St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER SCFREW 1.7X6MM

Facility OP

$183.30

Service Code	HCPCS C1713
Hospital Charge Code	40204488
Hospital Revenue Code	278
Min. Negotiated Rate	$64.16
Max. Negotiated Rate	$192.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$100.82
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	$91.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$105.40
Rate for Payer: Fidelis Medicare Advantage	$192.46
Rate for Payer: Group Health Inc Commercial	$91.65
Rate for Payer: Group Health Inc Medicare	$64.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$91.65
Rate for Payer: Hamaspik Choice Inc Medicare	$91.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$119.14

STRYKER SCFREW 1.7X6MM

Facility IP

$183.30

Service Code	HCPCS C1713
Hospital Charge Code	40204488
Hospital Revenue Code	278
Min. Negotiated Rate	$91.65
Max. Negotiated Rate	$91.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$91.65
Rate for Payer: Hamaspik Choice Inc Medicare	$91.65

STRYKER SCFREW LOCKING 1.7MMX5

Facility OP

$183.30

Service Code	HCPCS C1713
Hospital Charge Code	40204487
Hospital Revenue Code	278
Min. Negotiated Rate	$64.16
Max. Negotiated Rate	$192.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$100.82
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	$91.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$105.40
Rate for Payer: Fidelis Medicare Advantage	$192.46
Rate for Payer: Group Health Inc Commercial	$91.65
Rate for Payer: Group Health Inc Medicare	$64.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$91.65
Rate for Payer: Hamaspik Choice Inc Medicare	$91.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$119.14

STRYKER SCFREW LOCKING 1.7MMX5

Facility IP

$183.30

Service Code	HCPCS C1713
Hospital Charge Code	40204487
Hospital Revenue Code	278
Min. Negotiated Rate	$91.65
Max. Negotiated Rate	$91.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$91.65
Rate for Payer: Hamaspik Choice Inc Medicare	$91.65

STRYKER SCREW 2.4X10

Facility OP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	40202654
Hospital Revenue Code	278
Min. Negotiated Rate	$41.96
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$65.94
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	$59.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.94
Rate for Payer: Fidelis Medicare Advantage	$125.88
Rate for Payer: Group Health Inc Commercial	$59.94
Rate for Payer: Group Health Inc Medicare	$41.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.94
Rate for Payer: Hamaspik Choice Inc Medicare	$59.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$77.93

STRYKER SCREW 2.4X10

Facility IP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	40202654
Hospital Revenue Code	278
Min. Negotiated Rate	$59.94
Max. Negotiated Rate	$59.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.94
Rate for Payer: Hamaspik Choice Inc Medicare	$59.94

STRYKER SCREW 2.4X12

Facility OP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	40202655
Hospital Revenue Code	278
Min. Negotiated Rate	$41.96
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$65.94
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	$59.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.94
Rate for Payer: Fidelis Medicare Advantage	$125.88
Rate for Payer: Group Health Inc Commercial	$59.94
Rate for Payer: Group Health Inc Medicare	$41.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.94
Rate for Payer: Hamaspik Choice Inc Medicare	$59.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$77.93

STRYKER SCREW 2.4X12

Facility IP

$119.89

Service Code	HCPCS C1713
Hospital Charge Code	40202655
Hospital Revenue Code	278
Min. Negotiated Rate	$59.94
Max. Negotiated Rate	$59.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.94
Rate for Payer: Hamaspik Choice Inc Medicare	$59.94

STRYKER SCREW 35MM (1896-5035S)

Facility OP

$280.00

Service Code	HCPCS C1713
Hospital Charge Code	40029611
Hospital Revenue Code	278
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$294.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$154.00
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	$140.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.00
Rate for Payer: Fidelis Medicare Advantage	$294.00
Rate for Payer: Group Health Inc Commercial	$140.00
Rate for Payer: Group Health Inc Medicare	$98.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$182.00

STRYKER SCREW 35MM (1896-5035S)

Facility IP

$280.00

Service Code	HCPCS C1713
Hospital Charge Code	40029611
Hospital Revenue Code	278
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$140.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00

STRYKER SCREW 40 MM (1896-5040S)

Facility OP

$280.00

Service Code	HCPCS C1713
Hospital Charge Code	40029610
Hospital Revenue Code	278
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$294.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$154.00
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	$140.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.00
Rate for Payer: Fidelis Medicare Advantage	$294.00
Rate for Payer: Group Health Inc Commercial	$140.00
Rate for Payer: Group Health Inc Medicare	$98.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$182.00

STRYKER SCREW 40 MM (1896-5040S)

Facility IP

$280.00

Service Code	HCPCS C1713
Hospital Charge Code	40029610
Hospital Revenue Code	278
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$140.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00

STRYKER SCREW 45MM (1896-5045S)

