St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BONE SCREW LOCKING 4.0 X 44MM

Facility

$627.50

Service Code	HCPCS C1713
Hospital Charge Code	64905446
Hospital Revenue Code	278
Min. Negotiated Rate	$313.75
Max. Negotiated Rate	$313.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$313.75
Rate for Payer: Hamaspik Choice Inc Medicare	$313.75

BONE SCREW NEURO 1.5 X 4MM

Facility

$148.25

Service Code	HCPCS C1713
Hospital Charge Code	64902869
Hospital Revenue Code	278
Min. Negotiated Rate	$74.12
Max. Negotiated Rate	$74.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.12
Rate for Payer: Hamaspik Choice Inc Medicare	$74.12

BONE SCREW NEURO 1.5 X 4MM

Facility

$148.25

Service Code	HCPCS C1713
Hospital Charge Code	64902869
Hospital Revenue Code	278
Min. Negotiated Rate	$51.89
Max. Negotiated Rate	$155.66
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$88.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$74.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.24
Rate for Payer: EmblemHealth Commercial	$74.12
Rate for Payer: Fidelis Medicare Advantage	$155.66
Rate for Payer: Group Health Inc Commercial	$74.12
Rate for Payer: Group Health Inc Medicare	$51.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.12
Rate for Payer: Hamaspik Choice Inc Medicare	$74.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.36

BONE SCREW NONLOCKING 2.3X18

Facility

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64905153
Hospital Revenue Code	278
Min. Negotiated Rate	$89.38
Max. Negotiated Rate	$89.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38

BONE SCREW NONLOCKING 2.3X18

Facility

$178.75

Service Code	HCPCS C1713
Hospital Charge Code	64905153
Hospital Revenue Code	278
Min. Negotiated Rate	$62.56
Max. Negotiated Rate	$187.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$98.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$107.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$89.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.78
Rate for Payer: EmblemHealth Commercial	$89.38
Rate for Payer: Fidelis Medicare Advantage	$187.69
Rate for Payer: Group Health Inc Commercial	$89.38
Rate for Payer: Group Health Inc Medicare	$62.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.38
Rate for Payer: Hamaspik Choice Inc Medicare	$89.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$116.19

BONE SCREW NONLOCKING 2.7 X 24

Facility

$329.38

Service Code	HCPCS C1713
Hospital Charge Code	64905290
Hospital Revenue Code	278
Min. Negotiated Rate	$115.28
Max. Negotiated Rate	$345.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$197.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$164.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$189.39
Rate for Payer: EmblemHealth Commercial	$164.69
Rate for Payer: Fidelis Medicare Advantage	$345.85
Rate for Payer: Group Health Inc Commercial	$164.69
Rate for Payer: Group Health Inc Medicare	$115.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$164.69
Rate for Payer: Hamaspik Choice Inc Medicare	$164.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$214.10

BONE SCREW NONLOCKING 2.7 X 24

Facility

$329.38

Service Code	HCPCS C1713
Hospital Charge Code	64905290
Hospital Revenue Code	278
Min. Negotiated Rate	$164.69
Max. Negotiated Rate	$164.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$164.69
Rate for Payer: Hamaspik Choice Inc Medicare	$164.69

BONE SCREW NONLOCKING 2.7X38MM

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	64905161
Hospital Revenue Code	278
Min. Negotiated Rate	$200.00
Max. Negotiated Rate	$200.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00

BONE SCREW NONLOCKING 2.7X38MM

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	64905161
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.00
Rate for Payer: EmblemHealth Commercial	$200.00
Rate for Payer: Fidelis Medicare Advantage	$420.00
Rate for Payer: Group Health Inc Commercial	$200.00
Rate for Payer: Group Health Inc Medicare	$140.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.00

BONE SCREW NONLOCKING 3.5X38 B

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	64905170
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$420.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$240.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.00
Rate for Payer: EmblemHealth Commercial	$200.00
Rate for Payer: Fidelis Medicare Advantage	$420.00
Rate for Payer: Group Health Inc Commercial	$200.00
Rate for Payer: Group Health Inc Medicare	$140.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.00

BONE SCREW NONLOCKING 3.5X38 B

Facility

$400.00

Service Code	HCPCS C1713
Hospital Charge Code	64905170
Hospital Revenue Code	278
Min. Negotiated Rate	$200.00
Max. Negotiated Rate	$200.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00

BONE SCREW NONLOCKING 3.5X46

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905172
Hospital Revenue Code	278
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$357.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$187.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$204.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$170.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: EmblemHealth Commercial	$170.00
Rate for Payer: Fidelis Medicare Advantage	$357.00
Rate for Payer: Group Health Inc Commercial	$170.00
Rate for Payer: Group Health Inc Medicare	$119.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$221.00

