St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW VAR ANGL

Facility

$1,055.00

Service Code	HCPCS C1713
Hospital Charge Code	64907480
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,107.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$580.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$633.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$527.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$606.62
Rate for Payer: EmblemHealth Commercial	$527.50
Rate for Payer: Fidelis Medicare Advantage	$1,107.75
Rate for Payer: Group Health Inc Commercial	$527.50
Rate for Payer: Group Health Inc Medicare	$369.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$527.50
Rate for Payer: Hamaspik Choice Inc Medicare	$527.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$685.75

SCREW VAR ANGL

Facility

$1,055.00

Service Code	HCPCS C1713
Hospital Charge Code	64907480
Hospital Revenue Code	278
Min. Negotiated Rate	$527.50
Max. Negotiated Rate	$527.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$527.50
Rate for Payer: Hamaspik Choice Inc Medicare	$527.50

SCREW VARIABLE 4.2 X 12

Facility

$938.75

Service Code	HCPCS C1713
Hospital Charge Code	64904025
Hospital Revenue Code	278
Min. Negotiated Rate	$469.38
Max. Negotiated Rate	$469.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$469.38
Rate for Payer: Hamaspik Choice Inc Medicare	$469.38

SCREW VARIABLE 4.2 X 12

Facility

$938.75

Service Code	HCPCS C1713
Hospital Charge Code	64904025
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$985.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$516.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$563.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$539.78
Rate for Payer: EmblemHealth Commercial	$469.38
Rate for Payer: Fidelis Medicare Advantage	$985.69
Rate for Payer: Group Health Inc Commercial	$469.38
Rate for Payer: Group Health Inc Medicare	$328.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$469.38
Rate for Payer: Hamaspik Choice Inc Medicare	$469.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$610.19

SCREW VARIABLE 4.2 X 14

Facility

$938.75

Service Code	HCPCS C1713
Hospital Charge Code	64904022
Hospital Revenue Code	278
Min. Negotiated Rate	$469.38
Max. Negotiated Rate	$469.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$469.38
Rate for Payer: Hamaspik Choice Inc Medicare	$469.38

SCREW VARIABLE 4.2 X 14

Facility

$938.75

Service Code	HCPCS C1713
Hospital Charge Code	64904022
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$985.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$516.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$563.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$539.78
Rate for Payer: EmblemHealth Commercial	$469.38
Rate for Payer: Fidelis Medicare Advantage	$985.69
Rate for Payer: Group Health Inc Commercial	$469.38
Rate for Payer: Group Health Inc Medicare	$328.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$469.38
Rate for Payer: Hamaspik Choice Inc Medicare	$469.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$610.19

SCREW VARIABLE DRILLING 4.2 X 16

Facility

$938.75

Service Code	HCPCS C1713
Hospital Charge Code	64904013
Hospital Revenue Code	278
Min. Negotiated Rate	$469.38
Max. Negotiated Rate	$469.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$469.38
Rate for Payer: Hamaspik Choice Inc Medicare	$469.38

SCREW VARIABLE DRILLING 4.2 X 16

Facility

$938.75

Service Code	HCPCS C1713
Hospital Charge Code	64904013
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$985.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$516.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$563.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$469.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$539.78
Rate for Payer: EmblemHealth Commercial	$469.38
Rate for Payer: Fidelis Medicare Advantage	$985.69
Rate for Payer: Group Health Inc Commercial	$469.38
Rate for Payer: Group Health Inc Medicare	$328.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$469.38
Rate for Payer: Hamaspik Choice Inc Medicare	$469.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$610.19

SCREW VENTED

Facility

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64907196
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$774.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$405.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$442.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$368.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$424.06
Rate for Payer: EmblemHealth Commercial	$368.75
Rate for Payer: Fidelis Medicare Advantage	$774.38
Rate for Payer: Group Health Inc Commercial	$368.75
Rate for Payer: Group Health Inc Medicare	$258.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$479.38

SCREW VENTED

Facility

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64907196
Hospital Revenue Code	278
Min. Negotiated Rate	$368.75
Max. Negotiated Rate	$368.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75

SCREW VENTED 30MM

Facility

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64907111
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$774.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$405.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$442.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$368.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$424.06
Rate for Payer: EmblemHealth Commercial	$368.75
Rate for Payer: Fidelis Medicare Advantage	$774.38
Rate for Payer: Group Health Inc Commercial	$368.75
Rate for Payer: Group Health Inc Medicare	$258.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$479.38

