St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANNULATED 2.0 X 15MM

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902105
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 CANNULATED 2.0 X 15MM

Facility

$450.13

Service Code	HCPCS C1713
Hospital Charge Code	64902105
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 CANNULATED 3.5X50

Facility

$382.50

Service Code	HCPCS C1713
Hospital Charge Code	64901182
Hospital Revenue Code	278
Min. Negotiated Rate	$191.25
Max. Negotiated Rate	$191.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$191.25
Rate for Payer: Hamaspik Choice Inc Medicare	$191.25

SCREW CANNULATED 3.5X50

Facility

$382.50

Service Code	HCPCS C1713
Hospital Charge Code	64901182
Hospital Revenue Code	278
Min. Negotiated Rate	$133.88
Max. Negotiated Rate	$401.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$210.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$229.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$191.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$219.94
Rate for Payer: EmblemHealth Commercial	$191.25
Rate for Payer: Fidelis Medicare Advantage	$401.62
Rate for Payer: Group Health Inc Commercial	$191.25
Rate for Payer: Group Health Inc Medicare	$133.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$191.25
Rate for Payer: Hamaspik Choice Inc Medicare	$191.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$248.62

SCREW CANNULATED 4.0 X 50 FT

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64905132
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00

SCREW CANNULATED 4.0 X 50 FT

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64905132
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$409.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$234.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$195.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.25
Rate for Payer: EmblemHealth Commercial	$195.00
Rate for Payer: Fidelis Medicare Advantage	$409.50
Rate for Payer: Group Health Inc Commercial	$195.00
Rate for Payer: Group Health Inc Medicare	$136.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$253.50

SCREW CANNULATED 4.0 X 50MM FT

Facility

$453.25

Service Code	HCPCS C1713
Hospital Charge Code	64902448
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$475.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$249.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$271.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$226.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$260.62
Rate for Payer: EmblemHealth Commercial	$226.62
Rate for Payer: Fidelis Medicare Advantage	$475.91
Rate for Payer: Group Health Inc Commercial	$226.62
Rate for Payer: Group Health Inc Medicare	$158.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.62
Rate for Payer: Hamaspik Choice Inc Medicare	$226.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$294.61

SCREW CANNULATED 4.0 X 50MM FT

Facility

$453.25

Service Code	HCPCS C1713
Hospital Charge Code	64902448
Hospital Revenue Code	278
Min. Negotiated Rate	$226.62
Max. Negotiated Rate	$226.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.62
Rate for Payer: Hamaspik Choice Inc Medicare	$226.62

SCREW CANNULATED 4.0 X 60

Facility

$453.25

Service Code	HCPCS C1713
Hospital Charge Code	64902933
Hospital Revenue Code	278
Min. Negotiated Rate	$226.62
Max. Negotiated Rate	$226.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.62
Rate for Payer: Hamaspik Choice Inc Medicare	$226.62

SCREW CANNULATED 4.0 X 60

Facility

$453.25

Service Code	HCPCS C1713
Hospital Charge Code	64902933
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$475.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$249.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$271.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$226.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$260.62
Rate for Payer: EmblemHealth Commercial	$226.62
Rate for Payer: Fidelis Medicare Advantage	$475.91
Rate for Payer: Group Health Inc Commercial	$226.62
Rate for Payer: Group Health Inc Medicare	$158.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.62
Rate for Payer: Hamaspik Choice Inc Medicare	$226.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$294.61

SCREW CANNULATED 5/34

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	64906245
Hospital Revenue Code	278
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$262.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$137.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$125.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$143.75
Rate for Payer: EmblemHealth Commercial	$125.00
Rate for Payer: Fidelis Medicare Advantage	$262.50
Rate for Payer: Group Health Inc Commercial	$125.00
Rate for Payer: Group Health Inc Medicare	$87.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$125.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$162.50

SCREW CANNULATED 5/34

Facility

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	64906245
Hospital Revenue Code	278
Min. Negotiated Rate	$125.00
Max. Negotiated Rate	$125.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$125.00

SCREW CANNULATED 5 X 32.5MM

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64903019
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 CANNULATED 5 X 32.5MM

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64903019
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 CANNULATED 7.3 16MMX85

