St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CANNUL 5.0 X 75MM

Facility

$427.38

Service Code	HCPCS C1713
Hospital Charge Code	64905160
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$448.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$256.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$213.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$245.74
Rate for Payer: EmblemHealth Commercial	$213.69
Rate for Payer: Fidelis Medicare Advantage	$448.75
Rate for Payer: Group Health Inc Commercial	$213.69
Rate for Payer: Group Health Inc Medicare	$149.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$213.69
Rate for Payer: Hamaspik Choice Inc Medicare	$213.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$277.80

SCREW BONE CANNUL 5.0 X 75MM

Facility

$427.38

Service Code	HCPCS C1713
Hospital Charge Code	64905160
Hospital Revenue Code	278
Min. Negotiated Rate	$213.69
Max. Negotiated Rate	$213.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$213.69
Rate for Payer: Hamaspik Choice Inc Medicare	$213.69

SCREW BONE CANNUL5MM/2.5MM/4M

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64903775
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 CANNUL5MM/2.5MM/4M

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64903775
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 5MM DIA 46MM

Facility

$427.38

Service Code	HCPCS C1713
Hospital Charge Code	64902269
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$448.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$256.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$213.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$245.74
Rate for Payer: EmblemHealth Commercial	$213.69
Rate for Payer: Fidelis Medicare Advantage	$448.75
Rate for Payer: Group Health Inc Commercial	$213.69
Rate for Payer: Group Health Inc Medicare	$149.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$213.69
Rate for Payer: Hamaspik Choice Inc Medicare	$213.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$277.80

SCREW BONE CANNUL 5MM DIA 46MM

Facility

$427.38

Service Code	HCPCS C1713
Hospital Charge Code	64902269
Hospital Revenue Code	278
Min. Negotiated Rate	$213.69
Max. Negotiated Rate	$213.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$213.69
Rate for Payer: Hamaspik Choice Inc Medicare	$213.69

SCREW BONE CANNUL 5MM DIA 70MM

Facility

$427.38

Service Code	HCPCS C1713
Hospital Charge Code	64903595
Hospital Revenue Code	278
Min. Negotiated Rate	$213.69
Max. Negotiated Rate	$213.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$213.69
Rate for Payer: Hamaspik Choice Inc Medicare	$213.69

SCREW BONE CANNUL 5MM DIA 70MM

Facility

$427.38

Service Code	HCPCS C1713
Hospital Charge Code	64903595
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$448.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$256.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$213.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$245.74
Rate for Payer: EmblemHealth Commercial	$213.69
Rate for Payer: Fidelis Medicare Advantage	$448.75
Rate for Payer: Group Health Inc Commercial	$213.69
Rate for Payer: Group Health Inc Medicare	$149.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$213.69
Rate for Payer: Hamaspik Choice Inc Medicare	$213.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$277.80

SCREW BONE CANNUL 6.5MM 90MML

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64905412
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 CANNUL 6.5MM 90MML

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64905412
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 CANNUL 6.5MM DIA 10

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64901710
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 CANNUL 6.5MM DIA 10

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64901710
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 CANNUL 6.5MM DIA 80 A

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64901777
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 CANNUL 6.5MM DIA 80 A

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64901777
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 CANNUL 6.5MM DIA 80 B

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64902914
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 CANNUL 6.5MM DIA 80 B

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64902914
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 CANNUL 6.5MM DIA 85 A

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64902912
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 CANNUL 6.5MM DIA 85 A

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64902912
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 CANNUL 6.5MM DIA 85 B

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64903333
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 CANNUL 6.5MM DIA 85 B

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64903333
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 CANNUL 6.5MM DIA 90

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64902544
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 CANNUL 6.5MM DIA 90

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64902544
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 CANNUL 6.5MM DIA 95

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64901957
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 CANNUL 6.5MM DIA 95

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64901957
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 CANNUL 6.5X60MM

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64905607
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

Know your out-of-pocket cost for care.

All Charges