St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW, LOCKING PLATE 2.7X13MM

Facility

$413.96

Service Code	HCPCS C1713
Hospital Charge Code	40004421
Hospital Revenue Code	278
Min. Negotiated Rate	$206.98
Max. Negotiated Rate	$206.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$206.98
Rate for Payer: Hamaspik Choice Inc Medicare	$206.98

SCREW, LOCKING PLATE 2.7X13MM

Facility

$413.96

Service Code	HCPCS C1713
Hospital Charge Code	40004421
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$434.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$248.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$238.03
Rate for Payer: EmblemHealth Commercial	$206.98
Rate for Payer: Fidelis Medicare Advantage	$434.66
Rate for Payer: Group Health Inc Commercial	$206.98
Rate for Payer: Group Health Inc Medicare	$144.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$206.98
Rate for Payer: Hamaspik Choice Inc Medicare	$206.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$269.07

SCREW, LOCKING PLATE 2.7X15MM

Facility

$413.96

Service Code	HCPCS C1713
Hospital Charge Code	40004422
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$434.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$248.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$238.03
Rate for Payer: EmblemHealth Commercial	$206.98
Rate for Payer: Fidelis Medicare Advantage	$434.66
Rate for Payer: Group Health Inc Commercial	$206.98
Rate for Payer: Group Health Inc Medicare	$144.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$206.98
Rate for Payer: Hamaspik Choice Inc Medicare	$206.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$269.07

SCREW, LOCKING PLATE 2.7X15MM

Facility

$413.96

Service Code	HCPCS C1713
Hospital Charge Code	40004422
Hospital Revenue Code	278
Min. Negotiated Rate	$206.98
Max. Negotiated Rate	$206.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$206.98
Rate for Payer: Hamaspik Choice Inc Medicare	$206.98

SCREW, LOCKING PLATE 2.7X16MM

Facility

$413.96

Service Code	HCPCS C1713
Hospital Charge Code	40004423
Hospital Revenue Code	278
Min. Negotiated Rate	$206.98
Max. Negotiated Rate	$206.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$206.98
Rate for Payer: Hamaspik Choice Inc Medicare	$206.98

SCREW, LOCKING PLATE 2.7X16MM

Facility

$413.96

Service Code	HCPCS C1713
Hospital Charge Code	40004423
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$434.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$248.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$238.03
Rate for Payer: EmblemHealth Commercial	$206.98
Rate for Payer: Fidelis Medicare Advantage	$434.66
Rate for Payer: Group Health Inc Commercial	$206.98
Rate for Payer: Group Health Inc Medicare	$144.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$206.98
Rate for Payer: Hamaspik Choice Inc Medicare	$206.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$269.07

SCREW, LOCKING PLATE 2.7X17MM

Facility

$413.96

Service Code	HCPCS C1713
Hospital Charge Code	40004424
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$434.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$248.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$238.03
Rate for Payer: EmblemHealth Commercial	$206.98
Rate for Payer: Fidelis Medicare Advantage	$434.66
Rate for Payer: Group Health Inc Commercial	$206.98
Rate for Payer: Group Health Inc Medicare	$144.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$206.98
Rate for Payer: Hamaspik Choice Inc Medicare	$206.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$269.07

SCREW, LOCKING PLATE 2.7X17MM

Facility

$413.96

Service Code	HCPCS C1713
Hospital Charge Code	40004424
Hospital Revenue Code	278
Min. Negotiated Rate	$206.98
Max. Negotiated Rate	$206.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$206.98
Rate for Payer: Hamaspik Choice Inc Medicare	$206.98

SCREW, LOCKING PLATE 2.7X19MM

Facility

$413.96

Service Code	HCPCS C1713
Hospital Charge Code	40004425
Hospital Revenue Code	278
Min. Negotiated Rate	$206.98
Max. Negotiated Rate	$206.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$206.98
Rate for Payer: Hamaspik Choice Inc Medicare	$206.98

SCREW, LOCKING PLATE 2.7X19MM

Facility

$413.96

Service Code	HCPCS C1713
Hospital Charge Code	40004425
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$434.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$227.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$248.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$238.03
Rate for Payer: EmblemHealth Commercial	$206.98
Rate for Payer: Fidelis Medicare Advantage	$434.66
Rate for Payer: Group Health Inc Commercial	$206.98
Rate for Payer: Group Health Inc Medicare	$144.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$206.98
Rate for Payer: Hamaspik Choice Inc Medicare	$206.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$269.07

SCREW LOCKING SELF 2.7MM 14MM

Facility

$490.00

Service Code	HCPCS C1713
Hospital Charge Code	64903577
Hospital Revenue Code	278
Min. Negotiated Rate	$245.00
Max. Negotiated Rate	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.00
Rate for Payer: Hamaspik Choice Inc Medicare	$245.00

SCREW LOCKING SELF 2.7MM 14MM

Facility

$490.00

Service Code	HCPCS C1713
Hospital Charge Code	64903577
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$514.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$269.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$294.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$245.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.75
Rate for Payer: EmblemHealth Commercial	$245.00
Rate for Payer: Fidelis Medicare Advantage	$514.50
Rate for Payer: Group Health Inc Commercial	$245.00
Rate for Payer: Group Health Inc Medicare	$171.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.00
Rate for Payer: Hamaspik Choice Inc Medicare	$245.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$318.50

