St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER LOCKING 3.5

Facility OP

$597.80

Service Code	HCPCS C1713
Hospital Charge Code	40205366
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$627.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$328.79
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	$298.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$343.74
Rate for Payer: Fidelis Medicare Advantage	$627.69
Rate for Payer: Group Health Inc Commercial	$298.90
Rate for Payer: Group Health Inc Medicare	$209.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$298.90
Rate for Payer: Hamaspik Choice Inc Medicare	$298.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$388.57

STRYKER LOCKING 3.5

Facility IP

$597.80

Service Code	HCPCS C1713
Hospital Charge Code	40205366
Hospital Revenue Code	278
Min. Negotiated Rate	$298.90
Max. Negotiated Rate	$298.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$298.90
Rate for Payer: Hamaspik Choice Inc Medicare	$298.90

STRYKER LOCKING COMP PLATE 7 HOLE

Facility IP

$166.00

Service Code	HCPCS C1776
Hospital Charge Code	40208146
Hospital Revenue Code	278
Min. Negotiated Rate	$83.00
Max. Negotiated Rate	$83.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$83.00
Rate for Payer: Hamaspik Choice Inc Medicare	$83.00

STRYKER LOCKING COMP PLATE 7 HOLE

Facility OP

$166.00

Service Code	HCPCS C1776
Hospital Charge Code	40208146
Hospital Revenue Code	278
Min. Negotiated Rate	$58.10
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$91.30
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	$83.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$95.45
Rate for Payer: Fidelis Medicare Advantage	$174.30
Rate for Payer: Group Health Inc Commercial	$83.00
Rate for Payer: Group Health Inc Medicare	$58.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$83.00
Rate for Payer: Hamaspik Choice Inc Medicare	$83.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$107.90

STRYKER LOCKING COMP PLT 8H

Facility OP

$209.00

Service Code	HCPCS C1713
Hospital Charge Code	40205144
Hospital Revenue Code	278
Min. Negotiated Rate	$73.15
Max. Negotiated Rate	$219.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$114.95
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	$104.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$120.18
Rate for Payer: Fidelis Medicare Advantage	$219.45
Rate for Payer: Group Health Inc Commercial	$104.50
Rate for Payer: Group Health Inc Medicare	$73.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.50
Rate for Payer: Hamaspik Choice Inc Medicare	$104.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$135.85

STRYKER LOCKING COMP PLT 8H

Facility IP

$209.00

Service Code	HCPCS C1713
Hospital Charge Code	40205144
Hospital Revenue Code	278
Min. Negotiated Rate	$104.50
Max. Negotiated Rate	$104.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$104.50
Rate for Payer: Hamaspik Choice Inc Medicare	$104.50

STRYKER LOCKING INSERT 4.0

Facility OP

$63.00

Service Code	HCPCS C1776
Hospital Charge Code	40205254
Hospital Revenue Code	278
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.65
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	$31.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.22
Rate for Payer: Fidelis Medicare Advantage	$66.15
Rate for Payer: Group Health Inc Commercial	$31.50
Rate for Payer: Group Health Inc Medicare	$22.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.50
Rate for Payer: Hamaspik Choice Inc Medicare	$31.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$40.95

STRYKER LOCKING INSERT 4.0

Facility IP

$63.00

Service Code	HCPCS C1776
Hospital Charge Code	40205254
Hospital Revenue Code	278
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.50
Rate for Payer: Hamaspik Choice Inc Medicare	$31.50

STRYKER LOCKING INSERT 4.0MM L/S

Facility IP

$76.00

Service Code	HCPCS C1776
Hospital Charge Code	40208147
Hospital Revenue Code	278
Min. Negotiated Rate	$38.00
Max. Negotiated Rate	$38.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.00
Rate for Payer: Hamaspik Choice Inc Medicare	$38.00

STRYKER LOCKING INSERT 4.0MM L/S

Facility OP

$76.00

Service Code	HCPCS C1776
Hospital Charge Code	40208147
Hospital Revenue Code	278
Min. Negotiated Rate	$26.60
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.80
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	$38.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$43.70
Rate for Payer: Fidelis Medicare Advantage	$79.80
Rate for Payer: Group Health Inc Commercial	$38.00
Rate for Payer: Group Health Inc Medicare	$26.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.00
Rate for Payer: Hamaspik Choice Inc Medicare	$38.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$49.40

STRYKER LOCKING PEG 2.0MMX22

Facility OP

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	40005356
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$588.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$308.00
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	$280.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$322.00
Rate for Payer: Fidelis Medicare Advantage	$588.00
Rate for Payer: Group Health Inc Commercial	$280.00
Rate for Payer: Group Health Inc Medicare	$196.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.00
Rate for Payer: Hamaspik Choice Inc Medicare	$280.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$364.00

STRYKER LOCKING PEG 2.0MMX22

Facility IP

$560.00

Service Code	HCPCS C1713
Hospital Charge Code	40005356
Hospital Revenue Code	278
Min. Negotiated Rate	$280.00
Max. Negotiated Rate	$280.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$280.00
Rate for Payer: Hamaspik Choice Inc Medicare	$280.00

