St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 4.0 X 55MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902099
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 55MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902099
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 60MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902055
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 60MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902055
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 65MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902057
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 65MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902057
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 70MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902101
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 70MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902101
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 75MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902049
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 75MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902049
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 X75MM

Facility

$212.80

Service Code	HCPCS C1776
Hospital Charge Code	40206051
Hospital Revenue Code	278
Min. Negotiated Rate	$106.40
Max. Negotiated Rate	$106.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.40
Rate for Payer: Hamaspik Choice Inc Medicare	$106.40

SCREW LOCKING 4.0 X75MM

Facility

$212.80

Service Code	HCPCS C1776
Hospital Charge Code	40206051
Hospital Revenue Code	278
Min. Negotiated Rate	$74.48
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$117.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$127.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$106.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$122.36
Rate for Payer: EmblemHealth Commercial	$106.40
Rate for Payer: Fidelis Medicare Advantage	$223.44
Rate for Payer: Group Health Inc Commercial	$106.40
Rate for Payer: Group Health Inc Medicare	$74.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.40
Rate for Payer: Hamaspik Choice Inc Medicare	$106.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$138.32

SCREW LOCKING 4.0 X 80

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	64903316
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$693.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$363.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$396.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$330.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$379.50
Rate for Payer: EmblemHealth Commercial	$330.00
Rate for Payer: Fidelis Medicare Advantage	$693.00
Rate for Payer: Group Health Inc Commercial	$330.00
Rate for Payer: Group Health Inc Medicare	$231.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$429.00

SCREW LOCKING 4.0 X 80

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	64903316
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$330.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00

SCREW LOCKING 4.0 X 80MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902050
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 80MM

Facility

$241.25

Service Code	HCPCS C1713
Hospital Charge Code	64902050
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 4MM 4.0MM / L24M

Facility

$583.58

Service Code	HCPCS C1713
Hospital Charge Code	64904065
Hospital Revenue Code	278
Min. Negotiated Rate	$291.79
Max. Negotiated Rate	$291.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$291.79
Rate for Payer: Hamaspik Choice Inc Medicare	$291.79

SCREW LOCKING 4MM 4.0MM / L24M

Facility

$583.58

Service Code	HCPCS C1713
Hospital Charge Code	64904065
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$612.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$320.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$350.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$291.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$335.56
Rate for Payer: EmblemHealth Commercial	$291.79
Rate for Payer: Fidelis Medicare Advantage	$612.76
Rate for Payer: Group Health Inc Commercial	$291.79
Rate for Payer: Group Health Inc Medicare	$204.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$291.79
Rate for Payer: Hamaspik Choice Inc Medicare	$291.79
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$379.33

SCREW LOCKING 4MM X 85MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	64904994
Hospital Revenue Code	278
Min. Negotiated Rate	$330.00
Max. Negotiated Rate	$330.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00

SCREW LOCKING 4MM X 85MM

Facility

$660.00

Service Code	HCPCS C1713
Hospital Charge Code	64904994
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$693.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$363.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$396.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$330.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$379.50
Rate for Payer: EmblemHealth Commercial	$330.00
Rate for Payer: Fidelis Medicare Advantage	$693.00
Rate for Payer: Group Health Inc Commercial	$330.00
Rate for Payer: Group Health Inc Medicare	$231.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.00
Rate for Payer: Hamaspik Choice Inc Medicare	$330.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$429.00

SCREW LOCKING 4MM X L16MM

Facility

$408.40

Service Code	HCPCS C1713
Hospital Charge Code	64906792
Hospital Revenue Code	278
Min. Negotiated Rate	$204.20
Max. Negotiated Rate	$204.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.20
Rate for Payer: Hamaspik Choice Inc Medicare	$204.20

SCREW LOCKING 4MM X L16MM

Facility

$408.40

Service Code	HCPCS C1713
Hospital Charge Code	64906792
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$428.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$224.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$245.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$234.83
Rate for Payer: EmblemHealth Commercial	$204.20
Rate for Payer: Fidelis Medicare Advantage	$428.82
Rate for Payer: Group Health Inc Commercial	$204.20
Rate for Payer: Group Health Inc Medicare	$142.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.20
Rate for Payer: Hamaspik Choice Inc Medicare	$204.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$265.46

SCREW LOCKING 4 X 20MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64902501
Hospital Revenue Code	278
Min. Negotiated Rate	$212.88
Max. Negotiated Rate	$212.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$212.88
Rate for Payer: Hamaspik Choice Inc Medicare	$212.88

SCREW LOCKING 4 X 20MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64902501
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$447.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$234.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$255.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$212.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$244.81
Rate for Payer: EmblemHealth Commercial	$212.88
Rate for Payer: Fidelis Medicare Advantage	$447.04
Rate for Payer: Group Health Inc Commercial	$212.88
Rate for Payer: Group Health Inc Medicare	$149.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$212.88
Rate for Payer: Hamaspik Choice Inc Medicare	$212.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$276.74

SCREW LOCKING 4 X 24MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901439
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$447.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$234.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$255.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$212.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$244.81
Rate for Payer: EmblemHealth Commercial	$212.88
Rate for Payer: Fidelis Medicare Advantage	$447.04
Rate for Payer: Group Health Inc Commercial	$212.88
Rate for Payer: Group Health Inc Medicare	$149.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$212.88
Rate for Payer: Hamaspik Choice Inc Medicare	$212.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$276.74

Know your out-of-pocket cost for care.

All Charges