St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER UNIVERSAL FEM HEAD

Facility IP

$2,338.20

Service Code	HCPCS C1776
Hospital Charge Code	40029619
Hospital Revenue Code	278
Min. Negotiated Rate	$1,169.10
Max. Negotiated Rate	$1,169.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,169.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1,169.10

STRYKER UNIV HEAD COMP 49X28MM

Facility OP

$3,010.00

Service Code	HCPCS C1776
Hospital Charge Code	40205533
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,160.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,655.50
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	$1,505.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,730.75
Rate for Payer: Fidelis Medicare Advantage	$3,160.50
Rate for Payer: Group Health Inc Commercial	$1,505.00
Rate for Payer: Group Health Inc Medicare	$1,053.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,505.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,505.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,956.50

STRYKER UNIV HEAD COMP 49X28MM

Facility IP

$3,010.00

Service Code	HCPCS C1776
Hospital Charge Code	40205533
Hospital Revenue Code	278
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$1,505.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,505.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,505.00

STRYKER VARIAX CANN SCREW 3.0MM

Facility IP

$534.00

Service Code	HCPCS C1713
Hospital Charge Code	40205561
Hospital Revenue Code	278
Min. Negotiated Rate	$267.00
Max. Negotiated Rate	$267.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$267.00
Rate for Payer: Hamaspik Choice Inc Medicare	$267.00

STRYKER VARIAX CANN SCREW 3.0MM

Facility OP

$534.00

Service Code	HCPCS C1713
Hospital Charge Code	40205561
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$560.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$293.70
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	$267.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$307.05
Rate for Payer: Fidelis Medicare Advantage	$560.70
Rate for Payer: Group Health Inc Commercial	$267.00
Rate for Payer: Group Health Inc Medicare	$186.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$267.00
Rate for Payer: Hamaspik Choice Inc Medicare	$267.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$347.10

STRYKER VARIAX CANN SCRW 3.0

Facility OP

$355.60

Service Code	HCPCS C1713
Hospital Charge Code	40205220
Hospital Revenue Code	278
Min. Negotiated Rate	$124.46
Max. Negotiated Rate	$373.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$195.58
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	$177.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$204.47
Rate for Payer: Fidelis Medicare Advantage	$373.38
Rate for Payer: Group Health Inc Commercial	$177.80
Rate for Payer: Group Health Inc Medicare	$124.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.80
Rate for Payer: Hamaspik Choice Inc Medicare	$177.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$231.14

STRYKER VARIAX CANN SCRW 3.0

Facility IP

$355.60

Service Code	HCPCS C1713
Hospital Charge Code	40205220
Hospital Revenue Code	278
Min. Negotiated Rate	$177.80
Max. Negotiated Rate	$177.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.80
Rate for Payer: Hamaspik Choice Inc Medicare	$177.80

STRYKER VARIAX FIB PLT 6-HOLE

Facility IP

$1,024.80

Service Code	HCPCS C1713
Hospital Charge Code	40206099
Hospital Revenue Code	278
Min. Negotiated Rate	$512.40
Max. Negotiated Rate	$512.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$512.40
Rate for Payer: Hamaspik Choice Inc Medicare	$512.40

STRYKER VARIAX FIB PLT 6-HOLE

Facility OP

$1,024.80

Service Code	HCPCS C1713
Hospital Charge Code	40206099
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,076.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$563.64
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	$512.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$589.26
Rate for Payer: Fidelis Medicare Advantage	$1,076.04
Rate for Payer: Group Health Inc Commercial	$512.40
Rate for Payer: Group Health Inc Medicare	$358.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$512.40
Rate for Payer: Hamaspik Choice Inc Medicare	$512.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$666.12

STRYKER VARIAX FIB PLT 9H

Facility OP

$1,226.00

Service Code	HCPCS C1713
Hospital Charge Code	40205931
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,287.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$674.30
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	$613.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$704.95
Rate for Payer: Fidelis Medicare Advantage	$1,287.30
Rate for Payer: Group Health Inc Commercial	$613.00
Rate for Payer: Group Health Inc Medicare	$429.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$613.00
Rate for Payer: Hamaspik Choice Inc Medicare	$613.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$796.90

STRYKER VARIAX FIB PLT 9H

Facility IP

$1,226.00

Service Code	HCPCS C1713
Hospital Charge Code	40205931
Hospital Revenue Code	278
Min. Negotiated Rate	$613.00
Max. Negotiated Rate	$613.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$613.00
Rate for Payer: Hamaspik Choice Inc Medicare	$613.00

STRYKER VARIAX FIBULAR PLATE 4H

Facility IP

$891.00

Service Code	HCPCS C1776
Hospital Charge Code	40208082
Hospital Revenue Code	278
Min. Negotiated Rate	$445.50
Max. Negotiated Rate	$445.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.50
Rate for Payer: Hamaspik Choice Inc Medicare	$445.50

STRYKER VARIAX FIBULAR PLATE 4H

Facility OP

$891.00

Service Code	HCPCS C1776
Hospital Charge Code	40208082
Hospital Revenue Code	278
Min. Negotiated Rate	$311.85
Max. Negotiated Rate	$935.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$490.05
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	$445.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$512.32
Rate for Payer: Fidelis Medicare Advantage	$935.55
Rate for Payer: Group Health Inc Commercial	$445.50
Rate for Payer: Group Health Inc Medicare	$311.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$445.50
Rate for Payer: Hamaspik Choice Inc Medicare	$445.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$579.15

