St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW SLF DRL ANCHR-C 3.5X12MM

Facility

$656.18

Service Code	HCPCS C1713
Hospital Charge Code	64906382
Hospital Revenue Code	278
Min. Negotiated Rate	$328.09
Max. Negotiated Rate	$328.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$328.09
Rate for Payer: Hamaspik Choice Inc Medicare	$328.09

SCREW SLF DRL ANCHR-C 3.5X12MM

Facility

$656.18

Service Code	HCPCS C1713
Hospital Charge Code	64906382
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$688.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$360.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$393.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$328.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$377.30
Rate for Payer: EmblemHealth Commercial	$328.09
Rate for Payer: Fidelis Medicare Advantage	$688.99
Rate for Payer: Group Health Inc Commercial	$328.09
Rate for Payer: Group Health Inc Medicare	$229.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$328.09
Rate for Payer: Hamaspik Choice Inc Medicare	$328.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$426.52

SCREW SLF START VARI 14

Facility

$1,248.00

Service Code	HCPCS C1713
Hospital Charge Code	64906884
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,310.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$686.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$748.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$624.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$717.60
Rate for Payer: EmblemHealth Commercial	$624.00
Rate for Payer: Fidelis Medicare Advantage	$1,310.40
Rate for Payer: Group Health Inc Commercial	$624.00
Rate for Payer: Group Health Inc Medicare	$436.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$624.00
Rate for Payer: Hamaspik Choice Inc Medicare	$624.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$811.20

SCREW SLF START VARI 14

Facility

$1,248.00

Service Code	HCPCS C1713
Hospital Charge Code	64906884
Hospital Revenue Code	278
Min. Negotiated Rate	$624.00
Max. Negotiated Rate	$624.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$624.00
Rate for Payer: Hamaspik Choice Inc Medicare	$624.00

SCREW SLF TAP LOW PROFILE

Facility

$405.00

Service Code	HCPCS C1713
Hospital Charge Code	64907197
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$425.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$222.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$243.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$202.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$232.88
Rate for Payer: EmblemHealth Commercial	$202.50
Rate for Payer: Fidelis Medicare Advantage	$425.25
Rate for Payer: Group Health Inc Commercial	$202.50
Rate for Payer: Group Health Inc Medicare	$141.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$202.50
Rate for Payer: Hamaspik Choice Inc Medicare	$202.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$263.25

SCREW SLF TAP LOW PROFILE

Facility

$405.00

Service Code	HCPCS C1713
Hospital Charge Code	64907197
Hospital Revenue Code	278
Min. Negotiated Rate	$202.50
Max. Negotiated Rate	$202.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$202.50
Rate for Payer: Hamaspik Choice Inc Medicare	$202.50

SCREW SLF TP ANCHOR-C 3.5X10MM

Facility

$656.18

Service Code	HCPCS C1713
Hospital Charge Code	64906380
Hospital Revenue Code	278
Min. Negotiated Rate	$328.09
Max. Negotiated Rate	$328.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$328.09
Rate for Payer: Hamaspik Choice Inc Medicare	$328.09

SCREW SLF TP ANCHOR-C 3.5X10MM

Facility

$656.18

Service Code	HCPCS C1713
Hospital Charge Code	64906380
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$688.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$360.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$393.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$328.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$377.30
Rate for Payer: EmblemHealth Commercial	$328.09
Rate for Payer: Fidelis Medicare Advantage	$688.99
Rate for Payer: Group Health Inc Commercial	$328.09
Rate for Payer: Group Health Inc Medicare	$229.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$328.09
Rate for Payer: Hamaspik Choice Inc Medicare	$328.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$426.52

SCREW SNAP OFF 2.0 X 15

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64905316
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,372.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$719.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$784.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$653.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$751.81
Rate for Payer: EmblemHealth Commercial	$653.75
Rate for Payer: Fidelis Medicare Advantage	$1,372.88
Rate for Payer: Group Health Inc Commercial	$653.75
Rate for Payer: Group Health Inc Medicare	$457.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$849.88

SCREW SNAP OFF 2.0 X 15

Facility

$1,307.50

Service Code	HCPCS C1713
Hospital Charge Code	64905316
Hospital Revenue Code	278
Min. Negotiated Rate	$653.75
Max. Negotiated Rate	$653.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$653.75

SCREW SP 9MM X 25X8

Facility

$15,237.35

Service Code	HCPCS C1713
Hospital Charge Code	64903995
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$15,999.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8,380.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$9,142.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7,618.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$8,761.48
Rate for Payer: EmblemHealth Commercial	$7,618.68
Rate for Payer: Fidelis Medicare Advantage	$15,999.22
Rate for Payer: Group Health Inc Commercial	$7,618.68
Rate for Payer: Group Health Inc Medicare	$5,333.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,618.68
Rate for Payer: Hamaspik Choice Inc Medicare	$7,618.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9,904.28

