St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

4.0MMX36MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006981
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

4.0MMX36MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006981
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

4.0MMX38MM MOTIONLOC SCREW TI

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007246
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

4.0MMX38MM MOTIONLOC SCREW TI

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007246
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

4.0MMX38MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006982
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

4.0MMX38MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006982
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

4.0MMX40MM MOTIONLOC SCREW TI

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007247
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

4.0MMX40MM MOTIONLOC SCREW TI

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007247
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

4.0MMX40MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006983
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

4.0MMX40MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006983
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

4.0MMX42MM MOTIONLOC SCREW TI

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007248
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

4.0MMX42MM MOTIONLOC SCREW TI

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007248
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

4.0MMX42MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006984
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

4.0MMX42MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006984
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

4.0MMX44MM MOTIONLOC SCREW TI

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007249
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

4.0MMX44MM MOTIONLOC SCREW TI

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007249
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

4.0MMX44MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006985
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

4.0MMX44MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006985
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

4.0MMX46MM MOTIONLOC SCREW TI

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007250
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

4.0MMX46MM MOTIONLOC SCREW TI

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007250
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

4.0MMX46MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006986
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

4.0MMX46MM MOTIONLOC SCR TI STRL

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40006986
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

4.3MM DRILL MEASURING SLEEVE

Facility

$912.00

Service Code	HCPCS C1713
Hospital Charge Code	40006147
Hospital Revenue Code	278
Min. Negotiated Rate	$456.00
Max. Negotiated Rate	$456.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.00
Rate for Payer: Hamaspik Choice Inc Medicare	$456.00

4.3MM DRILL MEASURING SLEEVE

Facility

$912.00

Service Code	HCPCS C1713
Hospital Charge Code	40006147
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$957.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$501.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$547.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$456.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$524.40
Rate for Payer: EmblemHealth Commercial	$456.00
Rate for Payer: Fidelis Medicare Advantage	$957.60
Rate for Payer: Group Health Inc Commercial	$456.00
Rate for Payer: Group Health Inc Medicare	$319.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$456.00
Rate for Payer: Hamaspik Choice Inc Medicare	$456.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$592.80

4.3MM FREE HAND DRILL 152.5MM

Facility

$273.60

Service Code	HCPCS C1713
Hospital Charge Code	40006474
Hospital Revenue Code	278
Min. Negotiated Rate	$136.80
Max. Negotiated Rate	$136.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.80
Rate for Payer: Hamaspik Choice Inc Medicare	$136.80

Know your out-of-pocket cost for care.

All Charges