St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CANNUL C 3.2MM/4.1MB

Facility

$804.38

Service Code	HCPCS C1713
Hospital Charge Code	64902305
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$844.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$442.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$482.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$402.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$462.52
Rate for Payer: EmblemHealth Commercial	$402.19
Rate for Payer: Fidelis Medicare Advantage	$844.60
Rate for Payer: Group Health Inc Commercial	$402.19
Rate for Payer: Group Health Inc Medicare	$281.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$402.19
Rate for Payer: Hamaspik Choice Inc Medicare	$402.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$522.85

SCREW BONE CANNUL C 3.2MM/4.1MB

Facility

$804.38

Service Code	HCPCS C1713
Hospital Charge Code	64902305
Hospital Revenue Code	278
Min. Negotiated Rate	$402.19
Max. Negotiated Rate	$402.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$402.19
Rate for Payer: Hamaspik Choice Inc Medicare	$402.19

SCREW BONE CANNUL C 3.5MM DIA

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64904574
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,372.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$719.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$784.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$653.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$751.81
Rate for Payer: EmblemHealth Commercial	$653.75
Rate for Payer: Fidelis Medicare Advantage	$1,372.88
Rate for Payer: Group Health Inc Commercial	$653.75
Rate for Payer: Group Health Inc Medicare	$457.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$849.88

SCREW BONE CANNUL C 3.5MM DIA

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64904574
Hospital Revenue Code	278
Min. Negotiated Rate	$653.75
Max. Negotiated Rate	$653.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75

SCREW BONE CANNUL C C-FIX 3.5M

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904777
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,454.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$761.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$831.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$692.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$796.38
Rate for Payer: EmblemHealth Commercial	$692.50
Rate for Payer: Fidelis Medicare Advantage	$1,454.25
Rate for Payer: Group Health Inc Commercial	$692.50
Rate for Payer: Group Health Inc Medicare	$484.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$900.25

SCREW BONE CANNUL C C-FIX 3.5M

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904777
Hospital Revenue Code	278
Min. Negotiated Rate	$692.50
Max. Negotiated Rate	$692.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50

SCREW BONE CANNUL C C-FIX HEADA

Facility

$998.33

Service Code	HCPCS C1713
Hospital Charge Code	64904006
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,048.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$549.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$599.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$499.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$574.04
Rate for Payer: EmblemHealth Commercial	$499.16
Rate for Payer: Fidelis Medicare Advantage	$1,048.25
Rate for Payer: Group Health Inc Commercial	$499.16
Rate for Payer: Group Health Inc Medicare	$349.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$499.16
Rate for Payer: Hamaspik Choice Inc Medicare	$499.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$648.91

SCREW BONE CANNUL C C-FIX HEADA

Facility

$998.33

Service Code	HCPCS C1713
Hospital Charge Code	64904006
Hospital Revenue Code	278
Min. Negotiated Rate	$499.16
Max. Negotiated Rate	$499.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$499.16
Rate for Payer: Hamaspik Choice Inc Medicare	$499.16

SCREW BONE CANNUL C C-FIX HEADB

Facility

$1,078.70

Service Code	HCPCS C1713
Hospital Charge Code	64904008
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,132.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$593.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$647.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$539.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$620.25
Rate for Payer: EmblemHealth Commercial	$539.35
Rate for Payer: Fidelis Medicare Advantage	$1,132.64
Rate for Payer: Group Health Inc Commercial	$539.35
Rate for Payer: Group Health Inc Medicare	$377.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$539.35
Rate for Payer: Hamaspik Choice Inc Medicare	$539.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$701.16

SCREW BONE CANNUL C C-FIX HEADB

Facility

$1,078.70

Service Code	HCPCS C1713
Hospital Charge Code	64904008
Hospital Revenue Code	278
Min. Negotiated Rate	$539.35
Max. Negotiated Rate	$539.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$539.35
Rate for Payer: Hamaspik Choice Inc Medicare	$539.35

SCREW BONE CANNUL C C-FIX HEADC

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904883
Hospital Revenue Code	278
Min. Negotiated Rate	$692.50
Max. Negotiated Rate	$692.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50

