St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER R88 5H MPS CURVED PLATE

Facility IP

$597.80

Service Code	HCPCS C1713
Hospital Charge Code	40205683
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 RAD ROD XIA3 6MMX 70

Facility OP

$1,131.16

Service Code	HCPCS C1713
Hospital Charge Code	40205397
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,187.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$622.14
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	$565.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$650.42
Rate for Payer: Fidelis Medicare Advantage	$1,187.72
Rate for Payer: Group Health Inc Commercial	$565.58
Rate for Payer: Group Health Inc Medicare	$395.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$565.58
Rate for Payer: Hamaspik Choice Inc Medicare	$565.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$735.25

STRYKER RAD ROD XIA3 6MMX 70

Facility IP

$1,131.16

Service Code	HCPCS C1713
Hospital Charge Code	40205397
Hospital Revenue Code	278
Min. Negotiated Rate	$565.58
Max. Negotiated Rate	$565.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$565.58
Rate for Payer: Hamaspik Choice Inc Medicare	$565.58

STRYKER RAD TO ROD 70MM

Facility OP

$1,131.16

Service Code	HCPCS C1713
Hospital Charge Code	40205531
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,187.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$622.14
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	$565.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$650.42
Rate for Payer: Fidelis Medicare Advantage	$1,187.72
Rate for Payer: Group Health Inc Commercial	$565.58
Rate for Payer: Group Health Inc Medicare	$395.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$565.58
Rate for Payer: Hamaspik Choice Inc Medicare	$565.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$735.25

STRYKER RAD TO ROD 70MM

Facility IP

$1,131.16

Service Code	HCPCS C1713
Hospital Charge Code	40205531
Hospital Revenue Code	278
Min. Negotiated Rate	$565.58
Max. Negotiated Rate	$565.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$565.58
Rate for Payer: Hamaspik Choice Inc Medicare	$565.58

STRYKER RAD TO ROD XIA 6MM X 40

Facility OP

$1,106.92

Service Code	HCPCS C1713
Hospital Charge Code	40208153
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,162.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$608.81
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	$553.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$636.48
Rate for Payer: Fidelis Medicare Advantage	$1,162.27
Rate for Payer: Group Health Inc Commercial	$553.46
Rate for Payer: Group Health Inc Medicare	$387.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$553.46
Rate for Payer: Hamaspik Choice Inc Medicare	$553.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$719.50

STRYKER RAD TO ROD XIA 6MM X 40

Facility IP

$1,106.92

Service Code	HCPCS C1713
Hospital Charge Code	40208153
Hospital Revenue Code	278
Min. Negotiated Rate	$553.46
Max. Negotiated Rate	$553.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$553.46
Rate for Payer: Hamaspik Choice Inc Medicare	$553.46

STRYKER REJU SPT MODULAR STEM SZ7

Facility IP

$13,368.00

Service Code	HCPCS C1776
Hospital Charge Code	40205243
Hospital Revenue Code	278
Min. Negotiated Rate	$6,684.00
Max. Negotiated Rate	$6,684.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,684.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,684.00

STRYKER REJU SPT MODULAR STEM SZ7

Facility OP

$13,368.00

Service Code	HCPCS C1776
Hospital Charge Code	40205243
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$14,036.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,352.40
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	$6,684.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,686.60
Rate for Payer: Fidelis Medicare Advantage	$14,036.40
Rate for Payer: Group Health Inc Commercial	$6,684.00
Rate for Payer: Group Health Inc Medicare	$4,678.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,684.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,684.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,689.20

STRYKER REJUVE MODULAR HEAD 9MM

Facility IP

$13,770.00

Service Code	HCPCS C1776
Hospital Charge Code	40205597
Hospital Revenue Code	278
Min. Negotiated Rate	$6,885.00
Max. Negotiated Rate	$6,885.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,885.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,885.00

STRYKER REJUVE MODULAR HEAD 9MM

Facility OP

$13,770.00

Service Code	HCPCS C1776
Hospital Charge Code	40205597
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$14,458.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,573.50
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	$6,885.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,917.75
Rate for Payer: Fidelis Medicare Advantage	$14,458.50
Rate for Payer: Group Health Inc Commercial	$6,885.00
Rate for Payer: Group Health Inc Medicare	$4,819.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,885.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,885.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,950.50

STRYKER REJUV.MON STEM 26MMX115MM

Facility IP

$13,968.00

Service Code	HCPCS C1713
Hospital Charge Code	40205826
Hospital Revenue Code	278
Min. Negotiated Rate	$6,984.00
Max. Negotiated Rate	$6,984.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,984.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,984.00

