St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STRYKER CARBON ROD 8X350MM

Facility

$298.20

Service Code	HCPCS C1713
Hospital Charge Code	40209402
Hospital Revenue Code	278
Min. Negotiated Rate	$149.10
Max. Negotiated Rate	$149.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$149.10
Rate for Payer: Hamaspik Choice Inc Medicare	$149.10

STRYKER CARBON ROD 8X350MM

Facility

$298.20

Service Code	HCPCS C1713
Hospital Charge Code	40209402
Hospital Revenue Code	278
Min. Negotiated Rate	$104.37
Max. Negotiated Rate	$313.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$164.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$178.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$149.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$171.46
Rate for Payer: EmblemHealth Commercial	$149.10
Rate for Payer: Fidelis Medicare Advantage	$313.11
Rate for Payer: Group Health Inc Commercial	$149.10
Rate for Payer: Group Health Inc Medicare	$104.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$149.10
Rate for Payer: Hamaspik Choice Inc Medicare	$149.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$193.83

STRYKER CLAMP

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	40203358
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00

STRYKER CLAMP

Facility

$600.00

Hospital Charge Code	40009341
Hospital Revenue Code	272
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$480.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$330.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$300.00
Rate for Payer: Aetna Government	$300.00
Rate for Payer: Brighton Health Commercial	$450.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$480.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$408.00
Rate for Payer: Group Health Inc Commercial	$300.00
Rate for Payer: Group Health Inc Medicare	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00

STRYKER CLAMP

Facility

$600.00

Service Code	HCPCS C1713
Hospital Charge Code	40203358
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$630.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$330.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$360.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$345.00
Rate for Payer: EmblemHealth Commercial	$300.00
Rate for Payer: Fidelis Medicare Advantage	$630.00
Rate for Payer: Group Health Inc Commercial	$300.00
Rate for Payer: Group Health Inc Medicare	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$390.00

STRYKER CLAMP 10 HOLE

Facility

$1,450.00

Service Code	HCPCS C1713
Hospital Charge Code	40203340
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,522.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$797.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$870.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$725.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$833.75
Rate for Payer: EmblemHealth Commercial	$725.00
Rate for Payer: Fidelis Medicare Advantage	$1,522.50
Rate for Payer: Group Health Inc Commercial	$725.00
Rate for Payer: Group Health Inc Medicare	$507.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$725.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$942.50

STRYKER CLAMP 10 HOLE

Facility

$1,450.00

Hospital Charge Code	40009322
Hospital Revenue Code	272
Min. Negotiated Rate	$507.50
Max. Negotiated Rate	$1,160.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$797.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$725.00
Rate for Payer: Aetna Government	$725.00
Rate for Payer: Brighton Health Commercial	$1,087.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$986.00
Rate for Payer: Group Health Inc Commercial	$725.00
Rate for Payer: Group Health Inc Medicare	$507.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$725.00

STRYKER CLAMP 10 HOLE

Facility

$1,450.00

Service Code	HCPCS C1713
Hospital Charge Code	40203340
Hospital Revenue Code	278
Min. Negotiated Rate	$725.00
Max. Negotiated Rate	$725.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$725.00

STRYKER CLAMP 5 HOLE

Facility

$830.00

Service Code	HCPCS C1713
Hospital Charge Code	40203339
Hospital Revenue Code	278
Min. Negotiated Rate	$415.00
Max. Negotiated Rate	$415.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$415.00
Rate for Payer: Hamaspik Choice Inc Medicare	$415.00

STRYKER CLAMP 5 HOLE

Facility

$830.00

Service Code	HCPCS C1713
Hospital Charge Code	40203339
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$871.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$456.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$498.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$415.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$477.25
Rate for Payer: EmblemHealth Commercial	$415.00
Rate for Payer: Fidelis Medicare Advantage	$871.50
Rate for Payer: Group Health Inc Commercial	$415.00
Rate for Payer: Group Health Inc Medicare	$290.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$415.00
Rate for Payer: Hamaspik Choice Inc Medicare	$415.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$539.50

STRYKER CLAMP 5 HOLE

Facility

$830.00

Hospital Charge Code	40009321
Hospital Revenue Code	272
Min. Negotiated Rate	$290.50
Max. Negotiated Rate	$664.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$456.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$415.00
Rate for Payer: Aetna Government	$415.00
Rate for Payer: Brighton Health Commercial	$622.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$664.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$564.40
Rate for Payer: Group Health Inc Commercial	$415.00
Rate for Payer: Group Health Inc Medicare	$290.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$415.00
Rate for Payer: Hamaspik Choice Inc Medicare	$415.00

STRYKER CLAMP GOLD/BLUE

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	40203359
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$829.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$434.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$474.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$395.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$454.25
Rate for Payer: EmblemHealth Commercial	$395.00
Rate for Payer: Fidelis Medicare Advantage	$829.50
Rate for Payer: Group Health Inc Commercial	$395.00
Rate for Payer: Group Health Inc Medicare	$276.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$513.50

