St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 3.5 X 50MM FT T10

Facility

$732.50

Service Code	HCPCS C1713
Hospital Charge Code	64905317
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$769.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$402.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$439.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$366.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$421.19
Rate for Payer: EmblemHealth Commercial	$366.25
Rate for Payer: Fidelis Medicare Advantage	$769.12
Rate for Payer: Group Health Inc Commercial	$366.25
Rate for Payer: Group Health Inc Medicare	$256.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$366.25
Rate for Payer: Hamaspik Choice Inc Medicare	$366.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$476.12

SCREW LOCKING 3.5 X 50MM FT T10

Facility

$732.50

Service Code	HCPCS C1713
Hospital Charge Code	64905317
Hospital Revenue Code	278
Min. Negotiated Rate	$366.25
Max. Negotiated Rate	$366.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$366.25
Rate for Payer: Hamaspik Choice Inc Medicare	$366.25

SCREW LOCKING 4.0

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64903299
Hospital Revenue Code	278
Min. Negotiated Rate	$280.50
Max. Negotiated Rate	$280.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50

SCREW LOCKING 4.0

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64903299
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$589.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$308.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$336.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$280.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$322.58
Rate for Payer: EmblemHealth Commercial	$280.50
Rate for Payer: Fidelis Medicare Advantage	$589.05
Rate for Payer: Group Health Inc Commercial	$280.50
Rate for Payer: Group Health Inc Medicare	$196.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$364.65

SCREW LOCKING 4.0 24

Facility

$627.50

Service Code	HCPCS C1713
Hospital Charge Code	64904070
Hospital Revenue Code	278
Min. Negotiated Rate	$313.75
Max. Negotiated Rate	$313.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.75
Rate for Payer: Hamaspik Choice Inc Medicare	$313.75

SCREW LOCKING 4.0 24

Facility

$627.50

Service Code	HCPCS C1713
Hospital Charge Code	64904070
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$658.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$345.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$376.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$313.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$360.81
Rate for Payer: EmblemHealth Commercial	$313.75
Rate for Payer: Fidelis Medicare Advantage	$658.88
Rate for Payer: Group Health Inc Commercial	$313.75
Rate for Payer: Group Health Inc Medicare	$219.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.75
Rate for Payer: Hamaspik Choice Inc Medicare	$313.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$407.88

SCREW LOCKING 40 A

Facility

$549.00

Service Code	HCPCS C1713
Hospital Charge Code	64903655
Hospital Revenue Code	278
Min. Negotiated Rate	$274.50
Max. Negotiated Rate	$274.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.50
Rate for Payer: Hamaspik Choice Inc Medicare	$274.50

SCREW LOCKING 40 A

Facility

$549.00

Service Code	HCPCS C1713
Hospital Charge Code	64903655
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$576.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$301.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$329.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$274.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$315.68
Rate for Payer: EmblemHealth Commercial	$274.50
Rate for Payer: Fidelis Medicare Advantage	$576.45
Rate for Payer: Group Health Inc Commercial	$274.50
Rate for Payer: Group Health Inc Medicare	$192.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.50
Rate for Payer: Hamaspik Choice Inc Medicare	$274.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$356.85

SCREW LOCKING 40 B

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	64903657
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$527.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$301.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$251.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.65
Rate for Payer: EmblemHealth Commercial	$251.00
Rate for Payer: Fidelis Medicare Advantage	$527.10
Rate for Payer: Group Health Inc Commercial	$251.00
Rate for Payer: Group Health Inc Medicare	$175.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$326.30

SCREW LOCKING 40 B

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	64903657
Hospital Revenue Code	278
Min. Negotiated Rate	$251.00
Max. Negotiated Rate	$251.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00

SCREW LOCKING 4.0 X 14MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902273
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$144.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: EmblemHealth Commercial	$120.62
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 14MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902273
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 18MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902092
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 18MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902092
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$144.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: EmblemHealth Commercial	$120.62
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 26MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902194
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$144.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: EmblemHealth Commercial	$120.62
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 26MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902194
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 28

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64903505
Hospital Revenue Code	278
Min. Negotiated Rate	$280.50
Max. Negotiated Rate	$280.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50

SCREW LOCKING 4.0 X 28

Facility

$561.00

Service Code	HCPCS C1713
Hospital Charge Code	64903505
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$589.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$308.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$336.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$280.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$322.58
Rate for Payer: EmblemHealth Commercial	$280.50
Rate for Payer: Fidelis Medicare Advantage	$589.05
Rate for Payer: Group Health Inc Commercial	$280.50
Rate for Payer: Group Health Inc Medicare	$196.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.50
Rate for Payer: Hamaspik Choice Inc Medicare	$280.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$364.65

SCREW LOCKING 4.0 X 28MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902047
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$144.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: EmblemHealth Commercial	$120.62
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 28MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902047
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 30

Facility

$549.00

Service Code	HCPCS C1713
Hospital Charge Code	64903503
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$576.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$301.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$329.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$274.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$315.68
Rate for Payer: EmblemHealth Commercial	$274.50
Rate for Payer: Fidelis Medicare Advantage	$576.45
Rate for Payer: Group Health Inc Commercial	$274.50
Rate for Payer: Group Health Inc Medicare	$192.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.50
Rate for Payer: Hamaspik Choice Inc Medicare	$274.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$356.85

SCREW LOCKING 4.0 X 30

Facility

$549.00

Service Code	HCPCS C1713
Hospital Charge Code	64903503
Hospital Revenue Code	278
Min. Negotiated Rate	$274.50
Max. Negotiated Rate	$274.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.50
Rate for Payer: Hamaspik Choice Inc Medicare	$274.50

SCREW LOCKING 4.0 X 30MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902032
Hospital Revenue Code	278
Min. Negotiated Rate	$120.62
Max. Negotiated Rate	$120.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62

SCREW LOCKING 4.0 X 30MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902032
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$144.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: EmblemHealth Commercial	$120.62
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

SCREW LOCKING 4.0 X 32MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902035
Hospital Revenue Code	278
Min. Negotiated Rate	$84.44
Max. Negotiated Rate	$253.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$144.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$138.72
Rate for Payer: EmblemHealth Commercial	$120.62
Rate for Payer: Fidelis Medicare Advantage	$253.31
Rate for Payer: Group Health Inc Commercial	$120.62
Rate for Payer: Group Health Inc Medicare	$84.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.62
Rate for Payer: Hamaspik Choice Inc Medicare	$120.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156.81

Know your out-of-pocket cost for care.

All Charges