St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORTEX 3.5 X 70MM

Facility

$87.50

Service Code	HCPCS C1713
Hospital Charge Code	64902204
Hospital Revenue Code	278
Min. Negotiated Rate	$30.62
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$52.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$43.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$50.31
Rate for Payer: EmblemHealth Commercial	$43.75
Rate for Payer: Fidelis Medicare Advantage	$91.88
Rate for Payer: Group Health Inc Commercial	$43.75
Rate for Payer: Group Health Inc Medicare	$30.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.75
Rate for Payer: Hamaspik Choice Inc Medicare	$43.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$56.88

SCREW CORTEX 3.5 X 70MM FT ST

Facility

$53.65

Service Code	HCPCS C1713
Hospital Charge Code	64901669
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 70MM FT ST

Facility

$53.65

Service Code	HCPCS C1713
Hospital Charge Code	64901669
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 75MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64902045
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 75MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64902045
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 85MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64901963
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 85MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64901963
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 90MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64902090
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 90MM FT ST

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64902090
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 4.5 65

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64904371
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00

SCREW CORTEX 4.5 65

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64904371
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$72.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.00
Rate for Payer: EmblemHealth Commercial	$60.00
Rate for Payer: Fidelis Medicare Advantage	$126.00
Rate for Payer: Group Health Inc Commercial	$60.00
Rate for Payer: Group Health Inc Medicare	$42.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$78.00

SCREW CORTEX 4.5 8.5

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64904034
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$72.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.00
Rate for Payer: EmblemHealth Commercial	$60.00
Rate for Payer: Fidelis Medicare Advantage	$126.00
Rate for Payer: Group Health Inc Commercial	$60.00
Rate for Payer: Group Health Inc Medicare	$42.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$78.00

SCREW CORTEX 4.5 8.5

Facility

$120.00

Service Code	HCPCS C1713
Hospital Charge Code	64904034
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00

SCREW CORTEX 4.5 X 32

Facility

$115.00

Service Code	HCPCS C1713
Hospital Charge Code	64903834
Hospital Revenue Code	278
Min. Negotiated Rate	$40.25
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$69.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$57.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.12
Rate for Payer: EmblemHealth Commercial	$57.50
Rate for Payer: Fidelis Medicare Advantage	$120.75
Rate for Payer: Group Health Inc Commercial	$57.50
Rate for Payer: Group Health Inc Medicare	$40.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.50
Rate for Payer: Hamaspik Choice Inc Medicare	$57.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$74.75

SCREW CORTEX 4.5 X 32

Facility

$115.00

Service Code	HCPCS C1713
Hospital Charge Code	64903834
Hospital Revenue Code	278
Min. Negotiated Rate	$57.50
Max. Negotiated Rate	$57.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.50
Rate for Payer: Hamaspik Choice Inc Medicare	$57.50

SCREW CORTEX 4.5X50MM HEX FT ST

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901678
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 CORTEX 4.5X50MM HEX FT ST

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64901678
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 CORTEX 4.5X56MM HEX FT ST

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902212
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 CORTEX 4.5X56MM HEX FT ST

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902212
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 CORTEX SELF-TAPPING

Facility

$88.75

Service Code	HCPCS C1713
Hospital Charge Code	64901113
Hospital Revenue Code	278
Min. Negotiated Rate	$31.06
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$53.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.03
Rate for Payer: EmblemHealth Commercial	$44.38
Rate for Payer: Fidelis Medicare Advantage	$93.19
Rate for Payer: Group Health Inc Commercial	$44.38
Rate for Payer: Group Health Inc Medicare	$31.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.38
Rate for Payer: Hamaspik Choice Inc Medicare	$44.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$57.69

SCREW CORTEX SELF-TAPPING

Facility

$88.75

Service Code	HCPCS C1713
Hospital Charge Code	64901113
Hospital Revenue Code	278
Min. Negotiated Rate	$44.38
Max. Negotiated Rate	$44.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.38
Rate for Payer: Hamaspik Choice Inc Medicare	$44.38

SCREW CORTEX SELF TAPPING 12MM

Facility

$84.38

Service Code	HCPCS C1713
Hospital Charge Code	64901152
Hospital Revenue Code	278
Min. Negotiated Rate	$42.19
Max. Negotiated Rate	$42.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.19
Rate for Payer: Hamaspik Choice Inc Medicare	$42.19

SCREW CORTEX SELF TAPPING 12MM

Facility

$84.38

Service Code	HCPCS C1713
Hospital Charge Code	64901152
Hospital Revenue Code	278
Min. Negotiated Rate	$29.53
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$50.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.52
Rate for Payer: EmblemHealth Commercial	$42.19
Rate for Payer: Fidelis Medicare Advantage	$88.60
Rate for Payer: Group Health Inc Commercial	$42.19
Rate for Payer: Group Health Inc Medicare	$29.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.19
Rate for Payer: Hamaspik Choice Inc Medicare	$42.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$54.85

SCREW CORTEX SELF TAPPING 18MM

Facility

$84.38

Service Code	HCPCS C1713
Hospital Charge Code	64901150
Hospital Revenue Code	278
Min. Negotiated Rate	$29.53
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$50.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.52
Rate for Payer: EmblemHealth Commercial	$42.19
Rate for Payer: Fidelis Medicare Advantage	$88.60
Rate for Payer: Group Health Inc Commercial	$42.19
Rate for Payer: Group Health Inc Medicare	$29.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.19
Rate for Payer: Hamaspik Choice Inc Medicare	$42.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$54.85

SCREW CORTEX SELF TAPPING 18MM

Facility

$84.38

Service Code	HCPCS C1713
Hospital Charge Code	64901150
Hospital Revenue Code	278
Min. Negotiated Rate	$42.19
Max. Negotiated Rate	$42.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.19
Rate for Payer: Hamaspik Choice Inc Medicare	$42.19

Know your out-of-pocket cost for care.

All Charges