St. Barnabas Hospital

All Charges

Charge

Type

Price

BIT DRILL2.3M DIA ADJUS-701757001

Facility IP

$416.50

Service Code	HCPCS C1713
Hospital Charge Code	64906458
Hospital Revenue Code	278
Min. Negotiated Rate	$208.25
Max. Negotiated Rate	$208.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$208.25
Rate for Payer: Hamaspik Choice Inc Medicare	$208.25

BIT DRILL2.3M DIA ADJUS-701757001

Facility OP

$416.50

Service Code	HCPCS C1713
Hospital Charge Code	64906458
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$437.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$229.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$239.49
Rate for Payer: Fidelis Medicare Advantage	$437.32
Rate for Payer: Group Health Inc Commercial	$208.25
Rate for Payer: Group Health Inc Medicare	$145.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$208.25
Rate for Payer: Hamaspik Choice Inc Medicare	$208.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$270.72

BIT DRILL 2.5MM

Facility OP

$210.00

Hospital Charge Code	40200855
Hospital Revenue Code	270
Min. Negotiated Rate	$73.50
Max. Negotiated Rate	$168.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$115.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$105.00
Rate for Payer: Aetna Government	$105.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$168.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.80
Rate for Payer: Group Health Inc Commercial	$105.00
Rate for Payer: Group Health Inc Medicare	$73.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$105.00
Rate for Payer: Hamaspik Choice Inc Medicare	$105.00

BIT DRILL 2.5MM (700351)

Facility IP

$130.50

Service Code	HCPCS C1713
Hospital Charge Code	64906340
Hospital Revenue Code	278
Min. Negotiated Rate	$65.25
Max. Negotiated Rate	$65.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.25
Rate for Payer: Hamaspik Choice Inc Medicare	$65.25

BIT DRILL 2.5MM (700351)

Facility OP

$130.50

Service Code	HCPCS C1713
Hospital Charge Code	64906340
Hospital Revenue Code	278
Min. Negotiated Rate	$45.68
Max. Negotiated Rate	$137.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$71.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$65.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$75.04
Rate for Payer: Fidelis Medicare Advantage	$137.02
Rate for Payer: Group Health Inc Commercial	$65.25
Rate for Payer: Group Health Inc Medicare	$45.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.25
Rate for Payer: Hamaspik Choice Inc Medicare	$65.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$84.82

BIT DRILL 2.5MM 894330

Facility OP

$170.00

Service Code	HCPCS C1713
Hospital Charge Code	64906644
Hospital Revenue Code	278
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$178.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$85.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.75
Rate for Payer: Fidelis Medicare Advantage	$178.50
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$110.50

BIT DRILL 2.5MM 894330

Facility IP

$170.00

Service Code	HCPCS C1713
Hospital Charge Code	64906644
Hospital Revenue Code	278
Min. Negotiated Rate	$85.00
Max. Negotiated Rate	$85.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00

BIT DRILL 2.5MM CALIBRATED 894342

Facility OP

$170.00

Service Code	HCPCS C1713
Hospital Charge Code	64906653
Hospital Revenue Code	278
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$178.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$85.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.75
Rate for Payer: Fidelis Medicare Advantage	$178.50
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$110.50

BIT DRILL 2.5MM CALIBRATED 894342

Facility IP

$170.00

Service Code	HCPCS C1713
Hospital Charge Code	64906653
Hospital Revenue Code	278
Min. Negotiated Rate	$85.00
Max. Negotiated Rate	$85.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00

BIT DRILL 2.7M CALBRATD-214227070

Facility IP

$221.00

Service Code	HCPCS C1713
Hospital Charge Code	64906550
Hospital Revenue Code	278
Min. Negotiated Rate	$110.50
Max. Negotiated Rate	$110.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$110.50
Rate for Payer: Hamaspik Choice Inc Medicare	$110.50

BIT DRILL 2.7M CALBRATD-214227070

Facility OP

$221.00

Service Code	HCPCS C1713
Hospital Charge Code	64906550
Hospital Revenue Code	278
Min. Negotiated Rate	$77.35
Max. Negotiated Rate	$232.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$121.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$110.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.08
Rate for Payer: Fidelis Medicare Advantage	$232.05
Rate for Payer: Group Health Inc Commercial	$110.50
Rate for Payer: Group Health Inc Medicare	$77.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$110.50
Rate for Payer: Hamaspik Choice Inc Medicare	$110.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$143.65

BIT DRILL 2.7MM CALIBRATED

Facility OP

$221.00

Hospital Charge Code	40204641
Hospital Revenue Code	272
Min. Negotiated Rate	$77.35
Max. Negotiated Rate	$176.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$121.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$110.50
Rate for Payer: Aetna Government	$110.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$176.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.28
Rate for Payer: Group Health Inc Commercial	$110.50
Rate for Payer: Group Health Inc Medicare	$77.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$110.50
Rate for Payer: Hamaspik Choice Inc Medicare	$110.50

BIT DRILL 2.7MM CALIBRATED

Facility OP

$221.00

Hospital Charge Code	40007560
Hospital Revenue Code	272
Min. Negotiated Rate	$77.35
Max. Negotiated Rate	$176.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$121.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$110.50
Rate for Payer: Aetna Government	$110.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$176.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.28
Rate for Payer: Group Health Inc Commercial	$110.50
Rate for Payer: Group Health Inc Medicare	$77.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$110.50
Rate for Payer: Hamaspik Choice Inc Medicare	$110.50