STRYKER CLAMP GOLD/BLUE

Facility

$790.00

Hospital Charge Code	40009342
Hospital Revenue Code	272
Min. Negotiated Rate	$276.50
Max. Negotiated Rate	$632.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$434.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$395.00
Rate for Payer: Aetna Government	$395.00
Rate for Payer: Brighton Health Commercial	$592.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$632.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$537.20
Rate for Payer: Group Health Inc Commercial	$395.00
Rate for Payer: Group Health Inc Medicare	$276.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00

STRYKER CLAMP GOLD/BLUE

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	40203359
Hospital Revenue Code	278
Min. Negotiated Rate	$395.00
Max. Negotiated Rate	$395.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00

STRYKER CLAMP PIN TO ROD

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	40203350
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$829.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$434.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$474.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$395.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$454.25
Rate for Payer: EmblemHealth Commercial	$395.00
Rate for Payer: Fidelis Medicare Advantage	$829.50
Rate for Payer: Group Health Inc Commercial	$395.00
Rate for Payer: Group Health Inc Medicare	$276.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$513.50

STRYKER CLAMP PIN TO ROD

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	40203350
Hospital Revenue Code	278
Min. Negotiated Rate	$395.00
Max. Negotiated Rate	$395.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00

STRYKER CLAMP PIN TO ROD

Facility

$790.00

Hospital Charge Code	40009333
Hospital Revenue Code	272
Min. Negotiated Rate	$276.50
Max. Negotiated Rate	$632.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$434.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$395.00
Rate for Payer: Aetna Government	$395.00
Rate for Payer: Brighton Health Commercial	$592.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$632.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$537.20
Rate for Payer: Group Health Inc Commercial	$395.00
Rate for Payer: Group Health Inc Medicare	$276.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00

STRYKER CLAMP ROD TO ROD

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	40203351
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$829.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$434.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$474.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$395.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$454.25
Rate for Payer: EmblemHealth Commercial	$395.00
Rate for Payer: Fidelis Medicare Advantage	$829.50
Rate for Payer: Group Health Inc Commercial	$395.00
Rate for Payer: Group Health Inc Medicare	$276.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$513.50

STRYKER CLAMP ROD TO ROD

Facility

$790.00

Service Code	HCPCS C1713
Hospital Charge Code	40203351
Hospital Revenue Code	278
Min. Negotiated Rate	$395.00
Max. Negotiated Rate	$395.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00

STRYKER CLAMP ROD TO ROD

Facility

$790.00

Hospital Charge Code	40009334
Hospital Revenue Code	272
Min. Negotiated Rate	$276.50
Max. Negotiated Rate	$632.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$434.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$395.00
Rate for Payer: Aetna Government	$395.00
Rate for Payer: Brighton Health Commercial	$592.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$632.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$537.20
Rate for Payer: Group Health Inc Commercial	$395.00
Rate for Payer: Group Health Inc Medicare	$276.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$395.00
Rate for Payer: Hamaspik Choice Inc Medicare	$395.00

STRYKER CLAMP SINGLE

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	40203357
Hospital Revenue Code	278
Min. Negotiated Rate	$260.00
Max. Negotiated Rate	$260.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$260.00

STRYKER CLAMP SINGLE

Facility

$520.00

Hospital Charge Code	40009340
Hospital Revenue Code	272
Min. Negotiated Rate	$182.00
Max. Negotiated Rate	$416.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$286.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$260.00
Rate for Payer: Aetna Government	$260.00
Rate for Payer: Brighton Health Commercial	$390.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$416.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$353.60
Rate for Payer: Group Health Inc Commercial	$260.00
Rate for Payer: Group Health Inc Medicare	$182.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$260.00

STRYKER CLAMP SINGLE

Facility

$520.00

Service Code	HCPCS C1713
Hospital Charge Code	40203357
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$546.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$286.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$312.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$260.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.00
Rate for Payer: EmblemHealth Commercial	$260.00
Rate for Payer: Fidelis Medicare Advantage	$546.00
Rate for Payer: Group Health Inc Commercial	$260.00
Rate for Payer: Group Health Inc Medicare	$182.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$260.00
Rate for Payer: Hamaspik Choice Inc Medicare	$260.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$338.00

STRYKER CLOSED CLIP

Facility

$82.50

Hospital Charge Code	40200530
Hospital Revenue Code	270
Min. Negotiated Rate	$28.88
Max. Negotiated Rate	$66.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$41.25
Rate for Payer: Aetna Government	$41.25
Rate for Payer: Brighton Health Commercial	$61.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.10
Rate for Payer: Group Health Inc Commercial	$41.25
Rate for Payer: Group Health Inc Medicare	$28.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$41.25
Rate for Payer: Hamaspik Choice Inc Medicare	$41.25

STRYKER CMF CUSTOMIZED IMPLNT KIT

Facility

$25,554.00

Hospital Charge Code	40203400
Hospital Revenue Code	272
Min. Negotiated Rate	$8,943.90
Max. Negotiated Rate	$20,443.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14,054.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12,777.00
Rate for Payer: Aetna Government	$12,777.00
Rate for Payer: Brighton Health Commercial	$19,165.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20,443.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$17,376.72
Rate for Payer: Group Health Inc Commercial	$12,777.00
Rate for Payer: Group Health Inc Medicare	$8,943.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$12,777.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12,777.00

Know your out-of-pocket cost for care.

All Charges