St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SCREW XIA3 S 6.5 X 55

Facility

$4,754.35

Service Code	HCPCS C1713
Hospital Charge Code	64903939
Hospital Revenue Code	278
Min. Negotiated Rate	$2,377.18
Max. Negotiated Rate	$2,377.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,377.18
Rate for Payer: Hamaspik Choice Inc Medicare	$2,377.18

SCREW XIA3 S 6.5 X 55

Facility

$4,754.35

Service Code	HCPCS C1713
Hospital Charge Code	64903939
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,992.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,614.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,852.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,377.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,733.75
Rate for Payer: EmblemHealth Commercial	$2,377.18
Rate for Payer: Fidelis Medicare Advantage	$4,992.07
Rate for Payer: Group Health Inc Commercial	$2,377.18
Rate for Payer: Group Health Inc Medicare	$1,664.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,377.18
Rate for Payer: Hamaspik Choice Inc Medicare	$2,377.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,090.33

SCREW XIA 6.5X30MM

Facility

$4,754.35

Service Code	HCPCS C1713
Hospital Charge Code	64903993
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,992.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,614.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,852.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,377.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,733.75
Rate for Payer: EmblemHealth Commercial	$2,377.18
Rate for Payer: Fidelis Medicare Advantage	$4,992.07
Rate for Payer: Group Health Inc Commercial	$2,377.18
Rate for Payer: Group Health Inc Medicare	$1,664.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,377.18
Rate for Payer: Hamaspik Choice Inc Medicare	$2,377.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,090.33

SCREW XIA 6.5X30MM

Facility

$4,754.35

Service Code	HCPCS C1713
Hospital Charge Code	64903993
Hospital Revenue Code	278
Min. Negotiated Rate	$2,377.18
Max. Negotiated Rate	$2,377.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,377.18
Rate for Payer: Hamaspik Choice Inc Medicare	$2,377.18

SCREW XIA 70 MM

Facility

$4,310.60

Service Code	HCPCS C1713
Hospital Charge Code	64906868
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,526.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,370.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,586.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,155.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,478.60
Rate for Payer: EmblemHealth Commercial	$2,155.30
Rate for Payer: Fidelis Medicare Advantage	$4,526.13
Rate for Payer: Group Health Inc Commercial	$2,155.30
Rate for Payer: Group Health Inc Medicare	$1,508.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,155.30
Rate for Payer: Hamaspik Choice Inc Medicare	$2,155.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,801.89

SCREW XIA 70 MM

Facility

$4,310.60

Service Code	HCPCS C1713
Hospital Charge Code	64906868
Hospital Revenue Code	278
Min. Negotiated Rate	$2,155.30
Max. Negotiated Rate	$2,155.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,155.30
Rate for Payer: Hamaspik Choice Inc Medicare	$2,155.30

SCREW XIA 7.5X50MM

Facility

$4,606.93

Service Code	HCPCS C1713
Hospital Charge Code	64903925
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,837.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,533.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,764.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,303.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,648.98
Rate for Payer: EmblemHealth Commercial	$2,303.46
Rate for Payer: Fidelis Medicare Advantage	$4,837.28
Rate for Payer: Group Health Inc Commercial	$2,303.46
Rate for Payer: Group Health Inc Medicare	$1,612.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,303.46
Rate for Payer: Hamaspik Choice Inc Medicare	$2,303.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,994.50

SCREW XIA 7.5X50MM

Facility

$4,606.93

Service Code	HCPCS C1713
Hospital Charge Code	64903925
Hospital Revenue Code	278
Min. Negotiated Rate	$2,303.46
Max. Negotiated Rate	$2,303.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,303.46
Rate for Payer: Hamaspik Choice Inc Medicare	$2,303.46

SCREW YUKON 14MM 03514

Facility

$4,590.00

Service Code	HCPCS C1713
Hospital Charge Code	64906723
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,819.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,524.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,754.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,295.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,639.25
Rate for Payer: EmblemHealth Commercial	$2,295.00
Rate for Payer: Fidelis Medicare Advantage	$4,819.50
Rate for Payer: Group Health Inc Commercial	$2,295.00
Rate for Payer: Group Health Inc Medicare	$1,606.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,295.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,983.50

SCREW YUKON 14MM 03514

Facility

$4,590.00

Service Code	HCPCS C1713
Hospital Charge Code	64906723
Hospital Revenue Code	278
Min. Negotiated Rate	$2,295.00
Max. Negotiated Rate	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,295.00

SCREW YUKON 3.5

Facility

$5,737.50

Service Code	HCPCS C1713
Hospital Charge Code	64907189
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,024.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,155.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,442.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,868.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,299.06
Rate for Payer: EmblemHealth Commercial	$2,868.75
Rate for Payer: Fidelis Medicare Advantage	$6,024.38
Rate for Payer: Group Health Inc Commercial	$2,868.75
Rate for Payer: Group Health Inc Medicare	$2,008.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,868.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,868.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,729.38

SCREW YUKON 3.5

Facility

$5,737.50

Service Code	HCPCS C1713
Hospital Charge Code	64907189
Hospital Revenue Code	278
Min. Negotiated Rate	$2,868.75
Max. Negotiated Rate	$2,868.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,868.75
Rate for Payer: Hamaspik Choice Inc Medicare	$2,868.75

