St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER SOLAR ELBW H COM LG L RT

Facility OP

$13,898.00

Service Code	HCPCS C1776
Hospital Charge Code	40205157
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$14,592.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,643.90
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	$6,949.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,991.35
Rate for Payer: Fidelis Medicare Advantage	$14,592.90
Rate for Payer: Group Health Inc Commercial	$6,949.00
Rate for Payer: Group Health Inc Medicare	$4,864.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,949.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,949.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9,033.70

STRYKER SOLAR ELBW H COM LG L RT

Facility IP

$13,898.00

Service Code	HCPCS C1776
Hospital Charge Code	40205157
Hospital Revenue Code	278
Min. Negotiated Rate	$6,949.00
Max. Negotiated Rate	$6,949.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,949.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,949.00

STRYKER SOLAR ELBW ULNA COMP ST R

Facility OP

$6,784.00

Service Code	HCPCS C1713
Hospital Charge Code	40205447
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$7,123.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,731.20
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	$3,392.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,900.80
Rate for Payer: Fidelis Medicare Advantage	$7,123.20
Rate for Payer: Group Health Inc Commercial	$3,392.00
Rate for Payer: Group Health Inc Medicare	$2,374.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,392.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,392.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,409.60

STRYKER SOLAR ELBW ULNA COMP ST R

Facility IP

$6,784.00

Service Code	HCPCS C1713
Hospital Charge Code	40205447
Hospital Revenue Code	278
Min. Negotiated Rate	$3,392.00
Max. Negotiated Rate	$3,392.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,392.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,392.00

STRYKER SOLID STEP DRILL

Facility OP

$328.00

Hospital Charge Code	40204667
Hospital Revenue Code	272
Min. Negotiated Rate	$114.80
Max. Negotiated Rate	$262.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$180.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$164.00
Rate for Payer: Aetna Government	$164.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$262.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$223.04
Rate for Payer: Group Health Inc Commercial	$164.00
Rate for Payer: Group Health Inc Medicare	$114.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$164.00
Rate for Payer: Hamaspik Choice Inc Medicare	$164.00

STRYKER SPINE 3.5X60MM ROD

Facility OP

$543.16

Hospital Charge Code	40204469
Hospital Revenue Code	272
Min. Negotiated Rate	$190.11
Max. Negotiated Rate	$434.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$298.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$271.58
Rate for Payer: Aetna Government	$271.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$434.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$369.35
Rate for Payer: Group Health Inc Commercial	$271.58
Rate for Payer: Group Health Inc Medicare	$190.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$271.58
Rate for Payer: Hamaspik Choice Inc Medicare	$271.58

STRYKER SPINE 6.5MMX35MM

Facility OP

$3,379.94

Service Code	HCPCS C1776
Hospital Charge Code	40205259
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,548.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,858.97
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	$1,689.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,943.47
Rate for Payer: Fidelis Medicare Advantage	$3,548.94
Rate for Payer: Group Health Inc Commercial	$1,689.97
Rate for Payer: Group Health Inc Medicare	$1,182.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,689.97
Rate for Payer: Hamaspik Choice Inc Medicare	$1,689.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,196.96

STRYKER SPINE 6.5MMX35MM

Facility IP

$3,379.94

Service Code	HCPCS C1776
Hospital Charge Code	40205259
Hospital Revenue Code	278
Min. Negotiated Rate	$1,689.97
Max. Negotiated Rate	$1,689.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,689.97
Rate for Payer: Hamaspik Choice Inc Medicare	$1,689.97

STRYKER SPINE 7.5MMX30MM

Facility OP

$3,379.94

Service Code	HCPCS C1776
Hospital Charge Code	40205261
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,548.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,858.97
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	$1,689.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,943.47
Rate for Payer: Fidelis Medicare Advantage	$3,548.94
Rate for Payer: Group Health Inc Commercial	$1,689.97
Rate for Payer: Group Health Inc Medicare	$1,182.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,689.97
Rate for Payer: Hamaspik Choice Inc Medicare	$1,689.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,196.96

STRYKER SPINE 7.5MMX30MM

Facility IP

$3,379.94

Service Code	HCPCS C1776
Hospital Charge Code	40205261
Hospital Revenue Code	278
Min. Negotiated Rate	$1,689.97
Max. Negotiated Rate	$1,689.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,689.97
Rate for Payer: Hamaspik Choice Inc Medicare	$1,689.97

STRYKER SPINE ALLOCRAFT DBM 10CC

Facility IP

$2,170.00

Service Code	HCPCS C1776
Hospital Charge Code	40205007
Hospital Revenue Code	278
Min. Negotiated Rate	$1,085.00
Max. Negotiated Rate	$1,085.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,085.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,085.00

STRYKER SPINE ALLOCRAFT DBM 10CC

Facility OP

$2,170.00

Service Code	HCPCS C1776
Hospital Charge Code	40205007
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,278.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,193.50
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	$1,085.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,247.75
Rate for Payer: Fidelis Medicare Advantage	$2,278.50
Rate for Payer: Group Health Inc Commercial	$1,085.00
Rate for Payer: Group Health Inc Medicare	$759.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,085.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,085.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,410.50

