St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 2.3 X 22

Facility

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64903708
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 LOCKING 2.3 X 24 MM

Facility

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64902757
Hospital Revenue Code	278
Min. Negotiated Rate	$122.50
Max. Negotiated Rate	$122.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50

SCREW LOCKING 2.3 X 24 MM

Facility

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64902757
Hospital Revenue Code	278
Min. Negotiated Rate	$85.75
Max. Negotiated Rate	$257.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$134.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$147.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$122.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$140.88
Rate for Payer: EmblemHealth Commercial	$122.50
Rate for Payer: Fidelis Medicare Advantage	$257.25
Rate for Payer: Group Health Inc Commercial	$122.50
Rate for Payer: Group Health Inc Medicare	$85.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$159.25

SCREW LOCKING 2.3 X 26MM

Facility

$216.00

Service Code	HCPCS C1713
Hospital Charge Code	64906838
Hospital Revenue Code	278
Min. Negotiated Rate	$108.00
Max. Negotiated Rate	$108.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.00
Rate for Payer: Hamaspik Choice Inc Medicare	$108.00

SCREW LOCKING 2.3 X 26MM

Facility

$216.00

Service Code	HCPCS C1713
Hospital Charge Code	64906838
Hospital Revenue Code	278
Min. Negotiated Rate	$75.60
Max. Negotiated Rate	$226.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$118.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$129.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$108.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$124.20
Rate for Payer: EmblemHealth Commercial	$108.00
Rate for Payer: Fidelis Medicare Advantage	$226.80
Rate for Payer: Group Health Inc Commercial	$108.00
Rate for Payer: Group Health Inc Medicare	$75.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.00
Rate for Payer: Hamaspik Choice Inc Medicare	$108.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$140.40

SCREW LOCKING 2.3 X 6

Facility

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64904414
Hospital Revenue Code	278
Min. Negotiated Rate	$122.50
Max. Negotiated Rate	$122.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50

SCREW LOCKING 2.3 X 6

Facility

$245.00

Service Code	HCPCS C1713
Hospital Charge Code	64904414
Hospital Revenue Code	278
Min. Negotiated Rate	$85.75
Max. Negotiated Rate	$257.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$134.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$147.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$122.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$140.88
Rate for Payer: EmblemHealth Commercial	$122.50
Rate for Payer: Fidelis Medicare Advantage	$257.25
Rate for Payer: Group Health Inc Commercial	$122.50
Rate for Payer: Group Health Inc Medicare	$85.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$122.50
Rate for Payer: Hamaspik Choice Inc Medicare	$122.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$159.25

SCREW LOCKING 2.3 X 9MM

Facility

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64902827
Hospital Revenue Code	278
Min. Negotiated Rate	$89.38
Max. Negotiated Rate	$89.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38

SCREW LOCKING 2.3 X 9MM

Facility

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64902827
Hospital Revenue Code	278
Min. Negotiated Rate	$62.56
Max. Negotiated Rate	$187.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$107.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$89.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.78
Rate for Payer: EmblemHealth Commercial	$89.38
Rate for Payer: Fidelis Medicare Advantage	$187.69
Rate for Payer: Group Health Inc Commercial	$89.38
Rate for Payer: Group Health Inc Medicare	$62.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$116.19

SCREW LOCKING 2.4

Facility

$512.43

Service Code	HCPCS C1713
Hospital Charge Code	64907038
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$538.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$281.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$307.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$256.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$294.65
Rate for Payer: EmblemHealth Commercial	$256.22
Rate for Payer: Fidelis Medicare Advantage	$538.05
Rate for Payer: Group Health Inc Commercial	$256.22
Rate for Payer: Group Health Inc Medicare	$179.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.22
Rate for Payer: Hamaspik Choice Inc Medicare	$256.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$333.08

SCREW LOCKING 2.4

Facility

$512.43

Service Code	HCPCS C1713
Hospital Charge Code	64907038
Hospital Revenue Code	278
Min. Negotiated Rate	$256.22
Max. Negotiated Rate	$256.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.22
Rate for Payer: Hamaspik Choice Inc Medicare	$256.22

SCREW LOCKING 2.4 X 4MM

Facility

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	64901370
Hospital Revenue Code	278
Min. Negotiated Rate	$97.74
Max. Negotiated Rate	$97.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.74
Rate for Payer: Hamaspik Choice Inc Medicare	$97.74

