St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER BONE SCREW 3.5MMX24MM

Facility IP

$105.00

Service Code	HCPCS C1713
Hospital Charge Code	40205521
Hospital Revenue Code	278
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.50
Rate for Payer: Hamaspik Choice Inc Medicare	$52.50

STRYKER BONE SCREW 3.5MMX24MM

Facility OP

$105.00

Service Code	HCPCS C1713
Hospital Charge Code	40205521
Hospital Revenue Code	278
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.75
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	$52.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.38
Rate for Payer: Fidelis Medicare Advantage	$110.25
Rate for Payer: Group Health Inc Commercial	$52.50
Rate for Payer: Group Health Inc Medicare	$36.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.50
Rate for Payer: Hamaspik Choice Inc Medicare	$52.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$68.25

STRYKER BONE SCREW 3.5MMX30MM

Facility OP

$109.20

Service Code	HCPCS C1713
Hospital Charge Code	40205473
Hospital Revenue Code	278
Min. Negotiated Rate	$38.22
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$60.06
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	$54.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$62.79
Rate for Payer: Fidelis Medicare Advantage	$114.66
Rate for Payer: Group Health Inc Commercial	$54.60
Rate for Payer: Group Health Inc Medicare	$38.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.60
Rate for Payer: Hamaspik Choice Inc Medicare	$54.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.98

STRYKER BONE SCREW 3.5MMX30MM

Facility IP

$109.20

Service Code	HCPCS C1713
Hospital Charge Code	40205473
Hospital Revenue Code	278
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.60
Rate for Payer: Hamaspik Choice Inc Medicare	$54.60

STRYKER BONE SCREW 3.5MM X 40MM

Facility IP

$114.80

Service Code	HCPCS C1713
Hospital Charge Code	40205474
Hospital Revenue Code	278
Min. Negotiated Rate	$57.40
Max. Negotiated Rate	$57.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.40
Rate for Payer: Hamaspik Choice Inc Medicare	$57.40

STRYKER BONE SCREW 3.5MM X 40MM

Facility OP

$114.80

Service Code	HCPCS C1713
Hospital Charge Code	40205474
Hospital Revenue Code	278
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.14
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	$57.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.01
Rate for Payer: Fidelis Medicare Advantage	$120.54
Rate for Payer: Group Health Inc Commercial	$57.40
Rate for Payer: Group Health Inc Medicare	$40.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.40
Rate for Payer: Hamaspik Choice Inc Medicare	$57.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$74.62

STRYKER BONE SCREW3.5X14MM

Facility IP

$114.80

Service Code	HCPCS C1713
Hospital Charge Code	40205520
Hospital Revenue Code	278
Min. Negotiated Rate	$57.40
Max. Negotiated Rate	$57.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.40
Rate for Payer: Hamaspik Choice Inc Medicare	$57.40

STRYKER BONE SCREW3.5X14MM

Facility OP

$114.80

Service Code	HCPCS C1713
Hospital Charge Code	40205520
Hospital Revenue Code	278
Min. Negotiated Rate	$40.18
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.14
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	$57.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$66.01
Rate for Payer: Fidelis Medicare Advantage	$120.54
Rate for Payer: Group Health Inc Commercial	$57.40
Rate for Payer: Group Health Inc Medicare	$40.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.40
Rate for Payer: Hamaspik Choice Inc Medicare	$57.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$74.62

STRYKER BONE SCREW 3.5X20MM

Facility OP

$200.00

Service Code	HCPCS C1713
Hospital Charge Code	40205333
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$210.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
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	$100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.00
Rate for Payer: Fidelis Medicare Advantage	$210.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$130.00

STRYKER BONE SCREW 3.5X20MM

Facility IP

$200.00

Service Code	HCPCS C1713
Hospital Charge Code	40205333
Hospital Revenue Code	278
Min. Negotiated Rate	$100.00
Max. Negotiated Rate	$100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

STRYKER BONE SCREW 3.5X46MM

Facility OP

$260.40

Service Code	HCPCS C1713
Hospital Charge Code	40205777
Hospital Revenue Code	278
Min. Negotiated Rate	$91.14
Max. Negotiated Rate	$273.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$143.22
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	$130.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$149.73
Rate for Payer: Fidelis Medicare Advantage	$273.42
Rate for Payer: Group Health Inc Commercial	$130.20
Rate for Payer: Group Health Inc Medicare	$91.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.20
Rate for Payer: Hamaspik Choice Inc Medicare	$130.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$169.26

STRYKER BONE SCREW 3.5X46MM

Facility IP

$260.40

Service Code	HCPCS C1713
Hospital Charge Code	40205777
Hospital Revenue Code	278
Min. Negotiated Rate	$130.20
Max. Negotiated Rate	$130.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$130.20
Rate for Payer: Hamaspik Choice Inc Medicare	$130.20

STRYKER BONE SCREW 3.5X8

Facility IP

$431.90

Service Code	HCPCS C1713
Hospital Charge Code	40204461
Hospital Revenue Code	278
Min. Negotiated Rate	$215.95
Max. Negotiated Rate	$215.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$215.95
Rate for Payer: Hamaspik Choice Inc Medicare	$215.95

