St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$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 SERRATO POLY 6.5X45MM

Facility

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	64906683
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.79
Max. Negotiated Rate	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicare	$2,332.79

SCREW SERRATO POLY 6.5X45MM

Facility

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	64906683
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,898.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,566.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,799.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,332.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,682.71
Rate for Payer: EmblemHealth Commercial	$2,332.79
Rate for Payer: Fidelis Medicare Advantage	$4,898.86
Rate for Payer: Group Health Inc Commercial	$2,332.79
Rate for Payer: Group Health Inc Medicare	$1,632.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicare	$2,332.79
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,032.63

SCREW SERRATO X 40

Facility

$5,830.00

Service Code	HCPCS C1713
Hospital Charge Code	64907117
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,121.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,206.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,498.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,352.25
Rate for Payer: EmblemHealth Commercial	$2,915.00
Rate for Payer: Fidelis Medicare Advantage	$6,121.50
Rate for Payer: Group Health Inc Commercial	$2,915.00
Rate for Payer: Group Health Inc Medicare	$2,040.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,915.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,915.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,789.50

SCREW SERRATO X 40

Facility

$5,830.00

Service Code	HCPCS C1713
Hospital Charge Code	64907117
Hospital Revenue Code	278
Min. Negotiated Rate	$2,915.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,915.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,915.00

SCREW SERRATO X45

Facility

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	64906866
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,898.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,566.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,799.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,332.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,682.71
Rate for Payer: EmblemHealth Commercial	$2,332.79
Rate for Payer: Fidelis Medicare Advantage	$4,898.86
Rate for Payer: Group Health Inc Commercial	$2,332.79
Rate for Payer: Group Health Inc Medicare	$1,632.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicare	$2,332.79
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,032.63

SCREW SERRATO X45

Facility

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	64906866
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.79
Max. Negotiated Rate	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicare	$2,332.79

SCREW SERRATO X 50

Facility

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	64906867
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,898.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,566.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,799.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,332.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,682.71
Rate for Payer: EmblemHealth Commercial	$2,332.79
Rate for Payer: Fidelis Medicare Advantage	$4,898.86
Rate for Payer: Group Health Inc Commercial	$2,332.79
Rate for Payer: Group Health Inc Medicare	$1,632.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicare	$2,332.79
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,032.63

SCREW SERRATO X 50

Facility

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	64906867
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.79
Max. Negotiated Rate	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicare	$2,332.79

SCREW SET A

Facility

$435.50

Service Code	HCPCS C1713
Hospital Charge Code	64902896
Hospital Revenue Code	278
Min. Negotiated Rate	$217.75
Max. Negotiated Rate	$217.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$217.75
Rate for Payer: Hamaspik Choice Inc Medicare	$217.75

SCREW SET A

Facility

$435.50

Service Code	HCPCS C1713
Hospital Charge Code	64902896
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$457.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$239.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$261.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$217.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$250.41
Rate for Payer: EmblemHealth Commercial	$217.75
Rate for Payer: Fidelis Medicare Advantage	$457.28
Rate for Payer: Group Health Inc Commercial	$217.75
Rate for Payer: Group Health Inc Medicare	$152.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$217.75
Rate for Payer: Hamaspik Choice Inc Medicare	$217.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$283.08

SCREW SET B

Facility

$562.50

Service Code	HCPCS C1713
Hospital Charge Code	64904581
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$590.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$337.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$281.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$323.44
Rate for Payer: EmblemHealth Commercial	$281.25
Rate for Payer: Fidelis Medicare Advantage	$590.62
Rate for Payer: Group Health Inc Commercial	$281.25
Rate for Payer: Group Health Inc Medicare	$196.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.25
Rate for Payer: Hamaspik Choice Inc Medicare	$281.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$365.62

SCREW SET B

Facility

$562.50

Service Code	HCPCS C1713
Hospital Charge Code	64904581
Hospital Revenue Code	278
Min. Negotiated Rate	$281.25
Max. Negotiated Rate	$281.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.25
Rate for Payer: Hamaspik Choice Inc Medicare	$281.25

