St. Barnabas Hospital

All Charges

Charge

Type

Price

STRY 4 HL PLT LONG SPAN

Facility IP

$163.90

Service Code	HCPCS C1713
Hospital Charge Code	40204444
Hospital Revenue Code	278
Min. Negotiated Rate	$81.95
Max. Negotiated Rate	$81.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.95
Rate for Payer: Hamaspik Choice Inc Medicare	$81.95

STRY 6 HOLE PLATE

Facility OP

$2,782.00

Service Code	HCPCS C1776
Hospital Charge Code	40009287
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,921.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,530.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,391.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,599.65
Rate for Payer: Fidelis Medicare Advantage	$2,921.10
Rate for Payer: Group Health Inc Commercial	$1,391.00
Rate for Payer: Group Health Inc Medicare	$973.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,391.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,391.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,808.30

STRY 6 HOLE PLATE

Facility IP

$2,782.00

Service Code	HCPCS C1776
Hospital Charge Code	40009287
Hospital Revenue Code	278
Min. Negotiated Rate	$1,391.00
Max. Negotiated Rate	$1,391.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,391.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,391.00

STRY 6-HOLE PLATE

Facility IP

$742.32

Service Code	HCPCS C1713
Hospital Charge Code	40004608
Hospital Revenue Code	278
Min. Negotiated Rate	$371.16
Max. Negotiated Rate	$371.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$371.16
Rate for Payer: Hamaspik Choice Inc Medicare	$371.16

STRY 6-HOLE PLATE

Facility OP

$742.32

Service Code	HCPCS C1713
Hospital Charge Code	40004608
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$779.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$408.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$371.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$426.83
Rate for Payer: Fidelis Medicare Advantage	$779.44
Rate for Payer: Group Health Inc Commercial	$371.16
Rate for Payer: Group Health Inc Medicare	$259.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$371.16
Rate for Payer: Hamaspik Choice Inc Medicare	$371.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$482.51

STRY 8 HOLE MED PLATE

Facility IP

$408.80

Service Code	HCPCS C1713
Hospital Charge Code	40008287
Hospital Revenue Code	278
Min. Negotiated Rate	$204.40
Max. Negotiated Rate	$204.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.40
Rate for Payer: Hamaspik Choice Inc Medicare	$204.40

STRY 8 HOLE MED PLATE

Facility OP

$408.80

Service Code	HCPCS C1713
Hospital Charge Code	40008287
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$429.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$224.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$235.06
Rate for Payer: Fidelis Medicare Advantage	$429.24
Rate for Payer: Group Health Inc Commercial	$204.40
Rate for Payer: Group Health Inc Medicare	$143.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$204.40
Rate for Payer: Hamaspik Choice Inc Medicare	$204.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$265.72

STRY 8 HOLE MED TIBIA PLATE

Facility OP

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	40008281
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$840.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$440.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$460.00
Rate for Payer: Fidelis Medicare Advantage	$840.00
Rate for Payer: Group Health Inc Commercial	$400.00
Rate for Payer: Group Health Inc Medicare	$280.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$400.00
Rate for Payer: Hamaspik Choice Inc Medicare	$400.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$520.00

STRY 8 HOLE MED TIBIA PLATE

Facility IP

$800.00

Service Code	HCPCS C1713
Hospital Charge Code	40008281
Hospital Revenue Code	278
Min. Negotiated Rate	$400.00
Max. Negotiated Rate	$400.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$400.00
Rate for Payer: Hamaspik Choice Inc Medicare	$400.00

STRY 8-HOLE OLECRAN PLT_RT

Facility IP

$2,144.00

Service Code	HCPCS C1713
Hospital Charge Code	40004629
Hospital Revenue Code	278
Min. Negotiated Rate	$1,072.00
Max. Negotiated Rate	$1,072.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,072.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,072.00

STRY 8-HOLE OLECRAN PLT_RT

Facility OP

$2,144.00

Service Code	HCPCS C1713
Hospital Charge Code	40004629
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,251.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,179.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,072.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,232.80
Rate for Payer: Fidelis Medicare Advantage	$2,251.20
Rate for Payer: Group Health Inc Commercial	$1,072.00
Rate for Payer: Group Health Inc Medicare	$750.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,072.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,072.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,393.60

STRY 8-HOLE PLATE

Facility OP

$2,381.00

Service Code	HCPCS C1713
Hospital Charge Code	40009290
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,500.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,309.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,190.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,369.08
Rate for Payer: Fidelis Medicare Advantage	$2,500.05
Rate for Payer: Group Health Inc Commercial	$1,190.50
Rate for Payer: Group Health Inc Medicare	$833.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,190.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,190.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,547.65