Facility OP

$280.00

Service Code	HCPCS C1713
Hospital Charge Code	40029609
Hospital Revenue Code	278
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$294.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$154.00
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	$140.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.00
Rate for Payer: Fidelis Medicare Advantage	$294.00
Rate for Payer: Group Health Inc Commercial	$140.00
Rate for Payer: Group Health Inc Medicare	$98.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$182.00

STRYKER SCREW 45MM (1896-5045S)

Facility IP

$280.00

Service Code	HCPCS C1713
Hospital Charge Code	40029609
Hospital Revenue Code	278
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$140.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00

STRYKER SCREW 5MM T2 NAILING SYS

Facility IP

$266.00

Service Code	HCPCS C1776
Hospital Charge Code	40205181
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 SCREW 5MM T2 NAILING SYS

Facility OP

$266.00

Service Code	HCPCS C1776
Hospital Charge Code	40205181
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 SCREW 5X

Facility IP

$334.60

Service Code	HCPCS C1713
Hospital Charge Code	40206100
Hospital Revenue Code	278
Min. Negotiated Rate	$167.30
Max. Negotiated Rate	$167.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$167.30
Rate for Payer: Hamaspik Choice Inc Medicare	$167.30

STRYKER SCREW 5X

Facility OP

$334.60

Service Code	HCPCS C1713
Hospital Charge Code	40206100
Hospital Revenue Code	278
Min. Negotiated Rate	$117.11
Max. Negotiated Rate	$351.33
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$184.03
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	$167.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$192.40
Rate for Payer: Fidelis Medicare Advantage	$351.33
Rate for Payer: Group Health Inc Commercial	$167.30
Rate for Payer: Group Health Inc Medicare	$117.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$167.30
Rate for Payer: Hamaspik Choice Inc Medicare	$167.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$217.49

STRYKER SCREW 8MM T2 END CAP ST

Facility IP

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	40205415
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$168.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$168.70
Rate for Payer: Hamaspik Choice Inc Medicare	$168.70

STRYKER SCREW 8MM T2 END CAP ST

Facility OP

$337.40

Service Code	HCPCS C1713
Hospital Charge Code	40205415
Hospital Revenue Code	278
Min. Negotiated Rate	$118.09
Max. Negotiated Rate	$354.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$185.57
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	$168.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$194.00
Rate for Payer: Fidelis Medicare Advantage	$354.27
Rate for Payer: Group Health Inc Commercial	$168.70
Rate for Payer: Group Health Inc Medicare	$118.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$168.70
Rate for Payer: Hamaspik Choice Inc Medicare	$168.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$219.31

STRYKER SCREW BONE 2.3X18MM

Facility IP

$119.00

Service Code	HCPCS C1776
Hospital Charge Code	40205246
Hospital Revenue Code	278
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$59.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.50
Rate for Payer: Hamaspik Choice Inc Medicare	$59.50

STRYKER SCREW BONE 2.3X18MM

Facility OP

$119.00

Service Code	HCPCS C1776
Hospital Charge Code	40205246
Hospital Revenue Code	278
Min. Negotiated Rate	$41.65
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$65.45
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	$59.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.42
Rate for Payer: Fidelis Medicare Advantage	$124.95
Rate for Payer: Group Health Inc Commercial	$59.50
Rate for Payer: Group Health Inc Medicare	$41.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.50
Rate for Payer: Hamaspik Choice Inc Medicare	$59.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$77.35

STRYKER SCREW BONE 3.5

Facility OP

$109.20

Service Code	HCPCS C1713
Hospital Charge Code	40205418
Hospital Revenue Code	278
Min. Negotiated Rate	$38.22
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$60.06
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	$54.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$62.79
Rate for Payer: Fidelis Medicare Advantage	$114.66
Rate for Payer: Group Health Inc Commercial	$54.60
Rate for Payer: Group Health Inc Medicare	$38.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.60
Rate for Payer: Hamaspik Choice Inc Medicare	$54.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.98

STRYKER SCREW BONE 3.5

Facility IP

$109.20

Service Code	HCPCS C1713
Hospital Charge Code	40205418
Hospital Revenue Code	278
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$54.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$54.60
Rate for Payer: Hamaspik Choice Inc Medicare	$54.60

STRYKER SCREW BONE 3.5MM

Facility OP

$147.88

Service Code	HCPCS C1713
Hospital Charge Code	40205497
Hospital Revenue Code	278
Min. Negotiated Rate	$51.76
Max. Negotiated Rate	$155.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.33
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	$73.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.03
Rate for Payer: Fidelis Medicare Advantage	$155.27
Rate for Payer: Group Health Inc Commercial	$73.94
Rate for Payer: Group Health Inc Medicare	$51.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.94
Rate for Payer: Hamaspik Choice Inc Medicare	$73.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$96.12

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