St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER 135 DEGREE, 3 HOLE PLATE

Facility IP

$411.48

Service Code	HCPCS C1713
Hospital Charge Code	40201545
Hospital Revenue Code	278
Min. Negotiated Rate	$205.74
Max. Negotiated Rate	$205.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$205.74
Rate for Payer: Hamaspik Choice Inc Medicare	$205.74

STRYKER 135 DEGREE, 3 HOLE PLATE

Facility OP

$411.48

Service Code	HCPCS C1713
Hospital Charge Code	40201545
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$432.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$226.31
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	$205.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$236.60
Rate for Payer: Fidelis Medicare Advantage	$432.05
Rate for Payer: Group Health Inc Commercial	$205.74
Rate for Payer: Group Health Inc Medicare	$144.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$205.74
Rate for Payer: Hamaspik Choice Inc Medicare	$205.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$267.46

STRYKER 13MM STEM PLUS HIP

Facility IP

$12,208.00

Service Code	HCPCS C1776
Hospital Charge Code	40029621
Hospital Revenue Code	278
Min. Negotiated Rate	$6,104.00
Max. Negotiated Rate	$6,104.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,104.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,104.00

STRYKER 13MM STEM PLUS HIP

Facility OP

$12,208.00

Service Code	HCPCS C1776
Hospital Charge Code	40029621
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$12,818.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,714.40
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	$6,104.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,019.60
Rate for Payer: Fidelis Medicare Advantage	$12,818.40
Rate for Payer: Group Health Inc Commercial	$6,104.00
Rate for Payer: Group Health Inc Medicare	$4,272.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,104.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,104.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,935.20

STRYKER 1/3 TUB PL W/C 2 H L90MM

Facility OP

$88.20

Service Code	HCPCS C1713
Hospital Charge Code	40205548
Hospital Revenue Code	278
Min. Negotiated Rate	$30.87
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.51
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	$44.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$50.72
Rate for Payer: Fidelis Medicare Advantage	$92.61
Rate for Payer: Group Health Inc Commercial	$44.10
Rate for Payer: Group Health Inc Medicare	$30.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.10
Rate for Payer: Hamaspik Choice Inc Medicare	$44.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$57.33

STRYKER 1/3 TUB PL W/C 2 H L90MM

Facility IP

$88.20

Service Code	HCPCS C1713
Hospital Charge Code	40205548
Hospital Revenue Code	278
Min. Negotiated Rate	$44.10
Max. Negotiated Rate	$44.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$44.10
Rate for Payer: Hamaspik Choice Inc Medicare	$44.10

STRYKER 1.4 DRILL

Facility OP

$845.00

Hospital Charge Code	40204486
Hospital Revenue Code	272
Min. Negotiated Rate	$295.75
Max. Negotiated Rate	$676.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$464.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$422.50
Rate for Payer: Aetna Government	$422.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$676.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$574.60
Rate for Payer: Group Health Inc Commercial	$422.50
Rate for Payer: Group Health Inc Medicare	$295.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$422.50
Rate for Payer: Hamaspik Choice Inc Medicare	$422.50

STRYKER 1.4 K-WIRE FIXATION

Facility OP

$240.00

Hospital Charge Code	40204470
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$192.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$120.00
Rate for Payer: Aetna Government	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$192.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.20
Rate for Payer: Group Health Inc Commercial	$120.00
Rate for Payer: Group Health Inc Medicare	$84.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.00
Rate for Payer: Hamaspik Choice Inc Medicare	$120.00

STRYKER 1.4 K-WIRE FX

Facility OP

$466.00

Hospital Charge Code	40203449
Hospital Revenue Code	272
Min. Negotiated Rate	$163.10
Max. Negotiated Rate	$372.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$256.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$233.00
Rate for Payer: Aetna Government	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$372.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$316.88
Rate for Payer: Group Health Inc Commercial	$233.00
Rate for Payer: Group Health Inc Medicare	$163.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$233.00
Rate for Payer: Hamaspik Choice Inc Medicare	$233.00

STRYKER 14MM VAR RESCUE

Facility OP

$1,175.46

Service Code	HCPCS C1713
Hospital Charge Code	40009295
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,234.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$646.50
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	$587.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$675.89
Rate for Payer: Fidelis Medicare Advantage	$1,234.23
Rate for Payer: Group Health Inc Commercial	$587.73
Rate for Payer: Group Health Inc Medicare	$411.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$587.73
Rate for Payer: Hamaspik Choice Inc Medicare	$587.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$764.05

STRYKER 14MM VAR RESCUE

Facility IP

$1,175.46

Service Code	HCPCS C1713
Hospital Charge Code	40009295
Hospital Revenue Code	278
Min. Negotiated Rate	$587.73
Max. Negotiated Rate	$587.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$587.73
Rate for Payer: Hamaspik Choice Inc Medicare	$587.73

STRYKER 1.5MM 4 HOLE PLATE

Facility OP

$1,222.84

Service Code	HCPCS C1713
Hospital Charge Code	40203413
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,283.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$672.56
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	$611.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$703.13
Rate for Payer: Fidelis Medicare Advantage	$1,283.98
Rate for Payer: Group Health Inc Commercial	$611.42
Rate for Payer: Group Health Inc Medicare	$427.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$611.42
Rate for Payer: Hamaspik Choice Inc Medicare	$611.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$794.85

