St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW HEADLESS 4.0 X 46

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905294
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 46

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905294
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

SCREW HEADLESS 4.0 X 75

Facility

$1,473.75

Service Code	HCPCS C1713
Hospital Charge Code	64905428
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,547.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$810.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$884.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$736.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$847.41
Rate for Payer: EmblemHealth Commercial	$736.88
Rate for Payer: Fidelis Medicare Advantage	$1,547.44
Rate for Payer: Group Health Inc Commercial	$736.88
Rate for Payer: Group Health Inc Medicare	$515.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$736.88
Rate for Payer: Hamaspik Choice Inc Medicare	$736.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$957.94

SCREW HEADLESS 4.0 X 75

Facility

$1,473.75

Service Code	HCPCS C1713
Hospital Charge Code	64905428
Hospital Revenue Code	278
Min. Negotiated Rate	$736.88
Max. Negotiated Rate	$736.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$736.88
Rate for Payer: Hamaspik Choice Inc Medicare	$736.88

SCREW HEADLESS 5.0 X 70MM

Facility

$1,251.25

Service Code	HCPCS C1713
Hospital Charge Code	64906952
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,313.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$688.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$750.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$625.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$719.47
Rate for Payer: EmblemHealth Commercial	$625.62
Rate for Payer: Fidelis Medicare Advantage	$1,313.81
Rate for Payer: Group Health Inc Commercial	$625.62
Rate for Payer: Group Health Inc Medicare	$437.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$625.62
Rate for Payer: Hamaspik Choice Inc Medicare	$625.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$813.31

SCREW HEADLESS 5.0 X 70MM

Facility

$1,251.25

Service Code	HCPCS C1713
Hospital Charge Code	64906952
Hospital Revenue Code	278
Min. Negotiated Rate	$625.62
Max. Negotiated Rate	$625.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$625.62
Rate for Payer: Hamaspik Choice Inc Medicare	$625.62

SCREW HEADLESS COMP 5.0MM/L55MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905897
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 COMP 5.0MM/L55MM

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64905897
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

SCREW HEADLESS COMPRESSION 4.0A

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904596
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

SCREW HEADLESS COMPRESSION 4.0A

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904596
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 COMPRESSION 4.0B

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904600
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 COMPRESSION 4.0B

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904600
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

SCREW HEADLESS COMPRESSION 4X42

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904598
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

SCREW HEADLESS COMPRESSION 4X42

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904598
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 COMPRESSION 5.0A

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904602
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 COMPRESSION 5.0A

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904602
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

SCREW HEADLESS COMPRESSION 5.0B

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904604
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

SCREW HEADLESS COMPRESSION 5.0B

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904604
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 COMPRESSION 5.0C

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904607
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

SCREW HEADLESS COMPRESSION 5.0C

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904607
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 COMPRESSION 5.0D

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904608
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

SCREW HEADLESS COMPRESSION 5.0D

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904608
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 COMPRESSION 5.0M

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904605
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

SCREW HEADLESS COMPRESSION 5.0M

Facility

$1,375.00

Service Code	HCPCS C1713
Hospital Charge Code	64904605
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 HEAD MINI

Facility

$813.05

Service Code	HCPCS C1713
Hospital Charge Code	64907410
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$853.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$447.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$487.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$406.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$467.50
Rate for Payer: EmblemHealth Commercial	$406.52
Rate for Payer: Fidelis Medicare Advantage	$853.70
Rate for Payer: Group Health Inc Commercial	$406.52
Rate for Payer: Group Health Inc Medicare	$284.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$406.52
Rate for Payer: Hamaspik Choice Inc Medicare	$406.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$528.48

Know your out-of-pocket cost for care.

All Charges