St. Barnabas Hospital

All Charges

Charge

Type

Price

STRY LOCK SCREW 26 X 2.3MM

Facility OP

$196.00

Service Code	HCPCS C1713
Hospital Charge Code	40204728
Hospital Revenue Code	278
Min. Negotiated Rate	$68.60
Max. Negotiated Rate	$205.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.80
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	$98.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.70
Rate for Payer: Fidelis Medicare Advantage	$205.80
Rate for Payer: Group Health Inc Commercial	$98.00
Rate for Payer: Group Health Inc Medicare	$68.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.00
Rate for Payer: Hamaspik Choice Inc Medicare	$98.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.40

STRY LOCK SCREW THREAD 5X32.5MM

Facility IP

$3,803.80

Service Code	HCPCS C1713
Hospital Charge Code	40005202
Hospital Revenue Code	278
Min. Negotiated Rate	$1,901.90
Max. Negotiated Rate	$1,901.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,901.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,901.90

STRY LOCK SCREW THREAD 5X32.5MM

Facility OP

$3,803.80

Service Code	HCPCS C1713
Hospital Charge Code	40005202
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,993.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,092.09
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	$1,901.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,187.18
Rate for Payer: Fidelis Medicare Advantage	$3,993.99
Rate for Payer: Group Health Inc Commercial	$1,901.90
Rate for Payer: Group Health Inc Medicare	$1,331.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,901.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1,901.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,472.47

STRY LOCK SC, THREAD 5X52.5 MM

Facility OP

$343.20

Service Code	HCPCS C1713
Hospital Charge Code	40204220
Hospital Revenue Code	278
Min. Negotiated Rate	$120.12
Max. Negotiated Rate	$360.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$188.76
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	$171.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$197.34
Rate for Payer: Fidelis Medicare Advantage	$360.36
Rate for Payer: Group Health Inc Commercial	$171.60
Rate for Payer: Group Health Inc Medicare	$120.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.60
Rate for Payer: Hamaspik Choice Inc Medicare	$171.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$223.08

STRY LOCK SC, THREAD 5X52.5 MM

Facility IP

$343.20

Service Code	HCPCS C1713
Hospital Charge Code	40204220
Hospital Revenue Code	278
Min. Negotiated Rate	$171.60
Max. Negotiated Rate	$171.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$171.60
Rate for Payer: Hamaspik Choice Inc Medicare	$171.60

STRY LONG BLIT R1.5 T TI LEFT 11

Facility IP

$6,698.00

Service Code	HCPCS C1713
Hospital Charge Code	40009285
Hospital Revenue Code	278
Min. Negotiated Rate	$3,349.00
Max. Negotiated Rate	$3,349.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,349.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,349.00

STRY LONG BLIT R1.5 T TI LEFT 11

Facility OP

$6,698.00

Service Code	HCPCS C1713
Hospital Charge Code	40009285
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$7,032.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,683.90
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	$3,349.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,851.35
Rate for Payer: Fidelis Medicare Advantage	$7,032.90
Rate for Payer: Group Health Inc Commercial	$3,349.00
Rate for Payer: Group Health Inc Medicare	$2,344.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,349.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,349.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,353.70

STRY LONG BLSTRYKER L L 1

Facility IP

$6,262.40

Service Code	HCPCS C1713
Hospital Charge Code	40009748
Hospital Revenue Code	278
Min. Negotiated Rate	$3,131.20
Max. Negotiated Rate	$3,131.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,131.20
Rate for Payer: Hamaspik Choice Inc Medicare	$3,131.20

STRY LONG BLSTRYKER L L 1

Facility OP

$6,262.40

Service Code	HCPCS C1713
Hospital Charge Code	40009748
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,575.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,444.32
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	$3,131.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,600.88
Rate for Payer: Fidelis Medicare Advantage	$6,575.52
Rate for Payer: Group Health Inc Commercial	$3,131.20
Rate for Payer: Group Health Inc Medicare	$2,191.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,131.20
Rate for Payer: Hamaspik Choice Inc Medicare	$3,131.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,070.56

STRY LW PROF 3D BX PLT 2X2 H LEG

Facility OP

$553.00

Service Code	HCPCS C1776
Hospital Charge Code	40208013
Hospital Revenue Code	278
Min. Negotiated Rate	$193.55
Max. Negotiated Rate	$580.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$304.15
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	$276.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$317.98
Rate for Payer: Fidelis Medicare Advantage	$580.65
Rate for Payer: Group Health Inc Commercial	$276.50
Rate for Payer: Group Health Inc Medicare	$193.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$276.50
Rate for Payer: Hamaspik Choice Inc Medicare	$276.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$359.45

STRY LW PROF 3D BX PLT 2X2 H LEG

Facility IP

$553.00

Service Code	HCPCS C1776
Hospital Charge Code	40208013
Hospital Revenue Code	278
Min. Negotiated Rate	$276.50
Max. Negotiated Rate	$276.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$276.50
Rate for Payer: Hamaspik Choice Inc Medicare	$276.50

STRY NAIL 13 X 400MM

Facility IP

$3,746.60

Service Code	HCPCS C1713
Hospital Charge Code	40009291
Hospital Revenue Code	278
Min. Negotiated Rate	$1,873.30
Max. Negotiated Rate	$1,873.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,873.30
Rate for Payer: Hamaspik Choice Inc Medicare	$1,873.30

