St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$134.20
Max. Negotiated Rate	$695.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$364.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$397.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$331.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$380.94
Rate for Payer: EmblemHealth Commercial	$331.25
Rate for Payer: Fidelis Medicare Advantage	$695.62
Rate for Payer: Group Health Inc Commercial	$331.25
Rate for Payer: Group Health Inc Medicare	$231.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$331.25
Rate for Payer: Hamaspik Choice Inc Medicare	$331.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$430.62

SCREW LOCKING T8 FULL 2.7 L26

Facility

$563.13

Service Code	HCPCS C1713
Hospital Charge Code	64905011
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$591.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$337.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$281.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$323.80
Rate for Payer: EmblemHealth Commercial	$281.56
Rate for Payer: Fidelis Medicare Advantage	$591.29
Rate for Payer: Group Health Inc Commercial	$281.56
Rate for Payer: Group Health Inc Medicare	$197.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.56
Rate for Payer: Hamaspik Choice Inc Medicare	$281.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$366.03

SCREW LOCKING T8 FULL 2.7 L26

Facility

$563.13

Service Code	HCPCS C1713
Hospital Charge Code	64905011
Hospital Revenue Code	278
Min. Negotiated Rate	$281.56
Max. Negotiated Rate	$281.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.56
Rate for Payer: Hamaspik Choice Inc Medicare	$281.56

SCREW LOCKNG CORT 3.5X16M

Facility

$460.00

Service Code	HCPCS C1713
Hospital Charge Code	64906552
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$483.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$253.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$276.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$264.50
Rate for Payer: EmblemHealth Commercial	$230.00
Rate for Payer: Fidelis Medicare Advantage	$483.00
Rate for Payer: Group Health Inc Commercial	$230.00
Rate for Payer: Group Health Inc Medicare	$161.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$299.00

SCREW LOCKNG CORT 3.5X16M

Facility

$460.00

Service Code	HCPCS C1713
Hospital Charge Code	64906552
Hospital Revenue Code	278
Min. Negotiated Rate	$230.00
Max. Negotiated Rate	$230.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$230.00
Rate for Payer: Hamaspik Choice Inc Medicare	$230.00

SCREW LOCKNG D5X37.5L(2360-5037S)

Facility

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906347
Hospital Revenue Code	278
Min. Negotiated Rate	$121.28
Max. Negotiated Rate	$363.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$207.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$173.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$199.24
Rate for Payer: EmblemHealth Commercial	$173.25
Rate for Payer: Fidelis Medicare Advantage	$363.82
Rate for Payer: Group Health Inc Commercial	$173.25
Rate for Payer: Group Health Inc Medicare	$121.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$225.22

SCREW LOCKNG D5X37.5L(2360-5037S)

Facility

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906347
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$173.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25

SCREW LOCKNG D5X42.5L(2360-5042S)

Facility

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906349
Hospital Revenue Code	278
Min. Negotiated Rate	$121.28
Max. Negotiated Rate	$363.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$207.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$173.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$199.24
Rate for Payer: EmblemHealth Commercial	$173.25
Rate for Payer: Fidelis Medicare Advantage	$363.82
Rate for Payer: Group Health Inc Commercial	$173.25
Rate for Payer: Group Health Inc Medicare	$121.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$225.22

SCREW LOCKNG D5X42.5L(2360-5042S)

Facility

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906349
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$173.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25

SCREW LOCKNG D5X47.5L(2360-5047S)

Facility

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906351
Hospital Revenue Code	278
Min. Negotiated Rate	$121.28
Max. Negotiated Rate	$363.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$207.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$173.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$199.24
Rate for Payer: EmblemHealth Commercial	$173.25
Rate for Payer: Fidelis Medicare Advantage	$363.82
Rate for Payer: Group Health Inc Commercial	$173.25
Rate for Payer: Group Health Inc Medicare	$121.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$225.22

SCREW LOCKNG D5X47.5L(2360-5047S)

Facility

$346.50

Service Code	HCPCS C1713
Hospital Charge Code	64906351
Hospital Revenue Code	278
Min. Negotiated Rate	$173.25
Max. Negotiated Rate	$173.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.25
Rate for Payer: Hamaspik Choice Inc Medicare	$173.25

SCREW LOCKNG FL THRD 2.7MM L48MM

Facility

$456.36

Service Code	HCPCS C1713
Hospital Charge Code	64906808
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$479.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$251.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$273.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$228.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$262.41
Rate for Payer: EmblemHealth Commercial	$228.18
Rate for Payer: Fidelis Medicare Advantage	$479.18
Rate for Payer: Group Health Inc Commercial	$228.18
Rate for Payer: Group Health Inc Medicare	$159.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$228.18
Rate for Payer: Hamaspik Choice Inc Medicare	$228.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$296.63

SCREW LOCKNG FL THRD 2.7MM L48MM

Facility

$456.36

Service Code	HCPCS C1713
Hospital Charge Code	64906808
Hospital Revenue Code	278
Min. Negotiated Rate	$228.18
Max. Negotiated Rate	$228.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$228.18
Rate for Payer: Hamaspik Choice Inc Medicare	$228.18

SCREW LOCK ST SS 3.5X20MM

Facility

$362.25

Service Code	HCPCS C1713
Hospital Charge Code	64901292
Hospital Revenue Code	278
Min. Negotiated Rate	$181.12
Max. Negotiated Rate	$181.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$181.12
Rate for Payer: Hamaspik Choice Inc Medicare	$181.12

