St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCKING 5 X 70MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901267
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$450.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$257.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$214.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.68
Rate for Payer: EmblemHealth Commercial	$214.50
Rate for Payer: Fidelis Medicare Advantage	$450.45
Rate for Payer: Group Health Inc Commercial	$214.50
Rate for Payer: Group Health Inc Medicare	$150.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$278.85

SCREW LOCKING 5 X 70MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901267
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50

SCREW LOCKING 5 X 75MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901241
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$450.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$257.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$214.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.68
Rate for Payer: EmblemHealth Commercial	$214.50
Rate for Payer: Fidelis Medicare Advantage	$450.45
Rate for Payer: Group Health Inc Commercial	$214.50
Rate for Payer: Group Health Inc Medicare	$150.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$278.85

SCREW LOCKING 5 X 75MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901241
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50

SCREW LOCKING 5 X 80MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901273
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$450.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$257.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$214.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.68
Rate for Payer: EmblemHealth Commercial	$214.50
Rate for Payer: Fidelis Medicare Advantage	$450.45
Rate for Payer: Group Health Inc Commercial	$214.50
Rate for Payer: Group Health Inc Medicare	$150.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$278.85

SCREW LOCKING 5 X 80MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901273
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50

SCREW LOCKING 5 X 85MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901242
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$450.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$235.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$257.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$214.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$246.68
Rate for Payer: EmblemHealth Commercial	$214.50
Rate for Payer: Fidelis Medicare Advantage	$450.45
Rate for Payer: Group Health Inc Commercial	$214.50
Rate for Payer: Group Health Inc Medicare	$150.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$278.85

SCREW LOCKING 5 X 85MM FT T2

Facility

$429.00

Service Code	HCPCS C1713
Hospital Charge Code	64901242
Hospital Revenue Code	278
Min. Negotiated Rate	$214.50
Max. Negotiated Rate	$214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$214.50
Rate for Payer: Hamaspik Choice Inc Medicare	$214.50

SCREW LOCKING 5 X 90MM FT T2

Facility

$462.00

Service Code	HCPCS C1713
Hospital Charge Code	64901953
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$485.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$254.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$277.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$231.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$265.65
Rate for Payer: EmblemHealth Commercial	$231.00
Rate for Payer: Fidelis Medicare Advantage	$485.10
Rate for Payer: Group Health Inc Commercial	$231.00
Rate for Payer: Group Health Inc Medicare	$161.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$231.00
Rate for Payer: Hamaspik Choice Inc Medicare	$231.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$300.30

SCREW LOCKING 5 X 90MM FT T2

Facility

$462.00

Service Code	HCPCS C1713
Hospital Charge Code	64901953
Hospital Revenue Code	278
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$231.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$231.00
Rate for Payer: Hamaspik Choice Inc Medicare	$231.00

SCREW LOCKING 60MM

Facility

$317.80

Service Code	HCPCS C1776
Hospital Charge Code	40202416
Hospital Revenue Code	278
Min. Negotiated Rate	$158.90
Max. Negotiated Rate	$158.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.90
Rate for Payer: Hamaspik Choice Inc Medicare	$158.90

SCREW LOCKING 60MM

Facility

$317.80

Service Code	HCPCS C1776
Hospital Charge Code	40202416
Hospital Revenue Code	278
Min. Negotiated Rate	$111.23
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$190.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$158.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.74
Rate for Payer: EmblemHealth Commercial	$158.90
Rate for Payer: Fidelis Medicare Advantage	$333.69
Rate for Payer: Group Health Inc Commercial	$158.90
Rate for Payer: Group Health Inc Medicare	$111.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.90
Rate for Payer: Hamaspik Choice Inc Medicare	$158.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.57