STRYKER BONE SCREW 3.5X8

Facility OP

$431.90

Service Code	HCPCS C1713
Hospital Charge Code	40204461
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$453.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$237.54
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	$215.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$248.34
Rate for Payer: Fidelis Medicare Advantage	$453.50
Rate for Payer: Group Health Inc Commercial	$215.95
Rate for Payer: Group Health Inc Medicare	$151.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$215.95
Rate for Payer: Hamaspik Choice Inc Medicare	$215.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$280.74

STRYKER BONE SCREW 4.0X8

Facility IP

$474.28

Service Code	HCPCS C1713
Hospital Charge Code	40204462
Hospital Revenue Code	278
Min. Negotiated Rate	$237.14
Max. Negotiated Rate	$237.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$237.14
Rate for Payer: Hamaspik Choice Inc Medicare	$237.14

STRYKER BONE SCREW 4.0X8

Facility OP

$474.28

Service Code	HCPCS C1713
Hospital Charge Code	40204462
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$497.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$260.85
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	$237.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$272.71
Rate for Payer: Fidelis Medicare Advantage	$497.99
Rate for Payer: Group Health Inc Commercial	$237.14
Rate for Payer: Group Health Inc Medicare	$166.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$237.14
Rate for Payer: Hamaspik Choice Inc Medicare	$237.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$308.28

STRYKER CANCELLOUS 4.0X50MM

Facility OP

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	40209983
Hospital Revenue Code	278
Min. Negotiated Rate	$12.25
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.25
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	$17.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.12
Rate for Payer: Fidelis Medicare Advantage	$36.75
Rate for Payer: Group Health Inc Commercial	$17.50
Rate for Payer: Group Health Inc Medicare	$12.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.75

STRYKER CANCELLOUS 4.0X50MM

Facility IP

$35.00

Service Code	HCPCS C1713
Hospital Charge Code	40209983
Hospital Revenue Code	278
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50

STRYKER CANN SCR 2.0X10MM

Facility OP

$180.00

Service Code	HCPCS C1713
Hospital Charge Code	40207453
Hospital Revenue Code	278
Min. Negotiated Rate	$63.00
Max. Negotiated Rate	$189.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$99.00
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	$90.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$103.50
Rate for Payer: Fidelis Medicare Advantage	$189.00
Rate for Payer: Group Health Inc Commercial	$90.00
Rate for Payer: Group Health Inc Medicare	$63.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.00
Rate for Payer: Hamaspik Choice Inc Medicare	$90.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$117.00

STRYKER CANN SCR 2.0X10MM

Facility IP

$180.00

Service Code	HCPCS C1713
Hospital Charge Code	40207453
Hospital Revenue Code	278
Min. Negotiated Rate	$90.00
Max. Negotiated Rate	$90.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$90.00
Rate for Payer: Hamaspik Choice Inc Medicare	$90.00

STRYKER CANN.SCREW 3.0X36

Facility IP

$366.80

Service Code	HCPCS C1713
Hospital Charge Code	40205584
Hospital Revenue Code	278
Min. Negotiated Rate	$183.40
Max. Negotiated Rate	$183.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$183.40
Rate for Payer: Hamaspik Choice Inc Medicare	$183.40

STRYKER CANN.SCREW 3.0X36

Facility OP

$366.80

Service Code	HCPCS C1713
Hospital Charge Code	40205584
Hospital Revenue Code	278
Min. Negotiated Rate	$128.38
Max. Negotiated Rate	$385.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$201.74
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	$183.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$210.91
Rate for Payer: Fidelis Medicare Advantage	$385.14
Rate for Payer: Group Health Inc Commercial	$183.40
Rate for Payer: Group Health Inc Medicare	$128.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$183.40
Rate for Payer: Hamaspik Choice Inc Medicare	$183.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$238.42

STRYKER CANN. SCREW 3.2

Facility OP

$714.00

Service Code	HCPCS C1713
Hospital Charge Code	40205373
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$749.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$392.70
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	$357.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$410.55
Rate for Payer: Fidelis Medicare Advantage	$749.70
Rate for Payer: Group Health Inc Commercial	$357.00
Rate for Payer: Group Health Inc Medicare	$249.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$357.00
Rate for Payer: Hamaspik Choice Inc Medicare	$357.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$464.10

STRYKER CANN. SCREW 3.2

Facility IP

$714.00

Service Code	HCPCS C1713
Hospital Charge Code	40205373
Hospital Revenue Code	278
Min. Negotiated Rate	$357.00
Max. Negotiated Rate	$357.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$357.00
Rate for Payer: Hamaspik Choice Inc Medicare	$357.00

STRYKER CANN SCREW 3.2X30MM

Facility OP

$606.20

Service Code	HCPCS C1713
Hospital Charge Code	40205403
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$636.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$333.41
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	$303.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$348.56
Rate for Payer: Fidelis Medicare Advantage	$636.51
Rate for Payer: Group Health Inc Commercial	$303.10
Rate for Payer: Group Health Inc Medicare	$212.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$303.10
Rate for Payer: Hamaspik Choice Inc Medicare	$303.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$394.03

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