St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANNULATED ST SS 7.3

Facility

$456.00

Service Code	HCPCS C1713
Hospital Charge Code	40205125
Hospital Revenue Code	278
Min. Negotiated Rate	$228.00
Max. Negotiated Rate	$228.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$228.00
Rate for Payer: Hamaspik Choice Inc Medicare	$228.00

SCREW CANNULATED ST SS 7.3X130MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	40200156
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 CANNULATED ST SS 7.3X130MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	40200156
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 CANNULTD ASNIX III SS 8X100

Facility

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40006563
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$510.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$267.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$291.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$243.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$279.56
Rate for Payer: EmblemHealth Commercial	$243.10
Rate for Payer: Fidelis Medicare Advantage	$510.51
Rate for Payer: Group Health Inc Commercial	$243.10
Rate for Payer: Group Health Inc Medicare	$170.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$316.03

SCREW CANNULTD ASNIX III SS 8X100

Facility

$486.20

Service Code	HCPCS C1713
Hospital Charge Code	40006563
Hospital Revenue Code	278
Min. Negotiated Rate	$243.10
Max. Negotiated Rate	$243.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.10
Rate for Payer: Hamaspik Choice Inc Medicare	$243.10

SCREW CANNUL TI ASN III 4X48MM

Facility

$156.00

Service Code	HCPCS C1713
Hospital Charge Code	64906250
Hospital Revenue Code	278
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$163.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$93.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$78.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$89.70
Rate for Payer: EmblemHealth Commercial	$78.00
Rate for Payer: Fidelis Medicare Advantage	$163.80
Rate for Payer: Group Health Inc Commercial	$78.00
Rate for Payer: Group Health Inc Medicare	$54.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$78.00
Rate for Payer: Hamaspik Choice Inc Medicare	$78.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$101.40

SCREW CANNUL TI ASN III 4X48MM

Facility

$156.00

Service Code	HCPCS C1713
Hospital Charge Code	64906250
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$78.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$78.00
Rate for Payer: Hamaspik Choice Inc Medicare	$78.00

SCREW CANULL 8.0 X 115

Facility

$607.75

Service Code	HCPCS C1713
Hospital Charge Code	64905138
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 CANULL 8.0 X 115

Facility

$607.75

Service Code	HCPCS C1713
Hospital Charge Code	64905138
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 CANULTD SS 6.5 X 75MM

Facility

$447.18

Service Code	HCPCS C1713
Hospital Charge Code	64906575
Hospital Revenue Code	278
Min. Negotiated Rate	$223.59
Max. Negotiated Rate	$223.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$223.59
Rate for Payer: Hamaspik Choice Inc Medicare	$223.59

SCREW CANULTD SS 6.5 X 75MM

Facility

$447.18

Service Code	HCPCS C1713
Hospital Charge Code	64906575
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$469.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$245.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$268.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$223.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$257.13
Rate for Payer: EmblemHealth Commercial	$223.59
Rate for Payer: Fidelis Medicare Advantage	$469.54
Rate for Payer: Group Health Inc Commercial	$223.59
Rate for Payer: Group Health Inc Medicare	$156.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$223.59
Rate for Payer: Hamaspik Choice Inc Medicare	$223.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$290.67

SCREW CANULTD SS 6.5 X 85MM

Facility

$447.18

Service Code	HCPCS C1713
Hospital Charge Code	64906576
Hospital Revenue Code	278
Min. Negotiated Rate	$223.59
Max. Negotiated Rate	$223.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$223.59
Rate for Payer: Hamaspik Choice Inc Medicare	$223.59

SCREW CANULTD SS 6.5 X 85MM

Facility

$447.18

Service Code	HCPCS C1713
Hospital Charge Code	64906576
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$469.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$245.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$268.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$223.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$257.13
Rate for Payer: EmblemHealth Commercial	$223.59
Rate for Payer: Fidelis Medicare Advantage	$469.54
Rate for Payer: Group Health Inc Commercial	$223.59
Rate for Payer: Group Health Inc Medicare	$156.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$223.59
Rate for Payer: Hamaspik Choice Inc Medicare	$223.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$290.67

SCREW CENTRAL 6.5 X 25MM

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64906968
Hospital Revenue Code	278
Min. Negotiated Rate	$65.62
Max. Negotiated Rate	$196.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$103.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$93.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$107.81
Rate for Payer: EmblemHealth Commercial	$93.75
Rate for Payer: Fidelis Medicare Advantage	$196.88
Rate for Payer: Group Health Inc Commercial	$93.75
Rate for Payer: Group Health Inc Medicare	$65.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.75
Rate for Payer: Hamaspik Choice Inc Medicare	$93.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$121.88

