St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER 3HOLE L PROX HUMERUS PLT

Facility OP

$1,841.00

Service Code	HCPCS C1713
Hospital Charge Code	40205910
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,933.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,012.55
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	$920.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,058.58
Rate for Payer: Fidelis Medicare Advantage	$1,933.05
Rate for Payer: Group Health Inc Commercial	$920.50
Rate for Payer: Group Health Inc Medicare	$644.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$920.50
Rate for Payer: Hamaspik Choice Inc Medicare	$920.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,196.65

STRYKER 3HOLE L PROX HUMERUS PLT

Facility IP

$1,841.00

Service Code	HCPCS C1713
Hospital Charge Code	40205910
Hospital Revenue Code	278
Min. Negotiated Rate	$920.50
Max. Negotiated Rate	$920.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$920.50
Rate for Payer: Hamaspik Choice Inc Medicare	$920.50

STRYKER 3 HOLE TUBULAR PLATE

Facility OP

$81.20

Service Code	HCPCS C1713
Hospital Charge Code	40205711
Hospital Revenue Code	278
Min. Negotiated Rate	$28.42
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.66
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	$40.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.69
Rate for Payer: Fidelis Medicare Advantage	$85.26
Rate for Payer: Group Health Inc Commercial	$40.60
Rate for Payer: Group Health Inc Medicare	$28.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.60
Rate for Payer: Hamaspik Choice Inc Medicare	$40.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.78

STRYKER 3 HOLE TUBULAR PLATE

Facility IP

$81.20

Service Code	HCPCS C1713
Hospital Charge Code	40205711
Hospital Revenue Code	278
Min. Negotiated Rate	$40.60
Max. Negotiated Rate	$40.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.60
Rate for Payer: Hamaspik Choice Inc Medicare	$40.60

STRYKER 3 HUM PLATE

Facility OP

$4,605.30

Service Code	HCPCS C1713
Hospital Charge Code	40009264
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,835.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,532.92
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	$2,302.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,648.05
Rate for Payer: Fidelis Medicare Advantage	$4,835.56
Rate for Payer: Group Health Inc Commercial	$2,302.65
Rate for Payer: Group Health Inc Medicare	$1,611.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,302.65
Rate for Payer: Hamaspik Choice Inc Medicare	$2,302.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,993.44

STRYKER 3 HUM PLATE

Facility IP

$4,605.30

Service Code	HCPCS C1713
Hospital Charge Code	40009264
Hospital Revenue Code	278
Min. Negotiated Rate	$2,302.65
Max. Negotiated Rate	$2,302.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,302.65
Rate for Payer: Hamaspik Choice Inc Medicare	$2,302.65

STRYKER 3X80X10MM SLFD/STAPPING

Facility OP

$110.00

Service Code	HCPCS C1776
Hospital Charge Code	40208095
Hospital Revenue Code	278
Min. Negotiated Rate	$38.50
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$60.50
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	$55.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$63.25
Rate for Payer: Fidelis Medicare Advantage	$115.50
Rate for Payer: Group Health Inc Commercial	$55.00
Rate for Payer: Group Health Inc Medicare	$38.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.00
Rate for Payer: Hamaspik Choice Inc Medicare	$55.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$71.50

STRYKER 3X80X10MM SLFD/STAPPING

Facility IP

$110.00

Service Code	HCPCS C1776
Hospital Charge Code	40208095
Hospital Revenue Code	278
Min. Negotiated Rate	$55.00
Max. Negotiated Rate	$55.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.00
Rate for Payer: Hamaspik Choice Inc Medicare	$55.00

STRYKER 4.0X14MM L/S

Facility OP

$157.00

Service Code	HCPCS C1713
Hospital Charge Code	40205253
Hospital Revenue Code	278
Min. Negotiated Rate	$54.95
Max. Negotiated Rate	$164.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$86.35
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	$78.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$90.28
Rate for Payer: Fidelis Medicare Advantage	$164.85
Rate for Payer: Group Health Inc Commercial	$78.50
Rate for Payer: Group Health Inc Medicare	$54.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$78.50
Rate for Payer: Hamaspik Choice Inc Medicare	$78.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$102.05

STRYKER 4.0X14MM L/S

Facility IP

$157.00

Service Code	HCPCS C1713
Hospital Charge Code	40205253
Hospital Revenue Code	278
Min. Negotiated Rate	$78.50
Max. Negotiated Rate	$78.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$78.50
Rate for Payer: Hamaspik Choice Inc Medicare	$78.50

STRYKER 4.0X20 NON BIASED SCREW

Facility OP

$3,073.54

Service Code	HCPCS C1713
Hospital Charge Code	40204467
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,227.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,690.45
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	$1,536.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,767.29
Rate for Payer: Fidelis Medicare Advantage	$3,227.22
Rate for Payer: Group Health Inc Commercial	$1,536.77
Rate for Payer: Group Health Inc Medicare	$1,075.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,536.77
Rate for Payer: Hamaspik Choice Inc Medicare	$1,536.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,997.80

STRYKER 4.0X20 NON BIASED SCREW

Facility IP

$3,073.54

Service Code	HCPCS C1713
Hospital Charge Code	40204467
Hospital Revenue Code	278
Min. Negotiated Rate	$1,536.77
Max. Negotiated Rate	$1,536.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,536.77
Rate for Payer: Hamaspik Choice Inc Medicare	$1,536.77

