St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$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 3.5MM / L55MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905639
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 3.5MM / L55MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905639
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 FULL 3.5 L42

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905031
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 FULL 3.5 L42

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905031
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 FULL 3.5 L50

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905033
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 FULL 3.5 L50

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905033
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 T2 5MM

Facility

$866.25

Service Code	HCPCS C1713
Hospital Charge Code	64907502
Hospital Revenue Code	278
Min. Negotiated Rate	$433.12
Max. Negotiated Rate	$433.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$433.12
Rate for Payer: Hamaspik Choice Inc Medicare	$433.12

SCREW BONE T2 5MM

Facility

$866.25

Service Code	HCPCS C1713
Hospital Charge Code	64907502
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$909.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$476.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$519.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$433.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$498.09
Rate for Payer: EmblemHealth Commercial	$433.12
Rate for Payer: Fidelis Medicare Advantage	$909.56
Rate for Payer: Group Health Inc Commercial	$433.12
Rate for Payer: Group Health Inc Medicare	$303.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$433.12
Rate for Payer: Hamaspik Choice Inc Medicare	$433.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$563.06

SCREW BONE T2 FT 5 X 27.5MM

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64905729
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 T2 FT 5 X 27.5MM

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64905729
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 T8 2.7MM

Facility

$230.18

Service Code	HCPCS C1713
Hospital Charge Code	64907501
Hospital Revenue Code	278
Min. Negotiated Rate	$115.09
Max. Negotiated Rate	$115.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.09
Rate for Payer: Hamaspik Choice Inc Medicare	$115.09

SCREW BONE T8 2.7MM

Facility

$230.18

Service Code	HCPCS C1713
Hospital Charge Code	64907501
Hospital Revenue Code	278
Min. Negotiated Rate	$80.56
Max. Negotiated Rate	$241.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$138.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$115.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.35
Rate for Payer: EmblemHealth Commercial	$115.09
Rate for Payer: Fidelis Medicare Advantage	$241.69
Rate for Payer: Group Health Inc Commercial	$115.09
Rate for Payer: Group Health Inc Medicare	$80.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.09
Rate for Payer: Hamaspik Choice Inc Medicare	$115.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$149.62

SCREW BONE T8 FL THRD 2.7X32MML

Facility

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906529
Hospital Revenue Code	278
Min. Negotiated Rate	$83.92
Max. Negotiated Rate	$251.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$131.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$143.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$119.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$137.87
Rate for Payer: EmblemHealth Commercial	$119.89
Rate for Payer: Fidelis Medicare Advantage	$251.77
Rate for Payer: Group Health Inc Commercial	$119.89
Rate for Payer: Group Health Inc Medicare	$83.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.89
Rate for Payer: Hamaspik Choice Inc Medicare	$119.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$155.86

SCREW BONE T8 FL THRD 2.7X32MML

Facility

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906529
Hospital Revenue Code	278
Min. Negotiated Rate	$119.89
Max. Negotiated Rate	$119.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.89
Rate for Payer: Hamaspik Choice Inc Medicare	$119.89

SCREW BONE T8 F-THRD 2.7MMX30MML

Facility

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906528
Hospital Revenue Code	278
Min. Negotiated Rate	$119.89
Max. Negotiated Rate	$119.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.89
Rate for Payer: Hamaspik Choice Inc Medicare	$119.89

SCREW BONE T8 F-THRD 2.7MMX30MML

Facility

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906528
Hospital Revenue Code	278
Min. Negotiated Rate	$83.92
Max. Negotiated Rate	$251.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$131.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$143.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$119.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$137.87
Rate for Payer: EmblemHealth Commercial	$119.89
Rate for Payer: Fidelis Medicare Advantage	$251.77
Rate for Payer: Group Health Inc Commercial	$119.89
Rate for Payer: Group Health Inc Medicare	$83.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.89
Rate for Payer: Hamaspik Choice Inc Medicare	$119.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$155.86

SCREW BONE T8 FULL 2.4 L26

Facility

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64905007
Hospital Revenue Code	278
Min. Negotiated Rate	$193.75
Max. Negotiated Rate	$193.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75

SCREW BONE T8 FULL 2.4 L26

Facility

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64905007
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$406.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$213.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$232.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$193.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.81
Rate for Payer: EmblemHealth Commercial	$193.75
Rate for Payer: Fidelis Medicare Advantage	$406.88
Rate for Payer: Group Health Inc Commercial	$193.75
Rate for Payer: Group Health Inc Medicare	$135.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$251.88

SCREW BONE T8 FULL 2.7 L26

Facility

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64905009
Hospital Revenue Code	278
Min. Negotiated Rate	$193.75
Max. Negotiated Rate	$193.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75

SCREW BONE T8 FULL 2.7 L26

Facility

$387.50

Service Code	HCPCS C1713
Hospital Charge Code	64905009
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$406.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$213.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$232.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$193.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$222.81
Rate for Payer: EmblemHealth Commercial	$193.75
Rate for Payer: Fidelis Medicare Advantage	$406.88
Rate for Payer: Group Health Inc Commercial	$193.75
Rate for Payer: Group Health Inc Medicare	$135.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$193.75
Rate for Payer: Hamaspik Choice Inc Medicare	$193.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$251.88

SCREW BONE T8 FUL THRD 2.4,L30MM

Facility

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906313
Hospital Revenue Code	278
Min. Negotiated Rate	$59.94
Max. Negotiated Rate	$59.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.94
Rate for Payer: Hamaspik Choice Inc Medicare	$59.94

SCREW BONE T8 FUL THRD 2.4,L30MM

Facility

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906313
Hospital Revenue Code	278
Min. Negotiated Rate	$41.96
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$65.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$71.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$59.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.94
Rate for Payer: EmblemHealth Commercial	$59.94
Rate for Payer: Fidelis Medicare Advantage	$125.88
Rate for Payer: Group Health Inc Commercial	$59.94
Rate for Payer: Group Health Inc Medicare	$41.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.94
Rate for Payer: Hamaspik Choice Inc Medicare	$59.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$77.93

SCREW BONE T8 FUL THRD 2.4,L34MM

Facility

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906314
Hospital Revenue Code	278
Min. Negotiated Rate	$59.94
Max. Negotiated Rate	$59.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.94
Rate for Payer: Hamaspik Choice Inc Medicare	$59.94

SCREW BONE T8 FUL THRD 2.4,L34MM

Facility

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906314
Hospital Revenue Code	278
Min. Negotiated Rate	$41.96
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$65.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$71.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$59.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.94
Rate for Payer: EmblemHealth Commercial	$59.94
Rate for Payer: Fidelis Medicare Advantage	$125.88
Rate for Payer: Group Health Inc Commercial	$59.94
Rate for Payer: Group Health Inc Medicare	$41.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.94
Rate for Payer: Hamaspik Choice Inc Medicare	$59.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$77.93

Know your out-of-pocket cost for care.

All Charges