St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER K-WIRES 2.0X150MM

Facility IP

$14.00

Service Code	HCPCS C1769
Hospital Charge Code	40205277
Hospital Revenue Code	278
Min. Negotiated Rate	$7.00
Max. Negotiated Rate	$7.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.00
Rate for Payer: Hamaspik Choice Inc Medicare	$7.00

STRYKER LAG 6.5 X 75MM

Facility IP

$444.60

Service Code	HCPCS C1713
Hospital Charge Code	40204662
Hospital Revenue Code	278
Min. Negotiated Rate	$222.30
Max. Negotiated Rate	$222.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$222.30
Rate for Payer: Hamaspik Choice Inc Medicare	$222.30

STRYKER LAG 6.5 X 75MM

Facility OP

$444.60

Service Code	HCPCS C1713
Hospital Charge Code	40204662
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$466.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$244.53
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	$222.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$255.64
Rate for Payer: Fidelis Medicare Advantage	$466.83
Rate for Payer: Group Health Inc Commercial	$222.30
Rate for Payer: Group Health Inc Medicare	$155.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$222.30
Rate for Payer: Hamaspik Choice Inc Medicare	$222.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$288.99

STRYKER LCKNG CMP PLT 10H/L 136MM

Facility IP

$195.00

Service Code	HCPCS C1776
Hospital Charge Code	40205245
Hospital Revenue Code	278
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.50
Rate for Payer: Hamaspik Choice Inc Medicare	$97.50

STRYKER LCKNG CMP PLT 10H/L 136MM

Facility OP

$195.00

Service Code	HCPCS C1776
Hospital Charge Code	40205245
Hospital Revenue Code	278
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.25
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	$97.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.12
Rate for Payer: Fidelis Medicare Advantage	$204.75
Rate for Payer: Group Health Inc Commercial	$97.50
Rate for Payer: Group Health Inc Medicare	$68.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.50
Rate for Payer: Hamaspik Choice Inc Medicare	$97.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$126.75

STRYKER LCKNG RECON PLT 8H/L144MM

Facility OP

$594.00

Service Code	HCPCS C1713
Hospital Charge Code	40205448
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$623.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$326.70
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	$297.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$341.55
Rate for Payer: Fidelis Medicare Advantage	$623.70
Rate for Payer: Group Health Inc Commercial	$297.00
Rate for Payer: Group Health Inc Medicare	$207.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$297.00
Rate for Payer: Hamaspik Choice Inc Medicare	$297.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$386.10

STRYKER LCKNG RECON PLT 8H/L144MM

Facility IP

$594.00

Service Code	HCPCS C1713
Hospital Charge Code	40205448
Hospital Revenue Code	278
Min. Negotiated Rate	$297.00
Max. Negotiated Rate	$297.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$297.00
Rate for Payer: Hamaspik Choice Inc Medicare	$297.00

STRYKER LCKNG SCRW FT 5X40MM

Facility IP

$266.00

Service Code	HCPCS C1776
Hospital Charge Code	40208104
Hospital Revenue Code	278
Min. Negotiated Rate	$133.00
Max. Negotiated Rate	$133.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.00
Rate for Payer: Hamaspik Choice Inc Medicare	$133.00

STRYKER LCKNG SCRW FT 5X40MM

Facility OP

$266.00

Service Code	HCPCS C1776
Hospital Charge Code	40208104
Hospital Revenue Code	278
Min. Negotiated Rate	$93.10
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$146.30
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	$133.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$152.95
Rate for Payer: Fidelis Medicare Advantage	$279.30
Rate for Payer: Group Health Inc Commercial	$133.00
Rate for Payer: Group Health Inc Medicare	$93.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$133.00
Rate for Payer: Hamaspik Choice Inc Medicare	$133.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$172.90

STRYKER LCKNG SCRW FT 5X60MM

Facility OP

$317.80

Service Code	HCPCS C1776
Hospital Charge Code	40208169
Hospital Revenue Code	278
Min. Negotiated Rate	$111.23
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$174.79
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	$158.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.74
Rate for Payer: Fidelis Medicare Advantage	$333.69
Rate for Payer: Group Health Inc Commercial	$158.90
Rate for Payer: Group Health Inc Medicare	$111.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.90
Rate for Payer: Hamaspik Choice Inc Medicare	$158.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$206.57

STRYKER LCKNG SCRW FT 5X60MM

Facility IP

$317.80

Service Code	HCPCS C1776
Hospital Charge Code	40208169
Hospital Revenue Code	278
Min. Negotiated Rate	$158.90
Max. Negotiated Rate	$158.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.90
Rate for Payer: Hamaspik Choice Inc Medicare	$158.90

STRYKER LCK PLT PROX LAT TIB 2H L

Facility OP

$1,458.00

Service Code	HCPCS C1776
Hospital Charge Code	40205134
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,530.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$801.90
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	$729.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$838.35
Rate for Payer: Fidelis Medicare Advantage	$1,530.90
Rate for Payer: Group Health Inc Commercial	$729.00
Rate for Payer: Group Health Inc Medicare	$510.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$729.00
Rate for Payer: Hamaspik Choice Inc Medicare	$729.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$947.70