BONE SCREW NONLOCKING 3.5X46

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905172
Hospital Revenue Code	278
Min. Negotiated Rate	$170.00
Max. Negotiated Rate	$170.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00

BONE SCREW T10 3.5MM/L12MM

Facility

$272.00

Service Code	HCPCS C1713
Hospital Charge Code	40005854
Hospital Revenue Code	278
Min. Negotiated Rate	$136.00
Max. Negotiated Rate	$136.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00

BONE SCREW T10 3.5MM/L12MM

Facility

$272.00

Service Code	HCPCS C1713
Hospital Charge Code	40005854
Hospital Revenue Code	278
Min. Negotiated Rate	$95.20
Max. Negotiated Rate	$285.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$149.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$163.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.40
Rate for Payer: EmblemHealth Commercial	$136.00
Rate for Payer: Fidelis Medicare Advantage	$285.60
Rate for Payer: Group Health Inc Commercial	$136.00
Rate for Payer: Group Health Inc Medicare	$95.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$176.80

BONE SCREW T10 3.5MM/L16MM

Facility

$272.00

Service Code	HCPCS C1713
Hospital Charge Code	40005853
Hospital Revenue Code	278
Min. Negotiated Rate	$95.20
Max. Negotiated Rate	$285.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$149.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$163.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.40
Rate for Payer: EmblemHealth Commercial	$136.00
Rate for Payer: Fidelis Medicare Advantage	$285.60
Rate for Payer: Group Health Inc Commercial	$136.00
Rate for Payer: Group Health Inc Medicare	$95.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$176.80

BONE SCREW T10 3.5MM/L16MM

Facility

$272.00

Service Code	HCPCS C1713
Hospital Charge Code	40005853
Hospital Revenue Code	278
Min. Negotiated Rate	$136.00
Max. Negotiated Rate	$136.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00

BONE SCREW T10 FL THRD 2.7X24MML

Facility

$247.52

Service Code	HCPCS C1713
Hospital Charge Code	64906686
Hospital Revenue Code	278
Min. Negotiated Rate	$123.76
Max. Negotiated Rate	$123.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.76
Rate for Payer: Hamaspik Choice Inc Medicare	$123.76

BONE SCREW T10 FL THRD 2.7X24MML

Facility

$247.52

Service Code	HCPCS C1713
Hospital Charge Code	64906686
Hospital Revenue Code	278
Min. Negotiated Rate	$86.63
Max. Negotiated Rate	$259.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$148.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$123.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.32
Rate for Payer: EmblemHealth Commercial	$123.76
Rate for Payer: Fidelis Medicare Advantage	$259.90
Rate for Payer: Group Health Inc Commercial	$123.76
Rate for Payer: Group Health Inc Medicare	$86.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.76
Rate for Payer: Hamaspik Choice Inc Medicare	$123.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$160.89

BONE SCREW T10 FT 2.7MM / L32MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64904670
Hospital Revenue Code	278
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$357.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$187.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$204.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$170.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: EmblemHealth Commercial	$170.00
Rate for Payer: Fidelis Medicare Advantage	$357.00
Rate for Payer: Group Health Inc Commercial	$170.00
Rate for Payer: Group Health Inc Medicare	$119.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$221.00

BONE SCREW T10 FT 2.7MM / L32MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64904670
Hospital Revenue Code	278
Min. Negotiated Rate	$170.00
Max. Negotiated Rate	$170.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00

BONE SCREW T10 FT 3.5MM/L10MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905194
Hospital Revenue Code	278
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$357.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$187.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$204.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$170.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: EmblemHealth Commercial	$170.00
Rate for Payer: Fidelis Medicare Advantage	$357.00
Rate for Payer: Group Health Inc Commercial	$170.00
Rate for Payer: Group Health Inc Medicare	$119.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$221.00

BONE SCREW T10 FT 3.5MM/L10MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64905194
Hospital Revenue Code	278
Min. Negotiated Rate	$170.00
Max. Negotiated Rate	$170.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00

BONE SCREW T10 FT 3.5MM / L12MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64904663
Hospital Revenue Code	278
Min. Negotiated Rate	$119.00
Max. Negotiated Rate	$357.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$187.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$204.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$170.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: EmblemHealth Commercial	$170.00
Rate for Payer: Fidelis Medicare Advantage	$357.00
Rate for Payer: Group Health Inc Commercial	$170.00
Rate for Payer: Group Health Inc Medicare	$119.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$221.00

BONE SCREW T10 FT 3.5MM / L12MM

Facility

$340.00

Service Code	HCPCS C1713
Hospital Charge Code	64904663
Hospital Revenue Code	278
Min. Negotiated Rate	$170.00
Max. Negotiated Rate	$170.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$170.00
Rate for Payer: Hamaspik Choice Inc Medicare	$170.00

Know your out-of-pocket cost for care.

All Charges