SCREW LOCKING 2.4 X 4MM

Facility

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	64901370
Hospital Revenue Code	278
Min. Negotiated Rate	$68.42
Max. Negotiated Rate	$205.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$117.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$97.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.40
Rate for Payer: EmblemHealth Commercial	$97.74
Rate for Payer: Fidelis Medicare Advantage	$205.25
Rate for Payer: Group Health Inc Commercial	$97.74
Rate for Payer: Group Health Inc Medicare	$68.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.74
Rate for Payer: Hamaspik Choice Inc Medicare	$97.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.06

SCREW LOCKING 25MM

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901330
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 LOCKING 25MM

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901330
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 LOCKING 27 14MM 882714

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	64906647
Hospital Revenue Code	278
Min. Negotiated Rate	$80.50
Max. Negotiated Rate	$241.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$138.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$115.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.25
Rate for Payer: EmblemHealth Commercial	$115.00
Rate for Payer: Fidelis Medicare Advantage	$241.50
Rate for Payer: Group Health Inc Commercial	$115.00
Rate for Payer: Group Health Inc Medicare	$80.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$149.50

SCREW LOCKING 27 14MM 882714

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	64906647
Hospital Revenue Code	278
Min. Negotiated Rate	$115.00
Max. Negotiated Rate	$115.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00

SCREW LOCKING 27 16MM 882716

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	64906648
Hospital Revenue Code	278
Min. Negotiated Rate	$80.50
Max. Negotiated Rate	$241.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$138.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$115.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.25
Rate for Payer: EmblemHealth Commercial	$115.00
Rate for Payer: Fidelis Medicare Advantage	$241.50
Rate for Payer: Group Health Inc Commercial	$115.00
Rate for Payer: Group Health Inc Medicare	$80.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$149.50

SCREW LOCKING 27 16MM 882716

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	64906648
Hospital Revenue Code	278
Min. Negotiated Rate	$115.00
Max. Negotiated Rate	$115.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00

SCREW LOCKING 2.7 26

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64903882
Hospital Revenue Code	278
Min. Negotiated Rate	$143.50
Max. Negotiated Rate	$143.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.50
Rate for Payer: Hamaspik Choice Inc Medicare	$143.50

SCREW LOCKING 2.7 26

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64903882
Hospital Revenue Code	278
Min. Negotiated Rate	$100.45
Max. Negotiated Rate	$301.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$157.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$172.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$143.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$165.02
Rate for Payer: EmblemHealth Commercial	$143.50
Rate for Payer: Fidelis Medicare Advantage	$301.35
Rate for Payer: Group Health Inc Commercial	$143.50
Rate for Payer: Group Health Inc Medicare	$100.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.50
Rate for Payer: Hamaspik Choice Inc Medicare	$143.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$186.55

SCREW LOCKING 2.7MM L52MM

Facility

$456.36

Service Code	HCPCS C1713
Hospital Charge Code	64906809
Hospital Revenue Code	278
Min. Negotiated Rate	$228.18
Max. Negotiated Rate	$228.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$228.18
Rate for Payer: Hamaspik Choice Inc Medicare	$228.18

SCREW LOCKING 2.7MM L52MM

Facility

$456.36

Service Code	HCPCS C1713
Hospital Charge Code	64906809
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$479.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$251.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$273.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$228.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$262.41
Rate for Payer: EmblemHealth Commercial	$228.18
Rate for Payer: Fidelis Medicare Advantage	$479.18
Rate for Payer: Group Health Inc Commercial	$228.18
Rate for Payer: Group Health Inc Medicare	$159.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$228.18
Rate for Payer: Hamaspik Choice Inc Medicare	$228.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$296.63

SCREW LOCKING 2.7MM X 16MM ST

Facility

$407.50

Service Code	HCPCS C1713
Hospital Charge Code	64902533
Hospital Revenue Code	278
Min. Negotiated Rate	$203.75
Max. Negotiated Rate	$203.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.75
Rate for Payer: Hamaspik Choice Inc Medicare	$203.75

SCREW LOCKING 2.7MM X 16MM ST

Facility

$407.50

Service Code	HCPCS C1713
Hospital Charge Code	64902533
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$427.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$224.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$244.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$203.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$234.31
Rate for Payer: EmblemHealth Commercial	$203.75
Rate for Payer: Fidelis Medicare Advantage	$427.88
Rate for Payer: Group Health Inc Commercial	$203.75
Rate for Payer: Group Health Inc Medicare	$142.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.75
Rate for Payer: Hamaspik Choice Inc Medicare	$203.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$264.88

Know your out-of-pocket cost for care.

All Charges