St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE CANNUL LP 8MM DIA 9B

Facility

$607.75

Service Code	HCPCS C1713
Hospital Charge Code	64904612
Hospital Revenue Code	278
Min. Negotiated Rate	$303.88
Max. Negotiated Rate	$303.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$303.88
Rate for Payer: Hamaspik Choice Inc Medicare	$303.88

SCREW BONE COMPRESSION LOW-PRO

Facility

$157.50

Service Code	HCPCS C1713
Hospital Charge Code	64902793
Hospital Revenue Code	278
Min. Negotiated Rate	$78.75
Max. Negotiated Rate	$78.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$78.75
Rate for Payer: Hamaspik Choice Inc Medicare	$78.75

SCREW BONE COMPRESSION LOW-PRO

Facility

$157.50

Service Code	HCPCS C1713
Hospital Charge Code	64902793
Hospital Revenue Code	278
Min. Negotiated Rate	$55.12
Max. Negotiated Rate	$165.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$86.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$94.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$78.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$90.56
Rate for Payer: EmblemHealth Commercial	$78.75
Rate for Payer: Fidelis Medicare Advantage	$165.38
Rate for Payer: Group Health Inc Commercial	$78.75
Rate for Payer: Group Health Inc Medicare	$55.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$78.75
Rate for Payer: Hamaspik Choice Inc Medicare	$78.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$102.38

SCREW BONE CORT 5.0MM X 36MM

Facility

$496.00

Service Code	HCPCS C1713
Hospital Charge Code	40007506
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$520.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$272.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$297.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$248.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$285.20
Rate for Payer: EmblemHealth Commercial	$248.00
Rate for Payer: Fidelis Medicare Advantage	$520.80
Rate for Payer: Group Health Inc Commercial	$248.00
Rate for Payer: Group Health Inc Medicare	$173.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.00
Rate for Payer: Hamaspik Choice Inc Medicare	$248.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$322.40

SCREW BONE CORT 5.0MM X 36MM

Facility

$496.00

Service Code	HCPCS C1713
Hospital Charge Code	40007506
Hospital Revenue Code	278
Min. Negotiated Rate	$248.00
Max. Negotiated Rate	$248.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.00
Rate for Payer: Hamaspik Choice Inc Medicare	$248.00

SCREW BONE CORT 5.0MM X 36MM

Facility

$620.00

Service Code	HCPCS C1713
Hospital Charge Code	64905499
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$651.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$341.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$372.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$310.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$356.50
Rate for Payer: EmblemHealth Commercial	$310.00
Rate for Payer: Fidelis Medicare Advantage	$651.00
Rate for Payer: Group Health Inc Commercial	$310.00
Rate for Payer: Group Health Inc Medicare	$217.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$310.00
Rate for Payer: Hamaspik Choice Inc Medicare	$310.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$403.00

SCREW BONE CORT 5.0MM X 36MM

Facility

$620.00

Service Code	HCPCS C1713
Hospital Charge Code	64905499
Hospital Revenue Code	278
Min. Negotiated Rate	$310.00
Max. Negotiated Rate	$310.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$310.00
Rate for Payer: Hamaspik Choice Inc Medicare	$310.00

SCREW BONE CORT 5.0MMX36MM

Facility

$496.00

Service Code	HCPCS C1713
Hospital Charge Code	40204587
Hospital Revenue Code	278
Min. Negotiated Rate	$248.00
Max. Negotiated Rate	$248.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.00
Rate for Payer: Hamaspik Choice Inc Medicare	$248.00

SCREW BONE CORT 5.0MMX36MM

Facility

$496.00

Service Code	HCPCS C1713
Hospital Charge Code	40204587
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$520.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$272.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$297.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$248.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$285.20
Rate for Payer: EmblemHealth Commercial	$248.00
Rate for Payer: Fidelis Medicare Advantage	$520.80
Rate for Payer: Group Health Inc Commercial	$248.00
Rate for Payer: Group Health Inc Medicare	$173.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.00
Rate for Payer: Hamaspik Choice Inc Medicare	$248.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$322.40

SCREW BONE CORTICAL 5.0X38MM

Facility

$620.00

Service Code	HCPCS C1713
Hospital Charge Code	64905652
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$651.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$341.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$372.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$310.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$356.50
Rate for Payer: EmblemHealth Commercial	$310.00
Rate for Payer: Fidelis Medicare Advantage	$651.00
Rate for Payer: Group Health Inc Commercial	$310.00
Rate for Payer: Group Health Inc Medicare	$217.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$310.00
Rate for Payer: Hamaspik Choice Inc Medicare	$310.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$403.00

SCREW BONE CORTICAL 5.0X38MM

Facility

$620.00

Service Code	HCPCS C1713
Hospital Charge Code	64905652
Hospital Revenue Code	278
Min. Negotiated Rate	$310.00
Max. Negotiated Rate	$310.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$310.00
Rate for Payer: Hamaspik Choice Inc Medicare	$310.00

SCREW BONE CROSS PIN 2.0X14MM

Facility

$107.10

Service Code	HCPCS C1713
Hospital Charge Code	64901502
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$64.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.58
Rate for Payer: EmblemHealth Commercial	$53.55
Rate for Payer: Fidelis Medicare Advantage	$112.46
Rate for Payer: Group Health Inc Commercial	$53.55
Rate for Payer: Group Health Inc Medicare	$37.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.55
Rate for Payer: Hamaspik Choice Inc Medicare	$53.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$69.62