SCREW YUKON 4.5 X 30MM

Facility

$4,590.00

Service Code	HCPCS C1713
Hospital Charge Code	64906882
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,819.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,524.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,754.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,295.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,639.25
Rate for Payer: EmblemHealth Commercial	$2,295.00
Rate for Payer: Fidelis Medicare Advantage	$4,819.50
Rate for Payer: Group Health Inc Commercial	$2,295.00
Rate for Payer: Group Health Inc Medicare	$1,606.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,295.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,983.50

SCREW YUKON 4.5 X 30MM

Facility

$4,590.00

Service Code	HCPCS C1713
Hospital Charge Code	64906882
Hospital Revenue Code	278
Min. Negotiated Rate	$2,295.00
Max. Negotiated Rate	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,295.00

SCREW YUKON 5.0 X 26

Facility

$4,590.00

Service Code	HCPCS C1713
Hospital Charge Code	64906786
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,819.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,524.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,754.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,295.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,639.25
Rate for Payer: EmblemHealth Commercial	$2,295.00
Rate for Payer: Fidelis Medicare Advantage	$4,819.50
Rate for Payer: Group Health Inc Commercial	$2,295.00
Rate for Payer: Group Health Inc Medicare	$1,606.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,295.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,983.50

SCREW YUKON 5.0 X 26

Facility

$4,590.00

Service Code	HCPCS C1713
Hospital Charge Code	64906786
Hospital Revenue Code	278
Min. Negotiated Rate	$2,295.00
Max. Negotiated Rate	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,295.00

SCREW YUKON 5.0 X 28MM

Facility

$4,590.00

Service Code	HCPCS C1713
Hospital Charge Code	64906725
Hospital Revenue Code	278
Min. Negotiated Rate	$2,295.00
Max. Negotiated Rate	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,295.00

SCREW YUKON 5.0 X 28MM

Facility

$4,590.00

Service Code	HCPCS C1713
Hospital Charge Code	64906725
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,819.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,524.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,754.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,295.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,639.25
Rate for Payer: EmblemHealth Commercial	$2,295.00
Rate for Payer: Fidelis Medicare Advantage	$4,819.50
Rate for Payer: Group Health Inc Commercial	$2,295.00
Rate for Payer: Group Health Inc Medicare	$1,606.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,295.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,983.50

SCREW YUKON 5.0 X 30MM

Facility

$4,590.00

Service Code	HCPCS C1713
Hospital Charge Code	64906726
Hospital Revenue Code	278
Min. Negotiated Rate	$2,295.00
Max. Negotiated Rate	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,295.00

SCREW YUKON 5.0 X 30MM

Facility

$4,590.00

Service Code	HCPCS C1713
Hospital Charge Code	64906726
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,819.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,524.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,754.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,295.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,639.25
Rate for Payer: EmblemHealth Commercial	$2,295.00
Rate for Payer: Fidelis Medicare Advantage	$4,819.50
Rate for Payer: Group Health Inc Commercial	$2,295.00
Rate for Payer: Group Health Inc Medicare	$1,606.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,295.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,983.50

SCRFEW STRYKER LOCKING 2.7MMX12MM

Facility

$453.00

Service Code	HCPCS C1713
Hospital Charge Code	40204484
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$475.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$249.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$271.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$226.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$260.48
Rate for Payer: EmblemHealth Commercial	$226.50
Rate for Payer: Fidelis Medicare Advantage	$475.65
Rate for Payer: Group Health Inc Commercial	$226.50
Rate for Payer: Group Health Inc Medicare	$158.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.50
Rate for Payer: Hamaspik Choice Inc Medicare	$226.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$294.45

SCRFEW STRYKER LOCKING 2.7MMX12MM

Facility

$453.00

Service Code	HCPCS C1713
Hospital Charge Code	40204484
Hospital Revenue Code	278
Min. Negotiated Rate	$226.50
Max. Negotiated Rate	$226.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.50
Rate for Payer: Hamaspik Choice Inc Medicare	$226.50

SCR MAMMO UNI INC CAD

Facility

$402.90

Service Code	HCPCS 77067 TC
Hospital Charge Code	41104719
Hospital Revenue Code	403
Min. Negotiated Rate	$78.81
Max. Negotiated Rate	$322.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$221.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$78.81
Rate for Payer: Aetna Government	$78.81
Rate for Payer: Brighton Health Commercial	$302.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$322.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$273.97
Rate for Payer: Group Health Inc Commercial	$201.45
Rate for Payer: Group Health Inc Medicare	$141.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$201.45
Rate for Payer: Hamaspik Choice Inc Medicare	$201.45
Rate for Payer: United Healthcare Commercial	$83.18

SCRN MAM PERF RSLTS DOC

Facility

$0.01

Service Code	HCPCS G9899
Hospital Charge Code	30307877
Hospital Revenue Code	510
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: United Healthcare Commercial	$222.00

SCROTAL SUPPORT

Facility

$35.79

Hospital Charge Code	40195160
Hospital Revenue Code	710
Min. Negotiated Rate	$12.53
Max. Negotiated Rate	$28.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$17.90
Rate for Payer: Aetna Government	$17.90
Rate for Payer: Brighton Health Commercial	$26.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.34
Rate for Payer: Group Health Inc Commercial	$17.90
Rate for Payer: Group Health Inc Medicare	$12.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.90
Rate for Payer: Hamaspik Choice Inc Medicare	$17.90

Know your out-of-pocket cost for care.

All Charges