St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$115.00
Max. Negotiated Rate	$115.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00

SCREW LOPRO LOCK 2.7 X 10MM

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	64906940
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

SCREW LOPRO LOCK 2.7 X 10MM

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	64906940
Hospital Revenue Code	278
Min. Negotiated Rate	$115.00
Max. Negotiated Rate	$115.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00

SCREW LO-PRO LOCK 2.7X18M 882718

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	64906649
Hospital Revenue Code	278
Min. Negotiated Rate	$115.00
Max. Negotiated Rate	$115.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00

SCREW LO-PRO LOCK 2.7X18M 882718

Facility

$230.00

Service Code	HCPCS C1713
Hospital Charge Code	64906649
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

SCREW LO PRO SS 2.7

Facility

$112.50

Service Code	HCPCS C1713
Hospital Charge Code	64907393
Hospital Revenue Code	278
Min. Negotiated Rate	$39.38
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$67.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.69
Rate for Payer: EmblemHealth Commercial	$56.25
Rate for Payer: Fidelis Medicare Advantage	$118.12
Rate for Payer: Group Health Inc Commercial	$56.25
Rate for Payer: Group Health Inc Medicare	$39.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.25
Rate for Payer: Hamaspik Choice Inc Medicare	$56.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$73.12

SCREW LO PRO SS 2.7

Facility

$112.50

Service Code	HCPCS C1713
Hospital Charge Code	64907393
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.25
Rate for Payer: Hamaspik Choice Inc Medicare	$56.25

SCREW LO-PRO SS 2.7 X 16MM

Facility

$45.00

Service Code	HCPCS C1713
Hospital Charge Code	64906363
Hospital Revenue Code	278
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.50
Rate for Payer: Hamaspik Choice Inc Medicare	$22.50

SCREW LO-PRO SS 2.7 X 16MM

Facility

$45.00

Service Code	HCPCS C1713
Hospital Charge Code	64906363
Hospital Revenue Code	278
Min. Negotiated Rate	$15.75
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$27.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.88
Rate for Payer: EmblemHealth Commercial	$22.50
Rate for Payer: Fidelis Medicare Advantage	$47.25
Rate for Payer: Group Health Inc Commercial	$22.50
Rate for Payer: Group Health Inc Medicare	$15.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.50
Rate for Payer: Hamaspik Choice Inc Medicare	$22.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$29.25

SCREW LO-PRO TM SS 2.7X22MM

Facility

$90.00

Service Code	HCPCS C1713
Hospital Charge Code	40004881
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 LO-PRO TM SS 2.7X22MM

Facility

$90.00

Service Code	HCPCS C1713
Hospital Charge Code	40004881
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 TM SS 2.7X24MM

Facility

$90.00

Service Code	HCPCS C1713
Hospital Charge Code	40004882
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 TM SS 2.7X24MM

Facility

$90.00

Service Code	HCPCS C1713
Hospital Charge Code	40004882
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 LO-PR SS 2.7X22MM CRTX

Facility

$90.00

Service Code	HCPCS C1713
Hospital Charge Code	64906567
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-PR SS 2.7X22MM CRTX

Facility

$90.00

Service Code	HCPCS C1713
Hospital Charge Code	64906567
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 LOW PRO HEX

Facility

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	64907205
Hospital Revenue Code	278
Min. Negotiated Rate	$192.50
Max. Negotiated Rate	$192.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$192.50
Rate for Payer: Hamaspik Choice Inc Medicare	$192.50

SCREW LOW PRO HEX

Facility

$385.00

Service Code	HCPCS C1713
Hospital Charge Code	64907205
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$404.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$211.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$231.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$192.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$221.38
Rate for Payer: EmblemHealth Commercial	$192.50
Rate for Payer: Fidelis Medicare Advantage	$404.25
Rate for Payer: Group Health Inc Commercial	$192.50
Rate for Payer: Group Health Inc Medicare	$134.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$192.50
Rate for Payer: Hamaspik Choice Inc Medicare	$192.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$250.25

SCREW LOW P TI 4.5X45MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64903699
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 LOW P TI 4.5X45MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64903699
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 LOW P TI 4.5X50MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64903701
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 LOW P TI 4.5X50MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64903701
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 LOW P TI 4.5X55MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64903785
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 LOW P TI 4.5X55MM

Facility

$625.00

Service Code	HCPCS C1713
Hospital Charge Code	64903785
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 LPRO LCK 4.0

Facility

$70.00

Service Code	HCPCS C1713
Hospital Charge Code	64906941
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 LPRO LCK 4.0

Facility

$70.00

Service Code	HCPCS C1713
Hospital Charge Code	64906941
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

Know your out-of-pocket cost for care.

All Charges