SCREW LOCK ST SS 3.5X20MM

Facility

$362.25

Service Code	HCPCS C1713
Hospital Charge Code	64901292
Hospital Revenue Code	278
Min. Negotiated Rate	$126.79
Max. Negotiated Rate	$380.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$199.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$217.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$181.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$208.29
Rate for Payer: EmblemHealth Commercial	$181.12
Rate for Payer: Fidelis Medicare Advantage	$380.36
Rate for Payer: Group Health Inc Commercial	$181.12
Rate for Payer: Group Health Inc Medicare	$126.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$181.12
Rate for Payer: Hamaspik Choice Inc Medicare	$181.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$235.46

SCREW LOCK ST SS 3.5X24MM STR

Facility

$242.00

Service Code	HCPCS C1713
Hospital Charge Code	40209007
Hospital Revenue Code	278
Min. Negotiated Rate	$121.00
Max. Negotiated Rate	$121.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.00
Rate for Payer: Hamaspik Choice Inc Medicare	$121.00

SCREW LOCK ST SS 3.5X24MM STR

Facility

$242.00

Service Code	HCPCS C1713
Hospital Charge Code	40209007
Hospital Revenue Code	278
Min. Negotiated Rate	$84.70
Max. Negotiated Rate	$254.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$133.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$145.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$121.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$139.15
Rate for Payer: EmblemHealth Commercial	$121.00
Rate for Payer: Fidelis Medicare Advantage	$254.10
Rate for Payer: Group Health Inc Commercial	$121.00
Rate for Payer: Group Health Inc Medicare	$84.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.00
Rate for Payer: Hamaspik Choice Inc Medicare	$121.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$157.30

SCREW LOCK ST SS 3.5X26MM STR-DR

Facility

$432.50

Service Code	HCPCS C1713
Hospital Charge Code	64901306
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$454.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$237.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$259.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$216.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$248.69
Rate for Payer: EmblemHealth Commercial	$216.25
Rate for Payer: Fidelis Medicare Advantage	$454.12
Rate for Payer: Group Health Inc Commercial	$216.25
Rate for Payer: Group Health Inc Medicare	$151.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$216.25
Rate for Payer: Hamaspik Choice Inc Medicare	$216.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$281.12

SCREW LOCK ST SS 3.5X26MM STR-DR

Facility

$432.50

Service Code	HCPCS C1713
Hospital Charge Code	64901306
Hospital Revenue Code	278
Min. Negotiated Rate	$216.25
Max. Negotiated Rate	$216.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$216.25
Rate for Payer: Hamaspik Choice Inc Medicare	$216.25

SCREW LOCK ST SS 3.5X28MM STR

Facility

$242.00

Service Code	HCPCS C1713
Hospital Charge Code	40209006
Hospital Revenue Code	278
Min. Negotiated Rate	$84.70
Max. Negotiated Rate	$254.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$133.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$145.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$121.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$139.15
Rate for Payer: EmblemHealth Commercial	$121.00
Rate for Payer: Fidelis Medicare Advantage	$254.10
Rate for Payer: Group Health Inc Commercial	$121.00
Rate for Payer: Group Health Inc Medicare	$84.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.00
Rate for Payer: Hamaspik Choice Inc Medicare	$121.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$157.30

SCREW LOCK ST SS 3.5X28MM STR

Facility

$242.00

Service Code	HCPCS C1713
Hospital Charge Code	40209006
Hospital Revenue Code	278
Min. Negotiated Rate	$121.00
Max. Negotiated Rate	$121.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.00
Rate for Payer: Hamaspik Choice Inc Medicare	$121.00

SCREW LOCK ST SS 3.5X65MM STR-DR

Facility

$284.40

Service Code	HCPCS C1713
Hospital Charge Code	40205343
Hospital Revenue Code	278
Min. Negotiated Rate	$99.54
Max. Negotiated Rate	$298.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$156.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$170.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.53
Rate for Payer: EmblemHealth Commercial	$142.20
Rate for Payer: Fidelis Medicare Advantage	$298.62
Rate for Payer: Group Health Inc Commercial	$142.20
Rate for Payer: Group Health Inc Medicare	$99.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.20
Rate for Payer: Hamaspik Choice Inc Medicare	$142.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$184.86

SCREW LOCK ST SS 3.5X65MM STR-DR

Facility

$284.40

Service Code	HCPCS C1713
Hospital Charge Code	40205343
Hospital Revenue Code	278
Min. Negotiated Rate	$142.20
Max. Negotiated Rate	$142.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.20
Rate for Payer: Hamaspik Choice Inc Medicare	$142.20

SCREW LOCK ST SS 3.5X70MM STR-DR

Facility

$284.00

Service Code	HCPCS C1713
Hospital Charge Code	40205346
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$142.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.00
Rate for Payer: Hamaspik Choice Inc Medicare	$142.00

SCREW LOCK ST SS 3.5X70MM STR-DR

Facility

$284.00

Service Code	HCPCS C1713
Hospital Charge Code	40205346
Hospital Revenue Code	278
Min. Negotiated Rate	$99.40
Max. Negotiated Rate	$298.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$156.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$170.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.30
Rate for Payer: EmblemHealth Commercial	$142.00
Rate for Payer: Fidelis Medicare Advantage	$298.20
Rate for Payer: Group Health Inc Commercial	$142.00
Rate for Payer: Group Health Inc Medicare	$99.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.00
Rate for Payer: Hamaspik Choice Inc Medicare	$142.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$184.60

Know your out-of-pocket cost for care.

All Charges