St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NCB 4.3MM DRILL BIT, L 24

Facility

$229.90

Hospital Charge Code	40006784
Hospital Revenue Code	272
Min. Negotiated Rate	$80.46
Max. Negotiated Rate	$183.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.95
Rate for Payer: Aetna Government	$114.95
Rate for Payer: Brighton Health Commercial	$172.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$183.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.33
Rate for Payer: Group Health Inc Commercial	$114.95
Rate for Payer: Group Health Inc Medicare	$80.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.95
Rate for Payer: Hamaspik Choice Inc Medicare	$114.95

NCB 4.3MM DRILL_BIT, L 24

Facility

$237.32

Hospital Charge Code	40006868
Hospital Revenue Code	272
Min. Negotiated Rate	$83.06
Max. Negotiated Rate	$189.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.66
Rate for Payer: Aetna Government	$118.66
Rate for Payer: Brighton Health Commercial	$177.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$189.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.38
Rate for Payer: Group Health Inc Commercial	$118.66
Rate for Payer: Group Health Inc Medicare	$83.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.66
Rate for Payer: Hamaspik Choice Inc Medicare	$118.66

NCB 4.3MM DRILL GUIDE, LO

Facility

$734.20

Hospital Charge Code	40006785
Hospital Revenue Code	272
Min. Negotiated Rate	$256.97
Max. Negotiated Rate	$587.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$403.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$367.10
Rate for Payer: Aetna Government	$367.10
Rate for Payer: Brighton Health Commercial	$550.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$587.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$499.26
Rate for Payer: Group Health Inc Commercial	$367.10
Rate for Payer: Group Health Inc Medicare	$256.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$367.10
Rate for Payer: Hamaspik Choice Inc Medicare	$367.10

NCB 5.0MM DRILL BIT, L 24

Facility

$667.44

Hospital Charge Code	40006798
Hospital Revenue Code	272
Min. Negotiated Rate	$233.60
Max. Negotiated Rate	$533.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$367.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$333.72
Rate for Payer: Aetna Government	$333.72
Rate for Payer: Brighton Health Commercial	$500.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$533.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$453.86
Rate for Payer: Group Health Inc Commercial	$333.72
Rate for Payer: Group Health Inc Medicare	$233.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.72
Rate for Payer: Hamaspik Choice Inc Medicare	$333.72

NCB 5.0MM DRILL BIT, L 24

Facility

$237.32

Hospital Charge Code	40006870
Hospital Revenue Code	272
Min. Negotiated Rate	$83.06
Max. Negotiated Rate	$189.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.66
Rate for Payer: Aetna Government	$118.66
Rate for Payer: Brighton Health Commercial	$177.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$189.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.38
Rate for Payer: Group Health Inc Commercial	$118.66
Rate for Payer: Group Health Inc Medicare	$83.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.66
Rate for Payer: Hamaspik Choice Inc Medicare	$118.66

NCB 5.0MM DRILL GUIDE, LO

Facility

$667.44

Hospital Charge Code	40006799
Hospital Revenue Code	272
Min. Negotiated Rate	$233.60
Max. Negotiated Rate	$533.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$367.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$333.72
Rate for Payer: Aetna Government	$333.72
Rate for Payer: Brighton Health Commercial	$500.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$533.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$453.86
Rate for Payer: Group Health Inc Commercial	$333.72
Rate for Payer: Group Health Inc Medicare	$233.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.72
Rate for Payer: Hamaspik Choice Inc Medicare	$333.72

NCB_5.0_UNICORTICAL_SCR_1=12MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007086
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB_5.0_UNICORTICAL_SCR_1=12MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007086
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB 5.0 UNICORTICAL SCR L=10MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006902
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB 5.0 UNICORTICAL SCR L=10MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006902
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB_5.0_UNICORTICAL_SCR_L=10MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007085
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB_5.0_UNICORTICAL_SCR_L=10MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007085
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB 5.0 UNICORTICAL SCR L=12MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006903
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB 5.0 UNICORTICAL SCR L=12MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006903
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB 5.0 UNICORTICAL SCR L=14MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006904
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB 5.0 UNICORTICAL SCR L=14MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006904
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB_5.0_UNICORTICAL_SCR_L=14MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007087
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB_5.0_UNICORTICAL_SCR_L=14MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007087
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB 5.0 UNICORTICAL SCR L=16MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006905
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB 5.0 UNICORTICAL SCR L=16MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006905
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB_5.0_UNICORTICAL_SCR_L=16MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007088
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB_5.0_UNICORTICAL_SCR_L=16MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007088
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB 5.0 UNICORTICAL SCR L=18MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006906
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

NCB 5.0 UNICORTICAL SCR L=18MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40006906
Hospital Revenue Code	278
Min. Negotiated Rate	$111.62
Max. Negotiated Rate	$334.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$175.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$191.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$159.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.37
Rate for Payer: EmblemHealth Commercial	$159.45
Rate for Payer: Fidelis Medicare Advantage	$334.84
Rate for Payer: Group Health Inc Commercial	$159.45
Rate for Payer: Group Health Inc Medicare	$111.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$207.28

NCB_5.0_UNICORTICAL_SCR_L=18MM

Facility

$318.90

Service Code	HCPCS C1713
Hospital Charge Code	40007089
Hospital Revenue Code	278
Min. Negotiated Rate	$159.45
Max. Negotiated Rate	$159.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$159.45
Rate for Payer: Hamaspik Choice Inc Medicare	$159.45

Know your out-of-pocket cost for care.

All Charges