St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW LOCK ST SS 3.5X STR-DR

Facility

$284.00

Service Code	HCPCS C1713
Hospital Charge Code	40205347
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 3.5X STR-DR

Facility

$284.00

Service Code	HCPCS C1713
Hospital Charge Code	40205347
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

SCREW LONG IWASTE 6.5X40MM

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64905055
Hospital Revenue Code	278
Min. Negotiated Rate	$4,276.35
Max. Negotiated Rate	$4,276.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,276.35
Rate for Payer: Hamaspik Choice Inc Medicare	$4,276.35

SCREW LONG IWASTE 6.5X40MM

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64905055
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,980.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,703.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$5,131.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,276.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,917.80
Rate for Payer: EmblemHealth Commercial	$4,276.35
Rate for Payer: Fidelis Medicare Advantage	$8,980.34
Rate for Payer: Group Health Inc Commercial	$4,276.35
Rate for Payer: Group Health Inc Medicare	$2,993.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,276.35
Rate for Payer: Hamaspik Choice Inc Medicare	$4,276.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,559.26

SCREW LOPRO 3.5

Facility

$150.00

Service Code	HCPCS C1713
Hospital Charge Code	64907156
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

SCREW LOPRO 3.5

Facility

$150.00

Service Code	HCPCS C1713
Hospital Charge Code	64907156
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$157.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$90.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$86.25
Rate for Payer: EmblemHealth Commercial	$75.00
Rate for Payer: Fidelis Medicare Advantage	$157.50
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$97.50

SCREW LO PRO 3.5 22MM 131218022

Facility

$144.00

Service Code	HCPCS C1713
Hospital Charge Code	64906549
Hospital Revenue Code	278
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$151.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$79.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$86.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$82.80
Rate for Payer: EmblemHealth Commercial	$72.00
Rate for Payer: Fidelis Medicare Advantage	$151.20
Rate for Payer: Group Health Inc Commercial	$72.00
Rate for Payer: Group Health Inc Medicare	$50.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.00
Rate for Payer: Hamaspik Choice Inc Medicare	$72.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$93.60

SCREW LO PRO 3.5 22MM 131218022

Facility

$144.00

Service Code	HCPCS C1713
Hospital Charge Code	64906549
Hospital Revenue Code	278
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$72.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.00
Rate for Payer: Hamaspik Choice Inc Medicare	$72.00

SCREW LO PRO 3.5 26M 1312-18-026

Facility

$144.00

Service Code	HCPCS C1713
Hospital Charge Code	64906551
Hospital Revenue Code	278
Min. Negotiated Rate	$72.00
Max. Negotiated Rate	$72.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.00
Rate for Payer: Hamaspik Choice Inc Medicare	$72.00

SCREW LO PRO 3.5 26M 1312-18-026

Facility

$144.00

Service Code	HCPCS C1713
Hospital Charge Code	64906551
Hospital Revenue Code	278
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$151.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$79.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$86.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$82.80
Rate for Payer: EmblemHealth Commercial	$72.00
Rate for Payer: Fidelis Medicare Advantage	$151.20
Rate for Payer: Group Health Inc Commercial	$72.00
Rate for Payer: Group Health Inc Medicare	$50.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.00
Rate for Payer: Hamaspik Choice Inc Medicare	$72.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$93.60

SCREW LOPRO CANNLTD SS 4.0 X 40MM

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	64906578
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.00
Rate for Payer: Hamaspik Choice Inc Medicare	$165.00

SCREW LOPRO CANNLTD SS 4.0 X 40MM

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	64906578
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$346.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$198.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$165.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$189.75
Rate for Payer: EmblemHealth Commercial	$165.00
Rate for Payer: Fidelis Medicare Advantage	$346.50
Rate for Payer: Group Health Inc Commercial	$165.00
Rate for Payer: Group Health Inc Medicare	$115.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.00
Rate for Payer: Hamaspik Choice Inc Medicare	$165.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$214.50

SCREW LO PRO CORT

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	64907391
Hospital Revenue Code	278
Min. Negotiated Rate	$137.50
Max. Negotiated Rate	$137.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.50
Rate for Payer: Hamaspik Choice Inc Medicare	$137.50

