St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW CORT LCK 3.5 X 11MM

Facility

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64906997
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$142.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50

SCREW CORT LCK 3.5 X 11MM

Facility

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64906997
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$299.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$156.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$171.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.88
Rate for Payer: EmblemHealth Commercial	$142.50
Rate for Payer: Fidelis Medicare Advantage	$299.25
Rate for Payer: Group Health Inc Commercial	$142.50
Rate for Payer: Group Health Inc Medicare	$99.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.25

SCREW CORT LOCK 3.5

Facility

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64907050
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$299.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$156.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$171.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.88
Rate for Payer: EmblemHealth Commercial	$142.50
Rate for Payer: Fidelis Medicare Advantage	$299.25
Rate for Payer: Group Health Inc Commercial	$142.50
Rate for Payer: Group Health Inc Medicare	$99.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.25

SCREW CORT LOCK 3.5

Facility

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64907050
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$142.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50

SCREW CORT LOCKING 3.5 X 14MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	64901611
Hospital Revenue Code	278
Min. Negotiated Rate	$61.25
Max. Negotiated Rate	$183.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$96.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$105.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$87.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$100.62
Rate for Payer: EmblemHealth Commercial	$87.50
Rate for Payer: Fidelis Medicare Advantage	$183.75
Rate for Payer: Group Health Inc Commercial	$87.50
Rate for Payer: Group Health Inc Medicare	$61.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.50
Rate for Payer: Hamaspik Choice Inc Medicare	$87.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$113.75

SCREW CORT LOCKING 3.5 X 14MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	64901611
Hospital Revenue Code	278
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$87.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.50
Rate for Payer: Hamaspik Choice Inc Medicare	$87.50

SCREW CORT LOCKING 3.5 X 16MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	64901609
Hospital Revenue Code	278
Min. Negotiated Rate	$61.25
Max. Negotiated Rate	$183.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$96.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$105.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$87.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$100.62
Rate for Payer: EmblemHealth Commercial	$87.50
Rate for Payer: Fidelis Medicare Advantage	$183.75
Rate for Payer: Group Health Inc Commercial	$87.50
Rate for Payer: Group Health Inc Medicare	$61.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.50
Rate for Payer: Hamaspik Choice Inc Medicare	$87.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$113.75

SCREW CORT LOCKING 3.5 X 16MM

Facility

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	64901609
Hospital Revenue Code	278
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$87.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.50
Rate for Payer: Hamaspik Choice Inc Medicare	$87.50

SCREW CORT LOCKING 3.5 X 18MM

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64901613
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 CORT LOCKING 3.5 X 18MM

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64901613
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 CORT LOPRO SS 3.5X40MM

Facility

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	64906364
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 CORT LOPRO SS 3.5X40MM

Facility

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	64906364
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 CORT NOLCK 3.5 X 14MM

Facility

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64906998
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$142.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50

SCREW CORT NOLCK 3.5 X 14MM

Facility

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64906998
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$299.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$156.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$171.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.88
Rate for Payer: EmblemHealth Commercial	$142.50
Rate for Payer: Fidelis Medicare Advantage	$299.25
Rate for Payer: Group Health Inc Commercial	$142.50
Rate for Payer: Group Health Inc Medicare	$99.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.25

SCREW CORT PART THR 4X40MM

Facility

$6,294.30

Service Code	HCPCS C1713
Hospital Charge Code	64904038
Hospital Revenue Code	278
Min. Negotiated Rate	$3,147.15
Max. Negotiated Rate	$3,147.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,147.15
Rate for Payer: Hamaspik Choice Inc Medicare	$3,147.15

SCREW CORT PART THR 4X40MM

Facility

$6,294.30

Service Code	HCPCS C1713
Hospital Charge Code	64904038
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,609.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,461.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,776.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,147.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,619.22
Rate for Payer: EmblemHealth Commercial	$3,147.15
Rate for Payer: Fidelis Medicare Advantage	$6,609.02
Rate for Payer: Group Health Inc Commercial	$3,147.15
Rate for Payer: Group Health Inc Medicare	$2,203.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,147.15
Rate for Payer: Hamaspik Choice Inc Medicare	$3,147.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,091.30

SCREW CRANIAL TI 1.5MM

Facility

$687.50

Service Code	HCPCS C1713
Hospital Charge Code	64901320
Hospital Revenue Code	278
Min. Negotiated Rate	$343.75
Max. Negotiated Rate	$343.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$343.75
Rate for Payer: Hamaspik Choice Inc Medicare	$343.75

SCREW CRANIAL TI 1.5MM

Facility

$687.50

Service Code	HCPCS C1713
Hospital Charge Code	64901320
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$721.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$378.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$412.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$343.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$395.31
Rate for Payer: EmblemHealth Commercial	$343.75
Rate for Payer: Fidelis Medicare Advantage	$721.88
Rate for Payer: Group Health Inc Commercial	$343.75
Rate for Payer: Group Health Inc Medicare	$240.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$343.75
Rate for Payer: Hamaspik Choice Inc Medicare	$343.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$446.88

SCREW CRS SELF DRILL 1.2X10MM

Facility

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906598
Hospital Revenue Code	278
Min. Negotiated Rate	$53.24
Max. Negotiated Rate	$53.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24

SCREW CRS SELF DRILL 1.2X10MM

Facility

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906598
Hospital Revenue Code	278
Min. Negotiated Rate	$37.27
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$63.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.23
Rate for Payer: EmblemHealth Commercial	$53.24
Rate for Payer: Fidelis Medicare Advantage	$111.80
Rate for Payer: Group Health Inc Commercial	$53.24
Rate for Payer: Group Health Inc Medicare	$37.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$69.21

SCREW CRS SELF DRILL 1.2X12MM

Facility

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906599
Hospital Revenue Code	278
Min. Negotiated Rate	$37.27
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$63.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.23
Rate for Payer: EmblemHealth Commercial	$53.24
Rate for Payer: Fidelis Medicare Advantage	$111.80
Rate for Payer: Group Health Inc Commercial	$53.24
Rate for Payer: Group Health Inc Medicare	$37.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$69.21

SCREW CRS SELF DRILL 1.2X12MM

Facility

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906599
Hospital Revenue Code	278
Min. Negotiated Rate	$53.24
Max. Negotiated Rate	$53.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24

SCREW CRS SELF DRILL 1.2X8MM

Facility

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906597
Hospital Revenue Code	278
Min. Negotiated Rate	$37.27
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$63.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.23
Rate for Payer: EmblemHealth Commercial	$53.24
Rate for Payer: Fidelis Medicare Advantage	$111.80
Rate for Payer: Group Health Inc Commercial	$53.24
Rate for Payer: Group Health Inc Medicare	$37.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$69.21

SCREW CRS SELF DRILL 1.2X8MM

Facility

$106.48

Service Code	HCPCS C1713
Hospital Charge Code	64906597
Hospital Revenue Code	278
Min. Negotiated Rate	$53.24
Max. Negotiated Rate	$53.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.24
Rate for Payer: Hamaspik Choice Inc Medicare	$53.24

SCREW CRT LPR TM SS 3.5X14MM

Facility

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	64906362
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

Know your out-of-pocket cost for care.

All Charges