St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORTEX

Facility

$69.00

Service Code	HCPCS C1776
Hospital Charge Code	40209010
Hospital Revenue Code	278
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.50
Rate for Payer: Hamaspik Choice Inc Medicare	$34.50

SCREW CORTEX 3.5 X 10MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64901711
Hospital Revenue Code	278
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$39.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.38
Rate for Payer: EmblemHealth Commercial	$32.50
Rate for Payer: Fidelis Medicare Advantage	$68.25
Rate for Payer: Group Health Inc Commercial	$32.50
Rate for Payer: Group Health Inc Medicare	$22.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.50
Rate for Payer: Hamaspik Choice Inc Medicare	$32.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$42.25

SCREW CORTEX 3.5 X 10MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64901711
Hospital Revenue Code	278
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$32.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.50
Rate for Payer: Hamaspik Choice Inc Medicare	$32.50

SCREW CORTEX 3.5 X 12MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64901713
Hospital Revenue Code	278
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$32.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.50
Rate for Payer: Hamaspik Choice Inc Medicare	$32.50

SCREW CORTEX 3.5 X 12MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64901713
Hospital Revenue Code	278
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$39.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.38
Rate for Payer: EmblemHealth Commercial	$32.50
Rate for Payer: Fidelis Medicare Advantage	$68.25
Rate for Payer: Group Health Inc Commercial	$32.50
Rate for Payer: Group Health Inc Medicare	$22.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.50
Rate for Payer: Hamaspik Choice Inc Medicare	$32.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$42.25

SCREW CORTEX 3.5 X 14MM FT ST

Facility

$53.38

Service Code	HCPCS C1713
Hospital Charge Code	64901420
Hospital Revenue Code	278
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$32.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.69
Rate for Payer: EmblemHealth Commercial	$26.69
Rate for Payer: Fidelis Medicare Advantage	$56.05
Rate for Payer: Group Health Inc Commercial	$26.69
Rate for Payer: Group Health Inc Medicare	$18.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.69
Rate for Payer: Hamaspik Choice Inc Medicare	$26.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.70

SCREW CORTEX 3.5 X 14MM FT ST

Facility

$53.38

Service Code	HCPCS C1713
Hospital Charge Code	64901420
Hospital Revenue Code	278
Min. Negotiated Rate	$26.69
Max. Negotiated Rate	$26.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.69
Rate for Payer: Hamaspik Choice Inc Medicare	$26.69

SCREW CORTEX 3.5 X 16MM FT ST

Facility

$53.65

Service Code	HCPCS C1713
Hospital Charge Code	64901452
Hospital Revenue Code	278
Min. Negotiated Rate	$26.82
Max. Negotiated Rate	$26.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.82
Rate for Payer: Hamaspik Choice Inc Medicare	$26.82

SCREW CORTEX 3.5 X 16MM FT ST

Facility

$53.65

Service Code	HCPCS C1713
Hospital Charge Code	64901452
Hospital Revenue Code	278
Min. Negotiated Rate	$18.78
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$32.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.85
Rate for Payer: EmblemHealth Commercial	$26.82
Rate for Payer: Fidelis Medicare Advantage	$56.33
Rate for Payer: Group Health Inc Commercial	$26.82
Rate for Payer: Group Health Inc Medicare	$18.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.82
Rate for Payer: Hamaspik Choice Inc Medicare	$26.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.87

SCREW CORTEX 3.5 X 18MM ST FT

Facility

$55.00

Service Code	HCPCS C1713
Hospital Charge Code	64901658
Hospital Revenue Code	278
Min. Negotiated Rate	$27.50
Max. Negotiated Rate	$27.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.50
Rate for Payer: Hamaspik Choice Inc Medicare	$27.50

SCREW CORTEX 3.5 X 18MM ST FT

Facility

$55.00

Service Code	HCPCS C1713
Hospital Charge Code	64901658
Hospital Revenue Code	278
Min. Negotiated Rate	$19.25
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$33.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.62
Rate for Payer: EmblemHealth Commercial	$27.50
Rate for Payer: Fidelis Medicare Advantage	$57.75
Rate for Payer: Group Health Inc Commercial	$27.50
Rate for Payer: Group Health Inc Medicare	$19.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.50
Rate for Payer: Hamaspik Choice Inc Medicare	$27.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.75

SCREW CORTEX 3.5 X 20MM FT ST

Facility

$53.65

Service Code	HCPCS C1713
Hospital Charge Code	64901660
Hospital Revenue Code	278
Min. Negotiated Rate	$18.78
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$32.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.85
Rate for Payer: EmblemHealth Commercial	$26.82
Rate for Payer: Fidelis Medicare Advantage	$56.33
Rate for Payer: Group Health Inc Commercial	$26.82
Rate for Payer: Group Health Inc Medicare	$18.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.82
Rate for Payer: Hamaspik Choice Inc Medicare	$26.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.87

SCREW CORTEX 3.5 X 20MM FT ST

Facility

$53.65

Service Code	HCPCS C1713
Hospital Charge Code	64901660
Hospital Revenue Code	278
Min. Negotiated Rate	$26.82
Max. Negotiated Rate	$26.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.82
Rate for Payer: Hamaspik Choice Inc Medicare	$26.82

