St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER PLATE RADIUS

Facility OP

$2,758.00

Service Code	HCPCS C1713
Hospital Charge Code	40205564
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,895.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,516.90
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	$1,379.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,585.85
Rate for Payer: Fidelis Medicare Advantage	$2,895.90
Rate for Payer: Group Health Inc Commercial	$1,379.00
Rate for Payer: Group Health Inc Medicare	$965.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,379.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,379.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,792.70

STRYKER PLATE TUBULAR 1/3 11HOLES

Facility IP

$135.00

Service Code	HCPCS C1713
Hospital Charge Code	40209434
Hospital Revenue Code	278
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.50
Rate for Payer: Hamaspik Choice Inc Medicare	$67.50

STRYKER PLATE TUBULAR 1/3 11HOLES

Facility OP

$135.00

Service Code	HCPCS C1713
Hospital Charge Code	40209434
Hospital Revenue Code	278
Min. Negotiated Rate	$47.25
Max. Negotiated Rate	$141.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$74.25
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	$67.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$77.62
Rate for Payer: Fidelis Medicare Advantage	$141.75
Rate for Payer: Group Health Inc Commercial	$67.50
Rate for Payer: Group Health Inc Medicare	$47.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$67.50
Rate for Payer: Hamaspik Choice Inc Medicare	$67.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$87.75

STRYKER PLATE TUBULAR 1/3 3 H

Facility OP

$81.20

Service Code	HCPCS C1713
Hospital Charge Code	40205719
Hospital Revenue Code	278
Min. Negotiated Rate	$28.42
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$44.66
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	$40.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.69
Rate for Payer: Fidelis Medicare Advantage	$85.26
Rate for Payer: Group Health Inc Commercial	$40.60
Rate for Payer: Group Health Inc Medicare	$28.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.60
Rate for Payer: Hamaspik Choice Inc Medicare	$40.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$52.78

STRYKER PLATE TUBULAR 1/3 3 H

Facility IP

$81.20

Service Code	HCPCS C1713
Hospital Charge Code	40205719
Hospital Revenue Code	278
Min. Negotiated Rate	$40.60
Max. Negotiated Rate	$40.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$40.60
Rate for Payer: Hamaspik Choice Inc Medicare	$40.60

STRYKER PLATE TUBULAR 1/3 8HOLES

Facility OP

$121.50

Service Code	HCPCS C1713
Hospital Charge Code	40209443
Hospital Revenue Code	278
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.82
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	$60.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.86
Rate for Payer: Fidelis Medicare Advantage	$127.58
Rate for Payer: Group Health Inc Commercial	$60.75
Rate for Payer: Group Health Inc Medicare	$42.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.75
Rate for Payer: Hamaspik Choice Inc Medicare	$60.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$78.98

STRYKER PLATE TUBULAR 1/3 8HOLES

Facility IP

$121.50

Service Code	HCPCS C1713
Hospital Charge Code	40209443
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$60.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.75
Rate for Payer: Hamaspik Choice Inc Medicare	$60.75

STRYKER PLATE TUBULAR 1/3 9HOLES

Facility OP

$121.50

Service Code	HCPCS C1713
Hospital Charge Code	40209444
Hospital Revenue Code	278
Min. Negotiated Rate	$42.52
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.82
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	$60.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$69.86
Rate for Payer: Fidelis Medicare Advantage	$127.58
Rate for Payer: Group Health Inc Commercial	$60.75
Rate for Payer: Group Health Inc Medicare	$42.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.75
Rate for Payer: Hamaspik Choice Inc Medicare	$60.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$78.98

STRYKER PLATE TUBULAR 1/3 9HOLES

Facility IP

$121.50

Service Code	HCPCS C1713
Hospital Charge Code	40209444
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$60.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.75
Rate for Payer: Hamaspik Choice Inc Medicare	$60.75

STRYKER POINT REDUCTION

Facility OP

$677.00

Hospital Charge Code	40205491
Hospital Revenue Code	270
Min. Negotiated Rate	$236.95
Max. Negotiated Rate	$541.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$372.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$338.50
Rate for Payer: Aetna Government	$338.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$541.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$460.36
Rate for Payer: Group Health Inc Commercial	$338.50
Rate for Payer: Group Health Inc Medicare	$236.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$338.50
Rate for Payer: Hamaspik Choice Inc Medicare	$338.50

STRYKER POSTERIORLY STAB/FEMORAL

Facility OP

$6,324.00

Service Code	HCPCS C1776
Hospital Charge Code	40207045
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,640.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,478.20
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	$3,162.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,636.30
Rate for Payer: Fidelis Medicare Advantage	$6,640.20
Rate for Payer: Group Health Inc Commercial	$3,162.00
Rate for Payer: Group Health Inc Medicare	$2,213.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,162.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,162.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,110.60

STRYKER POSTERIORLY STAB/FEMORAL

Facility IP

$6,324.00

Service Code	HCPCS C1776
Hospital Charge Code	40207045
Hospital Revenue Code	278
Min. Negotiated Rate	$3,162.00
Max. Negotiated Rate	$3,162.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,162.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,162.00