STRYKER 1.5MM 4 HOLE PLATE

Facility IP

$1,222.84

Service Code	HCPCS C1713
Hospital Charge Code	40203413
Hospital Revenue Code	278
Min. Negotiated Rate	$611.42
Max. Negotiated Rate	$611.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$611.42
Rate for Payer: Hamaspik Choice Inc Medicare	$611.42

STRYKER 15 X 460

Facility OP

$3,803.80

Service Code	HCPCS C1713
Hospital Charge Code	40009747
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,993.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,092.09
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	$1,901.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,187.18
Rate for Payer: Fidelis Medicare Advantage	$3,993.99
Rate for Payer: Group Health Inc Commercial	$1,901.90
Rate for Payer: Group Health Inc Medicare	$1,331.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,901.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,901.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,472.47

STRYKER 15 X 460

Facility IP

$3,803.80

Service Code	HCPCS C1713
Hospital Charge Code	40009747
Hospital Revenue Code	278
Min. Negotiated Rate	$1,901.90
Max. Negotiated Rate	$1,901.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,901.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,901.90

STRYKER 1.5 X 5 MM SCREW

Facility OP

$164.00

Service Code	HCPCS C1713
Hospital Charge Code	40001787
Hospital Revenue Code	278
Min. Negotiated Rate	$57.40
Max. Negotiated Rate	$172.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$90.20
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	$82.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$94.30
Rate for Payer: Fidelis Medicare Advantage	$172.20
Rate for Payer: Group Health Inc Commercial	$82.00
Rate for Payer: Group Health Inc Medicare	$57.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.00
Rate for Payer: Hamaspik Choice Inc Medicare	$82.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$106.60

STRYKER 1.5 X 5 MM SCREW

Facility IP

$164.00

Service Code	HCPCS C1713
Hospital Charge Code	40001787
Hospital Revenue Code	278
Min. Negotiated Rate	$82.00
Max. Negotiated Rate	$82.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.00
Rate for Payer: Hamaspik Choice Inc Medicare	$82.00

STRYKER 16 H PLATE

Facility IP

$773.00

Service Code	HCPCS C1713
Hospital Charge Code	40204881
Hospital Revenue Code	278
Min. Negotiated Rate	$386.50
Max. Negotiated Rate	$386.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$386.50
Rate for Payer: Hamaspik Choice Inc Medicare	$386.50

STRYKER 16 H PLATE

Facility OP

$773.00

Service Code	HCPCS C1713
Hospital Charge Code	40204881
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$811.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$425.15
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	$386.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$444.48
Rate for Payer: Fidelis Medicare Advantage	$811.65
Rate for Payer: Group Health Inc Commercial	$386.50
Rate for Payer: Group Health Inc Medicare	$270.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$386.50
Rate for Payer: Hamaspik Choice Inc Medicare	$386.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$502.45

STRYKER 1.6X35MM DRILL BIT

Facility IP

$109.41

Service Code	HCPCS C1713
Hospital Charge Code	40201553
Hospital Revenue Code	278
Min. Negotiated Rate	$54.70
Max. Negotiated Rate	$54.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.70
Rate for Payer: Hamaspik Choice Inc Medicare	$54.70

STRYKER 1.6X35MM DRILL BIT

Facility OP

$109.41

Service Code	HCPCS C1713
Hospital Charge Code	40201553
Hospital Revenue Code	278
Min. Negotiated Rate	$38.29
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$60.18
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	$54.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$62.91
Rate for Payer: Fidelis Medicare Advantage	$114.88
Rate for Payer: Group Health Inc Commercial	$54.70
Rate for Payer: Group Health Inc Medicare	$38.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.70
Rate for Payer: Hamaspik Choice Inc Medicare	$54.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$71.12

STRYKER 1.6X5MM DRILL BIT

Facility IP

$96.94

Service Code	HCPCS C1713
Hospital Charge Code	40201640
Hospital Revenue Code	278
Min. Negotiated Rate	$48.47
Max. Negotiated Rate	$48.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.47
Rate for Payer: Hamaspik Choice Inc Medicare	$48.47

STRYKER 1.6X5MM DRILL BIT

Facility OP

$96.94

Service Code	HCPCS C1713
Hospital Charge Code	40201640
Hospital Revenue Code	278
Min. Negotiated Rate	$33.93
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.32
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	$48.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$55.74
Rate for Payer: Fidelis Medicare Advantage	$101.79
Rate for Payer: Group Health Inc Commercial	$48.47
Rate for Payer: Group Health Inc Medicare	$33.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.47
Rate for Payer: Hamaspik Choice Inc Medicare	$48.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$63.01

STRYKER 180MM RING

Facility IP

$1,111.60

Service Code	HCPCS C1713
Hospital Charge Code	40205936
Hospital Revenue Code	278
Min. Negotiated Rate	$555.80
Max. Negotiated Rate	$555.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$555.80
Rate for Payer: Hamaspik Choice Inc Medicare	$555.80

STRYKER 180MM RING

Facility OP

$1,111.60

Service Code	HCPCS C1713
Hospital Charge Code	40205936
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,167.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$611.38
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	$555.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$639.17
Rate for Payer: Fidelis Medicare Advantage	$1,167.18
Rate for Payer: Group Health Inc Commercial	$555.80
Rate for Payer: Group Health Inc Medicare	$389.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$555.80
Rate for Payer: Hamaspik Choice Inc Medicare	$555.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$722.54

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