St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE SLF DRL VARI 4X16MM

Facility

$4,482.40

Service Code	HCPCS C1713
Hospital Charge Code	64906750
Hospital Revenue Code	278
Min. Negotiated Rate	$2,241.20
Max. Negotiated Rate	$2,241.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,241.20
Rate for Payer: Hamaspik Choice Inc Medicare	$2,241.20

SCREW BONE SLF DRL VARI 4X16MM

Facility

$4,482.40

Service Code	HCPCS C1713
Hospital Charge Code	64906750
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,706.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,465.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,689.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,241.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,577.38
Rate for Payer: EmblemHealth Commercial	$2,241.20
Rate for Payer: Fidelis Medicare Advantage	$4,706.52
Rate for Payer: Group Health Inc Commercial	$2,241.20
Rate for Payer: Group Health Inc Medicare	$1,568.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,241.20
Rate for Payer: Hamaspik Choice Inc Medicare	$2,241.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,913.56

SCREW BONE SL TP 6.5MMD 20MM

Facility

$138.00

Service Code	HCPCS C1713
Hospital Charge Code	64906445
Hospital Revenue Code	278
Min. Negotiated Rate	$69.00
Max. Negotiated Rate	$69.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.00
Rate for Payer: Hamaspik Choice Inc Medicare	$69.00

SCREW BONE SL TP 6.5MMD 20MM

Facility

$138.00

Service Code	HCPCS C1713
Hospital Charge Code	64906445
Hospital Revenue Code	278
Min. Negotiated Rate	$48.30
Max. Negotiated Rate	$144.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$75.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$82.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$69.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$79.35
Rate for Payer: EmblemHealth Commercial	$69.00
Rate for Payer: Fidelis Medicare Advantage	$144.90
Rate for Payer: Group Health Inc Commercial	$69.00
Rate for Payer: Group Health Inc Medicare	$48.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$69.00
Rate for Payer: Hamaspik Choice Inc Medicare	$69.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$89.70

SCREW BONE T10 2.7 X 16MM

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902465
Hospital Revenue Code	278
Min. Negotiated Rate	$47.21
Max. Negotiated Rate	$141.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$80.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.56
Rate for Payer: EmblemHealth Commercial	$67.44
Rate for Payer: Fidelis Medicare Advantage	$141.62
Rate for Payer: Group Health Inc Commercial	$67.44
Rate for Payer: Group Health Inc Medicare	$47.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$87.67

SCREW BONE T10 2.7 X 16MM

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902465
Hospital Revenue Code	278
Min. Negotiated Rate	$67.44
Max. Negotiated Rate	$67.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44

SCREW BONE T10 2.7 X 18MM

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902462
Hospital Revenue Code	278
Min. Negotiated Rate	$47.21
Max. Negotiated Rate	$141.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$80.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.56
Rate for Payer: EmblemHealth Commercial	$67.44
Rate for Payer: Fidelis Medicare Advantage	$141.62
Rate for Payer: Group Health Inc Commercial	$67.44
Rate for Payer: Group Health Inc Medicare	$47.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$87.67

SCREW BONE T10 2.7 X 18MM

Facility

$134.88

Service Code	HCPCS C1713
Hospital Charge Code	64902462
Hospital Revenue Code	278
Min. Negotiated Rate	$67.44
Max. Negotiated Rate	$67.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.44
Rate for Payer: Hamaspik Choice Inc Medicare	$67.44

SCREW BONE T10 3.5X46MM

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902728
Hospital Revenue Code	278
Min. Negotiated Rate	$51.76
Max. Negotiated Rate	$155.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$88.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$73.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.03
Rate for Payer: EmblemHealth Commercial	$73.94
Rate for Payer: Fidelis Medicare Advantage	$155.27
Rate for Payer: Group Health Inc Commercial	$73.94
Rate for Payer: Group Health Inc Medicare	$51.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.94
Rate for Payer: Hamaspik Choice Inc Medicare	$73.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.12

SCREW BONE T10 3.5X46MM

Facility

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	64902728
Hospital Revenue Code	278
Min. Negotiated Rate	$73.94
Max. Negotiated Rate	$73.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.94
Rate for Payer: Hamaspik Choice Inc Medicare	$73.94

SCREW,BONE T10 FL THR 2.7MM/L12MM

Facility

$272.00

Service Code	HCPCS C1713
Hospital Charge Code	40005906
Hospital Revenue Code	278
Min. Negotiated Rate	$136.00
Max. Negotiated Rate	$136.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00

SCREW,BONE T10 FL THR 2.7MM/L12MM

Facility

$272.00

Service Code	HCPCS C1713
Hospital Charge Code	40005906
Hospital Revenue Code	278
Min. Negotiated Rate	$95.20
Max. Negotiated Rate	$285.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$149.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$163.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.40
Rate for Payer: EmblemHealth Commercial	$136.00
Rate for Payer: Fidelis Medicare Advantage	$285.60
Rate for Payer: Group Health Inc Commercial	$136.00
Rate for Payer: Group Health Inc Medicare	$95.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$176.80