STRYKER 4.2X340 DRILL BIT

Facility OP

$323.75

Hospital Charge Code	40205423
Hospital Revenue Code	270
Min. Negotiated Rate	$113.31
Max. Negotiated Rate	$259.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$178.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$161.88
Rate for Payer: Aetna Government	$161.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$259.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$220.15
Rate for Payer: Group Health Inc Commercial	$161.88
Rate for Payer: Group Health Inc Medicare	$113.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$161.88
Rate for Payer: Hamaspik Choice Inc Medicare	$161.88

STRYKER 4HOLE BP WITH BAR

Facility OP

$619.84

Service Code	HCPCS C1713
Hospital Charge Code	40209352
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$650.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$340.91
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	$309.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$356.41
Rate for Payer: Fidelis Medicare Advantage	$650.83
Rate for Payer: Group Health Inc Commercial	$309.92
Rate for Payer: Group Health Inc Medicare	$216.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$309.92
Rate for Payer: Hamaspik Choice Inc Medicare	$309.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$402.90

STRYKER 4HOLE BP WITH BAR

Facility IP

$619.84

Service Code	HCPCS C1713
Hospital Charge Code	40209352
Hospital Revenue Code	278
Min. Negotiated Rate	$309.92
Max. Negotiated Rate	$309.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$309.92
Rate for Payer: Hamaspik Choice Inc Medicare	$309.92

STRYKER 4 HOLE FIBULAR PLATE

Facility IP

$1,024.80

Service Code	HCPCS C1713
Hospital Charge Code	40208085
Hospital Revenue Code	278
Min. Negotiated Rate	$512.40
Max. Negotiated Rate	$512.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$512.40
Rate for Payer: Hamaspik Choice Inc Medicare	$512.40

STRYKER 4 HOLE FIBULAR PLATE

Facility OP

$1,024.80

Service Code	HCPCS C1713
Hospital Charge Code	40208085
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,076.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$563.64
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	$512.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$589.26
Rate for Payer: Fidelis Medicare Advantage	$1,076.04
Rate for Payer: Group Health Inc Commercial	$512.40
Rate for Payer: Group Health Inc Medicare	$358.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$512.40
Rate for Payer: Hamaspik Choice Inc Medicare	$512.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$666.12

STRYKER 4 HOLE PIN CLAMP

Facility IP

$710.00

Service Code	HCPCS C1776
Hospital Charge Code	40208096
Hospital Revenue Code	278
Min. Negotiated Rate	$355.00
Max. Negotiated Rate	$355.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$355.00
Rate for Payer: Hamaspik Choice Inc Medicare	$355.00

STRYKER 4 HOLE PIN CLAMP

Facility OP

$710.00

Service Code	HCPCS C1776
Hospital Charge Code	40208096
Hospital Revenue Code	278
Min. Negotiated Rate	$248.50
Max. Negotiated Rate	$745.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$390.50
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	$355.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$408.25
Rate for Payer: Fidelis Medicare Advantage	$745.50
Rate for Payer: Group Health Inc Commercial	$355.00
Rate for Payer: Group Health Inc Medicare	$248.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$355.00
Rate for Payer: Hamaspik Choice Inc Medicare	$355.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$461.50

STRYKER 4HOLE WAISTED COMP/PLATE

Facility OP

$182.00

Service Code	HCPCS C1713
Hospital Charge Code	40205671
Hospital Revenue Code	278
Min. Negotiated Rate	$63.70
Max. Negotiated Rate	$191.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$100.10
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	$91.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$104.65
Rate for Payer: Fidelis Medicare Advantage	$191.10
Rate for Payer: Group Health Inc Commercial	$91.00
Rate for Payer: Group Health Inc Medicare	$63.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$91.00
Rate for Payer: Hamaspik Choice Inc Medicare	$91.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$118.30

STRYKER 4HOLE WAISTED COMP/PLATE

Facility IP

$182.00

Service Code	HCPCS C1713
Hospital Charge Code	40205671
Hospital Revenue Code	278
Min. Negotiated Rate	$91.00
Max. Negotiated Rate	$91.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$91.00
Rate for Payer: Hamaspik Choice Inc Medicare	$91.00

STRYKER 4 H PLATE

Facility IP

$392.00

Service Code	HCPCS C1713
Hospital Charge Code	40204882
Hospital Revenue Code	278
Min. Negotiated Rate	$196.00
Max. Negotiated Rate	$196.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.00
Rate for Payer: Hamaspik Choice Inc Medicare	$196.00

STRYKER 4 H PLATE

Facility OP

$392.00

Service Code	HCPCS C1713
Hospital Charge Code	40204882
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$411.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$215.60
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	$196.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$225.40
Rate for Payer: Fidelis Medicare Advantage	$411.60
Rate for Payer: Group Health Inc Commercial	$196.00
Rate for Payer: Group Health Inc Medicare	$137.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.00
Rate for Payer: Hamaspik Choice Inc Medicare	$196.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$254.80

STRYKER 4MM 6 HOLE PLATE

Facility IP

$437.38

Service Code	HCPCS C1713
Hospital Charge Code	40204691
Hospital Revenue Code	278
Min. Negotiated Rate	$218.69
Max. Negotiated Rate	$218.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$218.69
Rate for Payer: Hamaspik Choice Inc Medicare	$218.69

STRYKER 4MM 6 HOLE PLATE

Facility OP

$437.38

Service Code	HCPCS C1713
Hospital Charge Code	40204691
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$459.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$240.56
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	$218.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$251.49
Rate for Payer: Fidelis Medicare Advantage	$459.25
Rate for Payer: Group Health Inc Commercial	$218.69
Rate for Payer: Group Health Inc Medicare	$153.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$218.69
Rate for Payer: Hamaspik Choice Inc Medicare	$218.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$284.30

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