St. Barnabas Hospital

All Charges

Charge

Type

Price

DRILL FREEHAND (2351-4236S)

Facility OP

$406.00

Hospital Charge Code	64906353
Hospital Revenue Code	270
Min. Negotiated Rate	$142.10
Max. Negotiated Rate	$324.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$223.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$203.00
Rate for Payer: Aetna Government	$203.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$324.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$276.08
Rate for Payer: Group Health Inc Commercial	$203.00
Rate for Payer: Group Health Inc Medicare	$142.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.00
Rate for Payer: Hamaspik Choice Inc Medicare	$203.00

DRILLFREE MAXIDRVE MINISCRW

Facility OP

$162.50

Service Code	HCPCS C1713
Hospital Charge Code	64903076
Hospital Revenue Code	278
Min. Negotiated Rate	$56.88
Max. Negotiated Rate	$170.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.38
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	$81.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.44
Rate for Payer: Fidelis Medicare Advantage	$170.62
Rate for Payer: Group Health Inc Commercial	$81.25
Rate for Payer: Group Health Inc Medicare	$56.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.25
Rate for Payer: Hamaspik Choice Inc Medicare	$81.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.62

DRILLFREE MAXIDRVE MINISCRW

Facility IP

$162.50

Service Code	HCPCS C1713
Hospital Charge Code	64903076
Hospital Revenue Code	278
Min. Negotiated Rate	$81.25
Max. Negotiated Rate	$81.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.25
Rate for Payer: Hamaspik Choice Inc Medicare	$81.25

DRILL GRAY PT 4.0MX200M-50852040

Facility IP

$164.00

Service Code	HCPCS C1713
Hospital Charge Code	64906662
Hospital Revenue Code	278
Min. Negotiated Rate	$82.00
Max. Negotiated Rate	$82.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.00
Rate for Payer: Hamaspik Choice Inc Medicare	$82.00

DRILL GRAY PT 4.0MX200M-50852040

Facility OP

$164.00

Service Code	HCPCS C1713
Hospital Charge Code	64906662
Hospital Revenue Code	278
Min. Negotiated Rate	$57.40
Max. Negotiated Rate	$172.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$90.20
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	$82.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$94.30
Rate for Payer: Fidelis Medicare Advantage	$172.20
Rate for Payer: Group Health Inc Commercial	$82.00
Rate for Payer: Group Health Inc Medicare	$57.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.00
Rate for Payer: Hamaspik Choice Inc Medicare	$82.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$106.60

DRILL GUIDE

Facility OP

$1,757.00

Hospital Charge Code	64907309
Hospital Revenue Code	270
Min. Negotiated Rate	$614.95
Max. Negotiated Rate	$1,405.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$966.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$878.50
Rate for Payer: Aetna Government	$878.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,405.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,194.76
Rate for Payer: Group Health Inc Commercial	$878.50
Rate for Payer: Group Health Inc Medicare	$614.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$878.50
Rate for Payer: Hamaspik Choice Inc Medicare	$878.50

DRILL GUIDE BLOCK FOR HIL 5HOLES

Facility IP

$350.00

Service Code	HCPCS C1776
Hospital Charge Code	40200505
Hospital Revenue Code	278
Min. Negotiated Rate	$175.00
Max. Negotiated Rate	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$175.00
Rate for Payer: Hamaspik Choice Inc Medicare	$175.00

DRILL GUIDE BLOCK FOR HIL 5HOLES

Facility OP

$350.00

Service Code	HCPCS C1776
Hospital Charge Code	40200505
Hospital Revenue Code	278
Min. Negotiated Rate	$122.50
Max. Negotiated Rate	$367.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$192.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$175.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$201.25
Rate for Payer: Fidelis Medicare Advantage	$367.50
Rate for Payer: Group Health Inc Commercial	$175.00
Rate for Payer: Group Health Inc Medicare	$122.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$175.00
Rate for Payer: Hamaspik Choice Inc Medicare	$175.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$227.50

DRILL GUIDE DOUBLE 3.2/49.MM

Facility OP

$844.48

Service Code	HCPCS C1713
Hospital Charge Code	64906536
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$886.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$464.46
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	$422.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$485.58
Rate for Payer: Fidelis Medicare Advantage	$886.70
Rate for Payer: Group Health Inc Commercial	$422.24
Rate for Payer: Group Health Inc Medicare	$295.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$422.24
Rate for Payer: Hamaspik Choice Inc Medicare	$422.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$548.91

DRILL GUIDE DOUBLE 3.2/49.MM

Facility IP

$844.48

Service Code	HCPCS C1713
Hospital Charge Code	64906536
Hospital Revenue Code	278
Min. Negotiated Rate	$422.24
Max. Negotiated Rate	$422.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$422.24
Rate for Payer: Hamaspik Choice Inc Medicare	$422.24

DRILL GUIDE HANDLE

Facility OP

$594.00

Hospital Charge Code	40200659
Hospital Revenue Code	270
Min. Negotiated Rate	$207.90
Max. Negotiated Rate	$475.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$326.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$297.00
Rate for Payer: Aetna Government	$297.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$475.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$403.92
Rate for Payer: Group Health Inc Commercial	$297.00
Rate for Payer: Group Health Inc Medicare	$207.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$297.00
Rate for Payer: Hamaspik Choice Inc Medicare	$297.00

