St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER ORTHO PLATE PUBIC 4H

Facility OP

$822.00

Service Code	HCPCS C1713
Hospital Charge Code	40205339
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$863.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$452.10
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	$411.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$472.65
Rate for Payer: Fidelis Medicare Advantage	$863.10
Rate for Payer: Group Health Inc Commercial	$411.00
Rate for Payer: Group Health Inc Medicare	$287.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.00
Rate for Payer: Hamaspik Choice Inc Medicare	$411.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$534.30

STRYKER ORTHO PLATE PUBIC 4H

Facility IP

$822.00

Service Code	HCPCS C1713
Hospital Charge Code	40205339
Hospital Revenue Code	278
Min. Negotiated Rate	$411.00
Max. Negotiated Rate	$411.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$411.00
Rate for Payer: Hamaspik Choice Inc Medicare	$411.00

STRYKER ORTHO SCREW HEX 2.5MM

Facility IP

$583.00

Service Code	HCPCS C1713
Hospital Charge Code	40205338
Hospital Revenue Code	278
Min. Negotiated Rate	$291.50
Max. Negotiated Rate	$291.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$291.50
Rate for Payer: Hamaspik Choice Inc Medicare	$291.50

STRYKER ORTHO SCREW HEX 2.5MM

Facility OP

$583.00

Service Code	HCPCS C1713
Hospital Charge Code	40205338
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$612.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$320.65
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	$291.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$335.22
Rate for Payer: Fidelis Medicare Advantage	$612.15
Rate for Payer: Group Health Inc Commercial	$291.50
Rate for Payer: Group Health Inc Medicare	$204.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$291.50
Rate for Payer: Hamaspik Choice Inc Medicare	$291.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$378.95

STRYKER ORTHO SCREW HEX 3.5M

Facility OP

$583.00

Service Code	HCPCS C1713
Hospital Charge Code	40205340
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$612.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$320.65
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	$291.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$335.22
Rate for Payer: Fidelis Medicare Advantage	$612.15
Rate for Payer: Group Health Inc Commercial	$291.50
Rate for Payer: Group Health Inc Medicare	$204.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$291.50
Rate for Payer: Hamaspik Choice Inc Medicare	$291.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$378.95

STRYKER ORTHO SCREW HEX 3.5M

Facility IP

$583.00

Service Code	HCPCS C1713
Hospital Charge Code	40205340
Hospital Revenue Code	278
Min. Negotiated Rate	$291.50
Max. Negotiated Rate	$291.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$291.50
Rate for Payer: Hamaspik Choice Inc Medicare	$291.50

STRYKER OSTEO TOTAL KNEE STEM EXT

Facility IP

$2,448.00

Service Code	HCPCS C1776
Hospital Charge Code	40205323
Hospital Revenue Code	278
Min. Negotiated Rate	$1,224.00
Max. Negotiated Rate	$1,224.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,224.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,224.00

STRYKER OSTEO TOTAL KNEE STEM EXT

Facility OP

$2,448.00

Service Code	HCPCS C1776
Hospital Charge Code	40205323
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,570.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,346.40
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	$1,224.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,407.60
Rate for Payer: Fidelis Medicare Advantage	$2,570.40
Rate for Payer: Group Health Inc Commercial	$1,224.00
Rate for Payer: Group Health Inc Medicare	$856.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,224.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,224.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,591.20

STRYKER PATELLA 11

Facility OP

$2,996.00

Service Code	HCPCS C1776
Hospital Charge Code	40205611
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,145.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,647.80
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	$1,498.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,722.70
Rate for Payer: Fidelis Medicare Advantage	$3,145.80
Rate for Payer: Group Health Inc Commercial	$1,498.00
Rate for Payer: Group Health Inc Medicare	$1,048.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,498.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,498.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,947.40

STRYKER PATELLA 11

Facility IP

$2,996.00

Service Code	HCPCS C1776
Hospital Charge Code	40205611
Hospital Revenue Code	278
Min. Negotiated Rate	$1,498.00
Max. Negotiated Rate	$1,498.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,498.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,498.00

STRYKER PELVIC PLATE 4 HOLE

Facility IP

$491.50

Service Code	HCPCS C1713
Hospital Charge Code	40205483
Hospital Revenue Code	278
Min. Negotiated Rate	$245.75
Max. Negotiated Rate	$245.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.75
Rate for Payer: Hamaspik Choice Inc Medicare	$245.75

STRYKER PELVIC PLATE 4 HOLE

Facility OP

$491.50

Service Code	HCPCS C1713
Hospital Charge Code	40205483
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$516.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$270.32
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	$245.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$282.61
Rate for Payer: Fidelis Medicare Advantage	$516.08
Rate for Payer: Group Health Inc Commercial	$245.75
Rate for Payer: Group Health Inc Medicare	$172.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$245.75
Rate for Payer: Hamaspik Choice Inc Medicare	$245.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$319.48

