St. Barnabas Hospital

All Charges

Charge

Type

Price

STRYKER XIA3PA SCRW 5.5X40MM

Facility OP

$3,307.50

Service Code	HCPCS C1776
Hospital Charge Code	40208156
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,472.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,819.12
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	$1,653.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,901.81
Rate for Payer: Fidelis Medicare Advantage	$3,472.88
Rate for Payer: Group Health Inc Commercial	$1,653.75
Rate for Payer: Group Health Inc Medicare	$1,157.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,653.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,149.88

STRYKER XIA3 PA SCRW C6.5X45MM

Facility OP

$3,307.50

Service Code	HCPCS C1713
Hospital Charge Code	40205291
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,472.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,819.12
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	$1,653.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,901.81
Rate for Payer: Fidelis Medicare Advantage	$3,472.88
Rate for Payer: Group Health Inc Commercial	$1,653.75
Rate for Payer: Group Health Inc Medicare	$1,157.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,653.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,149.88

STRYKER XIA3 PA SCRW C6.5X45MM

Facility IP

$3,307.50

Service Code	HCPCS C1713
Hospital Charge Code	40205291
Hospital Revenue Code	278
Min. Negotiated Rate	$1,653.75
Max. Negotiated Rate	$1,653.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,653.75

STRYKER XIA3PA SCRW C 7.5X

Facility IP

$3,379.94

Service Code	HCPCS C1713
Hospital Charge Code	40205307
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 XIA3PA SCRW C 7.5X

Facility OP

$3,379.94

Service Code	HCPCS C1713
Hospital Charge Code	40205307
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,548.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,858.97
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	$1,689.97
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 XIA# PA SCREW C 6.5X45MM

Facility IP

$3,307.50

Service Code	HCPCS C1776
Hospital Charge Code	40205240
Hospital Revenue Code	278
Min. Negotiated Rate	$1,653.75
Max. Negotiated Rate	$1,653.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,653.75

STRYKER XIA# PA SCREW C 6.5X45MM

Facility OP

$3,307.50

Service Code	HCPCS C1776
Hospital Charge Code	40205240
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,472.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,819.12
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	$1,653.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,901.81
Rate for Payer: Fidelis Medicare Advantage	$3,472.88
Rate for Payer: Group Health Inc Commercial	$1,653.75
Rate for Payer: Group Health Inc Medicare	$1,157.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,653.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,653.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,149.88

STRYK HYDRST INJ HA BONE CMT 10CC

Facility IP

$9,922.00

Service Code	HCPCS C1713
Hospital Charge Code	40204478
Hospital Revenue Code	278
Min. Negotiated Rate	$4,961.00
Max. Negotiated Rate	$4,961.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,961.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,961.00

STRYK HYDRST INJ HA BONE CMT 10CC

Facility OP

$9,922.00

Service Code	HCPCS C1713
Hospital Charge Code	40204478
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$10,418.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,457.10
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	$4,961.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,705.15
Rate for Payer: Fidelis Medicare Advantage	$10,418.10
Rate for Payer: Group Health Inc Commercial	$4,961.00
Rate for Payer: Group Health Inc Medicare	$3,472.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,961.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,961.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,449.30

STRYK HYDRST INJ HA BONE CMT 15CC

Facility IP

$14,236.00

Service Code	HCPCS C1713
Hospital Charge Code	40204479
Hospital Revenue Code	278
Min. Negotiated Rate	$7,118.00
Max. Negotiated Rate	$7,118.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,118.00
Rate for Payer: Hamaspik Choice Inc Medicare	$7,118.00

STRYK HYDRST INJ HA BONE CMT 15CC

Facility OP

$14,236.00

Service Code	HCPCS C1713
Hospital Charge Code	40204479
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$14,947.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,829.80
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	$7,118.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$8,185.70
Rate for Payer: Fidelis Medicare Advantage	$14,947.80
Rate for Payer: Group Health Inc Commercial	$7,118.00
Rate for Payer: Group Health Inc Medicare	$4,982.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,118.00
Rate for Payer: Hamaspik Choice Inc Medicare	$7,118.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9,253.40

STRY KIRSH K-WIRE 0.9 MM

Facility OP

$100.00

Hospital Charge Code	40004603
Hospital Revenue Code	272
Min. Negotiated Rate	$35.00
Max. Negotiated Rate	$80.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.00
Rate for Payer: Aetna Government	$50.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.00
Rate for Payer: Group Health Inc Commercial	$50.00
Rate for Payer: Group Health Inc Medicare	$35.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.00
Rate for Payer: Hamaspik Choice Inc Medicare	$50.00

STRYK MPS CURV R88 PLT 12HL PELV

Facility IP

$895.70

Service Code	HCPCS C1713
Hospital Charge Code	40204477
Hospital Revenue Code	278
Min. Negotiated Rate	$447.85
Max. Negotiated Rate	$447.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$447.85
Rate for Payer: Hamaspik Choice Inc Medicare	$447.85

