St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 2.7MM X 18MM

Facility

$407.50

Service Code	HCPCS C1713
Hospital Charge Code	64902121
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 18MM

Facility

$407.50

Service Code	HCPCS C1713
Hospital Charge Code	64902121
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

SCREW LOCKING 2.7MM X 20MM

Facility

$407.50

Service Code	HCPCS C1713
Hospital Charge Code	64902123
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 20MM

Facility

$407.50

Service Code	HCPCS C1713
Hospital Charge Code	64902123
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

SCREW LOCKING 2.7 STRY

Facility

$792.50

Service Code	HCPCS C1713
Hospital Charge Code	64907045
Hospital Revenue Code	278
Min. Negotiated Rate	$396.25
Max. Negotiated Rate	$396.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$396.25
Rate for Payer: Hamaspik Choice Inc Medicare	$396.25

SCREW LOCKING 2.7 STRY

Facility

$792.50

Service Code	HCPCS C1713
Hospital Charge Code	64907045
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$832.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$435.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$475.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$396.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$455.69
Rate for Payer: EmblemHealth Commercial	$396.25
Rate for Payer: Fidelis Medicare Advantage	$832.12
Rate for Payer: Group Health Inc Commercial	$396.25
Rate for Payer: Group Health Inc Medicare	$277.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$396.25
Rate for Payer: Hamaspik Choice Inc Medicare	$396.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$515.12

SCREW LOCKING 2.7X10

Facility

$317.50

Service Code	HCPCS C1713
Hospital Charge Code	64903753
Hospital Revenue Code	278
Min. Negotiated Rate	$158.75
Max. Negotiated Rate	$158.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.75
Rate for Payer: Hamaspik Choice Inc Medicare	$158.75

SCREW LOCKING 2.7X10

Facility

$317.50

Service Code	HCPCS C1713
Hospital Charge Code	64903753
Hospital Revenue Code	278
Min. Negotiated Rate	$111.12
Max. Negotiated Rate	$333.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$190.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$158.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.56
Rate for Payer: EmblemHealth Commercial	$158.75
Rate for Payer: Fidelis Medicare Advantage	$333.38
Rate for Payer: Group Health Inc Commercial	$158.75
Rate for Payer: Group Health Inc Medicare	$111.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.75
Rate for Payer: Hamaspik Choice Inc Medicare	$158.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.38

SCREW LOCKING 2.7X11

Facility

$302.50

Service Code	HCPCS C1713
Hospital Charge Code	64903755
Hospital Revenue Code	278
Min. Negotiated Rate	$151.25
Max. Negotiated Rate	$151.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$151.25
Rate for Payer: Hamaspik Choice Inc Medicare	$151.25

SCREW LOCKING 2.7X11

Facility

$302.50

Service Code	HCPCS C1713
Hospital Charge Code	64903755
Hospital Revenue Code	278
Min. Negotiated Rate	$105.88
Max. Negotiated Rate	$317.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$166.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$181.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$151.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.94
Rate for Payer: EmblemHealth Commercial	$151.25
Rate for Payer: Fidelis Medicare Advantage	$317.62
Rate for Payer: Group Health Inc Commercial	$151.25
Rate for Payer: Group Health Inc Medicare	$105.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$151.25
Rate for Payer: Hamaspik Choice Inc Medicare	$151.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$196.62

SCREW LOCKING 2.7X12

Facility

$302.50

Service Code	HCPCS C1713
Hospital Charge Code	64903757
Hospital Revenue Code	278
Min. Negotiated Rate	$105.88
Max. Negotiated Rate	$317.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$166.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$181.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$151.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.94
Rate for Payer: EmblemHealth Commercial	$151.25
Rate for Payer: Fidelis Medicare Advantage	$317.62
Rate for Payer: Group Health Inc Commercial	$151.25
Rate for Payer: Group Health Inc Medicare	$105.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$151.25
Rate for Payer: Hamaspik Choice Inc Medicare	$151.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$196.62

SCREW LOCKING 2.7X12

Facility

$302.50

Service Code	HCPCS C1713
Hospital Charge Code	64903757
Hospital Revenue Code	278
Min. Negotiated Rate	$151.25
Max. Negotiated Rate	$151.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$151.25
Rate for Payer: Hamaspik Choice Inc Medicare	$151.25

SCREW LOCKING 2.7 X 12MM A

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64902323
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 2.7 X 12MM A

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64902323
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 2.7X13

Facility

$317.50

Service Code	HCPCS C1713
Hospital Charge Code	64903935
Hospital Revenue Code	278
Min. Negotiated Rate	$158.75
Max. Negotiated Rate	$158.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.75
Rate for Payer: Hamaspik Choice Inc Medicare	$158.75

SCREW LOCKING 2.7X13

Facility

$317.50

Service Code	HCPCS C1713
Hospital Charge Code	64903935
Hospital Revenue Code	278
Min. Negotiated Rate	$111.12
Max. Negotiated Rate	$333.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$190.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$158.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.56
Rate for Payer: EmblemHealth Commercial	$158.75
Rate for Payer: Fidelis Medicare Advantage	$333.38
Rate for Payer: Group Health Inc Commercial	$158.75
Rate for Payer: Group Health Inc Medicare	$111.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.75
Rate for Payer: Hamaspik Choice Inc Medicare	$158.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.38

SCREW LOCKING 2.7X14

Facility

$317.50

Service Code	HCPCS C1713
Hospital Charge Code	64903933
Hospital Revenue Code	278
Min. Negotiated Rate	$111.12
Max. Negotiated Rate	$333.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$190.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$158.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.56
Rate for Payer: EmblemHealth Commercial	$158.75
Rate for Payer: Fidelis Medicare Advantage	$333.38
Rate for Payer: Group Health Inc Commercial	$158.75
Rate for Payer: Group Health Inc Medicare	$111.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.75
Rate for Payer: Hamaspik Choice Inc Medicare	$158.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.38

SCREW LOCKING 2.7X14

Facility

$317.50

Service Code	HCPCS C1713
Hospital Charge Code	64903933
Hospital Revenue Code	278
Min. Negotiated Rate	$158.75
Max. Negotiated Rate	$158.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.75
Rate for Payer: Hamaspik Choice Inc Medicare	$158.75

SCREW LOCKING 2.7 X 14MM B

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64902312
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 2.7 X 14MM B

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64902312
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 X 14MM C

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64902471
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 2.7 X 14MM C

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64902471
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 X 16MM B

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64902168
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 2.7 X 16MM B

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64902168
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 X 16MM C

Facility

$287.00

Service Code	HCPCS C1713
Hospital Charge Code	64902297
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

Know your out-of-pocket cost for care.

All Charges