St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CANCELL 6.0MM / L80MM

Facility

$177.50

Service Code	HCPCS C1713
Hospital Charge Code	64904088
Hospital Revenue Code	278
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$88.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$88.75
Rate for Payer: Hamaspik Choice Inc Medicare	$88.75

SCREW BONE CANCELL 6.0MM / L80MM

Facility

$177.50

Service Code	HCPCS C1713
Hospital Charge Code	64904088
Hospital Revenue Code	278
Min. Negotiated Rate	$62.12
Max. Negotiated Rate	$186.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$97.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$106.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$88.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.06
Rate for Payer: EmblemHealth Commercial	$88.75
Rate for Payer: Fidelis Medicare Advantage	$186.38
Rate for Payer: Group Health Inc Commercial	$88.75
Rate for Payer: Group Health Inc Medicare	$62.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$88.75
Rate for Payer: Hamaspik Choice Inc Medicare	$88.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$115.38

SCREW BONE CANCELL 6.0MM / L85MM

Facility

$177.50

Service Code	HCPCS C1713
Hospital Charge Code	64903832
Hospital Revenue Code	278
Min. Negotiated Rate	$62.12
Max. Negotiated Rate	$186.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$97.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$106.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$88.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.06
Rate for Payer: EmblemHealth Commercial	$88.75
Rate for Payer: Fidelis Medicare Advantage	$186.38
Rate for Payer: Group Health Inc Commercial	$88.75
Rate for Payer: Group Health Inc Medicare	$62.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$88.75
Rate for Payer: Hamaspik Choice Inc Medicare	$88.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$115.38

SCREW BONE CANCELL 6.0MM / L85MM

Facility

$177.50

Service Code	HCPCS C1713
Hospital Charge Code	64903832
Hospital Revenue Code	278
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$88.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$88.75
Rate for Payer: Hamaspik Choice Inc Medicare	$88.75

SCREW BONE CANCELL 8MM 3MM/6.5

Facility

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64903664
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 CANCELL 8MM 3MM/6.5

Facility

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64903664
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 CANCELL 8MM/3MM 6.5

Facility

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64903662
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 CANCELL 8MM/3MM 6.5

Facility

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64903662
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 CANCELL 8MM/3MM/6.5

Facility

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64903660
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 CANCELL 8MM/3MM/6.5

Facility

$81.25

Service Code	HCPCS C1713
Hospital Charge Code	64903660
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 CANCELLOUS 4.0MM

Facility

$72.80

Service Code	HCPCS C1713
Hospital Charge Code	40205911
Hospital Revenue Code	278
Min. Negotiated Rate	$25.48
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$40.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$43.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$41.86
Rate for Payer: EmblemHealth Commercial	$36.40
Rate for Payer: Fidelis Medicare Advantage	$76.44
Rate for Payer: Group Health Inc Commercial	$36.40
Rate for Payer: Group Health Inc Medicare	$25.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.40
Rate for Payer: Hamaspik Choice Inc Medicare	$36.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$47.32

SCREW BONE CANCELLOUS 4.0MM

Facility

$72.80

Service Code	HCPCS C1713
Hospital Charge Code	40205911
Hospital Revenue Code	278
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$36.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.40
Rate for Payer: Hamaspik Choice Inc Medicare	$36.40

SCREW BONE CANCELLOUS SS 4

Facility

$34.00

Service Code	HCPCS C1776
Hospital Charge Code	40206033
Hospital Revenue Code	278
Min. Negotiated Rate	$11.90
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$20.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.55
Rate for Payer: EmblemHealth Commercial	$17.00
Rate for Payer: Fidelis Medicare Advantage	$35.70
Rate for Payer: Group Health Inc Commercial	$17.00
Rate for Payer: Group Health Inc Medicare	$11.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.00
Rate for Payer: Hamaspik Choice Inc Medicare	$17.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.10

SCREW BONE CANCELLOUS SS 4

Facility

$34.00

Service Code	HCPCS C1776
Hospital Charge Code	40206033
Hospital Revenue Code	278
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$17.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.00
Rate for Payer: Hamaspik Choice Inc Medicare	$17.00

SCREW BONE CANN SS7.3X95MM

Facility

$406.00

Service Code	HCPCS C1776
Hospital Charge Code	40205103
Hospital Revenue Code	278
Min. Negotiated Rate	$203.00
Max. Negotiated Rate	$203.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.00
Rate for Payer: Hamaspik Choice Inc Medicare	$203.00