STRYKER SPINE ALLOCRFT DBM 10CC

Facility IP

$2,917.22

Service Code	HCPCS C1713
Hospital Charge Code	40208152
Hospital Revenue Code	278
Min. Negotiated Rate	$1,458.61
Max. Negotiated Rate	$1,458.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,458.61
Rate for Payer: Hamaspik Choice Inc Medicare	$1,458.61

STRYKER SPINE ALLOCRFT DBM 10CC

Facility OP

$2,917.22

Service Code	HCPCS C1713
Hospital Charge Code	40208152
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,063.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,604.47
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	$1,458.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,677.40
Rate for Payer: Fidelis Medicare Advantage	$3,063.08
Rate for Payer: Group Health Inc Commercial	$1,458.61
Rate for Payer: Group Health Inc Medicare	$1,021.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,458.61
Rate for Payer: Hamaspik Choice Inc Medicare	$1,458.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,896.19

STRYKER SPINE BONE GRAFT SUB 10CC

Facility IP

$8,400.00

Service Code	HCPCS C1713
Hospital Charge Code	40205804
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$4,200.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,200.00

STRYKER SPINE BONE GRAFT SUB 10CC

Facility OP

$8,400.00

Service Code	HCPCS C1713
Hospital Charge Code	40205804
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$8,820.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,620.00
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	$4,200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,830.00
Rate for Payer: Fidelis Medicare Advantage	$8,820.00
Rate for Payer: Group Health Inc Commercial	$4,200.00
Rate for Payer: Group Health Inc Medicare	$2,940.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,200.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,460.00

STRYKER SPINE OASYS BA 3.5X10MM

Facility OP

$2,107.54

Service Code	HCPCS C1776
Hospital Charge Code	40205008
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,212.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,159.15
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	$1,053.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,211.84
Rate for Payer: Fidelis Medicare Advantage	$2,212.92
Rate for Payer: Group Health Inc Commercial	$1,053.77
Rate for Payer: Group Health Inc Medicare	$737.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,053.77
Rate for Payer: Hamaspik Choice Inc Medicare	$1,053.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,369.90

STRYKER SPINE OASYS BA 3.5X10MM

Facility IP

$2,107.54

Service Code	HCPCS C1776
Hospital Charge Code	40205008
Hospital Revenue Code	278
Min. Negotiated Rate	$1,053.77
Max. Negotiated Rate	$1,053.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,053.77
Rate for Payer: Hamaspik Choice Inc Medicare	$1,053.77

STRYKER SPINE OASYS ROD3.5MMX80MM

Facility IP

$630.00

Service Code	HCPCS C1776
Hospital Charge Code	40201422
Hospital Revenue Code	278
Min. Negotiated Rate	$315.00
Max. Negotiated Rate	$315.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$315.00
Rate for Payer: Hamaspik Choice Inc Medicare	$315.00

STRYKER SPINE OASYS ROD3.5MMX80MM

Facility OP

$630.00

Service Code	HCPCS C1776
Hospital Charge Code	40201422
Hospital Revenue Code	278
Min. Negotiated Rate	$220.50
Max. Negotiated Rate	$661.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$346.50
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	$315.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$362.25
Rate for Payer: Fidelis Medicare Advantage	$661.50
Rate for Payer: Group Health Inc Commercial	$315.00
Rate for Payer: Group Health Inc Medicare	$220.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$315.00
Rate for Payer: Hamaspik Choice Inc Medicare	$315.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$409.50

STRYKER SPINE SCREW 14MM NONBIAS

Facility IP

$2,683.00

Service Code	HCPCS C1713
Hospital Charge Code	40205801
Hospital Revenue Code	278
Min. Negotiated Rate	$1,341.50
Max. Negotiated Rate	$1,341.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,341.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,341.50

STRYKER SPINE SCREW 14MM NONBIAS

Facility OP

$2,683.00

Service Code	HCPCS C1713
Hospital Charge Code	40205801
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,817.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,475.65
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	$1,341.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,542.72
Rate for Payer: Fidelis Medicare Advantage	$2,817.15
Rate for Payer: Group Health Inc Commercial	$1,341.50
Rate for Payer: Group Health Inc Medicare	$939.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,341.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,341.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,743.95

STRYKER SPINE SCREW 6.6MMX40MM

Facility OP

$3,379.94

Service Code	HCPCS C1776
Hospital Charge Code	40205260
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,548.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,858.97
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	$1,689.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,943.47
Rate for Payer: Fidelis Medicare Advantage	$3,548.94
Rate for Payer: Group Health Inc Commercial	$1,689.97
Rate for Payer: Group Health Inc Medicare	$1,182.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,689.97
Rate for Payer: Hamaspik Choice Inc Medicare	$1,689.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,196.96

STRYKER SPINE SCREW 6.6MMX40MM

Facility IP

$3,379.94

Service Code	HCPCS C1776
Hospital Charge Code	40205260
Hospital Revenue Code	278
Min. Negotiated Rate	$1,689.97
Max. Negotiated Rate	$1,689.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,689.97
Rate for Payer: Hamaspik Choice Inc Medicare	$1,689.97

STRYKER STEP K-WIRE W OLIVE STOP

Facility OP

$46.20

Service Code	HCPCS C1776
Hospital Charge Code	40205207
Hospital Revenue Code	278
Min. Negotiated Rate	$16.17
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.41
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	$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

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