St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

DRILL 2.75MM, .066 CANN

Facility

$1,000.00

Hospital Charge Code	40004884
Hospital Revenue Code	272
Min. Negotiated Rate	$350.00
Max. Negotiated Rate	$800.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$550.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$500.00
Rate for Payer: Aetna Government	$500.00
Rate for Payer: Brighton Health Commercial	$750.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$800.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$680.00
Rate for Payer: Group Health Inc Commercial	$500.00
Rate for Payer: Group Health Inc Medicare	$350.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$500.00

DRILL 3.1 SET (705301)

Facility

$219.00

Service Code	HCPCS C1713
Hospital Charge Code	64906489
Hospital Revenue Code	278
Min. Negotiated Rate	$109.50
Max. Negotiated Rate	$109.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.50
Rate for Payer: Hamaspik Choice Inc Medicare	$109.50

DRILL 3.1 SET (705301)

Facility

$219.00

Service Code	HCPCS C1713
Hospital Charge Code	64906489
Hospital Revenue Code	278
Min. Negotiated Rate	$76.65
Max. Negotiated Rate	$229.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$120.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$131.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$109.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$125.92
Rate for Payer: EmblemHealth Commercial	$109.50
Rate for Payer: Fidelis Medicare Advantage	$229.95
Rate for Payer: Group Health Inc Commercial	$109.50
Rate for Payer: Group Health Inc Medicare	$76.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.50
Rate for Payer: Hamaspik Choice Inc Medicare	$109.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$142.35

DRILL 3.5X230MM

Facility

$200.00

Service Code	HCPCS C1713
Hospital Charge Code	40200542
Hospital Revenue Code	278
Min. Negotiated Rate	$100.00
Max. Negotiated Rate	$100.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00

DRILL 3.5X230MM

Facility

$200.00

Service Code	HCPCS C1713
Hospital Charge Code	40200542
Hospital Revenue Code	278
Min. Negotiated Rate	$70.00
Max. Negotiated Rate	$210.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$110.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.00
Rate for Payer: EmblemHealth Commercial	$100.00
Rate for Payer: Fidelis Medicare Advantage	$210.00
Rate for Payer: Group Health Inc Commercial	$100.00
Rate for Payer: Group Health Inc Medicare	$70.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$100.00
Rate for Payer: Hamaspik Choice Inc Medicare	$100.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$130.00

DRILL 4.2MM

Facility

$220.00

Hospital Charge Code	40202136
Hospital Revenue Code	270
Min. Negotiated Rate	$77.00
Max. Negotiated Rate	$176.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$121.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$110.00
Rate for Payer: Aetna Government	$110.00
Rate for Payer: Brighton Health Commercial	$165.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$176.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$149.60
Rate for Payer: Group Health Inc Commercial	$110.00
Rate for Payer: Group Health Inc Medicare	$77.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$110.00
Rate for Payer: Hamaspik Choice Inc Medicare	$110.00

DRILL 4.2 X 130MM 4213S

Facility

$708.84

Service Code	HCPCS C1713
Hospital Charge Code	64906753
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$744.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$389.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$425.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$354.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$407.58
Rate for Payer: EmblemHealth Commercial	$354.42
Rate for Payer: Fidelis Medicare Advantage	$744.28
Rate for Payer: Group Health Inc Commercial	$354.42
Rate for Payer: Group Health Inc Medicare	$248.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.42
Rate for Payer: Hamaspik Choice Inc Medicare	$354.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$460.75

DRILL 4.2 X 130MM 4213S

Facility

$708.84

Service Code	HCPCS C1713
Hospital Charge Code	64906753
Hospital Revenue Code	278
Min. Negotiated Rate	$354.42
Max. Negotiated Rate	$354.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.42
Rate for Payer: Hamaspik Choice Inc Medicare	$354.42

DRILL 4.2 X 180MM

Facility

$238.00

Hospital Charge Code	40202412
Hospital Revenue Code	270
Min. Negotiated Rate	$83.30
Max. Negotiated Rate	$190.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$119.00
Rate for Payer: Aetna Government	$119.00
Rate for Payer: Brighton Health Commercial	$178.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$190.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$161.84
Rate for Payer: Group Health Inc Commercial	$119.00
Rate for Payer: Group Health Inc Medicare	$83.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.00
Rate for Payer: Hamaspik Choice Inc Medicare	$119.00

