St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW GO-EZ 2.5 X 16MM

Facility

$375.00

Service Code	HCPCS C1713
Hospital Charge Code	64902078
Hospital Revenue Code	278
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$187.50
Rate for Payer: Hamaspik Choice Inc Medicare	$187.50

SCREW GO EZ 2X8

Facility

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64903729
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25

SCREW GO EZ 2X8

Facility

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64903729
Hospital Revenue Code	278
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$275.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$157.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$131.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.94
Rate for Payer: EmblemHealth Commercial	$131.25
Rate for Payer: Fidelis Medicare Advantage	$275.62
Rate for Payer: Group Health Inc Commercial	$131.25
Rate for Payer: Group Health Inc Medicare	$91.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.62

SCREW GO-EZ 3.0 X 10MM

Facility

$131.25

Service Code	HCPCS C1713
Hospital Charge Code	64902082
Hospital Revenue Code	278
Min. Negotiated Rate	$45.94
Max. Negotiated Rate	$137.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$72.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$78.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$65.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$75.47
Rate for Payer: EmblemHealth Commercial	$65.62
Rate for Payer: Fidelis Medicare Advantage	$137.81
Rate for Payer: Group Health Inc Commercial	$65.62
Rate for Payer: Group Health Inc Medicare	$45.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.62
Rate for Payer: Hamaspik Choice Inc Medicare	$65.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$85.31

SCREW GO-EZ 3.0 X 10MM

Facility

$131.25

Service Code	HCPCS C1713
Hospital Charge Code	64902082
Hospital Revenue Code	278
Min. Negotiated Rate	$65.62
Max. Negotiated Rate	$65.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.62
Rate for Payer: Hamaspik Choice Inc Medicare	$65.62

SCREW GO-EZ 3.0 X 14MM

Facility

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64902019
Hospital Revenue Code	278
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$275.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$157.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$131.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.94
Rate for Payer: EmblemHealth Commercial	$131.25
Rate for Payer: Fidelis Medicare Advantage	$275.62
Rate for Payer: Group Health Inc Commercial	$131.25
Rate for Payer: Group Health Inc Medicare	$91.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.62

SCREW GO-EZ 3.0 X 14MM

Facility

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64902019
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25

SCREW GO-EZ 3.0 X 16MM

Facility

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64902131
Hospital Revenue Code	278
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$275.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$157.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$131.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.94
Rate for Payer: EmblemHealth Commercial	$131.25
Rate for Payer: Fidelis Medicare Advantage	$275.62
Rate for Payer: Group Health Inc Commercial	$131.25
Rate for Payer: Group Health Inc Medicare	$91.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.62

SCREW GO-EZ 3.0 X 16MM

Facility

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64902131
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25

SCREW GO-EZ 3.5 X 8MM

Facility

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64902086
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25

SCREW GO-EZ 3.5 X 8MM

Facility

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64902086
Hospital Revenue Code	278
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$275.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$157.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$131.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.94
Rate for Payer: EmblemHealth Commercial	$131.25
Rate for Payer: Fidelis Medicare Advantage	$275.62
Rate for Payer: Group Health Inc Commercial	$131.25
Rate for Payer: Group Health Inc Medicare	$91.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.62

SCREW H 20X25

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64903573
Hospital Revenue Code	278
Min. Negotiated Rate	$653.75
Max. Negotiated Rate	$653.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75

SCREW H 20X25

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64903573
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,372.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$719.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$784.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$653.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$751.81
Rate for Payer: EmblemHealth Commercial	$653.75
Rate for Payer: Fidelis Medicare Advantage	$1,372.88
Rate for Payer: Group Health Inc Commercial	$653.75
Rate for Payer: Group Health Inc Medicare	$457.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$849.88

SCREW H 22X25

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64903571
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,372.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$719.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$784.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$653.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$751.81
Rate for Payer: EmblemHealth Commercial	$653.75
Rate for Payer: Fidelis Medicare Advantage	$1,372.88
Rate for Payer: Group Health Inc Commercial	$653.75
Rate for Payer: Group Health Inc Medicare	$457.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$849.88

