St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORTICAL 3.5 X 12

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64905266
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 CORTICAL 3.5 X 22MM

Facility

$105.00

Service Code	HCPCS C1713
Hospital Charge Code	64905063
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.50
Rate for Payer: Hamaspik Choice Inc Medicare	$52.50

SCREW CORTICAL 3.5 X 22MM

Facility

$105.00

Service Code	HCPCS C1713
Hospital Charge Code	64905063
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$63.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.38
Rate for Payer: EmblemHealth Commercial	$52.50
Rate for Payer: Fidelis Medicare Advantage	$110.25
Rate for Payer: Group Health Inc Commercial	$52.50
Rate for Payer: Group Health Inc Medicare	$36.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.50
Rate for Payer: Hamaspik Choice Inc Medicare	$52.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$68.25

SCREW CORTICAL 3.5X44MM

Facility

$51.25

Service Code	HCPCS C1713
Hospital Charge Code	64902767
Hospital Revenue Code	278
Min. Negotiated Rate	$17.94
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$30.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$29.47
Rate for Payer: EmblemHealth Commercial	$25.62
Rate for Payer: Fidelis Medicare Advantage	$53.81
Rate for Payer: Group Health Inc Commercial	$25.62
Rate for Payer: Group Health Inc Medicare	$17.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.62
Rate for Payer: Hamaspik Choice Inc Medicare	$25.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.31

SCREW CORTICAL 3.5X44MM

Facility

$51.25

Service Code	HCPCS C1713
Hospital Charge Code	64902767
Hospital Revenue Code	278
Min. Negotiated Rate	$25.62
Max. Negotiated Rate	$25.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.62
Rate for Payer: Hamaspik Choice Inc Medicare	$25.62

SCREW CORTICAL 35 X 70

Facility

$100.00

Service Code	HCPCS C1713
Hospital Charge Code	64905147
Hospital Revenue Code	278
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$60.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$57.50
Rate for Payer: EmblemHealth Commercial	$50.00
Rate for Payer: Fidelis Medicare Advantage	$105.00
Rate for Payer: Group Health Inc Commercial	$50.00
Rate for Payer: Group Health Inc Medicare	$35.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.00
Rate for Payer: Hamaspik Choice Inc Medicare	$50.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$65.00

SCREW CORTICAL 35 X 70

Facility

$100.00

Service Code	HCPCS C1713
Hospital Charge Code	64905147
Hospital Revenue Code	278
Min. Negotiated Rate	$50.00
Max. Negotiated Rate	$50.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.00
Rate for Payer: Hamaspik Choice Inc Medicare	$50.00

SCREW CORTICAL 3.8 X 48

Facility

$89.25

Service Code	HCPCS C1713
Hospital Charge Code	64905362
Hospital Revenue Code	278
Min. Negotiated Rate	$44.62
Max. Negotiated Rate	$44.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.62
Rate for Payer: Hamaspik Choice Inc Medicare	$44.62

SCREW CORTICAL 3.8 X 48

Facility

$89.25

Service Code	HCPCS C1713
Hospital Charge Code	64905362
Hospital Revenue Code	278
Min. Negotiated Rate	$31.24
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$53.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.32
Rate for Payer: EmblemHealth Commercial	$44.62
Rate for Payer: Fidelis Medicare Advantage	$93.71
Rate for Payer: Group Health Inc Commercial	$44.62
Rate for Payer: Group Health Inc Medicare	$31.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.62
Rate for Payer: Hamaspik Choice Inc Medicare	$44.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$58.01

SCREW CORTICAL 4.5MM X 16MM

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902845
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 CORTICAL 4.5MM X 16MM

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64902845
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 CORTICAL BONE 5.0MMX38MM

Facility

$496.00

Service Code	HCPCS C1713
Hospital Charge Code	40204643
Hospital Revenue Code	278
Min. Negotiated Rate	$248.00
Max. Negotiated Rate	$248.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.00
Rate for Payer: Hamaspik Choice Inc Medicare	$248.00

SCREW CORTICAL BONE 5.0MMX38MM

Facility

$496.00

Service Code	HCPCS C1713
Hospital Charge Code	40204643
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$520.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$272.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$297.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$248.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$285.20
Rate for Payer: EmblemHealth Commercial	$248.00
Rate for Payer: Fidelis Medicare Advantage	$520.80
Rate for Payer: Group Health Inc Commercial	$248.00
Rate for Payer: Group Health Inc Medicare	$173.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$248.00
Rate for Payer: Hamaspik Choice Inc Medicare	$248.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$322.40

SCREW CORTICAL NO-LOCK 14MM

Facility

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	64906366
Hospital Revenue Code	278
Min. Negotiated Rate	$12.25
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$21.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.12
Rate for Payer: EmblemHealth Commercial	$17.50
Rate for Payer: Fidelis Medicare Advantage	$36.75
Rate for Payer: Group Health Inc Commercial	$17.50
Rate for Payer: Group Health Inc Medicare	$12.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.75

SCREW CORTICAL NO-LOCK 14MM

Facility

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	64906366
Hospital Revenue Code	278
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50

SCREW CORTICAL SS 2.7X20MM

Facility

$6.88

Service Code	HCPCS C1713
Hospital Charge Code	64901684
Hospital Revenue Code	278
Min. Negotiated Rate	$3.44
Max. Negotiated Rate	$3.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.44
Rate for Payer: Hamaspik Choice Inc Medicare	$3.44

SCREW CORTICAL SS 2.7X20MM

Facility

$6.88

Service Code	HCPCS C1713
Hospital Charge Code	64901684
Hospital Revenue Code	278
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$4.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.96
Rate for Payer: EmblemHealth Commercial	$3.44
Rate for Payer: Fidelis Medicare Advantage	$7.22
Rate for Payer: Group Health Inc Commercial	$3.44
Rate for Payer: Group Health Inc Medicare	$2.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.44
Rate for Payer: Hamaspik Choice Inc Medicare	$3.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.47

SCREW CORTICAL ST 3.5X26

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64902810
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 CORTICAL ST 3.5X26

Facility

$65.00

Service Code	HCPCS C1713
Hospital Charge Code	64902810
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 CORTICAL ST 3.5X55

Facility

$53.65

Service Code	HCPCS C1713
Hospital Charge Code	64902811
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 CORTICAL ST 3.5X55

Facility

$53.65

Service Code	HCPCS C1713
Hospital Charge Code	64902811
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 CORTICAL ST 4.5X58MM SS

Facility

$40.00

Service Code	HCPCS C1713
Hospital Charge Code	40200154
Hospital Revenue Code	278
Min. Negotiated Rate	$20.00
Max. Negotiated Rate	$20.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.00
Rate for Payer: Hamaspik Choice Inc Medicare	$20.00

SCREW CORTICAL ST 4.5X58MM SS

Facility

$40.00

Service Code	HCPCS C1713
Hospital Charge Code	40200154
Hospital Revenue Code	278
Min. Negotiated Rate	$14.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$24.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.00
Rate for Payer: EmblemHealth Commercial	$20.00
Rate for Payer: Fidelis Medicare Advantage	$42.00
Rate for Payer: Group Health Inc Commercial	$20.00
Rate for Payer: Group Health Inc Medicare	$14.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.00
Rate for Payer: Hamaspik Choice Inc Medicare	$20.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.00

SCREW CORTICOL 4.5 X 22

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64903875
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 CORTICOL 4.5 X 22

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64903875
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