St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 5.0 X 24

Facility

$667.50

Service Code	HCPCS C1713
Hospital Charge Code	64903828
Hospital Revenue Code	278
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$333.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$333.75

SCREW LOCKING 5.0 X 24

Facility

$667.50

Service Code	HCPCS C1713
Hospital Charge Code	64903828
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$700.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$367.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$400.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$333.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$383.81
Rate for Payer: EmblemHealth Commercial	$333.75
Rate for Payer: Fidelis Medicare Advantage	$700.88
Rate for Payer: Group Health Inc Commercial	$333.75
Rate for Payer: Group Health Inc Medicare	$233.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$333.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$433.88

SCREW LOCKING 5.0 X 28

Facility

$667.50

Service Code	HCPCS C1713
Hospital Charge Code	64903129
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$700.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$367.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$400.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$333.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$383.81
Rate for Payer: EmblemHealth Commercial	$333.75
Rate for Payer: Fidelis Medicare Advantage	$700.88
Rate for Payer: Group Health Inc Commercial	$333.75
Rate for Payer: Group Health Inc Medicare	$233.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$333.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$433.88

SCREW LOCKING 5.0 X 28

Facility

$667.50

Service Code	HCPCS C1713
Hospital Charge Code	64903129
Hospital Revenue Code	278
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$333.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$333.75

SCREW LOCKING 5.0 X 36

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903128
Hospital Revenue Code	278
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00

SCREW LOCKING 5.0 X 36

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903128
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$735.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$385.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$420.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$350.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$402.50
Rate for Payer: EmblemHealth Commercial	$350.00
Rate for Payer: Fidelis Medicare Advantage	$735.00
Rate for Payer: Group Health Inc Commercial	$350.00
Rate for Payer: Group Health Inc Medicare	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$455.00

SCREW LOCKING 5.0 X 36MM

Facility

$256.25

Service Code	HCPCS C1713
Hospital Charge Code	64902353
Hospital Revenue Code	278
Min. Negotiated Rate	$89.69
Max. Negotiated Rate	$269.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$140.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$153.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$128.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$147.34
Rate for Payer: EmblemHealth Commercial	$128.12
Rate for Payer: Fidelis Medicare Advantage	$269.06
Rate for Payer: Group Health Inc Commercial	$128.12
Rate for Payer: Group Health Inc Medicare	$89.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.12
Rate for Payer: Hamaspik Choice Inc Medicare	$128.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$166.56

SCREW LOCKING 5.0 X 36MM

Facility

$256.25

Service Code	HCPCS C1713
Hospital Charge Code	64902353
Hospital Revenue Code	278
Min. Negotiated Rate	$128.12
Max. Negotiated Rate	$128.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.12
Rate for Payer: Hamaspik Choice Inc Medicare	$128.12

SCREW LOCKING 5.0 X 42

Facility

$1,417.50

Service Code	HCPCS C1713
Hospital Charge Code	64903247
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,488.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$779.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$850.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$708.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$815.06
Rate for Payer: EmblemHealth Commercial	$708.75
Rate for Payer: Fidelis Medicare Advantage	$1,488.38
Rate for Payer: Group Health Inc Commercial	$708.75
Rate for Payer: Group Health Inc Medicare	$496.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$708.75
Rate for Payer: Hamaspik Choice Inc Medicare	$708.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$921.38

SCREW LOCKING 5.0 X 42

Facility

$1,417.50

Service Code	HCPCS C1713
Hospital Charge Code	64903247
Hospital Revenue Code	278
Min. Negotiated Rate	$708.75
Max. Negotiated Rate	$708.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$708.75
Rate for Payer: Hamaspik Choice Inc Medicare	$708.75

SCREW LOCKING 5.0 X 44

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903248
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$735.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$385.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$420.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$350.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$402.50
Rate for Payer: EmblemHealth Commercial	$350.00
Rate for Payer: Fidelis Medicare Advantage	$735.00
Rate for Payer: Group Health Inc Commercial	$350.00
Rate for Payer: Group Health Inc Medicare	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$455.00

SCREW LOCKING 5.0 X 44

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903248
Hospital Revenue Code	278
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00

SCREW LOCKING 5.0 X 50MM

Facility

$256.25

Service Code	HCPCS C1713
Hospital Charge Code	64902616
Hospital Revenue Code	278
Min. Negotiated Rate	$89.69
Max. Negotiated Rate	$269.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$140.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$153.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$128.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$147.34
Rate for Payer: EmblemHealth Commercial	$128.12
Rate for Payer: Fidelis Medicare Advantage	$269.06
Rate for Payer: Group Health Inc Commercial	$128.12
Rate for Payer: Group Health Inc Medicare	$89.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.12
Rate for Payer: Hamaspik Choice Inc Medicare	$128.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$166.56