STRYKER PELVIC SCREW CORTICAL

Facility OP

$46.20

Service Code	HCPCS C1713
Hospital Charge Code	40207037
Hospital Revenue Code	278
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.41
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	$23.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.56
Rate for Payer: Fidelis Medicare Advantage	$48.51
Rate for Payer: Group Health Inc Commercial	$23.10
Rate for Payer: Group Health Inc Medicare	$16.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.10
Rate for Payer: Hamaspik Choice Inc Medicare	$23.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$30.03

STRYKER PELVIC SCREW CORTICAL

Facility IP

$46.20

Service Code	HCPCS C1713
Hospital Charge Code	40207037
Hospital Revenue Code	278
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.10
Rate for Payer: Hamaspik Choice Inc Medicare	$23.10

STRYKER PELVIC SCRW CORT ST

Facility OP

$41.00

Service Code	HCPCS C1776
Hospital Charge Code	40206065
Hospital Revenue Code	278
Min. Negotiated Rate	$14.35
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.55
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	$20.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$23.58
Rate for Payer: Fidelis Medicare Advantage	$43.05
Rate for Payer: Group Health Inc Commercial	$20.50
Rate for Payer: Group Health Inc Medicare	$14.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.50
Rate for Payer: Hamaspik Choice Inc Medicare	$20.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.65

STRYKER PELVIC SCRW CORT ST

Facility IP

$41.00

Service Code	HCPCS C1776
Hospital Charge Code	40206065
Hospital Revenue Code	278
Min. Negotiated Rate	$20.50
Max. Negotiated Rate	$20.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.50
Rate for Payer: Hamaspik Choice Inc Medicare	$20.50

STRYKER PIN

Facility OP

$25.20

Service Code	HCPCS C1713
Hospital Charge Code	40205088
Hospital Revenue Code	278
Min. Negotiated Rate	$8.82
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.86
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	$12.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.49
Rate for Payer: Fidelis Medicare Advantage	$26.46
Rate for Payer: Group Health Inc Commercial	$12.60
Rate for Payer: Group Health Inc Medicare	$8.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.60
Rate for Payer: Hamaspik Choice Inc Medicare	$12.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$16.38

STRYKER PIN

Facility IP

$25.20

Service Code	HCPCS C1713
Hospital Charge Code	40205088
Hospital Revenue Code	278
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.60
Rate for Payer: Hamaspik Choice Inc Medicare	$12.60

STRYKER PIN APEX M TRANSFX3X250MM

Facility OP

$231.00

Service Code	HCPCS C1713
Hospital Charge Code	40205553
Hospital Revenue Code	278
Min. Negotiated Rate	$80.85
Max. Negotiated Rate	$242.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$127.05
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	$115.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.82
Rate for Payer: Fidelis Medicare Advantage	$242.55
Rate for Payer: Group Health Inc Commercial	$115.50
Rate for Payer: Group Health Inc Medicare	$80.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.50
Rate for Payer: Hamaspik Choice Inc Medicare	$115.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$150.15

STRYKER PIN APEX M TRANSFX3X250MM

Facility IP

$231.00

Service Code	HCPCS C1713
Hospital Charge Code	40205553
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$115.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.50
Rate for Payer: Hamaspik Choice Inc Medicare	$115.50

STRYKER PIN CLAMP

Facility OP

$2,179.80

Service Code	HCPCS C1713
Hospital Charge Code	40203002
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,288.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,198.89
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	$1,089.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,253.38
Rate for Payer: Fidelis Medicare Advantage	$2,288.79
Rate for Payer: Group Health Inc Commercial	$1,089.90
Rate for Payer: Group Health Inc Medicare	$762.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,089.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,089.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,416.87

STRYKER PIN CLAMP

Facility IP

$2,179.80

Service Code	HCPCS C1713
Hospital Charge Code	40203002
Hospital Revenue Code	278
Min. Negotiated Rate	$1,089.90
Max. Negotiated Rate	$1,089.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,089.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,089.90

STRYKER PIN CLAMP 10 HOLE

Facility IP

$1,496.60

Service Code	HCPCS C1713
Hospital Charge Code	40205557
Hospital Revenue Code	278
Min. Negotiated Rate	$748.30
Max. Negotiated Rate	$748.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$748.30
Rate for Payer: Hamaspik Choice Inc Medicare	$748.30

STRYKER PIN CLAMP 10 HOLE

Facility OP

$1,496.60

Service Code	HCPCS C1713
Hospital Charge Code	40205557
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,571.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$823.13
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	$748.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$860.54
Rate for Payer: Fidelis Medicare Advantage	$1,571.43
Rate for Payer: Group Health Inc Commercial	$748.30
Rate for Payer: Group Health Inc Medicare	$523.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$748.30
Rate for Payer: Hamaspik Choice Inc Medicare	$748.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$972.79

STRYKER PIN DRIVER COMPACT

Facility OP

$720.00

Service Code	HCPCS C1713
Hospital Charge Code	40203360
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$756.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$396.00
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	$360.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$414.00
Rate for Payer: Fidelis Medicare Advantage	$756.00
Rate for Payer: Group Health Inc Commercial	$360.00
Rate for Payer: Group Health Inc Medicare	$252.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$360.00
Rate for Payer: Hamaspik Choice Inc Medicare	$360.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$468.00

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