SCREW SP 9MM X 25X8

Facility

$15,237.35

Service Code	HCPCS C1713
Hospital Charge Code	64903995
Hospital Revenue Code	278
Min. Negotiated Rate	$7,618.68
Max. Negotiated Rate	$7,618.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,618.68
Rate for Payer: Hamaspik Choice Inc Medicare	$7,618.68

SCREW SPINAL 5.5X45 -15545

Facility

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	64906689
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 SPINAL 5.5X45 -15545

Facility

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	64906689
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 SPINAL CANNULATED 6.5M

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64904798
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 SPINAL CANNULATED 6.5M

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64904798
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 SPINAL CANNULATED 6.5MM

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64904645
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 SPINAL CANNULATED 6.5MM

Facility

$8,552.70

Service Code	HCPCS C1713
Hospital Charge Code	64904645
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 SPINAL SELF DRILL 10MM 5310

Facility

$1,312.36

Service Code	HCPCS C1713
Hospital Charge Code	64906737
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,377.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$721.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$787.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$656.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$754.61
Rate for Payer: EmblemHealth Commercial	$656.18
Rate for Payer: Fidelis Medicare Advantage	$1,377.98
Rate for Payer: Group Health Inc Commercial	$656.18
Rate for Payer: Group Health Inc Medicare	$459.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$656.18
Rate for Payer: Hamaspik Choice Inc Medicare	$656.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$853.03

SCREW SPINAL SELF DRILL 10MM 5310

Facility

$1,312.36

Service Code	HCPCS C1713
Hospital Charge Code	64906737
Hospital Revenue Code	278
Min. Negotiated Rate	$656.18
Max. Negotiated Rate	$656.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$656.18
Rate for Payer: Hamaspik Choice Inc Medicare	$656.18

SCREW S/T 1.2MMD X 5MML CRS-PIN

Facility

$135.80

Service Code	HCPCS C1713
Hospital Charge Code	64901459
Hospital Revenue Code	278
Min. Negotiated Rate	$67.90
Max. Negotiated Rate	$67.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.90
Rate for Payer: Hamaspik Choice Inc Medicare	$67.90

SCREW S/T 1.2MMD X 5MML CRS-PIN

Facility

$135.80

Service Code	HCPCS C1713
Hospital Charge Code	64901459
Hospital Revenue Code	278
Min. Negotiated Rate	$47.53
Max. Negotiated Rate	$142.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$81.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$67.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.08
Rate for Payer: EmblemHealth Commercial	$67.90
Rate for Payer: Fidelis Medicare Advantage	$142.59
Rate for Payer: Group Health Inc Commercial	$67.90
Rate for Payer: Group Health Inc Medicare	$47.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.90
Rate for Payer: Hamaspik Choice Inc Medicare	$67.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$88.27

SCREW STEM EXTENSON REPLACEMENT

Facility

$227.38

Service Code	HCPCS C1713
Hospital Charge Code	64901699
Hospital Revenue Code	278
Min. Negotiated Rate	$113.69
Max. Negotiated Rate	$113.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$113.69
Rate for Payer: Hamaspik Choice Inc Medicare	$113.69

SCREW STEM EXTENSON REPLACEMENT

Facility

$227.38

Service Code	HCPCS C1713
Hospital Charge Code	64901699
Hospital Revenue Code	278
Min. Negotiated Rate	$79.58
Max. Negotiated Rate	$238.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$136.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$113.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$130.74
Rate for Payer: EmblemHealth Commercial	$113.69
Rate for Payer: Fidelis Medicare Advantage	$238.75
Rate for Payer: Group Health Inc Commercial	$113.69
Rate for Payer: Group Health Inc Medicare	$79.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$113.69
Rate for Payer: Hamaspik Choice Inc Medicare	$113.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$147.80

SCREW STNDRD 5.0 X 25MM

Facility

$2,412.50

Service Code	HCPCS C1713
Hospital Charge Code	64905305
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,533.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,326.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,447.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,206.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,387.19
Rate for Payer: EmblemHealth Commercial	$1,206.25
Rate for Payer: Fidelis Medicare Advantage	$2,533.12
Rate for Payer: Group Health Inc Commercial	$1,206.25
Rate for Payer: Group Health Inc Medicare	$844.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,206.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,206.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,568.12

Know your out-of-pocket cost for care.

All Charges