DRILL 430MM

Facility

$228.00

Service Code	HCPCS C1776
Hospital Charge Code	40202421
Hospital Revenue Code	278
Min. Negotiated Rate	$114.00
Max. Negotiated Rate	$114.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.00
Rate for Payer: Hamaspik Choice Inc Medicare	$114.00

DRILL 430MM

Facility

$228.00

Service Code	HCPCS C1776
Hospital Charge Code	40202421
Hospital Revenue Code	278
Min. Negotiated Rate	$79.80
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$125.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$136.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$114.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.10
Rate for Payer: EmblemHealth Commercial	$114.00
Rate for Payer: Fidelis Medicare Advantage	$239.40
Rate for Payer: Group Health Inc Commercial	$114.00
Rate for Payer: Group Health Inc Medicare	$79.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$114.00
Rate for Payer: Hamaspik Choice Inc Medicare	$114.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$148.20

DRILL 4.3MM

Facility

$146.00

Hospital Charge Code	40202137
Hospital Revenue Code	270
Min. Negotiated Rate	$51.10
Max. Negotiated Rate	$116.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.00
Rate for Payer: Aetna Government	$73.00
Rate for Payer: Brighton Health Commercial	$109.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$116.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$99.28
Rate for Payer: Group Health Inc Commercial	$73.00
Rate for Payer: Group Health Inc Medicare	$51.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.00
Rate for Payer: Hamaspik Choice Inc Medicare	$73.00

DRILL 4.3MML DISTAL GRADUATED

Facility

$624.00

Hospital Charge Code	40003335
Hospital Revenue Code	272
Min. Negotiated Rate	$218.40
Max. Negotiated Rate	$499.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$312.00
Rate for Payer: Aetna Government	$312.00
Rate for Payer: Brighton Health Commercial	$468.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$499.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$424.32
Rate for Payer: Group Health Inc Commercial	$312.00
Rate for Payer: Group Health Inc Medicare	$218.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.00
Rate for Payer: Hamaspik Choice Inc Medicare	$312.00

DRILL 4.3MML DISTAL GRADUTD

Facility

$624.00

Hospital Charge Code	40204592
Hospital Revenue Code	272
Min. Negotiated Rate	$218.40
Max. Negotiated Rate	$499.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$312.00
Rate for Payer: Aetna Government	$312.00
Rate for Payer: Brighton Health Commercial	$468.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$499.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$424.32
Rate for Payer: Group Health Inc Commercial	$312.00
Rate for Payer: Group Health Inc Medicare	$218.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.00
Rate for Payer: Hamaspik Choice Inc Medicare	$312.00

DRILL 4.3MML DISTAL GRADUTD

Facility

$624.00

Hospital Charge Code	40007511
Hospital Revenue Code	272
Min. Negotiated Rate	$218.40
Max. Negotiated Rate	$499.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$312.00
Rate for Payer: Aetna Government	$312.00
Rate for Payer: Brighton Health Commercial	$468.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$499.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$424.32
Rate for Payer: Group Health Inc Commercial	$312.00
Rate for Payer: Group Health Inc Medicare	$218.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$312.00
Rate for Payer: Hamaspik Choice Inc Medicare	$312.00

DRILL ANCHOR-C 10MM (48328910)

Facility

$326.41

Service Code	HCPCS C1713
Hospital Charge Code	64906379
Hospital Revenue Code	278
Min. Negotiated Rate	$163.20
Max. Negotiated Rate	$163.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.20
Rate for Payer: Hamaspik Choice Inc Medicare	$163.20

DRILL ANCHOR-C 10MM (48328910)

Facility

$326.41

Service Code	HCPCS C1713
Hospital Charge Code	64906379
Hospital Revenue Code	278
Min. Negotiated Rate	$114.24
Max. Negotiated Rate	$342.73
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$179.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$195.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$163.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$187.69
Rate for Payer: EmblemHealth Commercial	$163.20
Rate for Payer: Fidelis Medicare Advantage	$342.73
Rate for Payer: Group Health Inc Commercial	$163.20
Rate for Payer: Group Health Inc Medicare	$114.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.20
Rate for Payer: Hamaspik Choice Inc Medicare	$163.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$212.17

