St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$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 26MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901641
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 26MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901641
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 28MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901643
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 28MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901643
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 30MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901441
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 30MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901441
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 32

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64903106
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 32

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64903106
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 34MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901950
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 34MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901950
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 38MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64902509
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 38MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64902509
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 40MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901952
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 40MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901952
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 45MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901644
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 45MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64901644
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 4X50MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64902629
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 4X50MM FT T2

Facility

$425.75

Service Code	HCPCS C1713
Hospital Charge Code	64902629
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 5'

Facility

$691.20

Service Code	HCPCS C1713
Hospital Charge Code	64906905
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$725.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$380.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$414.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$345.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$397.44
Rate for Payer: EmblemHealth Commercial	$345.60
Rate for Payer: Fidelis Medicare Advantage	$725.76
Rate for Payer: Group Health Inc Commercial	$345.60
Rate for Payer: Group Health Inc Medicare	$241.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$345.60
Rate for Payer: Hamaspik Choice Inc Medicare	$345.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$449.28

SCREW LOCKING 5'

Facility

$691.20

Service Code	HCPCS C1713
Hospital Charge Code	64906905
Hospital Revenue Code	278
Min. Negotiated Rate	$345.60
Max. Negotiated Rate	$345.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$345.60
Rate for Payer: Hamaspik Choice Inc Medicare	$345.60

SCREW LOCKING 5.0 MM 34

Facility

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	64904364
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$567.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$297.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$324.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$270.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$310.50
Rate for Payer: EmblemHealth Commercial	$270.00
Rate for Payer: Fidelis Medicare Advantage	$567.00
Rate for Payer: Group Health Inc Commercial	$270.00
Rate for Payer: Group Health Inc Medicare	$189.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$270.00
Rate for Payer: Hamaspik Choice Inc Medicare	$270.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$351.00

SCREW LOCKING 5.0 MM 34

Facility

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	64904364
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$270.00
Rate for Payer: Hamaspik Choice Inc Medicare	$270.00

SCREW LOCKING 5.0 MM 36

Facility

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	64904363
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$270.00
Rate for Payer: Hamaspik Choice Inc Medicare	$270.00

SCREW LOCKING 5.0 MM 36

Facility

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	64904363
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$567.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$297.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$324.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$270.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$310.50
Rate for Payer: EmblemHealth Commercial	$270.00
Rate for Payer: Fidelis Medicare Advantage	$567.00
Rate for Payer: Group Health Inc Commercial	$270.00
Rate for Payer: Group Health Inc Medicare	$189.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$270.00
Rate for Payer: Hamaspik Choice Inc Medicare	$270.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$351.00

Know your out-of-pocket cost for care.

All Charges