SCREW BONE T10 FT 2.7L16MM

Facility

$136.00

Service Code	HCPCS C1713
Hospital Charge Code	64906305
Hospital Revenue Code	278
Min. Negotiated Rate	$68.00
Max. Negotiated Rate	$68.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.00
Rate for Payer: Hamaspik Choice Inc Medicare	$68.00

SCREW BONE T10 FT 2.7L16MM

Facility

$136.00

Service Code	HCPCS C1713
Hospital Charge Code	64906305
Hospital Revenue Code	278
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$142.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$81.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$68.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.20
Rate for Payer: EmblemHealth Commercial	$68.00
Rate for Payer: Fidelis Medicare Advantage	$142.80
Rate for Payer: Group Health Inc Commercial	$68.00
Rate for Payer: Group Health Inc Medicare	$47.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.00
Rate for Payer: Hamaspik Choice Inc Medicare	$68.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$88.40

SCREW BONE T10 FT 2.7MM/L10MM

Facility

$626.88

Service Code	HCPCS C1713
Hospital Charge Code	64905799
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$658.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$344.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$376.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$313.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$360.46
Rate for Payer: EmblemHealth Commercial	$313.44
Rate for Payer: Fidelis Medicare Advantage	$658.22
Rate for Payer: Group Health Inc Commercial	$313.44
Rate for Payer: Group Health Inc Medicare	$219.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.44
Rate for Payer: Hamaspik Choice Inc Medicare	$313.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$407.47

SCREW BONE T10 FT 2.7MM/L10MM

Facility

$626.88

Service Code	HCPCS C1713
Hospital Charge Code	64905799
Hospital Revenue Code	278
Min. Negotiated Rate	$313.44
Max. Negotiated Rate	$313.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.44
Rate for Payer: Hamaspik Choice Inc Medicare	$313.44

SCREW BONE T10 FT 2.7MM/L12MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905480
Hospital Revenue Code	278
Min. Negotiated Rate	$170.00
Max. Negotiated Rate	$170.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00

SCREW BONE T10 FT 2.7MM/L12MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905480
Hospital Revenue Code	278
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$357.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$187.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$204.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$170.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: EmblemHealth Commercial	$170.00
Rate for Payer: Fidelis Medicare Advantage	$357.00
Rate for Payer: Group Health Inc Commercial	$170.00
Rate for Payer: Group Health Inc Medicare	$119.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$221.00

SCREW BONE T10 FT 2.7MM/L16MM

Facility

$626.88

Service Code	HCPCS C1713
Hospital Charge Code	64905801
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$658.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$344.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$376.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$313.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$360.46
Rate for Payer: EmblemHealth Commercial	$313.44
Rate for Payer: Fidelis Medicare Advantage	$658.22
Rate for Payer: Group Health Inc Commercial	$313.44
Rate for Payer: Group Health Inc Medicare	$219.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.44
Rate for Payer: Hamaspik Choice Inc Medicare	$313.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$407.47

SCREW BONE T10 FT 2.7MM/L16MM

Facility

$626.88

Service Code	HCPCS C1713
Hospital Charge Code	64905801
Hospital Revenue Code	278
Min. Negotiated Rate	$313.44
Max. Negotiated Rate	$313.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.44
Rate for Payer: Hamaspik Choice Inc Medicare	$313.44

SCREW BONE T10 FT 2.7MM / L20MM

Facility

$272.00

Service Code	HCPCS C1713
Hospital Charge Code	64906512
Hospital Revenue Code	278
Min. Negotiated Rate	$136.00
Max. Negotiated Rate	$136.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00

SCREW BONE T10 FT 2.7MM / L20MM

Facility

$272.00

Service Code	HCPCS C1713
Hospital Charge Code	64906512
Hospital Revenue Code	278
Min. Negotiated Rate	$95.20
Max. Negotiated Rate	$285.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$149.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$163.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.40
Rate for Payer: EmblemHealth Commercial	$136.00
Rate for Payer: Fidelis Medicare Advantage	$285.60
Rate for Payer: Group Health Inc Commercial	$136.00
Rate for Payer: Group Health Inc Medicare	$95.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$176.80

SCREW BONE T10 FT 2.7MM/L34MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905797
Hospital Revenue Code	278
Min. Negotiated Rate	$170.00
Max. Negotiated Rate	$170.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00

SCREW BONE T10 FT 2.7MM/L34MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905797
Hospital Revenue Code	278
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$357.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$187.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$204.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$170.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: EmblemHealth Commercial	$170.00
Rate for Payer: Fidelis Medicare Advantage	$357.00
Rate for Payer: Group Health Inc Commercial	$170.00
Rate for Payer: Group Health Inc Medicare	$119.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$221.00

SCREW BONE T10 FT 2.7MM / L40MM

Facility

$136.00

Service Code	HCPCS C1713
Hospital Charge Code	64906273
Hospital Revenue Code	278
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$142.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$81.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$68.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.20
Rate for Payer: EmblemHealth Commercial	$68.00
Rate for Payer: Fidelis Medicare Advantage	$142.80
Rate for Payer: Group Health Inc Commercial	$68.00
Rate for Payer: Group Health Inc Medicare	$47.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.00
Rate for Payer: Hamaspik Choice Inc Medicare	$68.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$88.40

Know your out-of-pocket cost for care.

All Charges