STRYKER VARIAX FIBULAR PLATE 5H

Facility IP

$1,024.80

Service Code	HCPCS C1776
Hospital Charge Code	40205142
Hospital Revenue Code	278
Min. Negotiated Rate	$512.40
Max. Negotiated Rate	$512.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$512.40
Rate for Payer: Hamaspik Choice Inc Medicare	$512.40

STRYKER VARIAX FIBULAR PLATE 5H

Facility OP

$1,024.80

Service Code	HCPCS C1776
Hospital Charge Code	40205142
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,076.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$563.64
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	$512.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$589.26
Rate for Payer: Fidelis Medicare Advantage	$1,076.04
Rate for Payer: Group Health Inc Commercial	$512.40
Rate for Payer: Group Health Inc Medicare	$358.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$512.40
Rate for Payer: Hamaspik Choice Inc Medicare	$512.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$666.12

STRYKER VARIAX FIBULAR PLATE 8H

Facility OP

$1,226.40

Service Code	HCPCS C1713
Hospital Charge Code	40205752
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,287.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$674.52
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	$613.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$705.18
Rate for Payer: Fidelis Medicare Advantage	$1,287.72
Rate for Payer: Group Health Inc Commercial	$613.20
Rate for Payer: Group Health Inc Medicare	$429.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$613.20
Rate for Payer: Hamaspik Choice Inc Medicare	$613.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$797.16

STRYKER VARIAX FIBULAR PLATE 8H

Facility IP

$1,226.40

Service Code	HCPCS C1713
Hospital Charge Code	40205752
Hospital Revenue Code	278
Min. Negotiated Rate	$613.20
Max. Negotiated Rate	$613.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$613.20
Rate for Payer: Hamaspik Choice Inc Medicare	$613.20

STRYKER VARIX FIBULAR PLATE 3 H

Facility OP

$1,024.80

Service Code	HCPCS C1713
Hospital Charge Code	40205395
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,076.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$563.64
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	$512.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$589.26
Rate for Payer: Fidelis Medicare Advantage	$1,076.04
Rate for Payer: Group Health Inc Commercial	$512.40
Rate for Payer: Group Health Inc Medicare	$358.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$512.40
Rate for Payer: Hamaspik Choice Inc Medicare	$512.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$666.12

STRYKER VARIX FIBULAR PLATE 3 H

Facility IP

$1,024.80

Service Code	HCPCS C1713
Hospital Charge Code	40205395
Hospital Revenue Code	278
Min. Negotiated Rate	$512.40
Max. Negotiated Rate	$512.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$512.40
Rate for Payer: Hamaspik Choice Inc Medicare	$512.40

STRYKER VASD SCREW 14MM

Facility IP

$1,120.60

Service Code	HCPCS C1713
Hospital Charge Code	40009296
Hospital Revenue Code	278
Min. Negotiated Rate	$560.30
Max. Negotiated Rate	$560.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$560.30
Rate for Payer: Hamaspik Choice Inc Medicare	$560.30

STRYKER VASD SCREW 14MM

Facility OP

$1,120.60

Service Code	HCPCS C1713
Hospital Charge Code	40009296
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,176.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$616.33
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	$560.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$644.34
Rate for Payer: Fidelis Medicare Advantage	$1,176.63
Rate for Payer: Group Health Inc Commercial	$560.30
Rate for Payer: Group Health Inc Medicare	$392.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$560.30
Rate for Payer: Hamaspik Choice Inc Medicare	$560.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$728.39

STRYKER V CANN SCRW 3.0MM 22

Facility OP

$355.60

Service Code	HCPCS C1776
Hospital Charge Code	40208118
Hospital Revenue Code	278
Min. Negotiated Rate	$124.46
Max. Negotiated Rate	$373.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$195.58
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	$177.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$204.47
Rate for Payer: Fidelis Medicare Advantage	$373.38
Rate for Payer: Group Health Inc Commercial	$177.80
Rate for Payer: Group Health Inc Medicare	$124.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.80
Rate for Payer: Hamaspik Choice Inc Medicare	$177.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$231.14

STRYKER V CANN SCRW 3.0MM 22

Facility IP

$355.60

Service Code	HCPCS C1776
Hospital Charge Code	40208118
Hospital Revenue Code	278
Min. Negotiated Rate	$177.80
Max. Negotiated Rate	$177.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$177.80
Rate for Payer: Hamaspik Choice Inc Medicare	$177.80

STRYKER VERTAPLEX HV R/PAQUE B/C

Facility IP

$257.25

Service Code	HCPCS C1713
Hospital Charge Code	40209455
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$128.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.62
Rate for Payer: Hamaspik Choice Inc Medicare	$128.62

STRYKER VERTAPLEX HV R/PAQUE B/C

Facility OP

$257.25

Service Code	HCPCS C1713
Hospital Charge Code	40209455
Hospital Revenue Code	278
Min. Negotiated Rate	$90.04
Max. Negotiated Rate	$270.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$141.49
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	$128.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$147.92
Rate for Payer: Fidelis Medicare Advantage	$270.11
Rate for Payer: Group Health Inc Commercial	$128.62
Rate for Payer: Group Health Inc Medicare	$90.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.62
Rate for Payer: Hamaspik Choice Inc Medicare	$128.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$167.21

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