SCREW H 22X25

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64903571
Hospital Revenue Code	278
Min. Negotiated Rate	$653.75
Max. Negotiated Rate	$653.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75

SCREW HDLS 2.5

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64907186
Hospital Revenue Code	278
Min. Negotiated Rate	$437.50
Max. Negotiated Rate	$437.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.50
Rate for Payer: Hamaspik Choice Inc Medicare	$437.50

SCREW HDLS 2.5

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64907186
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$918.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$481.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$525.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$437.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$503.12
Rate for Payer: EmblemHealth Commercial	$437.50
Rate for Payer: Fidelis Medicare Advantage	$918.75
Rate for Payer: Group Health Inc Commercial	$437.50
Rate for Payer: Group Health Inc Medicare	$306.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.50
Rate for Payer: Hamaspik Choice Inc Medicare	$437.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$568.75

SCREW H DRIVER BIT (703880)

Facility

$1,395.00

Service Code	HCPCS C1713
Hospital Charge Code	64904682
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,464.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$767.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$837.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$697.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$802.12
Rate for Payer: EmblemHealth Commercial	$697.50
Rate for Payer: Fidelis Medicare Advantage	$1,464.75
Rate for Payer: Group Health Inc Commercial	$697.50
Rate for Payer: Group Health Inc Medicare	$488.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$697.50
Rate for Payer: Hamaspik Choice Inc Medicare	$697.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$906.75

SCREW H DRIVER BIT (703880)

Facility

$331.00

Service Code	HCPCS C1713
Hospital Charge Code	40201544
Hospital Revenue Code	278
Min. Negotiated Rate	$115.85
Max. Negotiated Rate	$347.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$182.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$198.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$165.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$190.32
Rate for Payer: EmblemHealth Commercial	$165.50
Rate for Payer: Fidelis Medicare Advantage	$347.55
Rate for Payer: Group Health Inc Commercial	$165.50
Rate for Payer: Group Health Inc Medicare	$115.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.50
Rate for Payer: Hamaspik Choice Inc Medicare	$165.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$215.15

SCREW H DRIVER BIT (703880)

Facility

$331.00

Service Code	HCPCS C1713
Hospital Charge Code	40201544
Hospital Revenue Code	278
Min. Negotiated Rate	$165.50
Max. Negotiated Rate	$165.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.50
Rate for Payer: Hamaspik Choice Inc Medicare	$165.50

SCREW H DRIVER BIT (703880)

Facility

$1,395.00

Service Code	HCPCS C1713
Hospital Charge Code	64904682
Hospital Revenue Code	278
Min. Negotiated Rate	$697.50
Max. Negotiated Rate	$697.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$697.50
Rate for Payer: Hamaspik Choice Inc Medicare	$697.50

SCREW HEADLESS

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64907190
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$918.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$481.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$525.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$437.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$503.12
Rate for Payer: EmblemHealth Commercial	$437.50
Rate for Payer: Fidelis Medicare Advantage	$918.75
Rate for Payer: Group Health Inc Commercial	$437.50
Rate for Payer: Group Health Inc Medicare	$306.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.50
Rate for Payer: Hamaspik Choice Inc Medicare	$437.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$568.75

SCREW HEADLESS

Facility

$875.00

Service Code	HCPCS C1713
Hospital Charge Code	64907190
Hospital Revenue Code	278
Min. Negotiated Rate	$437.50
Max. Negotiated Rate	$437.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.50
Rate for Payer: Hamaspik Choice Inc Medicare	$437.50

SCREW HEADLESS 4.0 X 34

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905292
Hospital Revenue Code	278
Min. Negotiated Rate	$687.50
Max. Negotiated Rate	$687.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50

SCREW HEADLESS 4.0 X 34

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905292
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,443.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$756.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$825.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$687.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$790.62
Rate for Payer: EmblemHealth Commercial	$687.50
Rate for Payer: Fidelis Medicare Advantage	$1,443.75
Rate for Payer: Group Health Inc Commercial	$687.50
Rate for Payer: Group Health Inc Medicare	$481.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$687.50
Rate for Payer: Hamaspik Choice Inc Medicare	$687.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$893.75

Know your out-of-pocket cost for care.

All Charges