St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STRY SER POLYAX 6.5X35MM

Facility

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	40008315
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 SER POLYAX 6.5X35MM

Facility

$4,665.58

Service Code	HCPCS C1713
Hospital Charge Code	40008315
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 SPINE 3.5MM TAP

Facility

$1,025.80

Service Code	HCPCS C1713
Hospital Charge Code	40204254
Hospital Revenue Code	278
Min. Negotiated Rate	$512.90
Max. Negotiated Rate	$512.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$512.90
Rate for Payer: Hamaspik Choice Inc Medicare	$512.90

STRY SPINE 3.5MM TAP

Facility

$1,025.80

Service Code	HCPCS C1713
Hospital Charge Code	40204254
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,077.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$564.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$615.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$512.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$589.84
Rate for Payer: EmblemHealth Commercial	$512.90
Rate for Payer: Fidelis Medicare Advantage	$1,077.09
Rate for Payer: Group Health Inc Commercial	$512.90
Rate for Payer: Group Health Inc Medicare	$359.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$512.90
Rate for Payer: Hamaspik Choice Inc Medicare	$512.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$666.77

STRY SPINE 5.5 TAP

Facility

$720.16

Service Code	HCPCS C1713
Hospital Charge Code	40003441
Hospital Revenue Code	278
Min. Negotiated Rate	$360.08
Max. Negotiated Rate	$360.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$360.08
Rate for Payer: Hamaspik Choice Inc Medicare	$360.08

STRY SPINE 5.5 TAP

Facility

$720.16

Service Code	HCPCS C1713
Hospital Charge Code	40003441
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$756.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$396.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$432.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$360.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$414.09
Rate for Payer: EmblemHealth Commercial	$360.08
Rate for Payer: Fidelis Medicare Advantage	$756.17
Rate for Payer: Group Health Inc Commercial	$360.08
Rate for Payer: Group Health Inc Medicare	$252.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$360.08
Rate for Payer: Hamaspik Choice Inc Medicare	$360.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$468.10

STRY SRT INTERM VOLAR PL LT

Facility

$3,204.00

Service Code	HCPCS C1713
Hospital Charge Code	40204207
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$3,364.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,762.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,922.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,602.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,842.30
Rate for Payer: EmblemHealth Commercial	$1,602.00
Rate for Payer: Fidelis Medicare Advantage	$3,364.20
Rate for Payer: Group Health Inc Commercial	$1,602.00
Rate for Payer: Group Health Inc Medicare	$1,121.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,602.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,602.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,082.60

STRY SRT INTERM VOLAR PL LT

Facility

$3,204.00

Service Code	HCPCS C1713
Hospital Charge Code	40204207
Hospital Revenue Code	278
Min. Negotiated Rate	$1,602.00
Max. Negotiated Rate	$1,602.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,602.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,602.00

STRY STEM BLL ACCOLAD MM,

Facility

$13,041.00

Service Code	HCPCS C1776
Hospital Charge Code	40009749
Hospital Revenue Code	278
Min. Negotiated Rate	$6,520.50
Max. Negotiated Rate	$6,520.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,520.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,520.50

STRY STEM BLL ACCOLAD MM,

Facility

$13,041.00

Service Code	HCPCS C1776
Hospital Charge Code	40009749
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$13,693.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,172.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$7,824.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,520.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,498.58
Rate for Payer: EmblemHealth Commercial	$6,520.50
Rate for Payer: Fidelis Medicare Advantage	$13,693.05
Rate for Payer: Group Health Inc Commercial	$6,520.50
Rate for Payer: Group Health Inc Medicare	$4,564.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,520.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,520.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,476.65

STRY STRAIT PLATE, 8 HOLE W/O BAR

Facility

$292.46

Service Code	HCPCS C1713
Hospital Charge Code	40203402
Hospital Revenue Code	278
Min. Negotiated Rate	$102.36
Max. Negotiated Rate	$307.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$160.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$175.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$146.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$168.16
Rate for Payer: EmblemHealth Commercial	$146.23
Rate for Payer: Fidelis Medicare Advantage	$307.08
Rate for Payer: Group Health Inc Commercial	$146.23
Rate for Payer: Group Health Inc Medicare	$102.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$146.23
Rate for Payer: Hamaspik Choice Inc Medicare	$146.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$190.10

STRY STRAIT PLATE, 8 HOLE W/O BAR

Facility

$292.46

Service Code	HCPCS C1713
Hospital Charge Code	40203402
Hospital Revenue Code	278
Min. Negotiated Rate	$146.23
Max. Negotiated Rate	$146.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$146.23
Rate for Payer: Hamaspik Choice Inc Medicare	$146.23

STRY T2 SCN 11 X 380MM

Facility

$3,746.60

Service Code	HCPCS C1713
Hospital Charge Code	40009733
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: Brighton Health Commercial	$2,247.96
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: EmblemHealth Commercial	$1,873.30
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 T2 SCN 11 X 380MM

Facility

$3,746.60

Service Code	HCPCS C1713
Hospital Charge Code	40009733
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 TAP XIA3 5.0 MM