STRYKER REJUV.MON STEM 26MMX115MM

Facility OP

$13,968.00

Service Code	HCPCS C1713
Hospital Charge Code	40205826
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$14,666.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,682.40
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	$6,984.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$8,031.60
Rate for Payer: Fidelis Medicare Advantage	$14,666.40
Rate for Payer: Group Health Inc Commercial	$6,984.00
Rate for Payer: Group Health Inc Medicare	$4,888.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,984.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,984.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9,079.20

STRYKER REJUV SPT MOD STEM SZ 8

Facility IP

$13,368.00

Service Code	HCPCS C1776
Hospital Charge Code	40205013
Hospital Revenue Code	278
Min. Negotiated Rate	$6,684.00
Max. Negotiated Rate	$6,684.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,684.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,684.00

STRYKER REJUV SPT MOD STEM SZ 8

Facility OP

$13,368.00

Service Code	HCPCS C1776
Hospital Charge Code	40205013
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$14,036.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,352.40
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	$6,684.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,686.60
Rate for Payer: Fidelis Medicare Advantage	$14,036.40
Rate for Payer: Group Health Inc Commercial	$6,684.00
Rate for Payer: Group Health Inc Medicare	$4,678.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,684.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,684.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,689.20

STRYKER RING HALF

Facility OP

$210.00

Hospital Charge Code	40203362
Hospital Revenue Code	272
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$115.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$105.00
Rate for Payer: Aetna Government	$105.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$168.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.80
Rate for Payer: Group Health Inc Commercial	$105.00
Rate for Payer: Group Health Inc Medicare	$73.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00

STRYKER RING HALF

Facility OP

$210.00

Hospital Charge Code	40009345
Hospital Revenue Code	272
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$115.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$105.00
Rate for Payer: Aetna Government	$105.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$168.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.80
Rate for Payer: Group Health Inc Commercial	$105.00
Rate for Payer: Group Health Inc Medicare	$73.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00

STRYKER ROD 11X300MM

Facility OP

$726.60

Service Code	HCPCS C1713
Hospital Charge Code	40006505
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$762.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$399.63
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	$363.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$417.80
Rate for Payer: Fidelis Medicare Advantage	$762.93
Rate for Payer: Group Health Inc Commercial	$363.30
Rate for Payer: Group Health Inc Medicare	$254.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$363.30
Rate for Payer: Hamaspik Choice Inc Medicare	$363.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$472.29

STRYKER ROD 11X300MM

Facility IP

$726.60

Service Code	HCPCS C1713
Hospital Charge Code	40006505
Hospital Revenue Code	278
Min. Negotiated Rate	$363.30
Max. Negotiated Rate	$363.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$363.30
Rate for Payer: Hamaspik Choice Inc Medicare	$363.30

STRYKER ROD 8X350MM

Facility OP

$1,724.00

Service Code	HCPCS C1713
Hospital Charge Code	40202145
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,810.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$948.20
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	$862.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$991.30
Rate for Payer: Fidelis Medicare Advantage	$1,810.20
Rate for Payer: Group Health Inc Commercial	$862.00
Rate for Payer: Group Health Inc Medicare	$603.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$862.00
Rate for Payer: Hamaspik Choice Inc Medicare	$862.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,120.60

STRYKER ROD 8X350MM

Facility IP

$1,724.00

Service Code	HCPCS C1713
Hospital Charge Code	40202145
Hospital Revenue Code	278
Min. Negotiated Rate	$862.00
Max. Negotiated Rate	$862.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$862.00
Rate for Payer: Hamaspik Choice Inc Medicare	$862.00

STRYKER RODS 100MM

Facility OP

$81.20

Service Code	HCPCS C1713
Hospital Charge Code	40205827
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 RODS 100MM

Facility IP

$81.20

Service Code	HCPCS C1713
Hospital Charge Code	40205827
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 ROD UNIVERSAL

Facility OP

$784.00

Service Code	HCPCS C1713
Hospital Charge Code	40205579
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$823.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$431.20
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	$392.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$450.80
Rate for Payer: Fidelis Medicare Advantage	$823.20
Rate for Payer: Group Health Inc Commercial	$392.00
Rate for Payer: Group Health Inc Medicare	$274.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$392.00
Rate for Payer: Hamaspik Choice Inc Medicare	$392.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$509.60

STRYKER ROD UNIVERSAL

Facility IP

$784.00

Service Code	HCPCS C1713
Hospital Charge Code	40205579
Hospital Revenue Code	278
Min. Negotiated Rate	$392.00
Max. Negotiated Rate	$392.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$392.00
Rate for Payer: Hamaspik Choice Inc Medicare	$392.00

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