SCREW LOCKING 70MM T2 F/T

Facility

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202427
Hospital Revenue Code	278
Min. Negotiated Rate	$111.30
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$190.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.85
Rate for Payer: EmblemHealth Commercial	$159.00
Rate for Payer: Fidelis Medicare Advantage	$333.90
Rate for Payer: Group Health Inc Commercial	$159.00
Rate for Payer: Group Health Inc Medicare	$111.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00
Rate for Payer: Hamaspik Choice Inc Medicare	$159.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.70

SCREW LOCKING 70MM T2 F/T

Facility

$318.00

Service Code	HCPCS C1776
Hospital Charge Code	40202427
Hospital Revenue Code	278
Min. Negotiated Rate	$159.00
Max. Negotiated Rate	$159.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.00
Rate for Payer: Hamaspik Choice Inc Medicare	$159.00

SCREW LOCKING ANCHOR 3.5X24MM

Facility

$762.50

Service Code	HCPCS C1713
Hospital Charge Code	64905677
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 ANCHOR 3.5X24MM

Facility

$762.50

Service Code	HCPCS C1713
Hospital Charge Code	64905677
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 ARMADA TI

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	64903524
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00

SCREW LOCKING ARMADA TI

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	64903524
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$630.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$330.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$360.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$345.00
Rate for Payer: EmblemHealth Commercial	$300.00
Rate for Payer: Fidelis Medicare Advantage	$630.00
Rate for Payer: Group Health Inc Commercial	$300.00
Rate for Payer: Group Health Inc Medicare	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$390.00

SCREW LOCKING AXSOS 5.0MM

Facility

$256.25

Service Code	HCPCS C1713
Hospital Charge Code	64902744
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 AXSOS 5.0MM

Facility

$256.25

Service Code	HCPCS C1713
Hospital Charge Code	64902744
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 C PIN 2.0X5MM

Facility

$195.03

Service Code	HCPCS C1713
Hospital Charge Code	64902006
Hospital Revenue Code	278
Min. Negotiated Rate	$68.26
Max. Negotiated Rate	$204.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$117.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$97.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.14
Rate for Payer: EmblemHealth Commercial	$97.52
Rate for Payer: Fidelis Medicare Advantage	$204.78
Rate for Payer: Group Health Inc Commercial	$97.52
Rate for Payer: Group Health Inc Medicare	$68.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.52
Rate for Payer: Hamaspik Choice Inc Medicare	$97.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$126.77

SCREW LOCKING C PIN 2.0X5MM

Facility

$195.03

Service Code	HCPCS C1713
Hospital Charge Code	64902006
Hospital Revenue Code	278
Min. Negotiated Rate	$97.52
Max. Negotiated Rate	$97.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.52
Rate for Payer: Hamaspik Choice Inc Medicare	$97.52

SCREW LOCKING C PIN 2.3X4MM

Facility

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64902008
Hospital Revenue Code	278
Min. Negotiated Rate	$78.83
Max. Negotiated Rate	$236.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$123.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$135.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$112.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.51
Rate for Payer: EmblemHealth Commercial	$112.62
Rate for Payer: Fidelis Medicare Advantage	$236.49
Rate for Payer: Group Health Inc Commercial	$112.62
Rate for Payer: Group Health Inc Medicare	$78.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.62
Rate for Payer: Hamaspik Choice Inc Medicare	$112.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$146.40

SCREW LOCKING C PIN 2.3X4MM

Facility

$225.23

Service Code	HCPCS C1713
Hospital Charge Code	64902008
Hospital Revenue Code	278
Min. Negotiated Rate	$112.62
Max. Negotiated Rate	$112.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$112.62
Rate for Payer: Hamaspik Choice Inc Medicare	$112.62

SCREW LOCKING CROSS PIN 2.0MM

Facility

$195.48

Service Code	HCPCS C1713
Hospital Charge Code	40200150
Hospital Revenue Code	278
Min. Negotiated Rate	$97.74
Max. Negotiated Rate	$97.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.74
Rate for Payer: Hamaspik Choice Inc Medicare	$97.74

Know your out-of-pocket cost for care.

All Charges