St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW POLY SERRATO 6.0X35MM

Facility

$2,332.79

Service Code	HCPCS C1713
Hospital Charge Code	64906400
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,449.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,283.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,399.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,341.35
Rate for Payer: EmblemHealth Commercial	$1,166.40
Rate for Payer: Fidelis Medicare Advantage	$2,449.43
Rate for Payer: Group Health Inc Commercial	$1,166.40
Rate for Payer: Group Health Inc Medicare	$816.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.40
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,516.31

SCREW POLY SERRATO 6.0X40MM

Facility

$2,332.79

Service Code	HCPCS C1713
Hospital Charge Code	64906401
Hospital Revenue Code	278
Min. Negotiated Rate	$1,166.40
Max. Negotiated Rate	$1,166.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.40
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.40

SCREW POLY SERRATO 6.0X40MM

Facility

$2,332.79

Service Code	HCPCS C1713
Hospital Charge Code	64906401
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,449.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,283.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,399.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,341.35
Rate for Payer: EmblemHealth Commercial	$1,166.40
Rate for Payer: Fidelis Medicare Advantage	$2,449.43
Rate for Payer: Group Health Inc Commercial	$1,166.40
Rate for Payer: Group Health Inc Medicare	$816.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.40
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,516.31

SCREW PRECEPT 6.5X40MM P

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	64903550
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,410.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,310.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,520.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,415.00
Rate for Payer: EmblemHealth Commercial	$2,100.00
Rate for Payer: Fidelis Medicare Advantage	$4,410.00
Rate for Payer: Group Health Inc Commercial	$2,100.00
Rate for Payer: Group Health Inc Medicare	$1,470.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,730.00

SCREW PRECEPT 6.5X40MM P

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	64903550
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$2,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,100.00

SCREW PRECEPT 6.5X45MM P

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903552
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,200.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,400.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,000.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,300.00
Rate for Payer: EmblemHealth Commercial	$2,000.00
Rate for Payer: Fidelis Medicare Advantage	$4,200.00
Rate for Payer: Group Health Inc Commercial	$2,000.00
Rate for Payer: Group Health Inc Medicare	$1,400.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,000.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,600.00

SCREW PRECEPT 6.5X45MM P

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64903552
Hospital Revenue Code	278
Min. Negotiated Rate	$2,000.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,000.00

SCREW PRECEPT SET

Facility

$643.75

Service Code	HCPCS C1713
Hospital Charge Code	64903553
Hospital Revenue Code	278
Min. Negotiated Rate	$321.88
Max. Negotiated Rate	$321.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$321.88
Rate for Payer: Hamaspik Choice Inc Medicare	$321.88

SCREW PRECEPT SET

Facility

$643.75

Service Code	HCPCS C1713
Hospital Charge Code	64903553
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$675.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$354.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$386.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$321.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$370.16
Rate for Payer: EmblemHealth Commercial	$321.88
Rate for Payer: Fidelis Medicare Advantage	$675.94
Rate for Payer: Group Health Inc Commercial	$321.88
Rate for Payer: Group Health Inc Medicare	$225.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$321.88
Rate for Payer: Hamaspik Choice Inc Medicare	$321.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$418.44

SCREW PSN HEX

Facility

$277.50

Service Code	HCPCS C1713
Hospital Charge Code	64907166
Hospital Revenue Code	278
Min. Negotiated Rate	$138.75
Max. Negotiated Rate	$138.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.75
Rate for Payer: Hamaspik Choice Inc Medicare	$138.75

SCREW PSN HEX

Facility

$277.50

Service Code	HCPCS C1713
Hospital Charge Code	64907166
Hospital Revenue Code	278
Min. Negotiated Rate	$97.12
Max. Negotiated Rate	$291.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$166.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$138.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.56
Rate for Payer: EmblemHealth Commercial	$138.75
Rate for Payer: Fidelis Medicare Advantage	$291.38
Rate for Payer: Group Health Inc Commercial	$138.75
Rate for Payer: Group Health Inc Medicare	$97.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.75
Rate for Payer: Hamaspik Choice Inc Medicare	$138.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$180.38

SCREW PT 6.5 X 65MM

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64903066
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$644.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$337.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$368.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$307.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$353.19
Rate for Payer: EmblemHealth Commercial	$307.12
Rate for Payer: Fidelis Medicare Advantage	$644.96
Rate for Payer: Group Health Inc Commercial	$307.12
Rate for Payer: Group Health Inc Medicare	$214.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$399.26

