St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW STRYKER NON-LOCK 2.7MMX14MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40204482
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

SCREW STRYKER NON-LOCK 2.7MMX14MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40204482
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$315.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$180.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.50
Rate for Payer: EmblemHealth Commercial	$150.00
Rate for Payer: Fidelis Medicare Advantage	$315.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$195.00

SCREW STRYKER NON-LOCK 2.7MMX22MM

Facility

$263.50

Service Code	HCPCS C1713
Hospital Charge Code	40204498
Hospital Revenue Code	278
Min. Negotiated Rate	$92.22
Max. Negotiated Rate	$276.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$158.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$131.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$151.51
Rate for Payer: EmblemHealth Commercial	$131.75
Rate for Payer: Fidelis Medicare Advantage	$276.68
Rate for Payer: Group Health Inc Commercial	$131.75
Rate for Payer: Group Health Inc Medicare	$92.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.75
Rate for Payer: Hamaspik Choice Inc Medicare	$131.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$171.28

SCREW STRYKER NON-LOCK 2.7MMX22MM

Facility

$263.50

Service Code	HCPCS C1713
Hospital Charge Code	40204498
Hospital Revenue Code	278
Min. Negotiated Rate	$131.75
Max. Negotiated Rate	$131.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.75
Rate for Payer: Hamaspik Choice Inc Medicare	$131.75

SCREW STRY NON-LOCK 2.7MM X 22MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40204721
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

SCREW STRY NON-LOCK 2.7MM X 22MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40204721
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$315.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$180.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.50
Rate for Payer: EmblemHealth Commercial	$150.00
Rate for Payer: Fidelis Medicare Advantage	$315.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$195.00

SCREW STRY NON-LOCK 2.7 X 16 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40203393
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

SCREW STRY NON-LOCK 2.7 X 16 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40203393
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$315.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$180.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.50
Rate for Payer: EmblemHealth Commercial	$150.00
Rate for Payer: Fidelis Medicare Advantage	$315.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$195.00

SCREW STRY NON-LOCK 2.7 X 16MM

Facility

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40203395
Hospital Revenue Code	278
Min. Negotiated Rate	$281.00
Max. Negotiated Rate	$281.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00

SCREW STRY NON-LOCK 2.7 X 16MM

Facility

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40203395
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$590.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$337.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$281.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$323.15
Rate for Payer: EmblemHealth Commercial	$281.00
Rate for Payer: Fidelis Medicare Advantage	$590.10
Rate for Payer: Group Health Inc Commercial	$281.00
Rate for Payer: Group Health Inc Medicare	$196.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$365.30

SCREW STRY NON-LOCK 2.7 X 18 MM

Facility

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40203396
Hospital Revenue Code	278
Min. Negotiated Rate	$281.00
Max. Negotiated Rate	$281.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00

SCREW STRY NON-LOCK 2.7 X 18 MM

Facility

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40203396
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$590.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$337.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$281.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$323.15
Rate for Payer: EmblemHealth Commercial	$281.00
Rate for Payer: Fidelis Medicare Advantage	$590.10
Rate for Payer: Group Health Inc Commercial	$281.00
Rate for Payer: Group Health Inc Medicare	$196.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$365.30

SCREW STRY NON-LOCK 2.7 X 20 MM

Facility

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40203397
Hospital Revenue Code	278
Min. Negotiated Rate	$281.00
Max. Negotiated Rate	$281.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00

SCREW STRY NON-LOCK 2.7 X 20 MM

Facility

$562.00

Service Code	HCPCS C1713
Hospital Charge Code	40203397
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$590.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$309.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$337.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$281.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$323.15
Rate for Payer: EmblemHealth Commercial	$281.00
Rate for Payer: Fidelis Medicare Advantage	$590.10
Rate for Payer: Group Health Inc Commercial	$281.00
Rate for Payer: Group Health Inc Medicare	$196.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$281.00
Rate for Payer: Hamaspik Choice Inc Medicare	$281.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$365.30

SCREW STRY NON-LOCK 2.7 X 22 MM

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	40203398
Hospital Revenue Code	278
Min. Negotiated Rate	$260.00
Max. Negotiated Rate	$260.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$260.00

SCREW STRY NON-LOCK 2.7 X 22 MM

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	40203398
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$546.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$286.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$312.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$260.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.00
Rate for Payer: EmblemHealth Commercial	$260.00
Rate for Payer: Fidelis Medicare Advantage	$546.00
Rate for Payer: Group Health Inc Commercial	$260.00
Rate for Payer: Group Health Inc Medicare	$182.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$260.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$338.00

SCREW STRY NON-LOCK 2.7 X 26 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40203394
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

SCREW STRY NON-LOCK 2.7 X 26 MM

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40203394
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$315.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$180.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.50
Rate for Payer: EmblemHealth Commercial	$150.00
Rate for Payer: Fidelis Medicare Advantage	$315.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$195.00

SCREW STY NON-LOCK 2.7 X 24 MM

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	40203399
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$546.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$286.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$312.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$260.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.00
Rate for Payer: EmblemHealth Commercial	$260.00
Rate for Payer: Fidelis Medicare Advantage	$546.00
Rate for Payer: Group Health Inc Commercial	$260.00
Rate for Payer: Group Health Inc Medicare	$182.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$260.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$338.00

SCREW STY NON-LOCK 2.7 X 24 MM

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	40203399
Hospital Revenue Code	278
Min. Negotiated Rate	$260.00
Max. Negotiated Rate	$260.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$260.00

SCREWS VASD 14MM

Facility

$1,400.75

Service Code	HCPCS C1713
Hospital Charge Code	64905414
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,470.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$770.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$840.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$700.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$805.43
Rate for Payer: EmblemHealth Commercial	$700.38
Rate for Payer: Fidelis Medicare Advantage	$1,470.79
Rate for Payer: Group Health Inc Commercial	$700.38
Rate for Payer: Group Health Inc Medicare	$490.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$700.38
Rate for Payer: Hamaspik Choice Inc Medicare	$700.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$910.49

SCREWS VASD 14MM

Facility

$1,400.75

Service Code	HCPCS C1713
Hospital Charge Code	64905414
Hospital Revenue Code	278
Min. Negotiated Rate	$700.38
Max. Negotiated Rate	$700.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$700.38
Rate for Payer: Hamaspik Choice Inc Medicare	$700.38

SCREW SYS ANATOM SHOULDER

Facility

$320.00

Service Code	HCPCS C1713
Hospital Charge Code	64906914
Hospital Revenue Code	278
Min. Negotiated Rate	$160.00
Max. Negotiated Rate	$160.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.00
Rate for Payer: Hamaspik Choice Inc Medicare	$160.00

SCREW SYS ANATOM SHOULDER

Facility

$320.00

Service Code	HCPCS C1713
Hospital Charge Code	64906914
Hospital Revenue Code	278
Min. Negotiated Rate	$112.00
Max. Negotiated Rate	$336.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$176.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$192.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.00
Rate for Payer: EmblemHealth Commercial	$160.00
Rate for Payer: Fidelis Medicare Advantage	$336.00
Rate for Payer: Group Health Inc Commercial	$160.00
Rate for Payer: Group Health Inc Medicare	$112.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.00
Rate for Payer: Hamaspik Choice Inc Medicare	$160.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$208.00

SCREW SZ 1.2MMX7MM

Facility

$145.80

Service Code	HCPCS C1713
Hospital Charge Code	40209564
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

Know your out-of-pocket cost for care.

All Charges