STRYKER PROX HUMERAL NAIL 8X280MM

Facility IP

$3,162.00

Service Code	HCPCS C1776
Hospital Charge Code	40205143
Hospital Revenue Code	278
Min. Negotiated Rate	$1,581.00
Max. Negotiated Rate	$1,581.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,581.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,581.00

STRYKER PROX HUMERAL NAIL 8X280MM

Facility OP

$3,162.00

Service Code	HCPCS C1776
Hospital Charge Code	40205143
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,320.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,739.10
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	$1,581.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,818.15
Rate for Payer: Fidelis Medicare Advantage	$3,320.10
Rate for Payer: Group Health Inc Commercial	$1,581.00
Rate for Payer: Group Health Inc Medicare	$1,106.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,581.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,581.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,055.30

STRYKER PS FEM COMP #2 R CEMENTED

Facility OP

$5,352.00

Service Code	HCPCS C1776
Hospital Charge Code	40205218
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$5,619.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,943.60
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	$2,676.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,077.40
Rate for Payer: Fidelis Medicare Advantage	$5,619.60
Rate for Payer: Group Health Inc Commercial	$2,676.00
Rate for Payer: Group Health Inc Medicare	$1,873.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,676.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,676.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,478.80

STRYKER PS FEM COMP #2 R CEMENTED

Facility IP

$5,352.00

Service Code	HCPCS C1776
Hospital Charge Code	40205218
Hospital Revenue Code	278
Min. Negotiated Rate	$2,676.00
Max. Negotiated Rate	$2,676.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,676.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,676.00

STRYKER PS TIBIAL B/I SIZE 4

Facility IP

$5,808.00

Service Code	HCPCS C1776
Hospital Charge Code	40205205
Hospital Revenue Code	278
Min. Negotiated Rate	$2,904.00
Max. Negotiated Rate	$2,904.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,904.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,904.00

STRYKER PS TIBIAL B/I SIZE 4

Facility OP

$5,808.00

Service Code	HCPCS C1776
Hospital Charge Code	40205205
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,098.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,194.40
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	$2,904.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,339.60
Rate for Payer: Fidelis Medicare Advantage	$6,098.40
Rate for Payer: Group Health Inc Commercial	$2,904.00
Rate for Payer: Group Health Inc Medicare	$2,032.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,904.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,904.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,775.20

STRYKER PT CANCELLOUS SCREW 6.5MM

Facility OP

$53.20

Service Code	HCPCS C1713
Hospital Charge Code	40205275
Hospital Revenue Code	278
Min. Negotiated Rate	$18.62
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.26
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	$26.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$30.59
Rate for Payer: Fidelis Medicare Advantage	$55.86
Rate for Payer: Group Health Inc Commercial	$26.60
Rate for Payer: Group Health Inc Medicare	$18.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.60
Rate for Payer: Hamaspik Choice Inc Medicare	$26.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.58

STRYKER PT CANCELLOUS SCREW 6.5MM

Facility IP

$53.20

Service Code	HCPCS C1713
Hospital Charge Code	40205275
Hospital Revenue Code	278
Min. Negotiated Rate	$26.60
Max. Negotiated Rate	$26.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.60
Rate for Payer: Hamaspik Choice Inc Medicare	$26.60

STRYKER PT CNCLL SCRW 6.5X60MM

Facility OP

$66.00

Service Code	HCPCS C1713
Hospital Charge Code	40205274
Hospital Revenue Code	278
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.30
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	$33.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.95
Rate for Payer: Fidelis Medicare Advantage	$69.30
Rate for Payer: Group Health Inc Commercial	$33.00
Rate for Payer: Group Health Inc Medicare	$23.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.00
Rate for Payer: Hamaspik Choice Inc Medicare	$33.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$42.90

STRYKER PT CNCLL SCRW 6.5X60MM

Facility IP

$66.00

Service Code	HCPCS C1713
Hospital Charge Code	40205274
Hospital Revenue Code	278
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.00
Rate for Payer: Hamaspik Choice Inc Medicare	$33.00

STRYKER R88 4HOLE MPS CURVED PLT

Facility OP

$547.40

Service Code	HCPCS C1713
Hospital Charge Code	40205682
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$574.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$301.07
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	$273.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$314.76
Rate for Payer: Fidelis Medicare Advantage	$574.77
Rate for Payer: Group Health Inc Commercial	$273.70
Rate for Payer: Group Health Inc Medicare	$191.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$273.70
Rate for Payer: Hamaspik Choice Inc Medicare	$273.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$355.81

STRYKER R88 4HOLE MPS CURVED PLT

Facility IP

$547.40

Service Code	HCPCS C1713
Hospital Charge Code	40205682
Hospital Revenue Code	278
Min. Negotiated Rate	$273.70
Max. Negotiated Rate	$273.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$273.70
Rate for Payer: Hamaspik Choice Inc Medicare	$273.70

STRYKER R88 5H MPS CURVED PLATE

Facility OP

$597.80

Service Code	HCPCS C1713
Hospital Charge Code	40205683
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

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