St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$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 LAG 6.5MM DI1

Facility

$503.25

Service Code	HCPCS C1713
Hospital Charge Code	64901333
Hospital Revenue Code	278
Min. Negotiated Rate	$251.62
Max. Negotiated Rate	$251.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.62
Rate for Payer: Hamaspik Choice Inc Medicare	$251.62

SCREW BONE CANNUL LAG 6.5MM DI1

Facility

$503.25

Service Code	HCPCS C1713
Hospital Charge Code	64901333
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$528.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$301.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$251.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$289.37
Rate for Payer: EmblemHealth Commercial	$251.62
Rate for Payer: Fidelis Medicare Advantage	$528.41
Rate for Payer: Group Health Inc Commercial	$251.62
Rate for Payer: Group Health Inc Medicare	$176.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.62
Rate for Payer: Hamaspik Choice Inc Medicare	$251.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$327.11

SCREW BONE CANNUL LAG 6.5MM DI2

Facility

$554.75

Service Code	HCPCS C1713
Hospital Charge Code	64901357
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$582.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$305.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$332.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$277.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$318.98
Rate for Payer: EmblemHealth Commercial	$277.38
Rate for Payer: Fidelis Medicare Advantage	$582.49
Rate for Payer: Group Health Inc Commercial	$277.38
Rate for Payer: Group Health Inc Medicare	$194.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.38
Rate for Payer: Hamaspik Choice Inc Medicare	$277.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$360.59

SCREW BONE CANNUL LAG 6.5MM DI2

Facility

$554.75

Service Code	HCPCS C1713
Hospital Charge Code	64901357
Hospital Revenue Code	278
Min. Negotiated Rate	$277.38
Max. Negotiated Rate	$277.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.38
Rate for Payer: Hamaspik Choice Inc Medicare	$277.38

SCREW BONE CANNUL LAG 6.5MM DI3

Facility

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64901417
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$583.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$305.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$333.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$277.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$319.56
Rate for Payer: EmblemHealth Commercial	$277.88
Rate for Payer: Fidelis Medicare Advantage	$583.54
Rate for Payer: Group Health Inc Commercial	$277.88
Rate for Payer: Group Health Inc Medicare	$194.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$361.24

SCREW BONE CANNUL LAG 6.5MM DI3

Facility

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64901417
Hospital Revenue Code	278
Min. Negotiated Rate	$277.88
Max. Negotiated Rate	$277.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88

SCREW BONE CANNUL LAG 6.5MM DI4

Facility

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64901419
Hospital Revenue Code	278
Min. Negotiated Rate	$277.88
Max. Negotiated Rate	$277.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88

SCREW BONE CANNUL LAG 6.5MM DI4

Facility

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64901419
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$583.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$305.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$333.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$277.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$319.56
Rate for Payer: EmblemHealth Commercial	$277.88
Rate for Payer: Fidelis Medicare Advantage	$583.54
Rate for Payer: Group Health Inc Commercial	$277.88
Rate for Payer: Group Health Inc Medicare	$194.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$361.24

SCREW BONE CANNUL LAG 6.5MM DI5

Facility

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64901771
Hospital Revenue Code	278
Min. Negotiated Rate	$277.88
Max. Negotiated Rate	$277.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88

SCREW BONE CANNUL LAG 6.5MM DI5

Facility

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64901771
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$583.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$305.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$333.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$277.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$319.56
Rate for Payer: EmblemHealth Commercial	$277.88
Rate for Payer: Fidelis Medicare Advantage	$583.54
Rate for Payer: Group Health Inc Commercial	$277.88
Rate for Payer: Group Health Inc Medicare	$194.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$361.24

SCREW BONE CANNUL LAG 6.5MM DI6

Facility

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64904973
Hospital Revenue Code	278
Min. Negotiated Rate	$277.88
Max. Negotiated Rate	$277.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88

SCREW BONE CANNUL LAG 6.5MM DI6

Facility

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64904973
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$583.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$305.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$333.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$277.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$319.56
Rate for Payer: EmblemHealth Commercial	$277.88
Rate for Payer: Fidelis Medicare Advantage	$583.54
Rate for Payer: Group Health Inc Commercial	$277.88
Rate for Payer: Group Health Inc Medicare	$194.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$361.24

SCREW BONE CANNUL LAG LP 6.5MM

Facility

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64903791
Hospital Revenue Code	278
Min. Negotiated Rate	$277.88
Max. Negotiated Rate	$277.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88

SCREW BONE CANNUL LAG LP 6.5MM

Facility

$555.75

Service Code	HCPCS C1713
Hospital Charge Code	64903791
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$583.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$305.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$333.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$277.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$319.56
Rate for Payer: EmblemHealth Commercial	$277.88
Rate for Payer: Fidelis Medicare Advantage	$583.54
Rate for Payer: Group Health Inc Commercial	$277.88
Rate for Payer: Group Health Inc Medicare	$194.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$277.88
Rate for Payer: Hamaspik Choice Inc Medicare	$277.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$361.24

SCREW BONE CANNUL LOCKING 5M

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64902536
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50

SCREW BONE CANNUL LOCKING 5M

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64902536
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$450.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$257.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$214.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.68
Rate for Payer: EmblemHealth Commercial	$214.50
Rate for Payer: Fidelis Medicare Advantage	$450.45
Rate for Payer: Group Health Inc Commercial	$214.50
Rate for Payer: Group Health Inc Medicare	$150.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$278.85

SCREW BONE CANNUL LOCKING 5MM

Facility

$41,825.00

Service Code	HCPCS C1713
Hospital Charge Code	64902361
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$43,916.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23,003.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$25,095.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20,912.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$24,049.38
Rate for Payer: EmblemHealth Commercial	$20,912.50
Rate for Payer: Fidelis Medicare Advantage	$43,916.25
Rate for Payer: Group Health Inc Commercial	$20,912.50
Rate for Payer: Group Health Inc Medicare	$14,638.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,912.50
Rate for Payer: Hamaspik Choice Inc Medicare	$20,912.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$27,186.25

SCREW BONE CANNUL LOCKING 5MM

Facility

$41,825.00

Service Code	HCPCS C1713
Hospital Charge Code	64902361
Hospital Revenue Code	278
Min. Negotiated Rate	$20,912.50
Max. Negotiated Rate	$20,912.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$20,912.50
Rate for Payer: Hamaspik Choice Inc Medicare	$20,912.50

SCREW BONE CANNUL LP 2MM 10MM

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901929
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 LP 2MM 10MM

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901929
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 LP 2MM 13MM

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901931
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 LP 2MM 13MM

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64901931
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 LP 2MM 9MML

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902103
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 LP 2MM 9MML

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902103
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

Know your out-of-pocket cost for care.

All Charges