SCREW SET C

Facility

$945.00

Service Code	HCPCS C1713
Hospital Charge Code	64904701
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$992.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$519.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$567.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$472.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$543.38
Rate for Payer: EmblemHealth Commercial	$472.50
Rate for Payer: Fidelis Medicare Advantage	$992.25
Rate for Payer: Group Health Inc Commercial	$472.50
Rate for Payer: Group Health Inc Medicare	$330.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$472.50
Rate for Payer: Hamaspik Choice Inc Medicare	$472.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$614.25

SCREW SET C

Facility

$945.00

Service Code	HCPCS C1713
Hospital Charge Code	64904701
Hospital Revenue Code	278
Min. Negotiated Rate	$472.50
Max. Negotiated Rate	$472.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$472.50
Rate for Payer: Hamaspik Choice Inc Medicare	$472.50

SCREW SET HEX-FIX

Facility

$36.53

Service Code	HCPCS C1713
Hospital Charge Code	64901939
Hospital Revenue Code	278
Min. Negotiated Rate	$12.79
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$21.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.00
Rate for Payer: EmblemHealth Commercial	$18.26
Rate for Payer: Fidelis Medicare Advantage	$38.36
Rate for Payer: Group Health Inc Commercial	$18.26
Rate for Payer: Group Health Inc Medicare	$12.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.26
Rate for Payer: Hamaspik Choice Inc Medicare	$18.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$23.74

SCREW SET HEX-FIX

Facility

$36.53

Service Code	HCPCS C1713
Hospital Charge Code	64901939
Hospital Revenue Code	278
Min. Negotiated Rate	$18.26
Max. Negotiated Rate	$18.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.26
Rate for Payer: Hamaspik Choice Inc Medicare	$18.26

SCREW SET YUKNO 10001

Facility

$544.00

Service Code	HCPCS C1713
Hospital Charge Code	64906724
Hospital Revenue Code	278
Min. Negotiated Rate	$272.00
Max. Negotiated Rate	$272.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$272.00
Rate for Payer: Hamaspik Choice Inc Medicare	$272.00

SCREW SET YUKNO 10001

Facility

$544.00

Service Code	HCPCS C1713
Hospital Charge Code	64906724
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$571.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$299.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$326.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$272.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$312.80
Rate for Payer: EmblemHealth Commercial	$272.00
Rate for Payer: Fidelis Medicare Advantage	$571.20
Rate for Payer: Group Health Inc Commercial	$272.00
Rate for Payer: Group Health Inc Medicare	$190.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$272.00
Rate for Payer: Hamaspik Choice Inc Medicare	$272.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$353.60

SCREW SH 5.5 X 35

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64904932
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 SH 5.5 X 35

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64904932
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 SIZE 1.2MM X 6MM

Facility

$145.80

Service Code	HCPCS C1713
Hospital Charge Code	40209565
Hospital Revenue Code	278
Min. Negotiated Rate	$72.90
Max. Negotiated Rate	$72.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.90
Rate for Payer: Hamaspik Choice Inc Medicare	$72.90

SCREW SIZE 1.2MM X 6MM

Facility

$145.80

Service Code	HCPCS C1713
Hospital Charge Code	40209565
Hospital Revenue Code	278
Min. Negotiated Rate	$51.03
Max. Negotiated Rate	$153.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$87.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$83.84
Rate for Payer: EmblemHealth Commercial	$72.90
Rate for Payer: Fidelis Medicare Advantage	$153.09
Rate for Payer: Group Health Inc Commercial	$72.90
Rate for Payer: Group Health Inc Medicare	$51.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.90
Rate for Payer: Hamaspik Choice Inc Medicare	$72.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$94.77

SCREW SLF DRILL 14MM 48335314

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	64906660
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$840.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$440.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$480.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$460.00
Rate for Payer: EmblemHealth Commercial	$400.00
Rate for Payer: Fidelis Medicare Advantage	$840.00
Rate for Payer: Group Health Inc Commercial	$400.00
Rate for Payer: Group Health Inc Medicare	$280.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$400.00
Rate for Payer: Hamaspik Choice Inc Medicare	$400.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$520.00

SCREW SLF DRILL 14MM 48335314

Facility

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	64906660
Hospital Revenue Code	278
Min. Negotiated Rate	$400.00
Max. Negotiated Rate	$400.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$400.00
Rate for Payer: Hamaspik Choice Inc Medicare	$400.00

Know your out-of-pocket cost for care.

All Charges