St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW LUCK 1.7 X10

Facility

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903630
Hospital Revenue Code	278
Min. Negotiated Rate	$114.56
Max. Negotiated Rate	$114.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56

SCREW LUCK 1.7 X10

Facility

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903630
Hospital Revenue Code	278
Min. Negotiated Rate	$80.20
Max. Negotiated Rate	$240.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$137.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.75
Rate for Payer: EmblemHealth Commercial	$114.56
Rate for Payer: Fidelis Medicare Advantage	$240.59
Rate for Payer: Group Health Inc Commercial	$114.56
Rate for Payer: Group Health Inc Medicare	$80.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.93

SCREW LUCK 1.7 X11

Facility

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903631
Hospital Revenue Code	278
Min. Negotiated Rate	$80.20
Max. Negotiated Rate	$240.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$137.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.75
Rate for Payer: EmblemHealth Commercial	$114.56
Rate for Payer: Fidelis Medicare Advantage	$240.59
Rate for Payer: Group Health Inc Commercial	$114.56
Rate for Payer: Group Health Inc Medicare	$80.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.93

SCREW LUCK 1.7 X11

Facility

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903631
Hospital Revenue Code	278
Min. Negotiated Rate	$114.56
Max. Negotiated Rate	$114.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56

SCREW LUCK 1.7 X12

Facility

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903632
Hospital Revenue Code	278
Min. Negotiated Rate	$80.20
Max. Negotiated Rate	$240.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$137.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.75
Rate for Payer: EmblemHealth Commercial	$114.56
Rate for Payer: Fidelis Medicare Advantage	$240.59
Rate for Payer: Group Health Inc Commercial	$114.56
Rate for Payer: Group Health Inc Medicare	$80.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.93

SCREW LUCK 1.7 X12

Facility

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903632
Hospital Revenue Code	278
Min. Negotiated Rate	$114.56
Max. Negotiated Rate	$114.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56

SCREW LUCK 1.7 X 9

Facility

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903628
Hospital Revenue Code	278
Min. Negotiated Rate	$114.56
Max. Negotiated Rate	$114.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56

SCREW LUCK 1.7 X 9

Facility

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	64903628
Hospital Revenue Code	278
Min. Negotiated Rate	$80.20
Max. Negotiated Rate	$240.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$137.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.75
Rate for Payer: EmblemHealth Commercial	$114.56
Rate for Payer: Fidelis Medicare Advantage	$240.59
Rate for Payer: Group Health Inc Commercial	$114.56
Rate for Payer: Group Health Inc Medicare	$80.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.93

SCREW MAXDRIVE DRILL FREE

Facility

$160.95

Service Code	HCPCS C1713
Hospital Charge Code	64907374
Hospital Revenue Code	278
Min. Negotiated Rate	$56.33
Max. Negotiated Rate	$169.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$96.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$92.55
Rate for Payer: EmblemHealth Commercial	$80.48
Rate for Payer: Fidelis Medicare Advantage	$169.00
Rate for Payer: Group Health Inc Commercial	$80.48
Rate for Payer: Group Health Inc Medicare	$56.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.48
Rate for Payer: Hamaspik Choice Inc Medicare	$80.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$104.62

SCREW MAXDRIVE DRILL FREE

Facility

$160.95

Service Code	HCPCS C1713
Hospital Charge Code	64907374
Hospital Revenue Code	278
Min. Negotiated Rate	$80.48
Max. Negotiated Rate	$80.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.48
Rate for Payer: Hamaspik Choice Inc Medicare	$80.48

SCREW MAXDRIVE MINI 2.0X11MM

Facility

$142.50

Service Code	HCPCS C1713
Hospital Charge Code	64902469
Hospital Revenue Code	278
Min. Negotiated Rate	$49.88
Max. Negotiated Rate	$149.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$78.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$85.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$81.94
Rate for Payer: EmblemHealth Commercial	$71.25
Rate for Payer: Fidelis Medicare Advantage	$149.62
Rate for Payer: Group Health Inc Commercial	$71.25
Rate for Payer: Group Health Inc Medicare	$49.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.25
Rate for Payer: Hamaspik Choice Inc Medicare	$71.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$92.62

SCREW MAXDRIVE MINI 2.0X11MM

Facility

$142.50

Service Code	HCPCS C1713
Hospital Charge Code	64902469
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.25
Rate for Payer: Hamaspik Choice Inc Medicare	$71.25

SCREW MAXDRIVE MINI 2.0X9MM

Facility

$142.50

Service Code	HCPCS C1713
Hospital Charge Code	64902446
Hospital Revenue Code	278
Min. Negotiated Rate	$71.25
Max. Negotiated Rate	$71.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.25
Rate for Payer: Hamaspik Choice Inc Medicare	$71.25