SCREW VENTED 30MM

Facility

$737.50

Service Code	HCPCS C1713
Hospital Charge Code	64907111
Hospital Revenue Code	278
Min. Negotiated Rate	$368.75
Max. Negotiated Rate	$368.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$368.75
Rate for Payer: Hamaspik Choice Inc Medicare	$368.75

SCREW VENTED 9X20MM BC IF

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	64906335
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 VENTED 9X20MM BC IF

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	64906335
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 VENTED BC 9X30MM

Facility

$422.00

Service Code	HCPCS C1713
Hospital Charge Code	64906360
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$443.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$232.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$253.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$211.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$242.65
Rate for Payer: EmblemHealth Commercial	$211.00
Rate for Payer: Fidelis Medicare Advantage	$443.10
Rate for Payer: Group Health Inc Commercial	$211.00
Rate for Payer: Group Health Inc Medicare	$147.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$211.00
Rate for Payer: Hamaspik Choice Inc Medicare	$211.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$274.30

SCREW VENTED BC 9X30MM

Facility

$422.00

Service Code	HCPCS C1713
Hospital Charge Code	64906360
Hospital Revenue Code	278
Min. Negotiated Rate	$211.00
Max. Negotiated Rate	$211.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$211.00
Rate for Payer: Hamaspik Choice Inc Medicare	$211.00

SCREW VIRAGE 3.5X14MM

Facility

$1,399.00

Service Code	HCPCS C1713
Hospital Charge Code	64906472
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,468.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$769.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$839.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$699.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$804.42
Rate for Payer: EmblemHealth Commercial	$699.50
Rate for Payer: Fidelis Medicare Advantage	$1,468.95
Rate for Payer: Group Health Inc Commercial	$699.50
Rate for Payer: Group Health Inc Medicare	$489.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$699.50
Rate for Payer: Hamaspik Choice Inc Medicare	$699.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$909.35

SCREW VIRAGE 3.5X14MM

Facility

$1,399.00

Service Code	HCPCS C1713
Hospital Charge Code	64906472
Hospital Revenue Code	278
Min. Negotiated Rate	$699.50
Max. Negotiated Rate	$699.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$699.50
Rate for Payer: Hamaspik Choice Inc Medicare	$699.50

SCREW VOYAGER 6.5X40MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64905861
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,625.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,375.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,437.50
Rate for Payer: EmblemHealth Commercial	$1,250.00
Rate for Payer: Fidelis Medicare Advantage	$2,625.00
Rate for Payer: Group Health Inc Commercial	$1,250.00
Rate for Payer: Group Health Inc Medicare	$875.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,625.00

SCREW VOYAGER 6.5X40MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64905861
Hospital Revenue Code	278
Min. Negotiated Rate	$1,250.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,250.00

SCREW VOYAGER 6.5X45MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64905863
Hospital Revenue Code	278
Min. Negotiated Rate	$1,250.00
Max. Negotiated Rate	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,250.00

SCREW VOYAGER 6.5X45MM

Facility

$2,500.00

Service Code	HCPCS C1713
Hospital Charge Code	64905863
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,625.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,375.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,500.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,250.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,437.50
Rate for Payer: EmblemHealth Commercial	$1,250.00
Rate for Payer: Fidelis Medicare Advantage	$2,625.00
Rate for Payer: Group Health Inc Commercial	$1,250.00
Rate for Payer: Group Health Inc Medicare	$875.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,250.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,625.00

SCREW VOYAGER SET

Facility

$212.50

Service Code	HCPCS C1713
Hospital Charge Code	64905865
Hospital Revenue Code	278
Min. Negotiated Rate	$106.25
Max. Negotiated Rate	$106.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.25
Rate for Payer: Hamaspik Choice Inc Medicare	$106.25

SCREW VOYAGER SET

Facility

$212.50

Service Code	HCPCS C1713
Hospital Charge Code	64905865
Hospital Revenue Code	278
Min. Negotiated Rate	$74.38
Max. Negotiated Rate	$223.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$116.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$127.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$106.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$122.19
Rate for Payer: EmblemHealth Commercial	$106.25
Rate for Payer: Fidelis Medicare Advantage	$223.12
Rate for Payer: Group Health Inc Commercial	$106.25
Rate for Payer: Group Health Inc Medicare	$74.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.25
Rate for Payer: Hamaspik Choice Inc Medicare	$106.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$138.12

SCREW VUEP2 3.5X14MM

Facility

$3,350.00

Service Code	HCPCS C1713
Hospital Charge Code	64903805
Hospital Revenue Code	278
Min. Negotiated Rate	$1,675.00
Max. Negotiated Rate	$1,675.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,675.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,675.00

Know your out-of-pocket cost for care.

All Charges