St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW LEVERAGE 2.6X8MM LAT

Facility

$493.93

Service Code	HCPCS C1713
Hospital Charge Code	64904213
Hospital Revenue Code	278
Min. Negotiated Rate	$246.96
Max. Negotiated Rate	$246.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$246.96
Rate for Payer: Hamaspik Choice Inc Medicare	$246.96

SCREW LEVERAGE 2.6X8MM LAT

Facility

$493.93

Service Code	HCPCS C1713
Hospital Charge Code	64904213
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$518.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$271.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$296.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$246.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.01
Rate for Payer: EmblemHealth Commercial	$246.96
Rate for Payer: Fidelis Medicare Advantage	$518.63
Rate for Payer: Group Health Inc Commercial	$246.96
Rate for Payer: Group Health Inc Medicare	$172.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$246.96
Rate for Payer: Hamaspik Choice Inc Medicare	$246.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$321.05

SCREW LG 5.5 X 35

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64904930
Hospital Revenue Code	278
Min. Negotiated Rate	$4,276.35
Max. Negotiated Rate	$4,276.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,276.35
Rate for Payer: Hamaspik Choice Inc Medicare	$4,276.35

SCREW LG 5.5 X 35

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64904930
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,980.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,703.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$5,131.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,276.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,917.80
Rate for Payer: EmblemHealth Commercial	$4,276.35
Rate for Payer: Fidelis Medicare Advantage	$8,980.34
Rate for Payer: Group Health Inc Commercial	$4,276.35
Rate for Payer: Group Health Inc Medicare	$2,993.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,276.35
Rate for Payer: Hamaspik Choice Inc Medicare	$4,276.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,559.26

SCREW LG OMEGA 100MM

Facility

$729.63

Service Code	HCPCS C1713
Hospital Charge Code	64903641
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$766.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$401.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$437.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$364.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$419.54
Rate for Payer: EmblemHealth Commercial	$364.82
Rate for Payer: Fidelis Medicare Advantage	$766.11
Rate for Payer: Group Health Inc Commercial	$364.82
Rate for Payer: Group Health Inc Medicare	$255.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$364.82
Rate for Payer: Hamaspik Choice Inc Medicare	$364.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$474.26

SCREW LG OMEGA 100MM

Facility

$729.63

Service Code	HCPCS C1713
Hospital Charge Code	64903641
Hospital Revenue Code	278
Min. Negotiated Rate	$364.82
Max. Negotiated Rate	$364.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$364.82
Rate for Payer: Hamaspik Choice Inc Medicare	$364.82

SCREW LOCK 2.4X 10MM TI ST

Facility

$290.00

Service Code	HCPCS C1776
Hospital Charge Code	40205075
Hospital Revenue Code	278
Min. Negotiated Rate	$101.50
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$159.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$174.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$145.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$166.75
Rate for Payer: EmblemHealth Commercial	$145.00
Rate for Payer: Fidelis Medicare Advantage	$304.50
Rate for Payer: Group Health Inc Commercial	$145.00
Rate for Payer: Group Health Inc Medicare	$101.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$145.00
Rate for Payer: Hamaspik Choice Inc Medicare	$145.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$188.50

SCREW LOCK 2.4X 10MM TI ST

Facility

$290.00

Service Code	HCPCS C1776
Hospital Charge Code	40205075
Hospital Revenue Code	278
Min. Negotiated Rate	$145.00
Max. Negotiated Rate	$145.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$145.00
Rate for Payer: Hamaspik Choice Inc Medicare	$145.00

SCREW LOCK 2.4 X 8MM TI ST

Facility

$290.00

Service Code	HCPCS C1776
Hospital Charge Code	40205076
Hospital Revenue Code	278
Min. Negotiated Rate	$145.00
Max. Negotiated Rate	$145.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$145.00
Rate for Payer: Hamaspik Choice Inc Medicare	$145.00

SCREW LOCK 2.4 X 8MM TI ST

Facility

$290.00

Service Code	HCPCS C1776
Hospital Charge Code	40205076
Hospital Revenue Code	278
Min. Negotiated Rate	$101.50
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$159.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$174.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$145.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$166.75
Rate for Payer: EmblemHealth Commercial	$145.00
Rate for Payer: Fidelis Medicare Advantage	$304.50
Rate for Payer: Group Health Inc Commercial	$145.00
Rate for Payer: Group Health Inc Medicare	$101.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$145.00
Rate for Payer: Hamaspik Choice Inc Medicare	$145.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$188.50

SCREW LOCK 5 X 42.5MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64902576
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50

SCREW LOCK 5 X 42.5MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64902576
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$450.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$257.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$214.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.68
Rate for Payer: EmblemHealth Commercial	$214.50
Rate for Payer: Fidelis Medicare Advantage	$450.45
Rate for Payer: Group Health Inc Commercial	$214.50
Rate for Payer: Group Health Inc Medicare	$150.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$278.85

