St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW BONE T8 FUL THRD 2.4,L36MM

Facility

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906312
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,L36MM

Facility

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906312
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 2.7,L28MM

Facility

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906311
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 2.7,L28MM

Facility

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	64906311
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 THRD

Facility

$116.03

Service Code	HCPCS C1713
Hospital Charge Code	64907247
Hospital Revenue Code	278
Min. Negotiated Rate	$40.61
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$69.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$58.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.72
Rate for Payer: EmblemHealth Commercial	$58.02
Rate for Payer: Fidelis Medicare Advantage	$121.83
Rate for Payer: Group Health Inc Commercial	$58.02
Rate for Payer: Group Health Inc Medicare	$40.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.02
Rate for Payer: Hamaspik Choice Inc Medicare	$58.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$75.42

SCREW BONE THRD

Facility

$116.03

Service Code	HCPCS C1713
Hospital Charge Code	64907247
Hospital Revenue Code	278
Min. Negotiated Rate	$58.02
Max. Negotiated Rate	$58.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.02
Rate for Payer: Hamaspik Choice Inc Medicare	$58.02

SCREW BON T8 FL THD CRT 3.4X38MM

Facility

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906533
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 BON T8 FL THD CRT 3.4X38MM

Facility

$239.78

Service Code	HCPCS C1713
Hospital Charge Code	64906533
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 CALCANAIL

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64907152
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$656.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$375.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$359.38
Rate for Payer: EmblemHealth Commercial	$312.50
Rate for Payer: Fidelis Medicare Advantage	$656.25
Rate for Payer: Group Health Inc Commercial	$312.50
Rate for Payer: Group Health Inc Medicare	$218.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$406.25

SCREW CALCANAIL

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64907152
Hospital Revenue Code	278
Min. Negotiated Rate	$312.50
Max. Negotiated Rate	$312.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50

SCREW CALCANAIL CNLTD268325

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64907378
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$656.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$375.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$359.38
Rate for Payer: EmblemHealth Commercial	$312.50
Rate for Payer: Fidelis Medicare Advantage	$656.25
Rate for Payer: Group Health Inc Commercial	$312.50
Rate for Payer: Group Health Inc Medicare	$218.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$406.25

SCREW CALCANAIL CNLTD268325

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64907378
Hospital Revenue Code	278
Min. Negotiated Rate	$312.50
Max. Negotiated Rate	$312.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50

SCREW CAL CANNLTD 5X45 326

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	64906741
Hospital Revenue Code	278
Min. Negotiated Rate	$250.00
Max. Negotiated Rate	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00

SCREW CAL CANNLTD 5X45 326

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	64906741
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$525.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$300.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$287.50
Rate for Payer: EmblemHealth Commercial	$250.00
Rate for Payer: Fidelis Medicare Advantage	$525.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$325.00

SCREW CAL CANNLTD 5X65 330

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	64906742
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$525.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$300.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$287.50
Rate for Payer: EmblemHealth Commercial	$250.00
Rate for Payer: Fidelis Medicare Advantage	$525.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$325.00

SCREW CAL CANNLTD 5X65 330

Facility

$500.00

Service Code	HCPCS C1713
Hospital Charge Code	64906742
Hospital Revenue Code	278
Min. Negotiated Rate	$250.00
Max. Negotiated Rate	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00

SCREW CAN 3.75 X 32MM FT

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	64906863
Hospital Revenue Code	278
Min. Negotiated Rate	$200.00
Max. Negotiated Rate	$200.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00

SCREW CAN 3.75 X 32MM FT

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	64906863
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.00
Rate for Payer: EmblemHealth Commercial	$200.00
Rate for Payer: Fidelis Medicare Advantage	$420.00
Rate for Payer: Group Health Inc Commercial	$200.00
Rate for Payer: Group Health Inc Medicare	$140.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.00

SCREW CAN 4.0 X 80MM

Facility

$36.00

Service Code	HCPCS C1776
Hospital Charge Code	40205099
Hospital Revenue Code	278
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.00
Rate for Payer: Hamaspik Choice Inc Medicare	$18.00

SCREW CAN 4.0 X 80MM

Facility

$36.00

Service Code	HCPCS C1776
Hospital Charge Code	40205099
Hospital Revenue Code	278
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$21.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.70
Rate for Payer: EmblemHealth Commercial	$18.00
Rate for Payer: Fidelis Medicare Advantage	$37.80
Rate for Payer: Group Health Inc Commercial	$18.00
Rate for Payer: Group Health Inc Medicare	$12.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.00
Rate for Payer: Hamaspik Choice Inc Medicare	$18.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$23.40

SCREW CANC BONE FT 4.0 X 24MM

Facility

$44.38

Service Code	HCPCS C1713
Hospital Charge Code	64901800
Hospital Revenue Code	278
Min. Negotiated Rate	$15.53
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$26.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.52
Rate for Payer: EmblemHealth Commercial	$22.19
Rate for Payer: Fidelis Medicare Advantage	$46.60
Rate for Payer: Group Health Inc Commercial	$22.19
Rate for Payer: Group Health Inc Medicare	$15.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.19
Rate for Payer: Hamaspik Choice Inc Medicare	$22.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.85

SCREW CANC BONE FT 4.0 X 24MM

Facility

$44.38

Service Code	HCPCS C1713
Hospital Charge Code	64901800
Hospital Revenue Code	278
Min. Negotiated Rate	$22.19
Max. Negotiated Rate	$22.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.19
Rate for Payer: Hamaspik Choice Inc Medicare	$22.19

SCREW CANCEL 4.0 X 10MM FT SS

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901741
Hospital Revenue Code	278
Min. Negotiated Rate	$19.91
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$34.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.71
Rate for Payer: EmblemHealth Commercial	$28.44
Rate for Payer: Fidelis Medicare Advantage	$59.72
Rate for Payer: Group Health Inc Commercial	$28.44
Rate for Payer: Group Health Inc Medicare	$19.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.44
Rate for Payer: Hamaspik Choice Inc Medicare	$28.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.97

SCREW CANCEL 4.0 X 10MM FT SS

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901741
Hospital Revenue Code	278
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$28.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.44
Rate for Payer: Hamaspik Choice Inc Medicare	$28.44

SCREW CANCEL 4.0 X 12MM FT SS

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901680
Hospital Revenue Code	278
Min. Negotiated Rate	$19.91
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$34.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.71
Rate for Payer: EmblemHealth Commercial	$28.44
Rate for Payer: Fidelis Medicare Advantage	$59.72
Rate for Payer: Group Health Inc Commercial	$28.44
Rate for Payer: Group Health Inc Medicare	$19.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.44
Rate for Payer: Hamaspik Choice Inc Medicare	$28.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.97

Know your out-of-pocket cost for care.

All Charges