SCREW LOCKING SELF 2.7MM 34MM

Facility

$490.00

Service Code	HCPCS C1713
Hospital Charge Code	64903579
Hospital Revenue Code	278
Min. Negotiated Rate	$245.00
Max. Negotiated Rate	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.00
Rate for Payer: Hamaspik Choice Inc Medicare	$245.00

SCREW LOCKING SELF 2.7MM 34MM

Facility

$490.00

Service Code	HCPCS C1713
Hospital Charge Code	64903579
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$514.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$269.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$294.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$245.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.75
Rate for Payer: EmblemHealth Commercial	$245.00
Rate for Payer: Fidelis Medicare Advantage	$514.50
Rate for Payer: Group Health Inc Commercial	$245.00
Rate for Payer: Group Health Inc Medicare	$171.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.00
Rate for Payer: Hamaspik Choice Inc Medicare	$245.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$318.50

SCREW LOCKING SELF 2.7MM 36MM

Facility

$490.00

Service Code	HCPCS C1713
Hospital Charge Code	64903581
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$514.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$269.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$294.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$245.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$281.75
Rate for Payer: EmblemHealth Commercial	$245.00
Rate for Payer: Fidelis Medicare Advantage	$514.50
Rate for Payer: Group Health Inc Commercial	$245.00
Rate for Payer: Group Health Inc Medicare	$171.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.00
Rate for Payer: Hamaspik Choice Inc Medicare	$245.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$318.50

SCREW LOCKING SELF 2.7MM 36MM

Facility

$490.00

Service Code	HCPCS C1713
Hospital Charge Code	64903581
Hospital Revenue Code	278
Min. Negotiated Rate	$245.00
Max. Negotiated Rate	$245.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.00
Rate for Payer: Hamaspik Choice Inc Medicare	$245.00

SCREW LOCKING T10 FT 3.5MM/L46MM

Facility

$626.88

Service Code	HCPCS C1713
Hospital Charge Code	64905618
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$658.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$344.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$376.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$313.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$360.46
Rate for Payer: EmblemHealth Commercial	$313.44
Rate for Payer: Fidelis Medicare Advantage	$658.22
Rate for Payer: Group Health Inc Commercial	$313.44
Rate for Payer: Group Health Inc Medicare	$219.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.44
Rate for Payer: Hamaspik Choice Inc Medicare	$313.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$407.47

SCREW LOCKING T10 FT 3.5MM/L46MM

Facility

$626.88

Service Code	HCPCS C1713
Hospital Charge Code	64905618
Hospital Revenue Code	278
Min. Negotiated Rate	$313.44
Max. Negotiated Rate	$313.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.44
Rate for Payer: Hamaspik Choice Inc Medicare	$313.44

SCREW LOCKING T25 STRDRV 5X38MM

Facility

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	64902627
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 T25 STRDRV 5X38MM

Facility

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	64902627
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 T2 F/T 5MMX37.5MM

Facility

$343.20

Service Code	HCPCS C1713
Hospital Charge Code	40005908
Hospital Revenue Code	278
Min. Negotiated Rate	$171.60
Max. Negotiated Rate	$171.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.60
Rate for Payer: Hamaspik Choice Inc Medicare	$171.60

SCREW,LOCKING T2 F/T 5MMX37.5MM

Facility

$343.20

Service Code	HCPCS C1713
Hospital Charge Code	40005908
Hospital Revenue Code	278
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$360.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$188.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$205.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$171.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$197.34
Rate for Payer: EmblemHealth Commercial	$171.60
Rate for Payer: Fidelis Medicare Advantage	$360.36
Rate for Payer: Group Health Inc Commercial	$171.60
Rate for Payer: Group Health Inc Medicare	$120.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.60
Rate for Payer: Hamaspik Choice Inc Medicare	$171.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$223.08

SCREW LOCKING T8FL THRD 2.7 L34

Facility

$409.96

Service Code	HCPCS C1713
Hospital Charge Code	64906532
Hospital Revenue Code	278
Min. Negotiated Rate	$204.98
Max. Negotiated Rate	$204.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.98
Rate for Payer: Hamaspik Choice Inc Medicare	$204.98

SCREW LOCKING T8FL THRD 2.7 L34

Facility

$409.96

Service Code	HCPCS C1713
Hospital Charge Code	64906532
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$430.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$225.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$245.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$235.73
Rate for Payer: EmblemHealth Commercial	$204.98
Rate for Payer: Fidelis Medicare Advantage	$430.46
Rate for Payer: Group Health Inc Commercial	$204.98
Rate for Payer: Group Health Inc Medicare	$143.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.98
Rate for Payer: Hamaspik Choice Inc Medicare	$204.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$266.47

SCREW LOCKING T8 FULL 2.4 L26

Facility

$662.50

Service Code	HCPCS C1713
Hospital Charge Code	64905035
Hospital Revenue Code	278
Min. Negotiated Rate	$331.25
Max. Negotiated Rate	$331.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$331.25
Rate for Payer: Hamaspik Choice Inc Medicare	$331.25

Know your out-of-pocket cost for care.

All Charges