St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BIT DRILL 1.3 X 54MM 12M STOP

Facility

$101.00

Service Code	HCPCS C1713
Hospital Charge Code	64906466
Hospital Revenue Code	278
Min. Negotiated Rate	$50.50
Max. Negotiated Rate	$50.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.50
Rate for Payer: Hamaspik Choice Inc Medicare	$50.50

BIT DRILL 1.3 X 54MM 12M STOP

Facility

$101.00

Service Code	HCPCS C1713
Hospital Charge Code	64906466
Hospital Revenue Code	278
Min. Negotiated Rate	$35.35
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$60.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$58.08
Rate for Payer: EmblemHealth Commercial	$50.50
Rate for Payer: Fidelis Medicare Advantage	$106.05
Rate for Payer: Group Health Inc Commercial	$50.50
Rate for Payer: Group Health Inc Medicare	$35.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.50
Rate for Payer: Hamaspik Choice Inc Medicare	$50.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$65.65

BIT DRILL 1.5MM J-LATCH 110MM

Facility

$272.00

Service Code	HCPCS C1776
Hospital Charge Code	40202437
Hospital Revenue Code	278
Min. Negotiated Rate	$136.00
Max. Negotiated Rate	$136.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00

BIT DRILL 1.5MM J-LATCH 110MM

Facility

$272.00

Service Code	HCPCS C1776
Hospital Charge Code	40202437
Hospital Revenue Code	278
Min. Negotiated Rate	$95.20
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$149.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$163.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.40
Rate for Payer: EmblemHealth Commercial	$136.00
Rate for Payer: Fidelis Medicare Advantage	$285.60
Rate for Payer: Group Health Inc Commercial	$136.00
Rate for Payer: Group Health Inc Medicare	$95.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.00
Rate for Payer: Hamaspik Choice Inc Medicare	$136.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$176.80

BIT DRILL 1.5MM J LATCH 12MM

Facility

$636.00

Service Code	HCPCS C1776
Hospital Charge Code	40202446
Hospital Revenue Code	278
Min. Negotiated Rate	$222.60
Max. Negotiated Rate	$667.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$349.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$381.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$318.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$365.70
Rate for Payer: EmblemHealth Commercial	$318.00
Rate for Payer: Fidelis Medicare Advantage	$667.80
Rate for Payer: Group Health Inc Commercial	$318.00
Rate for Payer: Group Health Inc Medicare	$222.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$318.00
Rate for Payer: Hamaspik Choice Inc Medicare	$318.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$413.40

BIT DRILL 1.5MM J LATCH 12MM

Facility

$636.00

Service Code	HCPCS C1776
Hospital Charge Code	40202446
Hospital Revenue Code	278
Min. Negotiated Rate	$318.00
Max. Negotiated Rate	$318.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$318.00
Rate for Payer: Hamaspik Choice Inc Medicare	$318.00

BIT DRILL 1.6 X 26MM (6016526)

Facility

$126.72

Service Code	HCPCS C1713
Hospital Charge Code	64906404
Hospital Revenue Code	278
Min. Negotiated Rate	$63.36
Max. Negotiated Rate	$63.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.36
Rate for Payer: Hamaspik Choice Inc Medicare	$63.36

BIT DRILL 1.6 X 26MM (6016526)

Facility

$126.72

Service Code	HCPCS C1713
Hospital Charge Code	64906404
Hospital Revenue Code	278
Min. Negotiated Rate	$44.35
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$69.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$76.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$72.86
Rate for Payer: EmblemHealth Commercial	$63.36
Rate for Payer: Fidelis Medicare Advantage	$133.06
Rate for Payer: Group Health Inc Commercial	$63.36
Rate for Payer: Group Health Inc Medicare	$44.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.36
Rate for Payer: Hamaspik Choice Inc Medicare	$63.36
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$82.37

BIT DRILL 1.6 X 35MM

Facility

$438.58

Service Code	HCPCS C1713
Hospital Charge Code	64906772
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$460.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$241.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$263.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$219.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$252.18
Rate for Payer: EmblemHealth Commercial	$219.29
Rate for Payer: Fidelis Medicare Advantage	$460.51
Rate for Payer: Group Health Inc Commercial	$219.29
Rate for Payer: Group Health Inc Medicare	$153.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$219.29
Rate for Payer: Hamaspik Choice Inc Medicare	$219.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$285.08

BIT DRILL 1.6 X 35MM

Facility

$438.58

Service Code	HCPCS C1713
Hospital Charge Code	64906772
Hospital Revenue Code	278
Min. Negotiated Rate	$219.29
Max. Negotiated Rate	$219.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$219.29
Rate for Payer: Hamaspik Choice Inc Medicare	$219.29

