St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$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 CRTX 4.5X38MM HEX FT ST

Facility

$33.60

Service Code	HCPCS C1713
Hospital Charge Code	40205456
Hospital Revenue Code	278
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.80
Rate for Payer: Hamaspik Choice Inc Medicare	$16.80

SCREW CRTX 4.5X38MM HEX FT ST

Facility

$33.60

Service Code	HCPCS C1713
Hospital Charge Code	40205456
Hospital Revenue Code	278
Min. Negotiated Rate	$11.76
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$20.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.32
Rate for Payer: EmblemHealth Commercial	$16.80
Rate for Payer: Fidelis Medicare Advantage	$35.28
Rate for Payer: Group Health Inc Commercial	$16.80
Rate for Payer: Group Health Inc Medicare	$11.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.80
Rate for Payer: Hamaspik Choice Inc Medicare	$16.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21.84

SCREW CRTX LO PRO 26MM

Facility

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903583
Hospital Revenue Code	278
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$61.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88

SCREW CRTX LO PRO 26MM

Facility

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903583
Hospital Revenue Code	278
Min. Negotiated Rate	$43.31
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$74.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$61.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.16
Rate for Payer: EmblemHealth Commercial	$61.88
Rate for Payer: Fidelis Medicare Advantage	$129.94
Rate for Payer: Group Health Inc Commercial	$61.88
Rate for Payer: Group Health Inc Medicare	$43.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.44

SCREW CRTX LO PRO 28MM

Facility

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903587
Hospital Revenue Code	278
Min. Negotiated Rate	$43.31
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$74.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$61.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.16
Rate for Payer: EmblemHealth Commercial	$61.88
Rate for Payer: Fidelis Medicare Advantage	$129.94
Rate for Payer: Group Health Inc Commercial	$61.88
Rate for Payer: Group Health Inc Medicare	$43.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.44

SCREW CRTX LO PRO 28MM

Facility

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903587
Hospital Revenue Code	278
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$61.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88

SCREW CRTX LO PRO 34MM

Facility

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903585
Hospital Revenue Code	278
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$61.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88

SCREW CRTX LO PRO 34MM

Facility

$123.75

Service Code	HCPCS C1713
Hospital Charge Code	64903585
Hospital Revenue Code	278
Min. Negotiated Rate	$43.31
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$74.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$61.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$71.16
Rate for Payer: EmblemHealth Commercial	$61.88
Rate for Payer: Fidelis Medicare Advantage	$129.94
Rate for Payer: Group Health Inc Commercial	$61.88
Rate for Payer: Group Health Inc Medicare	$43.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$61.88
Rate for Payer: Hamaspik Choice Inc Medicare	$61.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$80.44

SCREW DF MINI 2.0X5MM

Facility

$108.00

Service Code	HCPCS C1776
Hospital Charge Code	40202401
Hospital Revenue Code	278
Min. Negotiated Rate	$54.00
Max. Negotiated Rate	$54.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.00
Rate for Payer: Hamaspik Choice Inc Medicare	$54.00

SCREW DF MINI 2.0X5MM

Facility

$108.00

Service Code	HCPCS C1776
Hospital Charge Code	40202401
Hospital Revenue Code	278
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$59.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$64.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$54.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$62.10
Rate for Payer: EmblemHealth Commercial	$54.00
Rate for Payer: Fidelis Medicare Advantage	$113.40
Rate for Payer: Group Health Inc Commercial	$54.00
Rate for Payer: Group Health Inc Medicare	$37.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.00
Rate for Payer: Hamaspik Choice Inc Medicare	$54.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.20

SCREW DF MINI 2.0X7MM

Facility

$104.00

Service Code	HCPCS C1769
Hospital Charge Code	40202402
Hospital Revenue Code	278
Min. Negotiated Rate	$52.00
Max. Negotiated Rate	$52.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00

SCREW DF MINI 2.0X7MM

Facility

$104.00

Service Code	HCPCS C1769
Hospital Charge Code	40202402
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$109.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$62.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$59.80
Rate for Payer: EmblemHealth Commercial	$52.00
Rate for Payer: Fidelis Medicare Advantage	$109.20
Rate for Payer: Group Health Inc Commercial	$52.00
Rate for Payer: Group Health Inc Medicare	$36.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$67.60

SCREW DIS ARCOS REV 301000

Facility

$2,352.00

Service Code	HCPCS C1713
Hospital Charge Code	64906710
Hospital Revenue Code	278
Min. Negotiated Rate	$1,176.00
Max. Negotiated Rate	$1,176.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,176.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,176.00