STRY 8-HOLE PLATE

Facility IP

$2,381.00

Service Code	HCPCS C1713
Hospital Charge Code	40009290
Hospital Revenue Code	278
Min. Negotiated Rate	$1,190.50
Max. Negotiated Rate	$1,190.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,190.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,190.50

STRY ACCOLADE BLZF PLUS 1 SYSTE

Facility OP

$13,041.00

Service Code	HCPCS C1776
Hospital Charge Code	40009288
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$13,693.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,172.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,520.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,498.58
Rate for Payer: Fidelis Medicare Advantage	$13,693.05
Rate for Payer: Group Health Inc Commercial	$6,520.50
Rate for Payer: Group Health Inc Medicare	$4,564.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,520.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,520.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,476.65

STRY ACCOLADE BLZF PLUS 1 SYSTE

Facility IP

$13,041.00

Service Code	HCPCS C1776
Hospital Charge Code	40009288
Hospital Revenue Code	278
Min. Negotiated Rate	$6,520.50
Max. Negotiated Rate	$6,520.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,520.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,520.50

STRY A LCK SCREW 4.0X60MM

Facility OP

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40008288
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$527.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$251.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.65
Rate for Payer: Fidelis Medicare Advantage	$527.10
Rate for Payer: Group Health Inc Commercial	$251.00
Rate for Payer: Group Health Inc Medicare	$175.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$326.30

STRY A LCK SCREW 4.0X60MM

Facility IP

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40008288
Hospital Revenue Code	278
Min. Negotiated Rate	$251.00
Max. Negotiated Rate	$251.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00

STRY A LCK SCREW 4.0X65MM

Facility IP

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40008282
Hospital Revenue Code	278
Min. Negotiated Rate	$251.00
Max. Negotiated Rate	$251.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00

STRY A LCK SCREW 4.0X65MM

Facility OP

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40008282
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$527.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$251.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.65
Rate for Payer: Fidelis Medicare Advantage	$527.10
Rate for Payer: Group Health Inc Commercial	$251.00
Rate for Payer: Group Health Inc Medicare	$175.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$326.30

STRY ANCHOR C 9X12X144

Facility IP

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	64906951
Hospital Revenue Code	278
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$5,625.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,625.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,625.00

STRY ANCHOR C 9X12X144

Facility OP

$11,250.00

Service Code	HCPCS C1713
Hospital Charge Code	64906951
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$11,812.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,187.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,625.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,468.75
Rate for Payer: Fidelis Medicare Advantage	$11,812.50
Rate for Payer: Group Health Inc Commercial	$5,625.00
Rate for Payer: Group Health Inc Medicare	$3,937.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,625.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,625.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,312.50

STRY A NON LCK SCREW 3.5X34MM

Facility OP

$80.00

Service Code	HCPCS C1713
Hospital Charge Code	40008283
Hospital Revenue Code	278
Min. Negotiated Rate	$28.00
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$40.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.00
Rate for Payer: Fidelis Medicare Advantage	$84.00
Rate for Payer: Group Health Inc Commercial	$40.00
Rate for Payer: Group Health Inc Medicare	$28.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.00

STRY A NON LCK SCREW 3.5X34MM

Facility IP

$80.00

Service Code	HCPCS C1713
Hospital Charge Code	40008283
Hospital Revenue Code	278
Min. Negotiated Rate	$40.00
Max. Negotiated Rate	$40.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.00
Rate for Payer: Hamaspik Choice Inc Medicare	$40.00

STRY APEX PIN 6 X 180 MM

Facility IP

$279.50

Service Code	HCPCS C1713
Hospital Charge Code	40203452
Hospital Revenue Code	278
Min. Negotiated Rate	$139.75
Max. Negotiated Rate	$139.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$139.75
Rate for Payer: Hamaspik Choice Inc Medicare	$139.75

STRY APEX PIN 6 X 180 MM

Facility OP

$279.50

Service Code	HCPCS C1713
Hospital Charge Code	40203452
Hospital Revenue Code	278
Min. Negotiated Rate	$97.82
Max. Negotiated Rate	$293.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$153.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$139.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$160.71
Rate for Payer: Fidelis Medicare Advantage	$293.48
Rate for Payer: Group Health Inc Commercial	$139.75
Rate for Payer: Group Health Inc Medicare	$97.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$139.75
Rate for Payer: Hamaspik Choice Inc Medicare	$139.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$181.68

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