St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER BLADE SCREW

Facility IP

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	40205502
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$168.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$168.70
Rate for Payer: Hamaspik Choice Inc Medicare	$168.70

STRYKER BLOCKERS

Facility IP

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	40208155
Hospital Revenue Code	278
Min. Negotiated Rate	$237.50
Max. Negotiated Rate	$237.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$237.50
Rate for Payer: Hamaspik Choice Inc Medicare	$237.50

STRYKER BLOCKERS

Facility OP

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	40208155
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$498.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$261.25
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	$237.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$273.12
Rate for Payer: Fidelis Medicare Advantage	$498.75
Rate for Payer: Group Health Inc Commercial	$237.50
Rate for Payer: Group Health Inc Medicare	$166.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$237.50
Rate for Payer: Hamaspik Choice Inc Medicare	$237.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$308.75

STRYKER BOARD COMP PLATE

Facility IP

$279.00

Service Code	HCPCS C1713
Hospital Charge Code	40203839
Hospital Revenue Code	278
Min. Negotiated Rate	$139.50
Max. Negotiated Rate	$139.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$139.50
Rate for Payer: Hamaspik Choice Inc Medicare	$139.50

STRYKER BOARD COMP PLATE

Facility OP

$279.00

Service Code	HCPCS C1713
Hospital Charge Code	40203839
Hospital Revenue Code	278
Min. Negotiated Rate	$97.65
Max. Negotiated Rate	$292.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$153.45
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	$139.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$160.42
Rate for Payer: Fidelis Medicare Advantage	$292.95
Rate for Payer: Group Health Inc Commercial	$139.50
Rate for Payer: Group Health Inc Medicare	$97.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$139.50
Rate for Payer: Hamaspik Choice Inc Medicare	$139.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$181.35

STRYKER BONE SCREW 2.3X12MM

Facility OP

$140.00

Service Code	HCPCS C1776
Hospital Charge Code	40205248
Hospital Revenue Code	278
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.00
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	$70.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$80.50
Rate for Payer: Fidelis Medicare Advantage	$147.00
Rate for Payer: Group Health Inc Commercial	$70.00
Rate for Payer: Group Health Inc Medicare	$49.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$91.00

STRYKER BONE SCREW 2.3X12MM

Facility IP

$140.00

Service Code	HCPCS C1776
Hospital Charge Code	40205248
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00

STRYKER BONE SCREW 2.3 X 14MM

Facility OP

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	40029593
Hospital Revenue Code	278
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$147.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.00
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	$70.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$80.50
Rate for Payer: Fidelis Medicare Advantage	$147.00
Rate for Payer: Group Health Inc Commercial	$70.00
Rate for Payer: Group Health Inc Medicare	$49.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$91.00

STRYKER BONE SCREW 2.3 X 14MM

Facility IP

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	40029593
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00

STRYKER BONE SCREW 2.3 X 16MM

Facility OP

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	40029594
Hospital Revenue Code	278
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$147.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.00
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	$70.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$80.50
Rate for Payer: Fidelis Medicare Advantage	$147.00
Rate for Payer: Group Health Inc Commercial	$70.00
Rate for Payer: Group Health Inc Medicare	$49.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$91.00

STRYKER BONE SCREW 2.3 X 16MM

Facility IP

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	40029594
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00

STRYKER BONE SCREW 2.3 X 26MM

Facility OP

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	40029595
Hospital Revenue Code	278
Min. Negotiated Rate	$49.00
Max. Negotiated Rate	$147.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.00
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	$70.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$80.50
Rate for Payer: Fidelis Medicare Advantage	$147.00
Rate for Payer: Group Health Inc Commercial	$70.00
Rate for Payer: Group Health Inc Medicare	$49.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$91.00

STRYKER BONE SCREW 2.3 X 26MM

Facility IP

$140.00

Service Code	HCPCS C1713
Hospital Charge Code	40029595
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.00
Rate for Payer: Hamaspik Choice Inc Medicare	$70.00

STRYKER BONE SCREW 24MM

Facility OP

$106.00

Service Code	HCPCS C1776
Hospital Charge Code	40208087
Hospital Revenue Code	278
Min. Negotiated Rate	$37.10
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$58.30
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	$53.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.95
Rate for Payer: Fidelis Medicare Advantage	$111.30
Rate for Payer: Group Health Inc Commercial	$53.00
Rate for Payer: Group Health Inc Medicare	$37.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.00
Rate for Payer: Hamaspik Choice Inc Medicare	$53.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$68.90

