St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 3.5 X 14MM A

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902181
Hospital Revenue Code	278
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.55
Rate for Payer: EmblemHealth Commercial	$166.56
Rate for Payer: Fidelis Medicare Advantage	$349.79
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.53

SCREW LOCKING 3.5 X 14MM A

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902181
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

SCREW LOCKING 3.5 X 14MM B

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902234
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

SCREW LOCKING 3.5 X 14MM B

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902234
Hospital Revenue Code	278
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.55
Rate for Payer: EmblemHealth Commercial	$166.56
Rate for Payer: Fidelis Medicare Advantage	$349.79
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.53

SCREW LOCKING 3.5 X 16MM A

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902164
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

SCREW LOCKING 3.5 X 16MM A

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902164
Hospital Revenue Code	278
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.55
Rate for Payer: EmblemHealth Commercial	$166.56
Rate for Payer: Fidelis Medicare Advantage	$349.79
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.53

SCREW LOCKING 3.5 X 16MM B

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902236
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

SCREW LOCKING 3.5 X 16MM B

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902236
Hospital Revenue Code	278
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.55
Rate for Payer: EmblemHealth Commercial	$166.56
Rate for Payer: Fidelis Medicare Advantage	$349.79
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.53

SCREW LOCKING 3.5 X 18

Facility

$692.50

Service Code	HCPCS C1713
Hospital Charge Code	64903089
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$727.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$380.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$415.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$346.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$398.19
Rate for Payer: EmblemHealth Commercial	$346.25
Rate for Payer: Fidelis Medicare Advantage	$727.12
Rate for Payer: Group Health Inc Commercial	$346.25
Rate for Payer: Group Health Inc Medicare	$242.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$346.25
Rate for Payer: Hamaspik Choice Inc Medicare	$346.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$450.12

SCREW LOCKING 3.5 X 18

Facility

$692.50

Service Code	HCPCS C1713
Hospital Charge Code	64903089
Hospital Revenue Code	278
Min. Negotiated Rate	$346.25
Max. Negotiated Rate	$346.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$346.25
Rate for Payer: Hamaspik Choice Inc Medicare	$346.25

SCREW LOCKING 3.5 X 18MM A

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902160
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

SCREW LOCKING 3.5 X 18MM A

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902160
Hospital Revenue Code	278
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.55
Rate for Payer: EmblemHealth Commercial	$166.56
Rate for Payer: Fidelis Medicare Advantage	$349.79
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.53

SCREW LOCKING 3.5 X 18MM B

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902162
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

SCREW LOCKING 3.5 X 18MM B

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902162
Hospital Revenue Code	278
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.55
Rate for Payer: EmblemHealth Commercial	$166.56
Rate for Payer: Fidelis Medicare Advantage	$349.79
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.53

SCREW LOCKING 3.5 X 20

Facility

$712.50

Service Code	HCPCS C1713
Hospital Charge Code	64903737
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$748.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$391.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$427.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$356.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$409.69
Rate for Payer: EmblemHealth Commercial	$356.25
Rate for Payer: Fidelis Medicare Advantage	$748.12
Rate for Payer: Group Health Inc Commercial	$356.25
Rate for Payer: Group Health Inc Medicare	$249.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$356.25
Rate for Payer: Hamaspik Choice Inc Medicare	$356.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$463.12

SCREW LOCKING 3.5 X 20

Facility

$712.50

Service Code	HCPCS C1713
Hospital Charge Code	64903737
Hospital Revenue Code	278
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$356.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$356.25
Rate for Payer: Hamaspik Choice Inc Medicare	$356.25

SCREW LOCKING 3.5 X 20MM A

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902156
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

SCREW LOCKING 3.5 X 20MM A

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902156
Hospital Revenue Code	278
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.55
Rate for Payer: EmblemHealth Commercial	$166.56
Rate for Payer: Fidelis Medicare Advantage	$349.79
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.53

SCREW LOCKING 3.5 X 20MM B

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902183
Hospital Revenue Code	278
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$349.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$199.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$166.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$191.55
Rate for Payer: EmblemHealth Commercial	$166.56
Rate for Payer: Fidelis Medicare Advantage	$349.79
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$216.53

SCREW LOCKING 3.5 X 20MM B

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902183
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

SCREW LOCKING 3.5 X 22

Facility

$762.50

Service Code	HCPCS C1713
Hospital Charge Code	64902908
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$800.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$419.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$457.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$381.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$438.44
Rate for Payer: EmblemHealth Commercial	$381.25
Rate for Payer: Fidelis Medicare Advantage	$800.62
Rate for Payer: Group Health Inc Commercial	$381.25
Rate for Payer: Group Health Inc Medicare	$266.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$381.25
Rate for Payer: Hamaspik Choice Inc Medicare	$381.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$495.62

SCREW LOCKING 3.5 X 22

Facility

$762.50

Service Code	HCPCS C1713
Hospital Charge Code	64902908
Hospital Revenue Code	278
Min. Negotiated Rate	$381.25
Max. Negotiated Rate	$381.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$381.25
Rate for Payer: Hamaspik Choice Inc Medicare	$381.25

SCREW LOCKING 3.5 X 22MM A

Facility

$326.25

Service Code	HCPCS C1713
Hospital Charge Code	64902169
Hospital Revenue Code	278
Min. Negotiated Rate	$163.12
Max. Negotiated Rate	$163.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.12
Rate for Payer: Hamaspik Choice Inc Medicare	$163.12

SCREW LOCKING 3.5 X 22MM A

Facility

$326.25

Service Code	HCPCS C1713
Hospital Charge Code	64902169
Hospital Revenue Code	278
Min. Negotiated Rate	$114.19
Max. Negotiated Rate	$342.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$179.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$195.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$163.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$187.59
Rate for Payer: EmblemHealth Commercial	$163.12
Rate for Payer: Fidelis Medicare Advantage	$342.56
Rate for Payer: Group Health Inc Commercial	$163.12
Rate for Payer: Group Health Inc Medicare	$114.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.12
Rate for Payer: Hamaspik Choice Inc Medicare	$163.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$212.06

SCREW LOCKING 3.5 X 22MM B

Facility

$333.13

Service Code	HCPCS C1713
Hospital Charge Code	64902304
Hospital Revenue Code	278
Min. Negotiated Rate	$166.56
Max. Negotiated Rate	$166.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

Know your out-of-pocket cost for care.

All Charges