SCREW BONE CANNUL C C-FIX HEADC

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904883
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,454.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$761.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$831.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$692.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$796.38
Rate for Payer: EmblemHealth Commercial	$692.50
Rate for Payer: Fidelis Medicare Advantage	$1,454.25
Rate for Payer: Group Health Inc Commercial	$692.50
Rate for Payer: Group Health Inc Medicare	$484.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$900.25

SCREW BONE CANNUL C C-FIX HEADD

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64904928
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,372.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$719.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$784.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$653.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$751.81
Rate for Payer: EmblemHealth Commercial	$653.75
Rate for Payer: Fidelis Medicare Advantage	$1,372.88
Rate for Payer: Group Health Inc Commercial	$653.75
Rate for Payer: Group Health Inc Medicare	$457.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$849.88

SCREW BONE CANNUL C C-FIX HEADD

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64904928
Hospital Revenue Code	278
Min. Negotiated Rate	$653.75
Max. Negotiated Rate	$653.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75

SCREW BONE CANNUL C MV 4MM DIA

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904887
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,454.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$761.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$831.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$692.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$796.38
Rate for Payer: EmblemHealth Commercial	$692.50
Rate for Payer: Fidelis Medicare Advantage	$1,454.25
Rate for Payer: Group Health Inc Commercial	$692.50
Rate for Payer: Group Health Inc Medicare	$484.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$900.25

SCREW BONE CANNUL C MV 4MM DIA

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904887
Hospital Revenue Code	278
Min. Negotiated Rate	$692.50
Max. Negotiated Rate	$692.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50

SCREW BONE CANNUL C MV HEADLES

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904885
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,454.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$761.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$831.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$692.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$796.38
Rate for Payer: EmblemHealth Commercial	$692.50
Rate for Payer: Fidelis Medicare Advantage	$1,454.25
Rate for Payer: Group Health Inc Commercial	$692.50
Rate for Payer: Group Health Inc Medicare	$484.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$900.25

SCREW BONE CANNUL C MV HEADLES

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904885
Hospital Revenue Code	278
Min. Negotiated Rate	$692.50
Max. Negotiated Rate	$692.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50

SCREW BONE CANNUL C S-FIX HEADB

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904692
Hospital Revenue Code	278
Min. Negotiated Rate	$692.50
Max. Negotiated Rate	$692.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50

SCREW BONE CANNUL C S-FIX HEADB

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904692
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,454.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$761.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$831.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$692.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$796.38
Rate for Payer: EmblemHealth Commercial	$692.50
Rate for Payer: Fidelis Medicare Advantage	$1,454.25
Rate for Payer: Group Health Inc Commercial	$692.50
Rate for Payer: Group Health Inc Medicare	$484.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$900.25

SCREW BONE CANNUL C S-FIX HEADC

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64904694
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,372.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$719.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$784.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$653.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$751.81
Rate for Payer: EmblemHealth Commercial	$653.75
Rate for Payer: Fidelis Medicare Advantage	$1,372.88
Rate for Payer: Group Health Inc Commercial	$653.75
Rate for Payer: Group Health Inc Medicare	$457.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$849.88

SCREW BONE CANNUL C S-FIX HEADC

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64904694
Hospital Revenue Code	278
Min. Negotiated Rate	$653.75
Max. Negotiated Rate	$653.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75

SCREW BONE CANNUL C S-FIX HEADD

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904775
Hospital Revenue Code	278
Min. Negotiated Rate	$692.50
Max. Negotiated Rate	$692.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50

SCREW BONE CANNUL C S-FIX HEADD

Facility

$1,385.00

Service Code	HCPCS C1713
Hospital Charge Code	64904775
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,454.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$761.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$831.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$692.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$796.38
Rate for Payer: EmblemHealth Commercial	$692.50
Rate for Payer: Fidelis Medicare Advantage	$1,454.25
Rate for Payer: Group Health Inc Commercial	$692.50
Rate for Payer: Group Health Inc Medicare	$484.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$692.50
Rate for Payer: Hamaspik Choice Inc Medicare	$692.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$900.25

SCREW BONE CANNUL HEADLESS 2.5X18

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64905220
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,372.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$719.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$784.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$653.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$751.81
Rate for Payer: EmblemHealth Commercial	$653.75
Rate for Payer: Fidelis Medicare Advantage	$1,372.88
Rate for Payer: Group Health Inc Commercial	$653.75
Rate for Payer: Group Health Inc Medicare	$457.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$849.88

Know your out-of-pocket cost for care.

All Charges