Facility

$318.00

Service Code	HCPCS C1713
Hospital Charge Code	40200155
Hospital Revenue Code	278
Min. Negotiated Rate	$111.30
Max. Negotiated Rate	$333.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$190.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.85
Rate for Payer: EmblemHealth Commercial	$159.00
Rate for Payer: Fidelis Medicare Advantage	$333.90
Rate for Payer: Group Health Inc Commercial	$159.00
Rate for Payer: Group Health Inc Medicare	$111.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00
Rate for Payer: Hamaspik Choice Inc Medicare	$159.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.70

SCREW CANNULATED 7.3 16MMX85

Facility

$318.00

Service Code	HCPCS C1713
Hospital Charge Code	40200155
Hospital Revenue Code	278
Min. Negotiated Rate	$159.00
Max. Negotiated Rate	$159.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00
Rate for Payer: Hamaspik Choice Inc Medicare	$159.00

SCREW CANNULATED 8.0 X 100

Facility

$607.75

Service Code	HCPCS C1713
Hospital Charge Code	64903200
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$638.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$334.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$364.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$303.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$349.46
Rate for Payer: EmblemHealth Commercial	$303.88
Rate for Payer: Fidelis Medicare Advantage	$638.14
Rate for Payer: Group Health Inc Commercial	$303.88
Rate for Payer: Group Health Inc Medicare	$212.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$303.88
Rate for Payer: Hamaspik Choice Inc Medicare	$303.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$395.04

SCREW CANNULATED 8.0 X 100

Facility

$607.75

Service Code	HCPCS C1713
Hospital Charge Code	64903200
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 CANNULATED 8.0 X 110

Facility

$607.75

Service Code	HCPCS C1713
Hospital Charge Code	64902884
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 CANNULATED 8.0 X 110

Facility

$607.75

Service Code	HCPCS C1713
Hospital Charge Code	64902884
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$638.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$334.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$364.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$303.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$349.46
Rate for Payer: EmblemHealth Commercial	$303.88
Rate for Payer: Fidelis Medicare Advantage	$638.14
Rate for Payer: Group Health Inc Commercial	$303.88
Rate for Payer: Group Health Inc Medicare	$212.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$303.88
Rate for Payer: Hamaspik Choice Inc Medicare	$303.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$395.04

SCREW CANNULATED 8.0 X 75MM

Facility

$607.75

Service Code	HCPCS C1713
Hospital Charge Code	64902474
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 CANNULATED 8.0 X 75MM

Facility

$607.75

Service Code	HCPCS C1713
Hospital Charge Code	64902474
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$638.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$334.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$364.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$303.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$349.46
Rate for Payer: EmblemHealth Commercial	$303.88
Rate for Payer: Fidelis Medicare Advantage	$638.14
Rate for Payer: Group Health Inc Commercial	$303.88
Rate for Payer: Group Health Inc Medicare	$212.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$303.88
Rate for Payer: Hamaspik Choice Inc Medicare	$303.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$395.04

SCREW CANNULATED PT 6.5X105MM

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64902624
Hospital Revenue Code	278
Min. Negotiated Rate	$307.12
Max. Negotiated Rate	$307.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12

SCREW CANNULATED PT 6.5X105MM

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64902624
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$644.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$337.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$368.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$307.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$353.19
Rate for Payer: EmblemHealth Commercial	$307.12
Rate for Payer: Fidelis Medicare Advantage	$644.96
Rate for Payer: Group Health Inc Commercial	$307.12
Rate for Payer: Group Health Inc Medicare	$214.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$399.26

SCREW CANNULATED ST SS 7.3

Facility

$456.00

Service Code	HCPCS C1713
Hospital Charge Code	40205125
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$478.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$250.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$273.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$228.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$262.20
Rate for Payer: EmblemHealth Commercial	$228.00
Rate for Payer: Fidelis Medicare Advantage	$478.80
Rate for Payer: Group Health Inc Commercial	$228.00
Rate for Payer: Group Health Inc Medicare	$159.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$228.00
Rate for Payer: Hamaspik Choice Inc Medicare	$228.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$296.40

Know your out-of-pocket cost for care.

All Charges