STRY NAIL 13 X 400MM

Facility OP

$3,746.60

Service Code	HCPCS C1713
Hospital Charge Code	40009291
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,933.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,060.63
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	$1,873.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,154.30
Rate for Payer: Fidelis Medicare Advantage	$3,933.93
Rate for Payer: Group Health Inc Commercial	$1,873.30
Rate for Payer: Group Health Inc Medicare	$1,311.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,873.30
Rate for Payer: Hamaspik Choice Inc Medicare	$1,873.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,435.29

STRY NON LCK SCREW 3.5X26MM

Facility IP

$448.80

Service Code	HCPCS C1713
Hospital Charge Code	40008289
Hospital Revenue Code	278
Min. Negotiated Rate	$224.40
Max. Negotiated Rate	$224.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$224.40
Rate for Payer: Hamaspik Choice Inc Medicare	$224.40

STRY NON LCK SCREW 3.5X26MM

Facility OP

$448.80

Service Code	HCPCS C1713
Hospital Charge Code	40008289
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$471.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$246.84
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	$224.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$258.06
Rate for Payer: Fidelis Medicare Advantage	$471.24
Rate for Payer: Group Health Inc Commercial	$224.40
Rate for Payer: Group Health Inc Medicare	$157.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$224.40
Rate for Payer: Hamaspik Choice Inc Medicare	$224.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$291.72

STRY PRE-BENT CHAMPY PLATE 4-HOLE

Facility IP

$586.92

Service Code	HCPCS C1713
Hospital Charge Code	40203419
Hospital Revenue Code	278
Min. Negotiated Rate	$293.46
Max. Negotiated Rate	$293.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.46
Rate for Payer: Hamaspik Choice Inc Medicare	$293.46

STRY PRE-BENT CHAMPY PLATE 4-HOLE

Facility OP

$586.92

Service Code	HCPCS C1713
Hospital Charge Code	40203419
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$616.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$322.81
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	$293.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$337.48
Rate for Payer: Fidelis Medicare Advantage	$616.27
Rate for Payer: Group Health Inc Commercial	$293.46
Rate for Payer: Group Health Inc Medicare	$205.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$293.46
Rate for Payer: Hamaspik Choice Inc Medicare	$293.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$381.50

STRY R108 PLT 6HOLE PELVIC

Facility OP

$742.30

Service Code	HCPCS C1713
Hospital Charge Code	40004611
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$779.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$408.26
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	$371.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$426.82
Rate for Payer: Fidelis Medicare Advantage	$779.42
Rate for Payer: Group Health Inc Commercial	$371.15
Rate for Payer: Group Health Inc Medicare	$259.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$371.15
Rate for Payer: Hamaspik Choice Inc Medicare	$371.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$482.50

STRY R108 PLT 6HOLE PELVIC

Facility IP

$742.30

Service Code	HCPCS C1713
Hospital Charge Code	40004611
Hospital Revenue Code	278
Min. Negotiated Rate	$371.15
Max. Negotiated Rate	$371.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$371.15
Rate for Payer: Hamaspik Choice Inc Medicare	$371.15

STRY ROD 11X200MM

Facility OP

$708.00

Service Code	HCPCS C1713
Hospital Charge Code	40008256
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$743.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$389.40
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	$354.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$407.10
Rate for Payer: Fidelis Medicare Advantage	$743.40
Rate for Payer: Group Health Inc Commercial	$354.00
Rate for Payer: Group Health Inc Medicare	$247.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.00
Rate for Payer: Hamaspik Choice Inc Medicare	$354.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$460.20

STRY ROD 11X200MM

Facility IP

$708.00

Service Code	HCPCS C1713
Hospital Charge Code	40008256
Hospital Revenue Code	278
Min. Negotiated Rate	$354.00
Max. Negotiated Rate	$354.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.00
Rate for Payer: Hamaspik Choice Inc Medicare	$354.00

STRYR R1.5 L11 360MMX125D NAIL KT

Facility IP

$3,164.00

Service Code	HCPCS C1713
Hospital Charge Code	40005246
Hospital Revenue Code	278
Min. Negotiated Rate	$1,582.00
Max. Negotiated Rate	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,582.00

STRYR R1.5 L11 360MMX125D NAIL KT

Facility OP

$3,164.00

Service Code	HCPCS C1713
Hospital Charge Code	40005246
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,322.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,740.20
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	$1,582.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,819.30
Rate for Payer: Fidelis Medicare Advantage	$3,322.20
Rate for Payer: Group Health Inc Commercial	$1,582.00
Rate for Payer: Group Health Inc Medicare	$1,107.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,582.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,582.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,056.60

STRY SC 1.7 X 5MM EMER SLF DRL

Facility IP

$98.42

Service Code	HCPCS C1713
Hospital Charge Code	40204211
Hospital Revenue Code	278
Min. Negotiated Rate	$49.21
Max. Negotiated Rate	$49.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.21
Rate for Payer: Hamaspik Choice Inc Medicare	$49.21

STRY SC 1.7 X 5MM EMER SLF DRL

Facility OP

$98.42

Service Code	HCPCS C1713
Hospital Charge Code	40204211
Hospital Revenue Code	278
Min. Negotiated Rate	$34.45
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$54.13
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	$49.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.59
Rate for Payer: Fidelis Medicare Advantage	$103.34
Rate for Payer: Group Health Inc Commercial	$49.21
Rate for Payer: Group Health Inc Medicare	$34.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.21
Rate for Payer: Hamaspik Choice Inc Medicare	$49.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$63.97

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