St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STRYK TOTAL KNEE TIBIAL BEARING

Facility

$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: Brighton Health Commercial	$2,232.72
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: EmblemHealth Commercial	$1,860.60
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

STRY K-WIRE 3.2 X 150 MM

Facility

$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: Brighton Health Commercial	$180.00
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

$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: Brighton Health Commercial	$180.00
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

$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: Brighton Health Commercial	$46.20
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

$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 K-WIRE .8MMX100MM

Facility

$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: Brighton Health Commercial	$36.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.42
Rate for Payer: EmblemHealth Commercial	$30.80
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 LARGE SCR 6.5X40MM

Facility

$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

$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: Brighton Health Commercial	$2,799.35
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: EmblemHealth Commercial	$2,332.79
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

STRY LCK 4.0X34MM SCREW

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40008284
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$527.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$301.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$251.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.65
Rate for Payer: EmblemHealth Commercial	$251.00
Rate for Payer: Fidelis Medicare Advantage	$527.10
Rate for Payer: Group Health Inc Commercial	$251.00
Rate for Payer: Group Health Inc Medicare	$175.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$326.30

STRY LCK 4.0X34MM SCREW

Facility

$502.00

Service Code	HCPCS C1713
Hospital Charge Code	40008284
Hospital Revenue Code	278
Min. Negotiated Rate	$251.00
Max. Negotiated Rate	$251.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$251.00
Rate for Payer: Hamaspik Choice Inc Medicare	$251.00

STRY LCK 4.0X38MM SCREW

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40008277
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

STRY LCK 4.0X38MM SCREW

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	40008277
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$315.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$180.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.50
Rate for Payer: EmblemHealth Commercial	$150.00
Rate for Payer: Fidelis Medicare Advantage	$315.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$195.00

STRYLER APEX PIN 4X90

Facility

$215.60

Service Code	HCPCS C1713
Hospital Charge Code	40202746
Hospital Revenue Code	278
Min. Negotiated Rate	$107.80
Max. Negotiated Rate	$107.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$107.80
Rate for Payer: Hamaspik Choice Inc Medicare	$107.80

STRYLER APEX PIN 4X90

Facility

$215.60

Service Code	HCPCS C1713
Hospital Charge Code	40202746
Hospital Revenue Code	278
Min. Negotiated Rate	$75.46
Max. Negotiated Rate	$226.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$118.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$129.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$107.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$123.97
Rate for Payer: EmblemHealth Commercial	$107.80
Rate for Payer: Fidelis Medicare Advantage	$226.38
Rate for Payer: Group Health Inc Commercial	$107.80
Rate for Payer: Group Health Inc Medicare	$75.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$107.80
Rate for Payer: Hamaspik Choice Inc Medicare	$107.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$140.14

STRY LG SUBOCCIPITAL SKL BASE PLT

Facility

$2,009.42

Service Code	HCPCS C1713
Hospital Charge Code	40002791
Hospital Revenue Code	278
Min. Negotiated Rate	$1,004.71
Max. Negotiated Rate	$1,004.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,004.71
Rate for Payer: Hamaspik Choice Inc Medicare	$1,004.71

STRY LG SUBOCCIPITAL SKL BASE PLT

Facility

$2,009.42

Service Code	HCPCS C1713
Hospital Charge Code	40002791
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,109.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,105.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,205.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,004.71
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,155.42
Rate for Payer: EmblemHealth Commercial	$1,004.71
Rate for Payer: Fidelis Medicare Advantage	$2,109.89
Rate for Payer: Group Health Inc Commercial	$1,004.71
Rate for Payer: Group Health Inc Medicare	$703.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,004.71
Rate for Payer: Hamaspik Choice Inc Medicare	$1,004.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,306.12

STRY LID FOR ASNIS SCR RACK

Facility

$170.00

Hospital Charge Code	40204261
Hospital Revenue Code	272
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$136.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$85.00
Rate for Payer: Aetna Government	$85.00
Rate for Payer: Brighton Health Commercial	$127.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.60
Rate for Payer: Group Health Inc Commercial	$85.00
Rate for Payer: Group Health Inc Medicare	$59.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00

STRY LIGHT PIPE

Facility

$741.60

Hospital Charge Code	40004607
Hospital Revenue Code	272
Min. Negotiated Rate	$259.56
Max. Negotiated Rate	$593.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$407.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$370.80
Rate for Payer: Aetna Government	$370.80
Rate for Payer: Brighton Health Commercial	$556.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$593.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$504.29
Rate for Payer: Group Health Inc Commercial	$370.80
Rate for Payer: Group Health Inc Medicare	$259.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$370.80
Rate for Payer: Hamaspik Choice Inc Medicare	$370.80

STRY LOCK 2.7 MM X 14 MM

Facility

$450.50

Service Code	HCPCS C1713
Hospital Charge Code	40203440
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$473.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$247.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$270.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$225.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$259.04
Rate for Payer: EmblemHealth Commercial	$225.25
Rate for Payer: Fidelis Medicare Advantage	$473.02
Rate for Payer: Group Health Inc Commercial	$225.25
Rate for Payer: Group Health Inc Medicare	$157.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.25
Rate for Payer: Hamaspik Choice Inc Medicare	$225.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$292.82

STRY LOCK 2.7 MM X 14 MM

Facility

$450.50

Service Code	HCPCS C1713
Hospital Charge Code	40203440
Hospital Revenue Code	278
Min. Negotiated Rate	$225.25
Max. Negotiated Rate	$225.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.25
Rate for Payer: Hamaspik Choice Inc Medicare	$225.25

STRY LOCK 2.7MM X 14MM

Facility

$450.50

Service Code	HCPCS C1713
Hospital Charge Code	40204722
Hospital Revenue Code	278
Min. Negotiated Rate	$225.25
Max. Negotiated Rate	$225.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.25
Rate for Payer: Hamaspik Choice Inc Medicare	$225.25

STRY LOCK 2.7MM X 14MM

Facility

$450.50

Service Code	HCPCS C1713
Hospital Charge Code	40204722
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$473.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$247.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$270.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$225.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$259.04
Rate for Payer: EmblemHealth Commercial	$225.25
Rate for Payer: Fidelis Medicare Advantage	$473.02
Rate for Payer: Group Health Inc Commercial	$225.25
Rate for Payer: Group Health Inc Medicare	$157.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$225.25
Rate for Payer: Hamaspik Choice Inc Medicare	$225.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$292.82

STRY LOCK SCREW 22 X 2.3 MM

Facility

$196.00

Service Code	HCPCS C1713
Hospital Charge Code	40203445
Hospital Revenue Code	278
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$98.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.00
Rate for Payer: Hamaspik Choice Inc Medicare	$98.00

STRY LOCK SCREW 22 X 2.3 MM

Facility

$196.00

Service Code	HCPCS C1713
Hospital Charge Code	40203445
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: Brighton Health Commercial	$117.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$98.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.70
Rate for Payer: EmblemHealth Commercial	$98.00
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 22 X 2.3MM

Facility

$196.00

Service Code	HCPCS C1713
Hospital Charge Code	40204727
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: Brighton Health Commercial	$117.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$98.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$112.70
Rate for Payer: EmblemHealth Commercial	$98.00
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

Know your out-of-pocket cost for care.

All Charges