SCREW LOCKING 5.0 X 50MM

Facility

$256.25

Service Code	HCPCS C1713
Hospital Charge Code	64902616
Hospital Revenue Code	278
Min. Negotiated Rate	$128.12
Max. Negotiated Rate	$128.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.12
Rate for Payer: Hamaspik Choice Inc Medicare	$128.12

SCREW LOCKING 5.0 X 65

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903138
Hospital Revenue Code	278
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00

SCREW LOCKING 5.0 X 65

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903138
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$735.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$385.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$420.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$350.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$402.50
Rate for Payer: EmblemHealth Commercial	$350.00
Rate for Payer: Fidelis Medicare Advantage	$735.00
Rate for Payer: Group Health Inc Commercial	$350.00
Rate for Payer: Group Health Inc Medicare	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$455.00

SCREW LOCKING 5.0 X 70

Facility

$667.50

Service Code	HCPCS C1713
Hospital Charge Code	64903132
Hospital Revenue Code	278
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$333.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$333.75

SCREW LOCKING 5.0 X 70

Facility

$667.50

Service Code	HCPCS C1713
Hospital Charge Code	64903132
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$700.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$367.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$400.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$333.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$383.81
Rate for Payer: EmblemHealth Commercial	$333.75
Rate for Payer: Fidelis Medicare Advantage	$700.88
Rate for Payer: Group Health Inc Commercial	$333.75
Rate for Payer: Group Health Inc Medicare	$233.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$333.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$433.88

SCREW LOCKING 5.0 X 75

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64903137
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$656.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$375.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$312.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$359.38
Rate for Payer: EmblemHealth Commercial	$312.50
Rate for Payer: Fidelis Medicare Advantage	$656.25
Rate for Payer: Group Health Inc Commercial	$312.50
Rate for Payer: Group Health Inc Medicare	$218.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$406.25

SCREW LOCKING 5.0 X 75

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64903137
Hospital Revenue Code	278
Min. Negotiated Rate	$312.50
Max. Negotiated Rate	$312.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.50
Rate for Payer: Hamaspik Choice Inc Medicare	$312.50

SCREW LOCKING 5.0 X 75MM

Facility

$256.25

Service Code	HCPCS C1713
Hospital Charge Code	64902617
Hospital Revenue Code	278
Min. Negotiated Rate	$128.12
Max. Negotiated Rate	$128.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.12
Rate for Payer: Hamaspik Choice Inc Medicare	$128.12

SCREW LOCKING 5.0 X 75MM

Facility

$256.25

Service Code	HCPCS C1713
Hospital Charge Code	64902617
Hospital Revenue Code	278
Min. Negotiated Rate	$89.69
Max. Negotiated Rate	$269.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$140.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$153.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$128.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$147.34
Rate for Payer: EmblemHealth Commercial	$128.12
Rate for Payer: Fidelis Medicare Advantage	$269.06
Rate for Payer: Group Health Inc Commercial	$128.12
Rate for Payer: Group Health Inc Medicare	$89.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.12
Rate for Payer: Hamaspik Choice Inc Medicare	$128.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$166.56

SCREW LOCKING 5.0 X 80

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903250
Hospital Revenue Code	278
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00

SCREW LOCKING 5.0 X 80

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	64903250
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$735.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$385.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$420.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$350.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$402.50
Rate for Payer: EmblemHealth Commercial	$350.00
Rate for Payer: Fidelis Medicare Advantage	$735.00
Rate for Payer: Group Health Inc Commercial	$350.00
Rate for Payer: Group Health Inc Medicare	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$350.00
Rate for Payer: Hamaspik Choice Inc Medicare	$350.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$455.00

SCREW LOCKING 5.0 X 85

Facility

$667.50

Service Code	HCPCS C1713
Hospital Charge Code	64903135
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$700.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$367.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$400.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$333.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$383.81
Rate for Payer: EmblemHealth Commercial	$333.75
Rate for Payer: Fidelis Medicare Advantage	$700.88
Rate for Payer: Group Health Inc Commercial	$333.75
Rate for Payer: Group Health Inc Medicare	$233.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.75
Rate for Payer: Hamaspik Choice Inc Medicare	$333.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$433.88

Know your out-of-pocket cost for care.

All Charges