SCREW MAXDRIVE MINI 2.0X9MM

Facility

$142.50

Service Code	HCPCS C1713
Hospital Charge Code	64902446
Hospital Revenue Code	278
Min. Negotiated Rate	$49.88
Max. Negotiated Rate	$149.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$78.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$85.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$71.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$81.94
Rate for Payer: EmblemHealth Commercial	$71.25
Rate for Payer: Fidelis Medicare Advantage	$149.62
Rate for Payer: Group Health Inc Commercial	$71.25
Rate for Payer: Group Health Inc Medicare	$49.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$71.25
Rate for Payer: Hamaspik Choice Inc Medicare	$71.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$92.62

SCREW MENISCAL 11MM W/DSP DRIVER

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	64902505
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 MENISCAL 11MM W/DSP DRIVER

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	64902505
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 MIDFACE 1.5X9MM

Facility

$111.48

Service Code	HCPCS C1713
Hospital Charge Code	64906600
Hospital Revenue Code	278
Min. Negotiated Rate	$39.02
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$66.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$64.10
Rate for Payer: EmblemHealth Commercial	$55.74
Rate for Payer: Fidelis Medicare Advantage	$117.05
Rate for Payer: Group Health Inc Commercial	$55.74
Rate for Payer: Group Health Inc Medicare	$39.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.74
Rate for Payer: Hamaspik Choice Inc Medicare	$55.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$72.46

SCREW MIDFACE 1.5X9MM

Facility

$111.48

Service Code	HCPCS C1713
Hospital Charge Code	64906600
Hospital Revenue Code	278
Min. Negotiated Rate	$55.74
Max. Negotiated Rate	$55.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.74
Rate for Payer: Hamaspik Choice Inc Medicare	$55.74

SCREW MIDFACE 1.5X9MM 19007

Facility

$98.42

Service Code	HCPCS C1713
Hospital Charge Code	64906601
Hospital Revenue Code	278
Min. Negotiated Rate	$34.45
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$54.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$59.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$49.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.59
Rate for Payer: EmblemHealth Commercial	$49.21
Rate for Payer: Fidelis Medicare Advantage	$103.34
Rate for Payer: Group Health Inc Commercial	$49.21
Rate for Payer: Group Health Inc Medicare	$34.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.21
Rate for Payer: Hamaspik Choice Inc Medicare	$49.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$63.97

SCREW MIDFACE 1.5X9MM 19007

Facility

$98.42

Service Code	HCPCS C1713
Hospital Charge Code	64906601
Hospital Revenue Code	278
Min. Negotiated Rate	$49.21
Max. Negotiated Rate	$49.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.21
Rate for Payer: Hamaspik Choice Inc Medicare	$49.21

SCREW MINI CROSSDRIVEDRILL FR

Facility

$96.00

Service Code	HCPCS C1776
Hospital Charge Code	40206053
Hospital Revenue Code	278
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$52.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$57.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$55.20
Rate for Payer: EmblemHealth Commercial	$48.00
Rate for Payer: Fidelis Medicare Advantage	$100.80
Rate for Payer: Group Health Inc Commercial	$48.00
Rate for Payer: Group Health Inc Medicare	$33.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.00
Rate for Payer: Hamaspik Choice Inc Medicare	$48.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$62.40

SCREW MINI CROSSDRIVEDRILL FR

Facility

$96.00

Service Code	HCPCS C1776
Hospital Charge Code	40206053
Hospital Revenue Code	278
Min. Negotiated Rate	$48.00
Max. Negotiated Rate	$48.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.00
Rate for Payer: Hamaspik Choice Inc Medicare	$48.00

SCREW MIRCO DRILL FREE 1.5X 3 MM

Facility

$100.00

Service Code	HCPCS C1713
Hospital Charge Code	40200377
Hospital Revenue Code	278
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$60.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$57.50
Rate for Payer: EmblemHealth Commercial	$50.00
Rate for Payer: Fidelis Medicare Advantage	$105.00
Rate for Payer: Group Health Inc Commercial	$50.00
Rate for Payer: Group Health Inc Medicare	$35.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.00
Rate for Payer: Hamaspik Choice Inc Medicare	$50.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$65.00

SCREW MIRCO DRILL FREE 1.5X 3 MM

Facility

$100.00

Service Code	HCPCS C1713
Hospital Charge Code	40200377
Hospital Revenue Code	278
Min. Negotiated Rate	$50.00
Max. Negotiated Rate	$50.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.00
Rate for Payer: Hamaspik Choice Inc Medicare	$50.00

SCREW MM 4.0 X 12

Facility

$1,112.50

Service Code	HCPCS C1713
Hospital Charge Code	64904957
Hospital Revenue Code	278
Min. Negotiated Rate	$556.25
Max. Negotiated Rate	$556.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$556.25
Rate for Payer: Hamaspik Choice Inc Medicare	$556.25

Know your out-of-pocket cost for care.

All Charges