SCREW BONE CROSS PIN 2.0X14MM

Facility

$107.10

Service Code	HCPCS C1713
Hospital Charge Code	64901502
Hospital Revenue Code	278
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$53.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.55
Rate for Payer: Hamaspik Choice Inc Medicare	$53.55

SCREW BONE CROSS PIN 2.0X16MM

Facility

$107.10

Service Code	HCPCS C1713
Hospital Charge Code	64901504
Hospital Revenue Code	278
Min. Negotiated Rate	$37.48
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$64.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.58
Rate for Payer: EmblemHealth Commercial	$53.55
Rate for Payer: Fidelis Medicare Advantage	$112.46
Rate for Payer: Group Health Inc Commercial	$53.55
Rate for Payer: Group Health Inc Medicare	$37.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.55
Rate for Payer: Hamaspik Choice Inc Medicare	$53.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$69.62

SCREW BONE CROSS PIN 2.0X16MM

Facility

$107.10

Service Code	HCPCS C1713
Hospital Charge Code	64901504
Hospital Revenue Code	278
Min. Negotiated Rate	$53.55
Max. Negotiated Rate	$53.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.55
Rate for Payer: Hamaspik Choice Inc Medicare	$53.55

SCREW BONE CROSS PIN 2.3X14MM

Facility

$131.18

Service Code	HCPCS C1713
Hospital Charge Code	64901478
Hospital Revenue Code	278
Min. Negotiated Rate	$65.59
Max. Negotiated Rate	$65.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.59
Rate for Payer: Hamaspik Choice Inc Medicare	$65.59

SCREW BONE CROSS PIN 2.3X14MM

Facility

$131.18

Service Code	HCPCS C1713
Hospital Charge Code	64901478
Hospital Revenue Code	278
Min. Negotiated Rate	$45.91
Max. Negotiated Rate	$137.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$72.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$78.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$65.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$75.43
Rate for Payer: EmblemHealth Commercial	$65.59
Rate for Payer: Fidelis Medicare Advantage	$137.74
Rate for Payer: Group Health Inc Commercial	$65.59
Rate for Payer: Group Health Inc Medicare	$45.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.59
Rate for Payer: Hamaspik Choice Inc Medicare	$65.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$85.27

SCREW BONE CROS ST 1.7X13MM

Facility

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64905504
Hospital Revenue Code	278
Min. Negotiated Rate	$62.56
Max. Negotiated Rate	$187.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$107.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$89.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.78
Rate for Payer: EmblemHealth Commercial	$89.38
Rate for Payer: Fidelis Medicare Advantage	$187.69
Rate for Payer: Group Health Inc Commercial	$89.38
Rate for Payer: Group Health Inc Medicare	$62.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$116.19

SCREW BONE CROS ST 1.7X13MM

Facility

$143.00

Service Code	HCPCS C1713
Hospital Charge Code	40005909
Hospital Revenue Code	278
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$71.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.50
Rate for Payer: Hamaspik Choice Inc Medicare	$71.50

SCREW BONE CROS ST 1.7X13MM

Facility

$143.00

Service Code	HCPCS C1713
Hospital Charge Code	40005909
Hospital Revenue Code	278
Min. Negotiated Rate	$50.05
Max. Negotiated Rate	$150.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$78.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$85.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$82.22
Rate for Payer: EmblemHealth Commercial	$71.50
Rate for Payer: Fidelis Medicare Advantage	$150.15
Rate for Payer: Group Health Inc Commercial	$71.50
Rate for Payer: Group Health Inc Medicare	$50.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.50
Rate for Payer: Hamaspik Choice Inc Medicare	$71.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$92.95

SCREW BONE CROS ST 1.7X13MM

Facility

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64905504
Hospital Revenue Code	278
Min. Negotiated Rate	$89.38
Max. Negotiated Rate	$89.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38

SCREW BONE CROS ST 1.7X15MM

Facility

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64905506
Hospital Revenue Code	278
Min. Negotiated Rate	$89.38
Max. Negotiated Rate	$89.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38

SCREW BONE CROS ST 1.7X15MM

Facility

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64905506
Hospital Revenue Code	278
Min. Negotiated Rate	$62.56
Max. Negotiated Rate	$187.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$107.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$89.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.78
Rate for Payer: EmblemHealth Commercial	$89.38
Rate for Payer: Fidelis Medicare Advantage	$187.69
Rate for Payer: Group Health Inc Commercial	$89.38
Rate for Payer: Group Health Inc Medicare	$62.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$116.19

SCREW BONE CROS ST 1.7X15MM

Facility

$143.00

Service Code	HCPCS C1713
Hospital Charge Code	40005910
Hospital Revenue Code	278
Min. Negotiated Rate	$50.05
Max. Negotiated Rate	$150.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$78.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$85.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$82.22
Rate for Payer: EmblemHealth Commercial	$71.50
Rate for Payer: Fidelis Medicare Advantage	$150.15
Rate for Payer: Group Health Inc Commercial	$71.50
Rate for Payer: Group Health Inc Medicare	$50.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.50
Rate for Payer: Hamaspik Choice Inc Medicare	$71.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$92.95

SCREW BONE CROS ST 1.7X15MM

Facility

$143.00

Service Code	HCPCS C1713
Hospital Charge Code	40005910
Hospital Revenue Code	278
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$71.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.50
Rate for Payer: Hamaspik Choice Inc Medicare	$71.50

Know your out-of-pocket cost for care.

All Charges