Max. Negotiated Rate	$77.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.78
Rate for Payer: Hamaspik Choice Inc Medicare	$77.78

SCREW BONE AXS 1.7

Facility

$138.98

Service Code	HCPCS C1713
Hospital Charge Code	64907450
Hospital Revenue Code	278
Min. Negotiated Rate	$69.49
Max. Negotiated Rate	$69.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.49
Rate for Payer: Hamaspik Choice Inc Medicare	$69.49

SCREW BONE AXS 1.7

Facility

$138.98

Service Code	HCPCS C1713
Hospital Charge Code	64907450
Hospital Revenue Code	278
Min. Negotiated Rate	$48.64
Max. Negotiated Rate	$145.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$76.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$83.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$69.49
Rate for Payer: Cigna LocalPlus Benefit Plan	$79.91
Rate for Payer: EmblemHealth Commercial	$69.49
Rate for Payer: Fidelis Medicare Advantage	$145.93
Rate for Payer: Group Health Inc Commercial	$69.49
Rate for Payer: Group Health Inc Medicare	$48.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.49
Rate for Payer: Hamaspik Choice Inc Medicare	$69.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$90.34

SCREW BONE CANCELL 4.0MM

Facility

$112.93

Service Code	HCPCS C1713
Hospital Charge Code	40202404
Hospital Revenue Code	278
Min. Negotiated Rate	$56.46
Max. Negotiated Rate	$56.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.46
Rate for Payer: Hamaspik Choice Inc Medicare	$56.46

SCREW BONE CANCELL 4.0MM

Facility

$112.93

Service Code	HCPCS C1713
Hospital Charge Code	40202404
Hospital Revenue Code	278
Min. Negotiated Rate	$39.53
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$62.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$67.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.93
Rate for Payer: EmblemHealth Commercial	$56.46
Rate for Payer: Fidelis Medicare Advantage	$118.58
Rate for Payer: Group Health Inc Commercial	$56.46
Rate for Payer: Group Health Inc Medicare	$39.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.46
Rate for Payer: Hamaspik Choice Inc Medicare	$56.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$73.40

SCREW BONE CANCELL 4.0MM /36MM

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	64905436
Hospital Revenue Code	278
Min. Negotiated Rate	$77.50
Max. Negotiated Rate	$77.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50

SCREW BONE CANCELL 4.0MM /36MM

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	64905436
Hospital Revenue Code	278
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$162.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$93.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$77.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$89.12
Rate for Payer: EmblemHealth Commercial	$77.50
Rate for Payer: Fidelis Medicare Advantage	$162.75
Rate for Payer: Group Health Inc Commercial	$77.50
Rate for Payer: Group Health Inc Medicare	$54.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.75

SCREW BONE CANCELL 4.0MM DIA 40

Facility

$58.50

Service Code	HCPCS C1713
Hospital Charge Code	64905268
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 CANCELL 4.0MM DIA 40

Facility

$58.50

Service Code	HCPCS C1713
Hospital Charge Code	64905268
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 CANCELL 4.0MM DIA 453

Facility

$58.50

Service Code	HCPCS C1713
Hospital Charge Code	64905270
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 CANCELL 4.0MM DIA 453

Facility

$58.50

Service Code	HCPCS C1713
Hospital Charge Code	64905270
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 CANCELL 4.0MM / L32MM

Facility

$150.00

Service Code	HCPCS C1713
Hospital Charge Code	64904904
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

SCREW BONE CANCELL 4.0MM / L32MM

Facility

$150.00

Service Code	HCPCS C1713
Hospital Charge Code	64904904
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$157.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$90.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$86.25
Rate for Payer: EmblemHealth Commercial	$75.00
Rate for Payer: Fidelis Medicare Advantage	$157.50
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$97.50

SCREW BONE CANCELL 4.0MM / L40MM

Facility

$142.50

Service Code	HCPCS C1713
Hospital Charge Code	64904067
Hospital Revenue Code	278
Min. Negotiated Rate	$49.88
Max. Negotiated Rate	$149.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$78.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$85.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$81.94
Rate for Payer: EmblemHealth Commercial	$71.25
Rate for Payer: Fidelis Medicare Advantage	$149.62
Rate for Payer: Group Health Inc Commercial	$71.25
Rate for Payer: Group Health Inc Medicare	$49.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.25
Rate for Payer: Hamaspik Choice Inc Medicare	$71.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$92.62

SCREW BONE CANCELL 4.0MM / L40MM

Facility

$142.50

Service Code	HCPCS C1713
Hospital Charge Code	64904067
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.25
Rate for Payer: Hamaspik Choice Inc Medicare	$71.25

SCREW BONE CANCELL 4.0MM / L42MM

Facility

$150.00

Service Code	HCPCS C1713
Hospital Charge Code	64904207
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

Know your out-of-pocket cost for care.

All Charges