St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BIT DRILL 2.5MM 894330

Facility

$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: 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 2.5MM 894330

Facility

$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

$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: 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 2.5MM CALIBRATED 894342

Facility

$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

$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: Brighton Health Commercial	$132.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$110.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$127.08
Rate for Payer: EmblemHealth Commercial	$110.50
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 2.7M CALBRATD-214227070

Facility

$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 2.7MM CALIBRATED

Facility

$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: Brighton Health Commercial	$165.75
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

$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: Brighton Health Commercial	$165.75
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

$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

$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: Brighton Health Commercial	$159.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$132.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$152.38
Rate for Payer: EmblemHealth Commercial	$132.50
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

$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: Brighton Health Commercial	$97.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.78
Rate for Payer: EmblemHealth Commercial	$81.55
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

$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

$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: Brighton Health Commercial	$133.50
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

$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: Brighton Health Commercial	$165.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$137.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.41
Rate for Payer: EmblemHealth Commercial	$137.75
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

$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

$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 3.7MM

Facility

$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: Brighton Health Commercial	$150.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$125.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$143.75
Rate for Payer: EmblemHealth Commercial	$125.00
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 4.0MM

Facility

$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

$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: Brighton Health Commercial	$121.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$101.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$116.72
Rate for Payer: EmblemHealth Commercial	$101.50
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

$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: Brighton Health Commercial	$136.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$113.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$130.52
Rate for Payer: EmblemHealth Commercial	$113.50
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

BIT DRILL 4.2X130MM AO ST

Facility

$227.00

Service Code	HCPCS C1713
Hospital Charge Code	40202419
Hospital Revenue Code	278
Min. Negotiated Rate	$113.50
Max. Negotiated Rate	$113.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$113.50
Rate for Payer: Hamaspik Choice Inc Medicare	$113.50

BIT DRILL 4.3MM DIA 315M AO703541

Facility

$168.70

Service Code	HCPCS C1713
Hospital Charge Code	64906438
Hospital Revenue Code	278
Min. Negotiated Rate	$84.35
Max. Negotiated Rate	$84.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$84.35
Rate for Payer: Hamaspik Choice Inc Medicare	$84.35

BIT DRILL 4.3MM DIA 315M AO703541

Facility

$168.70

Service Code	HCPCS C1713
Hospital Charge Code	64906438
Hospital Revenue Code	278
Min. Negotiated Rate	$59.04
Max. Negotiated Rate	$177.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$92.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$101.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$84.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.00
Rate for Payer: EmblemHealth Commercial	$84.35
Rate for Payer: Fidelis Medicare Advantage	$177.14
Rate for Payer: Group Health Inc Commercial	$84.35
Rate for Payer: Group Health Inc Medicare	$59.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$84.35
Rate for Payer: Hamaspik Choice Inc Medicare	$84.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$109.66

BIT DRILL 4.9MM DIA LARGE CAN

Facility

$616.00

Service Code	HCPCS C1713
Hospital Charge Code	64906673
Hospital Revenue Code	278
Min. Negotiated Rate	$308.00
Max. Negotiated Rate	$308.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$308.00
Rate for Payer: Hamaspik Choice Inc Medicare	$308.00

BIT DRILL 4.9MM DIA LARGE CAN

Facility

$616.00

Service Code	HCPCS C1713
Hospital Charge Code	64906673
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$646.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$338.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$369.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$308.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$354.20
Rate for Payer: EmblemHealth Commercial	$308.00
Rate for Payer: Fidelis Medicare Advantage	$646.80
Rate for Payer: Group Health Inc Commercial	$308.00
Rate for Payer: Group Health Inc Medicare	$215.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$308.00
Rate for Payer: Hamaspik Choice Inc Medicare	$308.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$400.40

Know your out-of-pocket cost for care.

All Charges