SCREW CORTEX 3.5 X 22MM FT ST

Facility

$54.88

Service Code	HCPCS C1713
Hospital Charge Code	64901661
Hospital Revenue Code	278
Min. Negotiated Rate	$27.44
Max. Negotiated Rate	$27.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.44
Rate for Payer: Hamaspik Choice Inc Medicare	$27.44

SCREW CORTEX 3.5 X 22MM FT ST

Facility

$54.88

Service Code	HCPCS C1713
Hospital Charge Code	64901661
Hospital Revenue Code	278
Min. Negotiated Rate	$19.21
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$32.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.56
Rate for Payer: EmblemHealth Commercial	$27.44
Rate for Payer: Fidelis Medicare Advantage	$57.62
Rate for Payer: Group Health Inc Commercial	$27.44
Rate for Payer: Group Health Inc Medicare	$19.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.44
Rate for Payer: Hamaspik Choice Inc Medicare	$27.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.67

SCREW CORTEX 3.5 X 24MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64901631
Hospital Revenue Code	278
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$39.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.38
Rate for Payer: EmblemHealth Commercial	$32.50
Rate for Payer: Fidelis Medicare Advantage	$68.25
Rate for Payer: Group Health Inc Commercial	$32.50
Rate for Payer: Group Health Inc Medicare	$22.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.50
Rate for Payer: Hamaspik Choice Inc Medicare	$32.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$42.25

SCREW CORTEX 3.5 X 24MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64901631
Hospital Revenue Code	278
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$32.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.50
Rate for Payer: Hamaspik Choice Inc Medicare	$32.50

SCREW CORTEX 3.5 X 28MM FT ST

Facility

$54.38

Service Code	HCPCS C1713
Hospital Charge Code	64901626
Hospital Revenue Code	278
Min. Negotiated Rate	$19.03
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$32.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$27.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.27
Rate for Payer: EmblemHealth Commercial	$27.19
Rate for Payer: Fidelis Medicare Advantage	$57.10
Rate for Payer: Group Health Inc Commercial	$27.19
Rate for Payer: Group Health Inc Medicare	$19.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.19
Rate for Payer: Hamaspik Choice Inc Medicare	$27.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.35

SCREW CORTEX 3.5 X 28MM FT ST

Facility

$54.38

Service Code	HCPCS C1713
Hospital Charge Code	64901626
Hospital Revenue Code	278
Min. Negotiated Rate	$27.19
Max. Negotiated Rate	$27.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.19
Rate for Payer: Hamaspik Choice Inc Medicare	$27.19

SCREW CORTEX 3.5X30MM

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64902765
Hospital Revenue Code	278
Min. Negotiated Rate	$22.75
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$39.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.38
Rate for Payer: EmblemHealth Commercial	$32.50
Rate for Payer: Fidelis Medicare Advantage	$68.25
Rate for Payer: Group Health Inc Commercial	$32.50
Rate for Payer: Group Health Inc Medicare	$22.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.50
Rate for Payer: Hamaspik Choice Inc Medicare	$32.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$42.25

SCREW CORTEX 3.5X30MM

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64902765
Hospital Revenue Code	278
Min. Negotiated Rate	$32.50
Max. Negotiated Rate	$32.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.50
Rate for Payer: Hamaspik Choice Inc Medicare	$32.50

SCREW CORTEX 3.5 X 30MM ST FT

Facility

$18.00

Service Code	HCPCS C1776
Hospital Charge Code	40202442
Hospital Revenue Code	278
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$10.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.35
Rate for Payer: EmblemHealth Commercial	$9.00
Rate for Payer: Fidelis Medicare Advantage	$18.90
Rate for Payer: Group Health Inc Commercial	$9.00
Rate for Payer: Group Health Inc Medicare	$6.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.00
Rate for Payer: Hamaspik Choice Inc Medicare	$9.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.70

SCREW CORTEX 3.5 X 30MM ST FT

Facility

$18.00

Service Code	HCPCS C1776
Hospital Charge Code	40202442
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.00
Rate for Payer: Hamaspik Choice Inc Medicare	$9.00

SCREW CORTEX 3.5 X 32MM FT ST

Facility

$52.50

Service Code	HCPCS C1713
Hospital Charge Code	64901663
Hospital Revenue Code	278
Min. Negotiated Rate	$18.38
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$31.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.19
Rate for Payer: EmblemHealth Commercial	$26.25
Rate for Payer: Fidelis Medicare Advantage	$55.12
Rate for Payer: Group Health Inc Commercial	$26.25
Rate for Payer: Group Health Inc Medicare	$18.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.25
Rate for Payer: Hamaspik Choice Inc Medicare	$26.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.12

SCREW CORTEX 3.5 X 32MM FT ST

Facility

$52.50

Service Code	HCPCS C1713
Hospital Charge Code	64901663
Hospital Revenue Code	278
Min. Negotiated Rate	$26.25
Max. Negotiated Rate	$26.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.25
Rate for Payer: Hamaspik Choice Inc Medicare	$26.25

Know your out-of-pocket cost for care.

All Charges