STRYK MPS CURV R88 PLT 12HL PELV

Facility OP

$895.70

Service Code	HCPCS C1713
Hospital Charge Code	40204477
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$940.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$492.64
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	$447.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$515.03
Rate for Payer: Fidelis Medicare Advantage	$940.48
Rate for Payer: Group Health Inc Commercial	$447.85
Rate for Payer: Group Health Inc Medicare	$313.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$447.85
Rate for Payer: Hamaspik Choice Inc Medicare	$447.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$582.20

STRYKR III CANN. SCREW 4.0 X48MM

Facility IP

$156.00

Service Code	HCPCS C1713
Hospital Charge Code	40201540
Hospital Revenue Code	278
Min. Negotiated Rate	$78.00
Max. Negotiated Rate	$78.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$78.00
Rate for Payer: Hamaspik Choice Inc Medicare	$78.00

STRYKR III CANN. SCREW 4.0 X48MM

Facility OP

$156.00

Service Code	HCPCS C1713
Hospital Charge Code	40201540
Hospital Revenue Code	278
Min. Negotiated Rate	$54.60
Max. Negotiated Rate	$163.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.80
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	$78.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$89.70
Rate for Payer: Fidelis Medicare Advantage	$163.80
Rate for Payer: Group Health Inc Commercial	$78.00
Rate for Payer: Group Health Inc Medicare	$54.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$78.00
Rate for Payer: Hamaspik Choice Inc Medicare	$78.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$101.40

STRYK TOTAL KNEE TIBIAL BEARING

Facility OP

$3,721.20

Service Code	HCPCS C1776
Hospital Charge Code	40029625
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,907.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,046.66
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	$1,860.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,139.69
Rate for Payer: Fidelis Medicare Advantage	$3,907.26
Rate for Payer: Group Health Inc Commercial	$1,860.60
Rate for Payer: Group Health Inc Medicare	$1,302.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,860.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,860.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,418.78

STRYK TOTAL KNEE TIBIAL BEARING

Facility IP

$3,721.20

Service Code	HCPCS C1776
Hospital Charge Code	40029625
Hospital Revenue Code	278
Min. Negotiated Rate	$1,860.60
Max. Negotiated Rate	$1,860.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,860.60
Rate for Payer: Hamaspik Choice Inc Medicare	$1,860.60

STRY K-WIRE 3.2 X 150 MM

Facility OP

$240.00

Hospital Charge Code	40004610
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$192.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$120.00
Rate for Payer: Aetna Government	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$192.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.20
Rate for Payer: Group Health Inc Commercial	$120.00
Rate for Payer: Group Health Inc Medicare	$84.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.00
Rate for Payer: Hamaspik Choice Inc Medicare	$120.00

STRY K-WIRE 3.2 X 150MM

Facility OP

$240.00

Hospital Charge Code	40004606
Hospital Revenue Code	272
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$192.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$132.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$120.00
Rate for Payer: Aetna Government	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$192.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.20
Rate for Payer: Group Health Inc Commercial	$120.00
Rate for Payer: Group Health Inc Medicare	$84.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$120.00
Rate for Payer: Hamaspik Choice Inc Medicare	$120.00

STRY K-WIRE .8MM X 100MM

Facility OP

$61.60

Hospital Charge Code	40203448
Hospital Revenue Code	272
Min. Negotiated Rate	$21.56
Max. Negotiated Rate	$49.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.80
Rate for Payer: Aetna Government	$30.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$49.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$41.89
Rate for Payer: Group Health Inc Commercial	$30.80
Rate for Payer: Group Health Inc Medicare	$21.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.80
Rate for Payer: Hamaspik Choice Inc Medicare	$30.80

STRY K-WIRE .8MMX100MM

Facility OP

$61.60

Service Code	HCPCS C1713
Hospital Charge Code	40204730
Hospital Revenue Code	278
Min. Negotiated Rate	$21.56
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.88
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	$30.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.42
Rate for Payer: Fidelis Medicare Advantage	$64.68
Rate for Payer: Group Health Inc Commercial	$30.80
Rate for Payer: Group Health Inc Medicare	$21.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.80
Rate for Payer: Hamaspik Choice Inc Medicare	$30.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$40.04

STRY K-WIRE .8MMX100MM

Facility IP

$61.60

Service Code	HCPCS C1713
Hospital Charge Code	40204730
Hospital Revenue Code	278
Min. Negotiated Rate	$30.80
Max. Negotiated Rate	$30.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.80
Rate for Payer: Hamaspik Choice Inc Medicare	$30.80

STRY LARGE SCR 6.5X40MM

Facility IP

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	40008312
Hospital Revenue Code	278
Min. Negotiated Rate	$2,332.79
Max. Negotiated Rate	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicare	$2,332.79

STRY LARGE SCR 6.5X40MM

Facility OP

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	40008312
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,898.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,566.07
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	$2,332.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,682.71
Rate for Payer: Fidelis Medicare Advantage	$4,898.86
Rate for Payer: Group Health Inc Commercial	$2,332.79
Rate for Payer: Group Health Inc Medicare	$1,632.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,332.79
Rate for Payer: Hamaspik Choice Inc Medicare	$2,332.79
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,032.63

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