SCREW PT 6.5 X 65MM

Facility

$614.25

Service Code	HCPCS C1713
Hospital Charge Code	64903066
Hospital Revenue Code	278
Min. Negotiated Rate	$307.12
Max. Negotiated Rate	$307.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.12
Rate for Payer: Hamaspik Choice Inc Medicare	$307.12

SCREW REDUCT 6.25 X 40

Facility

$4,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904583
Hospital Revenue Code	278
Min. Negotiated Rate	$2,248.75
Max. Negotiated Rate	$2,248.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,248.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,248.75

SCREW REDUCT 6.25 X 40

Facility

$4,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904583
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,722.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,473.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,698.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,248.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,586.06
Rate for Payer: EmblemHealth Commercial	$2,248.75
Rate for Payer: Fidelis Medicare Advantage	$4,722.38
Rate for Payer: Group Health Inc Commercial	$2,248.75
Rate for Payer: Group Health Inc Medicare	$1,574.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,248.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,248.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,923.38

SCREW RELINE 6.5X50MM

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904181
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,648.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,911.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,085.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,737.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,998.12
Rate for Payer: EmblemHealth Commercial	$1,737.50
Rate for Payer: Fidelis Medicare Advantage	$3,648.75
Rate for Payer: Group Health Inc Commercial	$1,737.50
Rate for Payer: Group Health Inc Medicare	$1,216.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,258.75

SCREW RELINE 6.5X50MM

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904181
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.50
Max. Negotiated Rate	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50

SCREW RELINE MAS 6.5X40MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	64905337
Hospital Revenue Code	278
Min. Negotiated Rate	$2,100.00
Max. Negotiated Rate	$2,100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,100.00

SCREW RELINE MAS 6.5X40MM

Facility

$4,200.00

Service Code	HCPCS C1713
Hospital Charge Code	64905337
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,410.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,310.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,520.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,415.00
Rate for Payer: EmblemHealth Commercial	$2,100.00
Rate for Payer: Fidelis Medicare Advantage	$4,410.00
Rate for Payer: Group Health Inc Commercial	$2,100.00
Rate for Payer: Group Health Inc Medicare	$1,470.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,730.00

SCREW RELINE O 7.5X40MM 2S

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904809
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.50
Max. Negotiated Rate	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50

SCREW RELINE O 7.5X40MM 2S

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904809
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,648.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,911.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,085.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,737.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,998.12
Rate for Payer: EmblemHealth Commercial	$1,737.50
Rate for Payer: Fidelis Medicare Advantage	$3,648.75
Rate for Payer: Group Health Inc Commercial	$1,737.50
Rate for Payer: Group Health Inc Medicare	$1,216.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,258.75

SCREW RELINE O 7.5X45 2S POLY

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904619
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,648.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,911.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,085.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,737.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,998.12
Rate for Payer: EmblemHealth Commercial	$1,737.50
Rate for Payer: Fidelis Medicare Advantage	$3,648.75
Rate for Payer: Group Health Inc Commercial	$1,737.50
Rate for Payer: Group Health Inc Medicare	$1,216.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,258.75

SCREW RELINE O 7.5X45 2S POLY

Facility

$3,475.00

Service Code	HCPCS C1713
Hospital Charge Code	64904619
Hospital Revenue Code	278
Min. Negotiated Rate	$1,737.50
Max. Negotiated Rate	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,737.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,737.50

SCREW RELINE-O 7.5 X 70MM 2S

Facility

$3,725.00

Service Code	HCPCS C1713
Hospital Charge Code	64904929
Hospital Revenue Code	278
Min. Negotiated Rate	$1,862.50
Max. Negotiated Rate	$1,862.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,862.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,862.50

SCREW RELINE-O 7.5 X 70MM 2S

Facility

$3,725.00

Service Code	HCPCS C1713
Hospital Charge Code	64904929
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,911.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,048.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,235.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,862.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,141.88
Rate for Payer: EmblemHealth Commercial	$1,862.50
Rate for Payer: Fidelis Medicare Advantage	$3,911.25
Rate for Payer: Group Health Inc Commercial	$1,862.50
Rate for Payer: Group Health Inc Medicare	$1,303.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,862.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,862.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,421.25

Know your out-of-pocket cost for care.

All Charges