SCREW LOCK 5 X 47.5MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64902579
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50

SCREW LOCK 5 X 47.5MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64902579
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$450.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$257.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$214.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.68
Rate for Payer: EmblemHealth Commercial	$214.50
Rate for Payer: Fidelis Medicare Advantage	$450.45
Rate for Payer: Group Health Inc Commercial	$214.50
Rate for Payer: Group Health Inc Medicare	$150.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$278.85

SCREW LOCK AXS 1.7

Facility

$179.78

Service Code	HCPCS C1713
Hospital Charge Code	64907453
Hospital Revenue Code	278
Min. Negotiated Rate	$62.92
Max. Negotiated Rate	$188.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$107.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$89.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$103.37
Rate for Payer: EmblemHealth Commercial	$89.89
Rate for Payer: Fidelis Medicare Advantage	$188.77
Rate for Payer: Group Health Inc Commercial	$89.89
Rate for Payer: Group Health Inc Medicare	$62.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.89
Rate for Payer: Hamaspik Choice Inc Medicare	$89.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$116.86

SCREW LOCK AXS 1.7

Facility

$179.78

Service Code	HCPCS C1713
Hospital Charge Code	64907453
Hospital Revenue Code	278
Min. Negotiated Rate	$89.89
Max. Negotiated Rate	$89.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.89
Rate for Payer: Hamaspik Choice Inc Medicare	$89.89

SCREW LOCK CORT 2.5

Facility

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64907034
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 LOCK CORT 2.5

Facility

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64907034
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 LOCK F-THRD T10 2.7MM L46

Facility

$228.18

Service Code	HCPCS C1713
Hospital Charge Code	64906434
Hospital Revenue Code	278
Min. Negotiated Rate	$114.09
Max. Negotiated Rate	$114.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.09
Rate for Payer: Hamaspik Choice Inc Medicare	$114.09

SCREW LOCK F-THRD T10 2.7MM L46

Facility

$228.18

Service Code	HCPCS C1713
Hospital Charge Code	64906434
Hospital Revenue Code	278
Min. Negotiated Rate	$79.86
Max. Negotiated Rate	$239.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$136.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.20
Rate for Payer: EmblemHealth Commercial	$114.09
Rate for Payer: Fidelis Medicare Advantage	$239.59
Rate for Payer: Group Health Inc Commercial	$114.09
Rate for Payer: Group Health Inc Medicare	$79.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.09
Rate for Payer: Hamaspik Choice Inc Medicare	$114.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.32

SCREW LOCK F-THRD T10 2.7MM L50

Facility

$912.72

Service Code	HCPCS C1713
Hospital Charge Code	64906812
Hospital Revenue Code	278
Min. Negotiated Rate	$456.36
Max. Negotiated Rate	$456.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.36
Rate for Payer: Hamaspik Choice Inc Medicare	$456.36

SCREW LOCK F-THRD T10 2.7MM L50

Facility

$912.72

Service Code	HCPCS C1713
Hospital Charge Code	64906812
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$958.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$502.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$547.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$456.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$524.81
Rate for Payer: EmblemHealth Commercial	$456.36
Rate for Payer: Fidelis Medicare Advantage	$958.36
Rate for Payer: Group Health Inc Commercial	$456.36
Rate for Payer: Group Health Inc Medicare	$319.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.36
Rate for Payer: Hamaspik Choice Inc Medicare	$456.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$593.27

SCREW LOCK FULL THRD 5X65MM

Facility

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202426
Hospital Revenue Code	278
Min. Negotiated Rate	$111.30
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$190.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.85
Rate for Payer: EmblemHealth Commercial	$159.00
Rate for Payer: Fidelis Medicare Advantage	$333.90
Rate for Payer: Group Health Inc Commercial	$159.00
Rate for Payer: Group Health Inc Medicare	$111.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00
Rate for Payer: Hamaspik Choice Inc Medicare	$159.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.70

SCREW LOCK FULL THRD 5X65MM

Facility

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202426
Hospital Revenue Code	278
Min. Negotiated Rate	$159.00
Max. Negotiated Rate	$159.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00
Rate for Payer: Hamaspik Choice Inc Medicare	$159.00

SCREW LOCKIG FULL THRD T10 2.7X40

Facility

$228.18

Service Code	HCPCS C1713
Hospital Charge Code	64906504
Hospital Revenue Code	278
Min. Negotiated Rate	$114.09
Max. Negotiated Rate	$114.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.09
Rate for Payer: Hamaspik Choice Inc Medicare	$114.09

Know your out-of-pocket cost for care.

All Charges