BIT DRILL 1.8 X 125 CALIB

Facility

$358.00

Service Code	HCPCS C1776
Hospital Charge Code	40205074
Hospital Revenue Code	278
Min. Negotiated Rate	$179.00
Max. Negotiated Rate	$179.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$179.00
Rate for Payer: Hamaspik Choice Inc Medicare	$179.00

BIT DRILL 1.8 X 125 CALIB

Facility

$358.00

Service Code	HCPCS C1776
Hospital Charge Code	40205074
Hospital Revenue Code	278
Min. Negotiated Rate	$125.30
Max. Negotiated Rate	$375.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$196.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$214.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$179.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$205.85
Rate for Payer: EmblemHealth Commercial	$179.00
Rate for Payer: Fidelis Medicare Advantage	$375.90
Rate for Payer: Group Health Inc Commercial	$179.00
Rate for Payer: Group Health Inc Medicare	$125.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$179.00
Rate for Payer: Hamaspik Choice Inc Medicare	$179.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$232.70

BIT DRILL 2.0 882701

Facility

$170.00

Service Code	HCPCS C1713
Hospital Charge Code	64906646
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: Brighton Health Commercial	$102.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$85.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.75
Rate for Payer: EmblemHealth Commercial	$85.00
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 2.0 882701

Facility

$170.00

Service Code	HCPCS C1713
Hospital Charge Code	64906646
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 2.0M CALBRATED 894316

Facility

$190.00

Service Code	HCPCS C1713
Hospital Charge Code	64906652
Hospital Revenue Code	278
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$199.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$114.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$95.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$109.25
Rate for Payer: EmblemHealth Commercial	$95.00
Rate for Payer: Fidelis Medicare Advantage	$199.50
Rate for Payer: Group Health Inc Commercial	$95.00
Rate for Payer: Group Health Inc Medicare	$66.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$95.00
Rate for Payer: Hamaspik Choice Inc Medicare	$95.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$123.50

BIT DRILL 2.0M CALBRATED 894316

Facility

$190.00

Service Code	HCPCS C1713
Hospital Charge Code	64906652
Hospital Revenue Code	278
Min. Negotiated Rate	$95.00
Max. Negotiated Rate	$95.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$95.00
Rate for Payer: Hamaspik Choice Inc Medicare	$95.00

BIT DRILL 2.0MM CALIBRTD

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64906901
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$409.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$214.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$234.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$195.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.25
Rate for Payer: EmblemHealth Commercial	$195.00
Rate for Payer: Fidelis Medicare Advantage	$409.50
Rate for Payer: Group Health Inc Commercial	$195.00
Rate for Payer: Group Health Inc Medicare	$136.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$253.50

BIT DRILL 2.0MM CALIBRTD

Facility

$390.00

Service Code	HCPCS C1713
Hospital Charge Code	64906901
Hospital Revenue Code	278
Min. Negotiated Rate	$195.00
Max. Negotiated Rate	$195.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$195.00
Rate for Payer: Hamaspik Choice Inc Medicare	$195.00

BIT DRILL 2.2MM DIA 100MML F/

Facility

$152.00

Service Code	HCPCS C1713
Hospital Charge Code	64906560
Hospital Revenue Code	278
Min. Negotiated Rate	$76.00
Max. Negotiated Rate	$76.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$76.00
Rate for Payer: Hamaspik Choice Inc Medicare	$76.00

BIT DRILL 2.2MM DIA 100MML F/

Facility

$152.00

Service Code	HCPCS C1713
Hospital Charge Code	64906560
Hospital Revenue Code	278
Min. Negotiated Rate	$53.20
Max. Negotiated Rate	$159.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$83.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$91.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$76.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$87.40
Rate for Payer: EmblemHealth Commercial	$76.00
Rate for Payer: Fidelis Medicare Advantage	$159.60
Rate for Payer: Group Health Inc Commercial	$76.00
Rate for Payer: Group Health Inc Medicare	$53.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$76.00
Rate for Payer: Hamaspik Choice Inc Medicare	$76.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$98.80

BIT DRILL2.3M DIA ADJUS-701757001

Facility

$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: Brighton Health Commercial	$249.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$239.49
Rate for Payer: EmblemHealth Commercial	$208.25
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 DRILL2.3M DIA ADJUS-701757001

Facility

$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 DRILL 2.5MM

Facility

$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: Brighton Health Commercial	$157.50
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

$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

$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: Brighton Health Commercial	$78.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$65.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$75.04
Rate for Payer: EmblemHealth Commercial	$65.25
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

Know your out-of-pocket cost for care.

All Charges