STRYKER LCK PLT PROX LAT TIB 2H L

Facility IP

$1,458.00

Service Code	HCPCS C1776
Hospital Charge Code	40205134
Hospital Revenue Code	278
Min. Negotiated Rate	$729.00
Max. Negotiated Rate	$729.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$729.00
Rate for Payer: Hamaspik Choice Inc Medicare	$729.00

STRYKER LCK RECON PLT 10 H/144MM

Facility OP

$671.00

Service Code	HCPCS C1713
Hospital Charge Code	40205736
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$704.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$369.05
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	$335.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$385.82
Rate for Payer: Fidelis Medicare Advantage	$704.55
Rate for Payer: Group Health Inc Commercial	$335.50
Rate for Payer: Group Health Inc Medicare	$234.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$335.50
Rate for Payer: Hamaspik Choice Inc Medicare	$335.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$436.15

STRYKER LCK RECON PLT 10 H/144MM

Facility IP

$671.00

Service Code	HCPCS C1713
Hospital Charge Code	40205736
Hospital Revenue Code	278
Min. Negotiated Rate	$335.50
Max. Negotiated Rate	$335.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$335.50
Rate for Payer: Hamaspik Choice Inc Medicare	$335.50

STRYKER LEIBINGER M/F 1.5 SCREW

Facility OP

$162.00

Service Code	HCPCS C1713
Hospital Charge Code	40207038
Hospital Revenue Code	278
Min. Negotiated Rate	$56.70
Max. Negotiated Rate	$170.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.10
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	$81.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.15
Rate for Payer: Fidelis Medicare Advantage	$170.10
Rate for Payer: Group Health Inc Commercial	$81.00
Rate for Payer: Group Health Inc Medicare	$56.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.00
Rate for Payer: Hamaspik Choice Inc Medicare	$81.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.30

STRYKER LEIBINGER M/F 1.5 SCREW

Facility IP

$162.00

Service Code	HCPCS C1713
Hospital Charge Code	40207038
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$81.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.00
Rate for Payer: Hamaspik Choice Inc Medicare	$81.00

STRYKER LFIT V40 FEM/HEAD 28MM

Facility IP

$2,272.00

Service Code	HCPCS C1776
Hospital Charge Code	40205903
Hospital Revenue Code	278
Min. Negotiated Rate	$1,136.00
Max. Negotiated Rate	$1,136.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,136.00

STRYKER LFIT V40 FEM/HEAD 28MM

Facility OP

$2,272.00

Service Code	HCPCS C1776
Hospital Charge Code	40205903
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,385.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,249.60
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	$1,136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,306.40
Rate for Payer: Fidelis Medicare Advantage	$2,385.60
Rate for Payer: Group Health Inc Commercial	$1,136.00
Rate for Payer: Group Health Inc Medicare	$795.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,136.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,476.80

STRYKER LOCK 2.4MMX22MM 656022

Facility OP

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	40005351
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$567.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$297.00
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	$270.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$310.50
Rate for Payer: Fidelis Medicare Advantage	$567.00
Rate for Payer: Group Health Inc Commercial	$270.00
Rate for Payer: Group Health Inc Medicare	$189.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$270.00
Rate for Payer: Hamaspik Choice Inc Medicare	$270.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$351.00

STRYKER LOCK 2.4MMX22MM 656022

Facility IP

$540.00

Service Code	HCPCS C1713
Hospital Charge Code	40005351
Hospital Revenue Code	278
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$270.00
Rate for Payer: Hamaspik Choice Inc Medicare	$270.00

STRYKER LOCKIG SCREW, FT 5X

Facility IP

$351.40

Service Code	HCPCS C1776
Hospital Charge Code	40208135
Hospital Revenue Code	278
Min. Negotiated Rate	$175.70
Max. Negotiated Rate	$175.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$175.70
Rate for Payer: Hamaspik Choice Inc Medicare	$175.70

STRYKER LOCKIG SCREW, FT 5X

Facility OP

$351.40

Service Code	HCPCS C1776
Hospital Charge Code	40208135
Hospital Revenue Code	278
Min. Negotiated Rate	$122.99
Max. Negotiated Rate	$368.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$193.27
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	$175.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$202.06
Rate for Payer: Fidelis Medicare Advantage	$368.97
Rate for Payer: Group Health Inc Commercial	$175.70
Rate for Payer: Group Health Inc Medicare	$122.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$175.70
Rate for Payer: Hamaspik Choice Inc Medicare	$175.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$228.41

STRYKER LOCKING 2.4MMX20MM 656020

Facility OP

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	40005355
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$546.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$286.00
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	$260.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.00
Rate for Payer: Fidelis Medicare Advantage	$546.00
Rate for Payer: Group Health Inc Commercial	$260.00
Rate for Payer: Group Health Inc Medicare	$182.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$260.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$338.00

STRYKER LOCKING 2.4MMX20MM 656020

Facility IP

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	40005355
Hospital Revenue Code	278
Min. Negotiated Rate	$260.00
Max. Negotiated Rate	$260.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$260.00

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