St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CANNUL 2MM 18MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902107
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 20MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902109
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 20MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902109
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 8MML TI

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902420
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 8MML TI

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902420
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 3.0MM 5/6

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64905591
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 3.0MM 5/6

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64905591
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 3MM 14MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902026
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 3MM 14MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902026
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 3MM 16MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901901
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 3MM 16MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901901
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 3MM 18MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901903
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 3MM 18MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901903
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 3MM 20MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901905
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 3MM 20MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901905
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 3MM 22MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901960
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 3MM 22MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901960
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 3MM 38MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902061
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 3MM 38MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902061
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 3MM 40MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902113
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 3MM 40MML T

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902113
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 4.0MM DIA 30MM

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64905222
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$409.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$234.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$195.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.25
Rate for Payer: EmblemHealth Commercial	$195.00
Rate for Payer: Fidelis Medicare Advantage	$409.50
Rate for Payer: Group Health Inc Commercial	$195.00
Rate for Payer: Group Health Inc Medicare	$136.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$253.50

SCREW BONE CANNUL 4.0MM DIA 30MM

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64905222
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00

SCREW BONE CANNUL 4MM 36MML

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64905198
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00

SCREW BONE CANNUL 4MM 36MML

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64905198
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$409.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$234.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$195.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.25
Rate for Payer: EmblemHealth Commercial	$195.00
Rate for Payer: Fidelis Medicare Advantage	$409.50
Rate for Payer: Group Health Inc Commercial	$195.00
Rate for Payer: Group Health Inc Medicare	$136.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$253.50

Know your out-of-pocket cost for care.

All Charges