SCREW BONE CANN SS7.3X95MM

Facility

$406.00

Service Code	HCPCS C1776
Hospital Charge Code	40205103
Hospital Revenue Code	278
Min. Negotiated Rate	$142.10
Max. Negotiated Rate	$426.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$223.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$243.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$203.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$233.45
Rate for Payer: EmblemHealth Commercial	$203.00
Rate for Payer: Fidelis Medicare Advantage	$426.30
Rate for Payer: Group Health Inc Commercial	$203.00
Rate for Payer: Group Health Inc Medicare	$142.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.00
Rate for Payer: Hamaspik Choice Inc Medicare	$203.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$263.90

SCREW BONE CANNUL 2MM 11MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902422
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$472.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$247.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$270.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$225.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$258.82
Rate for Payer: EmblemHealth Commercial	$225.06
Rate for Payer: Fidelis Medicare Advantage	$472.64
Rate for Payer: Group Health Inc Commercial	$225.06
Rate for Payer: Group Health Inc Medicare	$157.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.06
Rate for Payer: Hamaspik Choice Inc Medicare	$225.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$292.58

SCREW BONE CANNUL 2MM 11MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902422
Hospital Revenue Code	278
Min. Negotiated Rate	$225.06
Max. Negotiated Rate	$225.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.06
Rate for Payer: Hamaspik Choice Inc Medicare	$225.06

SCREW BONE CANNUL 2MM 12MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902424
Hospital Revenue Code	278
Min. Negotiated Rate	$225.06
Max. Negotiated Rate	$225.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.06
Rate for Payer: Hamaspik Choice Inc Medicare	$225.06

SCREW BONE CANNUL 2MM 12MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902424
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$472.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$247.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$270.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$225.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$258.82
Rate for Payer: EmblemHealth Commercial	$225.06
Rate for Payer: Fidelis Medicare Advantage	$472.64
Rate for Payer: Group Health Inc Commercial	$225.06
Rate for Payer: Group Health Inc Medicare	$157.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.06
Rate for Payer: Hamaspik Choice Inc Medicare	$225.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$292.58

SCREW BONE CANNUL 2MM 14MML T

Facility

$484.75

Service Code	HCPCS C1713
Hospital Charge Code	64902315
Hospital Revenue Code	278
Min. Negotiated Rate	$242.38
Max. Negotiated Rate	$242.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$242.38
Rate for Payer: Hamaspik Choice Inc Medicare	$242.38

SCREW BONE CANNUL 2MM 14MML T

Facility

$484.75

Service Code	HCPCS C1713
Hospital Charge Code	64902315
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$508.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$266.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$290.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$242.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$278.73
Rate for Payer: EmblemHealth Commercial	$242.38
Rate for Payer: Fidelis Medicare Advantage	$508.99
Rate for Payer: Group Health Inc Commercial	$242.38
Rate for Payer: Group Health Inc Medicare	$169.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$242.38
Rate for Payer: Hamaspik Choice Inc Medicare	$242.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$315.09

SCREW BONE CANNUL 2MM 16MML

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902021
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$472.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$247.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$270.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$225.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$258.82
Rate for Payer: EmblemHealth Commercial	$225.06
Rate for Payer: Fidelis Medicare Advantage	$472.64
Rate for Payer: Group Health Inc Commercial	$225.06
Rate for Payer: Group Health Inc Medicare	$157.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.06
Rate for Payer: Hamaspik Choice Inc Medicare	$225.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$292.58

SCREW BONE CANNUL 2MM 16MML

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902021
Hospital Revenue Code	278
Min. Negotiated Rate	$225.06
Max. Negotiated Rate	$225.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.06
Rate for Payer: Hamaspik Choice Inc Medicare	$225.06

SCREW BONE CANNUL 2MM 18MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902107
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$472.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$247.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$270.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$225.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$258.82
Rate for Payer: EmblemHealth Commercial	$225.06
Rate for Payer: Fidelis Medicare Advantage	$472.64
Rate for Payer: Group Health Inc Commercial	$225.06
Rate for Payer: Group Health Inc Medicare	$157.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.06
Rate for Payer: Hamaspik Choice Inc Medicare	$225.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$292.58

Know your out-of-pocket cost for care.

All Charges