DRILL BIT

Facility

$280.00

Hospital Charge Code	40029605
Hospital Revenue Code	272
Min. Negotiated Rate	$98.00
Max. Negotiated Rate	$224.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$154.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$140.00
Rate for Payer: Aetna Government	$140.00
Rate for Payer: Brighton Health Commercial	$210.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$224.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$190.40
Rate for Payer: Group Health Inc Commercial	$140.00
Rate for Payer: Group Health Inc Medicare	$98.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$140.00
Rate for Payer: Hamaspik Choice Inc Medicare	$140.00

DRILL BIT

Facility

$963.00

Hospital Charge Code	40203575
Hospital Revenue Code	272
Min. Negotiated Rate	$337.05
Max. Negotiated Rate	$770.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$529.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$481.50
Rate for Payer: Aetna Government	$481.50
Rate for Payer: Brighton Health Commercial	$722.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$770.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$654.84
Rate for Payer: Group Health Inc Commercial	$481.50
Rate for Payer: Group Health Inc Medicare	$337.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$481.50
Rate for Payer: Hamaspik Choice Inc Medicare	$481.50

DRILL BIT 1.7MM

Facility

$416.00

Service Code	HCPCS C1713
Hospital Charge Code	40200157
Hospital Revenue Code	278
Min. Negotiated Rate	$208.00
Max. Negotiated Rate	$208.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$208.00
Rate for Payer: Hamaspik Choice Inc Medicare	$208.00

DRILL BIT 1.7MM

Facility

$416.00

Service Code	HCPCS C1713
Hospital Charge Code	40200157
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$436.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$228.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$249.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$208.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$239.20
Rate for Payer: EmblemHealth Commercial	$208.00
Rate for Payer: Fidelis Medicare Advantage	$436.80
Rate for Payer: Group Health Inc Commercial	$208.00
Rate for Payer: Group Health Inc Medicare	$145.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$208.00
Rate for Payer: Hamaspik Choice Inc Medicare	$208.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$270.40

DRILL BIT 2.0

Facility

$592.00

Hospital Charge Code	40004604
Hospital Revenue Code	272
Min. Negotiated Rate	$207.20
Max. Negotiated Rate	$473.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$325.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$296.00
Rate for Payer: Aetna Government	$296.00
Rate for Payer: Brighton Health Commercial	$444.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$473.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$402.56
Rate for Payer: Group Health Inc Commercial	$296.00
Rate for Payer: Group Health Inc Medicare	$207.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$296.00
Rate for Payer: Hamaspik Choice Inc Medicare	$296.00

DRILL BIT 2.0MM

Facility

$129.33

Service Code	HCPCS C1713
Hospital Charge Code	40200158
Hospital Revenue Code	278
Min. Negotiated Rate	$64.66
Max. Negotiated Rate	$64.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$64.66
Rate for Payer: Hamaspik Choice Inc Medicare	$64.66

DRILL BIT 2.0MM

Facility

$129.33

Service Code	HCPCS C1713
Hospital Charge Code	40200158
Hospital Revenue Code	278
Min. Negotiated Rate	$45.27
Max. Negotiated Rate	$135.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$71.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$77.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$64.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$74.36
Rate for Payer: EmblemHealth Commercial	$64.66
Rate for Payer: Fidelis Medicare Advantage	$135.80
Rate for Payer: Group Health Inc Commercial	$64.66
Rate for Payer: Group Health Inc Medicare	$45.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$64.66
Rate for Payer: Hamaspik Choice Inc Medicare	$64.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$84.06

DRILL BIT 2.5 MM

Facility

$170.00

Hospital Charge Code	40203112
Hospital Revenue Code	272
Min. Negotiated Rate	$59.50
Max. Negotiated Rate	$136.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$85.00
Rate for Payer: Aetna Government	$85.00
Rate for Payer: Brighton Health Commercial	$127.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$115.60
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

Know your out-of-pocket cost for care.

All Charges