BIT DRILL 2.7MM X 122MM

Facility IP

$265.00

Service Code	HCPCS C1713
Hospital Charge Code	64906239
Hospital Revenue Code	278
Min. Negotiated Rate	$132.50
Max. Negotiated Rate	$132.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$132.50
Rate for Payer: Hamaspik Choice Inc Medicare	$132.50

BIT DRILL 2.7MM X 122MM

Facility OP

$265.00

Service Code	HCPCS C1713
Hospital Charge Code	64906239
Hospital Revenue Code	278
Min. Negotiated Rate	$92.75
Max. Negotiated Rate	$278.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$145.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$132.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$152.38
Rate for Payer: Fidelis Medicare Advantage	$278.25
Rate for Payer: Group Health Inc Commercial	$132.50
Rate for Payer: Group Health Inc Medicare	$92.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$132.50
Rate for Payer: Hamaspik Choice Inc Medicare	$132.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$172.25

BIT DRILL 3.2M DIA 315M AO-703542

Facility OP

$163.10

Service Code	HCPCS C1713
Hospital Charge Code	64906441
Hospital Revenue Code	278
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$171.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.78
Rate for Payer: Fidelis Medicare Advantage	$171.26
Rate for Payer: Group Health Inc Commercial	$81.55
Rate for Payer: Group Health Inc Medicare	$57.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.55
Rate for Payer: Hamaspik Choice Inc Medicare	$81.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$106.02

BIT DRILL 3.2M DIA 315M AO-703542

Facility IP

$163.10

Service Code	HCPCS C1713
Hospital Charge Code	64906441
Hospital Revenue Code	278
Min. Negotiated Rate	$81.55
Max. Negotiated Rate	$81.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.55
Rate for Payer: Hamaspik Choice Inc Medicare	$81.55

BIT DRILL 3.2X1/2QK-REL

Facility OP

$178.00

Hospital Charge Code	40200259
Hospital Revenue Code	270
Min. Negotiated Rate	$62.30
Max. Negotiated Rate	$142.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$97.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$89.00
Rate for Payer: Aetna Government	$89.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$121.04
Rate for Payer: Group Health Inc Commercial	$89.00
Rate for Payer: Group Health Inc Medicare	$62.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$89.00
Rate for Payer: Hamaspik Choice Inc Medicare	$89.00

BIT DRILL 3.5MM DIA 230MML HU

Facility OP

$275.50

Service Code	HCPCS C1713
Hospital Charge Code	64906687
Hospital Revenue Code	278
Min. Negotiated Rate	$96.42
Max. Negotiated Rate	$289.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$137.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.41
Rate for Payer: Fidelis Medicare Advantage	$289.28
Rate for Payer: Group Health Inc Commercial	$137.75
Rate for Payer: Group Health Inc Medicare	$96.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.75
Rate for Payer: Hamaspik Choice Inc Medicare	$137.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$179.08

BIT DRILL 3.5MM DIA 230MML HU

Facility IP

$275.50

Service Code	HCPCS C1713
Hospital Charge Code	64906687
Hospital Revenue Code	278
Min. Negotiated Rate	$137.75
Max. Negotiated Rate	$137.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.75
Rate for Payer: Hamaspik Choice Inc Medicare	$137.75

BIT DRILL 3.7MM

Facility OP

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	64906248
Hospital Revenue Code	278
Min. Negotiated Rate	$87.50
Max. Negotiated Rate	$262.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$137.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$125.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$143.75
Rate for Payer: Fidelis Medicare Advantage	$262.50
Rate for Payer: Group Health Inc Commercial	$125.00
Rate for Payer: Group Health Inc Medicare	$87.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$125.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$162.50

BIT DRILL 3.7MM

Facility IP

$250.00

Service Code	HCPCS C1713
Hospital Charge Code	64906248
Hospital Revenue Code	278
Min. Negotiated Rate	$125.00
Max. Negotiated Rate	$125.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$125.00
Rate for Payer: Hamaspik Choice Inc Medicare	$125.00

BIT DRILL 4.0MM

Facility IP

$203.00

Service Code	HCPCS C1713
Hospital Charge Code	40202415
Hospital Revenue Code	278
Min. Negotiated Rate	$101.50
Max. Negotiated Rate	$101.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$101.50
Rate for Payer: Hamaspik Choice Inc Medicare	$101.50

BIT DRILL 4.0MM

Facility OP

$203.00

Service Code	HCPCS C1713
Hospital Charge Code	40202415
Hospital Revenue Code	278
Min. Negotiated Rate	$71.05
Max. Negotiated Rate	$213.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$111.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$101.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$116.72
Rate for Payer: Fidelis Medicare Advantage	$213.15
Rate for Payer: Group Health Inc Commercial	$101.50
Rate for Payer: Group Health Inc Medicare	$71.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$101.50
Rate for Payer: Hamaspik Choice Inc Medicare	$101.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$131.95

BIT DRILL 4.2X130MM AO ST

Facility OP

$227.00

Service Code	HCPCS C1713
Hospital Charge Code	40202419
Hospital Revenue Code	278
Min. Negotiated Rate	$79.45
Max. Negotiated Rate	$238.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$124.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$113.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$130.52
Rate for Payer: Fidelis Medicare Advantage	$238.35
Rate for Payer: Group Health Inc Commercial	$113.50
Rate for Payer: Group Health Inc Medicare	$79.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$113.50
Rate for Payer: Hamaspik Choice Inc Medicare	$113.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$147.55

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