SCREW LO PRO CORT

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	64907391
Hospital Revenue Code	278
Min. Negotiated Rate	$96.25
Max. Negotiated Rate	$288.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$165.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$137.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.12
Rate for Payer: EmblemHealth Commercial	$137.50
Rate for Payer: Fidelis Medicare Advantage	$288.75
Rate for Payer: Group Health Inc Commercial	$137.50
Rate for Payer: Group Health Inc Medicare	$96.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.50
Rate for Payer: Hamaspik Choice Inc Medicare	$137.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$178.75

SCREW LO PRO CORT 1.4

Facility

$275.00

Hospital Charge Code	64907243
Hospital Revenue Code	278
Min. Negotiated Rate	$96.25
Max. Negotiated Rate	$288.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$137.50
Rate for Payer: Aetna Government	$137.50
Rate for Payer: Brighton Health Commercial	$165.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$137.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.12
Rate for Payer: EmblemHealth Commercial	$137.50
Rate for Payer: Fidelis Medicare Advantage	$288.75
Rate for Payer: Group Health Inc Commercial	$137.50
Rate for Payer: Group Health Inc Medicare	$96.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.50
Rate for Payer: Hamaspik Choice Inc Medicare	$137.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$178.75

SCREW LO PRO CORT 1.4

Facility

$275.00

Hospital Charge Code	64907243
Hospital Revenue Code	278
Min. Negotiated Rate	$137.50
Max. Negotiated Rate	$137.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.50
Rate for Payer: Hamaspik Choice Inc Medicare	$137.50

SCREW LOPRO CORTEX SS 2.7 X 12MM

Facility

$90.00

Service Code	HCPCS C1713
Hospital Charge Code	64906577
Hospital Revenue Code	278
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00

SCREW LOPRO CORTEX SS 2.7 X 12MM

Facility

$90.00

Service Code	HCPCS C1713
Hospital Charge Code	64906577
Hospital Revenue Code	278
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$54.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.75
Rate for Payer: EmblemHealth Commercial	$45.00
Rate for Payer: Fidelis Medicare Advantage	$94.50
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$58.50

SCREW LO-PRO CORT SS 3.5X45

Facility

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	64906365
Hospital Revenue Code	278
Min. Negotiated Rate	$12.25
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$21.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.12
Rate for Payer: EmblemHealth Commercial	$17.50
Rate for Payer: Fidelis Medicare Advantage	$36.75
Rate for Payer: Group Health Inc Commercial	$17.50
Rate for Payer: Group Health Inc Medicare	$12.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.75

SCREW LO-PRO CORT SS 3.5X45

Facility

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	64906365
Hospital Revenue Code	278
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50

SCREW LO-PRO CRTCL 3.5X16M 883514

Facility

$70.00

Service Code	HCPCS C1713
Hospital Charge Code	64906650
Hospital Revenue Code	278
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$42.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$35.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.25
Rate for Payer: EmblemHealth Commercial	$35.00
Rate for Payer: Fidelis Medicare Advantage	$73.50
Rate for Payer: Group Health Inc Commercial	$35.00
Rate for Payer: Group Health Inc Medicare	$24.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.00
Rate for Payer: Hamaspik Choice Inc Medicare	$35.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$45.50

SCREW LO-PRO CRTCL 3.5X16M 883514

Facility

$70.00

Service Code	HCPCS C1713
Hospital Charge Code	64906650
Hospital Revenue Code	278
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$35.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.00
Rate for Payer: Hamaspik Choice Inc Medicare	$35.00

SCREW LOPROFL 4.0

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	64906886
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.00
Rate for Payer: Hamaspik Choice Inc Medicare	$165.00

SCREW LOPROFL 4.0

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	64906886
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$346.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$198.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$165.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$189.75
Rate for Payer: EmblemHealth Commercial	$165.00
Rate for Payer: Fidelis Medicare Advantage	$346.50
Rate for Payer: Group Health Inc Commercial	$165.00
Rate for Payer: Group Health Inc Medicare	$115.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.00
Rate for Payer: Hamaspik Choice Inc Medicare	$165.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$214.50

SCREW LO-PRO LCK SS 2.7X10

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	64906674
Hospital Revenue Code	278
Min. Negotiated Rate	$80.50
Max. Negotiated Rate	$241.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$138.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$115.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.25
Rate for Payer: EmblemHealth Commercial	$115.00
Rate for Payer: Fidelis Medicare Advantage	$241.50
Rate for Payer: Group Health Inc Commercial	$115.00
Rate for Payer: Group Health Inc Medicare	$80.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$149.50

Know your out-of-pocket cost for care.

All Charges