SCREW DIS ARCOS REV 301000

Facility

$2,352.00

Service Code	HCPCS C1713
Hospital Charge Code	64906710
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,469.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,293.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,411.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,176.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,352.40
Rate for Payer: EmblemHealth Commercial	$1,176.00
Rate for Payer: Fidelis Medicare Advantage	$2,469.60
Rate for Payer: Group Health Inc Commercial	$1,176.00
Rate for Payer: Group Health Inc Medicare	$823.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,176.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,176.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,528.80

SCREW DRILL 3.5 X 12

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64904765
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,168.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$611.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$667.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$556.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$639.69
Rate for Payer: EmblemHealth Commercial	$556.25
Rate for Payer: Fidelis Medicare Advantage	$1,168.12
Rate for Payer: Group Health Inc Commercial	$556.25
Rate for Payer: Group Health Inc Medicare	$389.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$723.12

SCREW DRILL 3.5 X 12

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64904765
Hospital Revenue Code	278
Min. Negotiated Rate	$556.25
Max. Negotiated Rate	$556.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25

SCREW DRILL-FREE 1.5X4MM CRS

Facility

$170.00

Service Code	HCPCS C1713
Hospital Charge Code	64902430
Hospital Revenue Code	278
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$178.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$102.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$85.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.75
Rate for Payer: EmblemHealth Commercial	$85.00
Rate for Payer: Fidelis Medicare Advantage	$178.50
Rate for Payer: Group Health Inc Commercial	$85.00
Rate for Payer: Group Health Inc Medicare	$59.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$110.50

SCREW DRILL-FREE 1.5X4MM CRS

Facility

$170.00

Service Code	HCPCS C1713
Hospital Charge Code	64902430
Hospital Revenue Code	278
Min. Negotiated Rate	$85.00
Max. Negotiated Rate	$85.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00

SCREW DRILL-FREE 1.5X5MM CRS

Facility

$144.63

Service Code	HCPCS C1713
Hospital Charge Code	64902404
Hospital Revenue Code	278
Min. Negotiated Rate	$72.32
Max. Negotiated Rate	$72.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.32
Rate for Payer: Hamaspik Choice Inc Medicare	$72.32

SCREW DRILL-FREE 1.5X5MM CRS

Facility

$144.63

Service Code	HCPCS C1713
Hospital Charge Code	64902404
Hospital Revenue Code	278
Min. Negotiated Rate	$50.62
Max. Negotiated Rate	$151.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$79.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$86.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$83.16
Rate for Payer: EmblemHealth Commercial	$72.32
Rate for Payer: Fidelis Medicare Advantage	$151.86
Rate for Payer: Group Health Inc Commercial	$72.32
Rate for Payer: Group Health Inc Medicare	$50.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.32
Rate for Payer: Hamaspik Choice Inc Medicare	$72.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$94.01

SCREW DRILL FREE MAXDRV MIN

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	64903073
Hospital Revenue Code	278
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$162.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$93.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$77.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$89.12
Rate for Payer: EmblemHealth Commercial	$77.50
Rate for Payer: Fidelis Medicare Advantage	$162.75
Rate for Payer: Group Health Inc Commercial	$77.50
Rate for Payer: Group Health Inc Medicare	$54.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$100.75

SCREW DRILL FREE MAXDRV MIN

Facility

$155.00

Service Code	HCPCS C1713
Hospital Charge Code	64903073
Hospital Revenue Code	278
Min. Negotiated Rate	$77.50
Max. Negotiated Rate	$77.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.50
Rate for Payer: Hamaspik Choice Inc Medicare	$77.50

SCREW DRILLING 5.0 X 20

Facility

$1,305.00

Service Code	HCPCS C1713
Hospital Charge Code	64904678
Hospital Revenue Code	278
Min. Negotiated Rate	$652.50
Max. Negotiated Rate	$652.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$652.50
Rate for Payer: Hamaspik Choice Inc Medicare	$652.50

SCREW DRILLING 5.0 X 20

Facility

$1,305.00

Service Code	HCPCS C1713
Hospital Charge Code	64904678
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,370.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$717.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$783.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$652.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$750.38
Rate for Payer: EmblemHealth Commercial	$652.50
Rate for Payer: Fidelis Medicare Advantage	$1,370.25
Rate for Payer: Group Health Inc Commercial	$652.50
Rate for Payer: Group Health Inc Medicare	$456.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$652.50
Rate for Payer: Hamaspik Choice Inc Medicare	$652.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$848.25

Know your out-of-pocket cost for care.

All Charges