DRILL NON CANN 4MM

Facility OP

$230.00

Hospital Charge Code	40004883
Hospital Revenue Code	272
Min. Negotiated Rate	$80.50
Max. Negotiated Rate	$184.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$126.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$115.00
Rate for Payer: Aetna Government	$115.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$184.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.40
Rate for Payer: Group Health Inc Commercial	$115.00
Rate for Payer: Group Health Inc Medicare	$80.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$115.00
Rate for Payer: Hamaspik Choice Inc Medicare	$115.00

DRILL ORTHO

Facility OP

$1,297.50

Service Code	HCPCS C1713
Hospital Charge Code	64906983
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,362.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$713.62
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	$648.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$746.06
Rate for Payer: Fidelis Medicare Advantage	$1,362.38
Rate for Payer: Group Health Inc Commercial	$648.75
Rate for Payer: Group Health Inc Medicare	$454.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$648.75
Rate for Payer: Hamaspik Choice Inc Medicare	$648.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$843.38

DRILL ORTHO

Facility IP

$1,297.50

Service Code	HCPCS C1713
Hospital Charge Code	64906983
Hospital Revenue Code	278
Min. Negotiated Rate	$648.75
Max. Negotiated Rate	$648.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$648.75
Rate for Payer: Hamaspik Choice Inc Medicare	$648.75

DRILL PILOT 1.6MM LONG MANDIBLE

Facility IP

$242.00

Service Code	HCPCS C1776
Hospital Charge Code	40206060
Hospital Revenue Code	278
Min. Negotiated Rate	$121.00
Max. Negotiated Rate	$121.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.00
Rate for Payer: Hamaspik Choice Inc Medicare	$121.00

DRILL PILOT 1.6MM LONG MANDIBLE

Facility OP

$242.00

Service Code	HCPCS C1776
Hospital Charge Code	40206060
Hospital Revenue Code	278
Min. Negotiated Rate	$84.70
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$133.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$121.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$139.15
Rate for Payer: Fidelis Medicare Advantage	$254.10
Rate for Payer: Group Health Inc Commercial	$121.00
Rate for Payer: Group Health Inc Medicare	$84.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.00
Rate for Payer: Hamaspik Choice Inc Medicare	$121.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$157.30

DRILL PROFILE

Facility OP

$500.00

Hospital Charge Code	64907237
Hospital Revenue Code	270
Min. Negotiated Rate	$175.00
Max. Negotiated Rate	$400.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$275.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$250.00
Rate for Payer: Aetna Government	$250.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$400.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$340.00
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$175.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$250.00

DRILL SLD CUT 40'MM

Facility OP

$268.00

Service Code	HCPCS C1713
Hospital Charge Code	64906911
Hospital Revenue Code	278
Min. Negotiated Rate	$93.80
Max. Negotiated Rate	$281.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$147.40
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	$134.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$154.10
Rate for Payer: Fidelis Medicare Advantage	$281.40
Rate for Payer: Group Health Inc Commercial	$134.00
Rate for Payer: Group Health Inc Medicare	$93.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$134.00
Rate for Payer: Hamaspik Choice Inc Medicare	$134.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$174.20

DRILL SLD CUT 40'MM

Facility IP

$268.00

Service Code	HCPCS C1713
Hospital Charge Code	64906911
Hospital Revenue Code	278
Min. Negotiated Rate	$134.00
Max. Negotiated Rate	$134.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$134.00
Rate for Payer: Hamaspik Choice Inc Medicare	$134.00

DRILL SLD STATE 2.5 X 40MM

Facility OP

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64906999
Hospital Revenue Code	278
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$299.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$156.75
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	$142.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.88
Rate for Payer: Fidelis Medicare Advantage	$299.25
Rate for Payer: Group Health Inc Commercial	$142.50
Rate for Payer: Group Health Inc Medicare	$99.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$185.25

DRILL SLD STATE 2.5 X 40MM

Facility IP

$285.00

Service Code	HCPCS C1713
Hospital Charge Code	64906999
Hospital Revenue Code	278
Min. Negotiated Rate	$142.50
Max. Negotiated Rate	$142.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50

DRILL SMALL 17660

Facility OP

$90.00

Hospital Charge Code	64906770
Hospital Revenue Code	270
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$72.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$49.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.00
Rate for Payer: Aetna Government	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.20
Rate for Payer: Group Health Inc Commercial	$45.00
Rate for Payer: Group Health Inc Medicare	$31.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.00
Rate for Payer: Hamaspik Choice Inc Medicare	$45.00

DRILL, SOLID AO 2.0X110MM

Facility OP

$393.93

Hospital Charge Code	40004428
Hospital Revenue Code	272
Min. Negotiated Rate	$137.88
Max. Negotiated Rate	$315.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$216.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$196.96
Rate for Payer: Aetna Government	$196.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$315.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$267.87
Rate for Payer: Group Health Inc Commercial	$196.96
Rate for Payer: Group Health Inc Medicare	$137.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.96
Rate for Payer: Hamaspik Choice Inc Medicare	$196.96

DRILL STEP

Facility IP

$2,097.00

Service Code	HCPCS C1713
Hospital Charge Code	40204059
Hospital Revenue Code	278
Min. Negotiated Rate	$1,048.50
Max. Negotiated Rate	$1,048.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,048.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,048.50

DRILL STEP

Facility OP

$2,097.00

Service Code	HCPCS C1713
Hospital Charge Code	40204059
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,201.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,153.35
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	$1,048.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,205.78
Rate for Payer: Fidelis Medicare Advantage	$2,201.85
Rate for Payer: Group Health Inc Commercial	$1,048.50
Rate for Payer: Group Health Inc Medicare	$733.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,048.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,048.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,363.05

Price Transparency.

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