Facility

$720.16

Service Code	HCPCS C1713
Hospital Charge Code	40003442
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$756.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$396.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$432.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$360.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$414.09
Rate for Payer: EmblemHealth Commercial	$360.08
Rate for Payer: Fidelis Medicare Advantage	$756.17
Rate for Payer: Group Health Inc Commercial	$360.08
Rate for Payer: Group Health Inc Medicare	$252.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$360.08
Rate for Payer: Hamaspik Choice Inc Medicare	$360.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$468.10

STRY TAP XIA3 5.0 MM

Facility

$720.16

Service Code	HCPCS C1713
Hospital Charge Code	40003442
Hospital Revenue Code	278
Min. Negotiated Rate	$360.08
Max. Negotiated Rate	$360.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$360.08
Rate for Payer: Hamaspik Choice Inc Medicare	$360.08

STRY TITAN WASHERS

Facility

$54.60

Hospital Charge Code	40008258
Hospital Revenue Code	270
Min. Negotiated Rate	$19.11
Max. Negotiated Rate	$43.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$27.30
Rate for Payer: Aetna Government	$27.30
Rate for Payer: Brighton Health Commercial	$40.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$43.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.13
Rate for Payer: Group Health Inc Commercial	$27.30
Rate for Payer: Group Health Inc Medicare	$19.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.30
Rate for Payer: Hamaspik Choice Inc Medicare	$27.30

STRY TIT WASHER FOR 5.0MM SCREW

Facility

$58.00

Service Code	HCPCS C1713
Hospital Charge Code	40004616
Hospital Revenue Code	278
Min. Negotiated Rate	$20.30
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$34.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.35
Rate for Payer: EmblemHealth Commercial	$29.00
Rate for Payer: Fidelis Medicare Advantage	$60.90
Rate for Payer: Group Health Inc Commercial	$29.00
Rate for Payer: Group Health Inc Medicare	$20.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.00
Rate for Payer: Hamaspik Choice Inc Medicare	$29.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$37.70

STRY TIT WASHER FOR 5.0MM SCREW

Facility

$58.00

Service Code	HCPCS C1713
Hospital Charge Code	40004616
Hospital Revenue Code	278
Min. Negotiated Rate	$29.00
Max. Negotiated Rate	$29.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.00
Rate for Payer: Hamaspik Choice Inc Medicare	$29.00

STRY TWST DRLL 1.6X58MM WKLG 26MM

Facility

$218.82

Service Code	HCPCS C1713
Hospital Charge Code	40203423
Hospital Revenue Code	278
Min. Negotiated Rate	$109.41
Max. Negotiated Rate	$109.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.41
Rate for Payer: Hamaspik Choice Inc Medicare	$109.41

STRY TWST DRLL 1.6X58MM WKLG 26MM

Facility

$218.82

Service Code	HCPCS C1713
Hospital Charge Code	40203423
Hospital Revenue Code	278
Min. Negotiated Rate	$76.59
Max. Negotiated Rate	$229.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$120.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$131.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$109.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$125.82
Rate for Payer: EmblemHealth Commercial	$109.41
Rate for Payer: Fidelis Medicare Advantage	$229.76
Rate for Payer: Group Health Inc Commercial	$109.41
Rate for Payer: Group Health Inc Medicare	$76.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.41
Rate for Payer: Hamaspik Choice Inc Medicare	$109.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$142.23

STRY UN3 BOX PLATE

Facility

$501.82

Service Code	HCPCS C1713
Hospital Charge Code	40204201
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$526.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$301.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$250.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.55
Rate for Payer: EmblemHealth Commercial	$250.91
Rate for Payer: Fidelis Medicare Advantage	$526.91
Rate for Payer: Group Health Inc Commercial	$250.91
Rate for Payer: Group Health Inc Medicare	$175.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.91
Rate for Payer: Hamaspik Choice Inc Medicare	$250.91
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$326.18

STRY UN3 BOX PLATE

Facility

$501.82

Service Code	HCPCS C1713
Hospital Charge Code	40204201
Hospital Revenue Code	278
Min. Negotiated Rate	$250.91
Max. Negotiated Rate	$250.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.91
Rate for Payer: Hamaspik Choice Inc Medicare	$250.91

STRY UN3 BOX_PLATE

Facility

$501.82

Service Code	HCPCS C1713
Hospital Charge Code	40204206
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$526.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$276.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$301.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$250.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$288.55
Rate for Payer: EmblemHealth Commercial	$250.91
Rate for Payer: Fidelis Medicare Advantage	$526.91
Rate for Payer: Group Health Inc Commercial	$250.91
Rate for Payer: Group Health Inc Medicare	$175.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.91
Rate for Payer: Hamaspik Choice Inc Medicare	$250.91
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$326.18

STRY UN3 BOX_PLATE

Facility

$501.82

Service Code	HCPCS C1713
Hospital Charge Code	40204206
Hospital Revenue Code	278
Min. Negotiated Rate	$250.91
Max. Negotiated Rate	$250.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.91
Rate for Payer: Hamaspik Choice Inc Medicare	$250.91

Know your out-of-pocket cost for care.

All Charges