SCREW CENTRAL 6.5 X 25MM

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64906968
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.75
Rate for Payer: Hamaspik Choice Inc Medicare	$93.75

SCREW CENTRAL SHLDR REV

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64907002
Hospital Revenue Code	278
Min. Negotiated Rate	$65.62
Max. Negotiated Rate	$196.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$103.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$93.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$107.81
Rate for Payer: EmblemHealth Commercial	$93.75
Rate for Payer: Fidelis Medicare Advantage	$196.88
Rate for Payer: Group Health Inc Commercial	$93.75
Rate for Payer: Group Health Inc Medicare	$65.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.75
Rate for Payer: Hamaspik Choice Inc Medicare	$93.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$121.88

SCREW CENTRAL SHLDR REV

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64907002
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.75
Rate for Payer: Hamaspik Choice Inc Medicare	$93.75

SCREW CLEARFIX MENISCAL 2X10MM

Facility

$414.00

Service Code	HCPCS C1713
Hospital Charge Code	40202286
Hospital Revenue Code	278
Min. Negotiated Rate	$207.00
Max. Negotiated Rate	$207.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.00
Rate for Payer: Hamaspik Choice Inc Medicare	$207.00

SCREW CLEARFIX MENISCAL 2X10MM

Facility

$414.00

Service Code	HCPCS C1713
Hospital Charge Code	40202286
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$434.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$248.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$207.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$238.05
Rate for Payer: EmblemHealth Commercial	$207.00
Rate for Payer: Fidelis Medicare Advantage	$434.70
Rate for Payer: Group Health Inc Commercial	$207.00
Rate for Payer: Group Health Inc Medicare	$144.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$207.00
Rate for Payer: Hamaspik Choice Inc Medicare	$207.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$269.10

SCREW CNLTD 8MM ASNIS III 135MML

Facility

$221.22

Service Code	HCPCS C1713
Hospital Charge Code	64906262
Hospital Revenue Code	278
Min. Negotiated Rate	$77.43
Max. Negotiated Rate	$232.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$121.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$132.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$110.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.20
Rate for Payer: EmblemHealth Commercial	$110.61
Rate for Payer: Fidelis Medicare Advantage	$232.28
Rate for Payer: Group Health Inc Commercial	$110.61
Rate for Payer: Group Health Inc Medicare	$77.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$110.61
Rate for Payer: Hamaspik Choice Inc Medicare	$110.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$143.79

SCREW CNLTD 8MM ASNIS III 135MML

Facility

$221.22

Service Code	HCPCS C1713
Hospital Charge Code	64906262
Hospital Revenue Code	278
Min. Negotiated Rate	$110.61
Max. Negotiated Rate	$110.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$110.61
Rate for Payer: Hamaspik Choice Inc Medicare	$110.61

SCREW CNLTD STST 8MM ASNIS 150MM

Facility

$243.10

Service Code	HCPCS C1713
Hospital Charge Code	64906391
Hospital Revenue Code	278
Min. Negotiated Rate	$85.08
Max. Negotiated Rate	$255.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$133.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$145.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$121.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$139.78
Rate for Payer: EmblemHealth Commercial	$121.55
Rate for Payer: Fidelis Medicare Advantage	$255.26
Rate for Payer: Group Health Inc Commercial	$121.55
Rate for Payer: Group Health Inc Medicare	$85.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.55
Rate for Payer: Hamaspik Choice Inc Medicare	$121.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$158.02

SCREW CNLTD STST 8MM ASNIS 150MM

Facility

$243.10

Service Code	HCPCS C1713
Hospital Charge Code	64906391
Hospital Revenue Code	278
Min. Negotiated Rate	$121.55
Max. Negotiated Rate	$121.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.55
Rate for Payer: Hamaspik Choice Inc Medicare	$121.55

SCREW CNNLTD ASNIS 3 6.5X105MM

Facility

$447.18

Service Code	HCPCS C1713
Hospital Charge Code	64906539
Hospital Revenue Code	278
Min. Negotiated Rate	$223.59
Max. Negotiated Rate	$223.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$223.59
Rate for Payer: Hamaspik Choice Inc Medicare	$223.59

SCREW CNNLTD ASNIS 3 6.5X105MM

Facility

$447.18

Service Code	HCPCS C1713
Hospital Charge Code	64906539
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$469.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$245.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$268.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$223.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$257.13
Rate for Payer: EmblemHealth Commercial	$223.59
Rate for Payer: Fidelis Medicare Advantage	$469.54
Rate for Payer: Group Health Inc Commercial	$223.59
Rate for Payer: Group Health Inc Medicare	$156.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$223.59
Rate for Payer: Hamaspik Choice Inc Medicare	$223.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$290.67

Know your out-of-pocket cost for care.

All Charges