St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW SELF START 14MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64907504
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,150.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,650.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,800.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,725.00
Rate for Payer: EmblemHealth Commercial	$1,500.00
Rate for Payer: Fidelis Medicare Advantage	$3,150.00
Rate for Payer: Group Health Inc Commercial	$1,500.00
Rate for Payer: Group Health Inc Medicare	$1,050.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,950.00

SCREW SELF START 14MM

Facility

$3,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64907504
Hospital Revenue Code	278
Min. Negotiated Rate	$1,500.00
Max. Negotiated Rate	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,500.00

SCREW SELF-TAP 1.7

Facility

$46.32

Service Code	HCPCS C1713
Hospital Charge Code	64907477
Hospital Revenue Code	278
Min. Negotiated Rate	$23.16
Max. Negotiated Rate	$23.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.16
Rate for Payer: Hamaspik Choice Inc Medicare	$23.16

SCREW SELF-TAP 1.7

Facility

$46.32

Service Code	HCPCS C1713
Hospital Charge Code	64907477
Hospital Revenue Code	278
Min. Negotiated Rate	$16.21
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$27.79
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.63
Rate for Payer: EmblemHealth Commercial	$23.16
Rate for Payer: Fidelis Medicare Advantage	$48.64
Rate for Payer: Group Health Inc Commercial	$23.16
Rate for Payer: Group Health Inc Medicare	$16.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.16
Rate for Payer: Hamaspik Choice Inc Medicare	$23.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$30.11

SCREW SELF TAP CORTICAL 4.5X18MM

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64905743
Hospital Revenue Code	278
Min. Negotiated Rate	$28.44
Max. Negotiated Rate	$28.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.44
Rate for Payer: Hamaspik Choice Inc Medicare	$28.44

SCREW SELF TAP CORTICAL 4.5X18MM

Facility

$56.88

Service Code	HCPCS C1713
Hospital Charge Code	64905743
Hospital Revenue Code	278
Min. Negotiated Rate	$19.91
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$34.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.71
Rate for Payer: EmblemHealth Commercial	$28.44
Rate for Payer: Fidelis Medicare Advantage	$59.72
Rate for Payer: Group Health Inc Commercial	$28.44
Rate for Payer: Group Health Inc Medicare	$19.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.44
Rate for Payer: Hamaspik Choice Inc Medicare	$28.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.97

SCREW SELF-TAPPING 1.5 X 5MM

Facility

$237.50

Service Code	HCPCS C1713
Hospital Charge Code	64902592
Hospital Revenue Code	278
Min. Negotiated Rate	$83.12
Max. Negotiated Rate	$249.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$142.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$118.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.56
Rate for Payer: EmblemHealth Commercial	$118.75
Rate for Payer: Fidelis Medicare Advantage	$249.38
Rate for Payer: Group Health Inc Commercial	$118.75
Rate for Payer: Group Health Inc Medicare	$83.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.75
Rate for Payer: Hamaspik Choice Inc Medicare	$118.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$154.38

SCREW SELF-TAPPING 1.5 X 5MM

Facility

$237.50

Service Code	HCPCS C1713
Hospital Charge Code	64902592
Hospital Revenue Code	278
Min. Negotiated Rate	$118.75
Max. Negotiated Rate	$118.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.75
Rate for Payer: Hamaspik Choice Inc Medicare	$118.75

SCREW SELF TAPPING CORTEX A

Facility

$84.38

Service Code	HCPCS C1713
Hospital Charge Code	64901145
Hospital Revenue Code	278
Min. Negotiated Rate	$42.19
Max. Negotiated Rate	$42.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.19
Rate for Payer: Hamaspik Choice Inc Medicare	$42.19

SCREW SELF TAPPING CORTEX A

Facility

$84.38

Service Code	HCPCS C1713
Hospital Charge Code	64901145
Hospital Revenue Code	278
Min. Negotiated Rate	$29.53
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$46.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$50.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.52
Rate for Payer: EmblemHealth Commercial	$42.19
Rate for Payer: Fidelis Medicare Advantage	$88.60
Rate for Payer: Group Health Inc Commercial	$42.19
Rate for Payer: Group Health Inc Medicare	$29.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$42.19
Rate for Payer: Hamaspik Choice Inc Medicare	$42.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$54.85

SCREW SELF TAPPING CORTEX B

Facility

$68.13

Service Code	HCPCS C1713
Hospital Charge Code	64901147
Hospital Revenue Code	278
Min. Negotiated Rate	$34.06
Max. Negotiated Rate	$34.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.06
Rate for Payer: Hamaspik Choice Inc Medicare	$34.06

SCREW SELF TAPPING CORTEX B

Facility

$68.13

Service Code	HCPCS C1713
Hospital Charge Code	64901147
Hospital Revenue Code	278
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$40.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.17
Rate for Payer: EmblemHealth Commercial	$34.06
Rate for Payer: Fidelis Medicare Advantage	$71.54
Rate for Payer: Group Health Inc Commercial	$34.06
Rate for Payer: Group Health Inc Medicare	$23.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.06
Rate for Payer: Hamaspik Choice Inc Medicare	$34.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$44.28