STRYKER LOCKING REC PLATE 7 HOLE

Facility IP

$1,999.20

Service Code	HCPCS C1713
Hospital Charge Code	40209940
Hospital Revenue Code	278
Min. Negotiated Rate	$999.60
Max. Negotiated Rate	$999.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$999.60
Rate for Payer: Hamaspik Choice Inc Medicare	$999.60

STRYKER LOCKING REC PLATE 7 HOLE

Facility OP

$1,999.20

Service Code	HCPCS C1713
Hospital Charge Code	40209940
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,099.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,099.56
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	$999.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,149.54
Rate for Payer: Fidelis Medicare Advantage	$2,099.16
Rate for Payer: Group Health Inc Commercial	$999.60
Rate for Payer: Group Health Inc Medicare	$699.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$999.60
Rate for Payer: Hamaspik Choice Inc Medicare	$999.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,299.48

STRYKER LOCKING SCREW

Facility IP

$160.00

Service Code	HCPCS C1713
Hospital Charge Code	40029596
Hospital Revenue Code	278
Min. Negotiated Rate	$80.00
Max. Negotiated Rate	$80.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00

STRYKER LOCKING SCREW

Facility OP

$160.00

Service Code	HCPCS C1713
Hospital Charge Code	40029596
Hospital Revenue Code	278
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.00
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	$80.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$92.00
Rate for Payer: Fidelis Medicare Advantage	$168.00
Rate for Payer: Group Health Inc Commercial	$80.00
Rate for Payer: Group Health Inc Medicare	$56.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$104.00

STRYKER LOCKING SCREW 1.7

Facility IP

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	40209612
Hospital Revenue Code	278
Min. Negotiated Rate	$114.56
Max. Negotiated Rate	$114.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56

STRYKER LOCKING SCREW 1.7

Facility OP

$229.13

Service Code	HCPCS C1713
Hospital Charge Code	40209612
Hospital Revenue Code	278
Min. Negotiated Rate	$80.20
Max. Negotiated Rate	$240.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.02
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	$114.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.75
Rate for Payer: Fidelis Medicare Advantage	$240.59
Rate for Payer: Group Health Inc Commercial	$114.56
Rate for Payer: Group Health Inc Medicare	$80.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.56
Rate for Payer: Hamaspik Choice Inc Medicare	$114.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.93

STRYKER LOCKING SCREW 2.3X12MM

Facility OP

$136.00

Service Code	HCPCS C1776
Hospital Charge Code	40205249
Hospital Revenue Code	278
Min. Negotiated Rate	$47.60
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.80
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	$68.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.20
Rate for Payer: Fidelis Medicare Advantage	$142.80
Rate for Payer: Group Health Inc Commercial	$68.00
Rate for Payer: Group Health Inc Medicare	$47.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.00
Rate for Payer: Hamaspik Choice Inc Medicare	$68.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$88.40

STRYKER LOCKING SCREW 2.3X12MM

Facility IP

$136.00

Service Code	HCPCS C1776
Hospital Charge Code	40205249
Hospital Revenue Code	278
Min. Negotiated Rate	$68.00
Max. Negotiated Rate	$68.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.00
Rate for Payer: Hamaspik Choice Inc Medicare	$68.00

STRYKER LOCKING SCREW 2.3X16MM

Facility OP

$162.40

Service Code	HCPCS C1776
Hospital Charge Code	40205250
Hospital Revenue Code	278
Min. Negotiated Rate	$56.84
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.32
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	$81.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.38
Rate for Payer: Fidelis Medicare Advantage	$170.52
Rate for Payer: Group Health Inc Commercial	$81.20
Rate for Payer: Group Health Inc Medicare	$56.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.20
Rate for Payer: Hamaspik Choice Inc Medicare	$81.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.56

STRYKER LOCKING SCREW 2.3X16MM

Facility IP

$162.40

Service Code	HCPCS C1776
Hospital Charge Code	40205250
Hospital Revenue Code	278
Min. Negotiated Rate	$81.20
Max. Negotiated Rate	$81.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.20
Rate for Payer: Hamaspik Choice Inc Medicare	$81.20

STRYKER LOCKING SCREW 2.3X18MM

Facility OP

$117.60

Service Code	HCPCS C1713
Hospital Charge Code	40205251
Hospital Revenue Code	278
Min. Negotiated Rate	$41.16
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$64.68
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	$58.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$67.62
Rate for Payer: Fidelis Medicare Advantage	$123.48
Rate for Payer: Group Health Inc Commercial	$58.80
Rate for Payer: Group Health Inc Medicare	$41.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.80
Rate for Payer: Hamaspik Choice Inc Medicare	$58.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$76.44

STRYKER LOCKING SCREW 2.3X18MM

Facility IP

$117.60

Service Code	HCPCS C1713
Hospital Charge Code	40205251
Hospital Revenue Code	278
Min. Negotiated Rate	$58.80
Max. Negotiated Rate	$58.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$58.80
Rate for Payer: Hamaspik Choice Inc Medicare	$58.80

STRYKER LOCKING SCREW 2.3X20MM

Facility IP

$124.60

Service Code	HCPCS C1776
Hospital Charge Code	40205252
Hospital Revenue Code	278
Min. Negotiated Rate	$62.30
Max. Negotiated Rate	$62.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.30
Rate for Payer: Hamaspik Choice Inc Medicare	$62.30

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