STRYKER BONE SCREW 24MM

Facility IP

$106.00

Service Code	HCPCS C1776
Hospital Charge Code	40208087
Hospital Revenue Code	278
Min. Negotiated Rate	$53.00
Max. Negotiated Rate	$53.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$53.00
Rate for Payer: Hamaspik Choice Inc Medicare	$53.00

STRYKER BONE SCREW 2.7

Facility OP

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	40205569
Hospital Revenue Code	278
Min. Negotiated Rate	$61.25
Max. Negotiated Rate	$183.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$96.25
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	$87.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$100.62
Rate for Payer: Fidelis Medicare Advantage	$183.75
Rate for Payer: Group Health Inc Commercial	$87.50
Rate for Payer: Group Health Inc Medicare	$61.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.50
Rate for Payer: Hamaspik Choice Inc Medicare	$87.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$113.75

STRYKER BONE SCREW 2.7

Facility IP

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	40205569
Hospital Revenue Code	278
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$87.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.50
Rate for Payer: Hamaspik Choice Inc Medicare	$87.50

STRYKER BONE SCREW 2.7X24MM

Facility OP

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	40205594
Hospital Revenue Code	278
Min. Negotiated Rate	$61.25
Max. Negotiated Rate	$183.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$96.25
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	$87.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$100.62
Rate for Payer: Fidelis Medicare Advantage	$183.75
Rate for Payer: Group Health Inc Commercial	$87.50
Rate for Payer: Group Health Inc Medicare	$61.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.50
Rate for Payer: Hamaspik Choice Inc Medicare	$87.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$113.75

STRYKER BONE SCREW 2.7X24MM

Facility IP

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	40205594
Hospital Revenue Code	278
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$87.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.50
Rate for Payer: Hamaspik Choice Inc Medicare	$87.50

STRYKER BONE SCREW 2.7X26MM

Facility OP

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	40205596
Hospital Revenue Code	278
Min. Negotiated Rate	$61.25
Max. Negotiated Rate	$183.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$96.25
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	$87.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$100.62
Rate for Payer: Fidelis Medicare Advantage	$183.75
Rate for Payer: Group Health Inc Commercial	$87.50
Rate for Payer: Group Health Inc Medicare	$61.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.50
Rate for Payer: Hamaspik Choice Inc Medicare	$87.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$113.75

STRYKER BONE SCREW 2.7X26MM

Facility IP

$175.00

Service Code	HCPCS C1713
Hospital Charge Code	40205596
Hospital Revenue Code	278
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$87.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.50
Rate for Payer: Hamaspik Choice Inc Medicare	$87.50

STRYKER BONE SCREW 3.5MM

Facility IP

$247.80

Service Code	HCPCS C1776
Hospital Charge Code	40208076
Hospital Revenue Code	278
Min. Negotiated Rate	$123.90
Max. Negotiated Rate	$123.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.90
Rate for Payer: Hamaspik Choice Inc Medicare	$123.90

STRYKER BONE SCREW 3.5MM

Facility OP

$247.80

Service Code	HCPCS C1776
Hospital Charge Code	40208076
Hospital Revenue Code	278
Min. Negotiated Rate	$86.73
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.29
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	$123.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.48
Rate for Payer: Fidelis Medicare Advantage	$260.19
Rate for Payer: Group Health Inc Commercial	$123.90
Rate for Payer: Group Health Inc Medicare	$86.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.90
Rate for Payer: Hamaspik Choice Inc Medicare	$123.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$161.07

STRYKER BONE SCREW 3.5MM X 22MM

Facility IP

$210.00

Service Code	HCPCS C1776
Hospital Charge Code	40205030
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00

STRYKER BONE SCREW 3.5MM X 22MM

Facility OP

$210.00

Service Code	HCPCS C1776
Hospital Charge Code	40205030
Hospital Revenue Code	278
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$115.50
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	$105.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$120.75
Rate for Payer: Fidelis Medicare Advantage	$220.50
Rate for Payer: Group Health Inc Commercial	$105.00
Rate for Payer: Group Health Inc Medicare	$73.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$136.50

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