SCREW SELF-TAP STAR D 3.5MM

Facility

$87.50

Service Code	HCPCS C1713
Hospital Charge Code	64903979
Hospital Revenue Code	278
Min. Negotiated Rate	$43.75
Max. Negotiated Rate	$43.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.75
Rate for Payer: Hamaspik Choice Inc Medicare	$43.75

SCREW SELF-TAP STAR D 3.5MM

Facility

$87.50

Service Code	HCPCS C1713
Hospital Charge Code	64903979
Hospital Revenue Code	278
Min. Negotiated Rate	$30.62
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$52.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$43.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$50.31
Rate for Payer: EmblemHealth Commercial	$43.75
Rate for Payer: Fidelis Medicare Advantage	$91.88
Rate for Payer: Group Health Inc Commercial	$43.75
Rate for Payer: Group Health Inc Medicare	$30.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.75
Rate for Payer: Hamaspik Choice Inc Medicare	$43.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$56.88

SCREW SELF-TAP TI 2.06MM

Facility

$120.00

Service Code	HCPCS C1776
Hospital Charge Code	40202429
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$72.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.00
Rate for Payer: EmblemHealth Commercial	$60.00
Rate for Payer: Fidelis Medicare Advantage	$126.00
Rate for Payer: Group Health Inc Commercial	$60.00
Rate for Payer: Group Health Inc Medicare	$42.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$78.00

SCREW SELF-TAP TI 2.06MM

Facility

$120.00

Service Code	HCPCS C1776
Hospital Charge Code	40202429
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00

SCREW SELF- TAP TI 2.0X5MM

Facility

$120.00

Service Code	HCPCS C1776
Hospital Charge Code	40202445
Hospital Revenue Code	278
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$72.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.00
Rate for Payer: EmblemHealth Commercial	$60.00
Rate for Payer: Fidelis Medicare Advantage	$126.00
Rate for Payer: Group Health Inc Commercial	$60.00
Rate for Payer: Group Health Inc Medicare	$42.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$78.00

SCREW SELF- TAP TI 2.0X5MM

Facility

$120.00

Service Code	HCPCS C1776
Hospital Charge Code	40202445
Hospital Revenue Code	278
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.00
Rate for Payer: Hamaspik Choice Inc Medicare	$60.00

SCREWS EMERGENCY 1.7MM

Facility

$145.28

Service Code	HCPCS C1713
Hospital Charge Code	64901868
Hospital Revenue Code	278
Min. Negotiated Rate	$72.64
Max. Negotiated Rate	$72.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.64
Rate for Payer: Hamaspik Choice Inc Medicare	$72.64

SCREWS EMERGENCY 1.7MM

Facility

$145.28

Service Code	HCPCS C1713
Hospital Charge Code	64901868
Hospital Revenue Code	278
Min. Negotiated Rate	$50.85
Max. Negotiated Rate	$152.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$79.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$87.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$83.54
Rate for Payer: EmblemHealth Commercial	$72.64
Rate for Payer: Fidelis Medicare Advantage	$152.54
Rate for Payer: Group Health Inc Commercial	$72.64
Rate for Payer: Group Health Inc Medicare	$50.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.64
Rate for Payer: Hamaspik Choice Inc Medicare	$72.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$94.43

SCREW SEQUOIA 6.5 X 50

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904094
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,672.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,923.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,098.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,748.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,011.06
Rate for Payer: EmblemHealth Commercial	$1,748.75
Rate for Payer: Fidelis Medicare Advantage	$3,672.38
Rate for Payer: Group Health Inc Commercial	$1,748.75
Rate for Payer: Group Health Inc Medicare	$1,224.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,748.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,748.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,273.38

SCREW SEQUOIA 6.5 X 50

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904094
Hospital Revenue Code	278
Min. Negotiated Rate	$1,748.75
Max. Negotiated Rate	$1,748.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,748.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,748.75

SCREW SEQUOIS 6.5 X 40

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904506
Hospital Revenue Code	278
Min. Negotiated Rate	$1,748.75
Max. Negotiated Rate	$1,748.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,748.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,748.75

SCREW SEQUOIS 6.5 X 40

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904506
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,672.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,923.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,098.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,748.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,011.06
Rate for Payer: EmblemHealth Commercial	$1,748.75
Rate for Payer: Fidelis Medicare Advantage	$3,672.38
Rate for Payer: Group Health Inc Commercial	$1,748.75
Rate for Payer: Group Health Inc Medicare	$1,224.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,748.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,748.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,273.38

SCREW SEQUOIS 6.5 X 45

Facility

$3,497.50

Service Code	HCPCS C1713
Hospital Charge Code	64904507
Hospital Revenue Code	278
Min. Negotiated Rate	$1,748.75
Max. Negotiated Rate	$1,748.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,748.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,748.75

Know your out-of-pocket cost for care.

All Charges