St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

DRILL BIT 2.5MM

Facility

$440.00

Hospital Charge Code	40200655
Hospital Revenue Code	270
Min. Negotiated Rate	$154.00
Max. Negotiated Rate	$352.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$242.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$220.00
Rate for Payer: Aetna Government	$220.00
Rate for Payer: Brighton Health Commercial	$330.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$352.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$299.20
Rate for Payer: Group Health Inc Commercial	$220.00
Rate for Payer: Group Health Inc Medicare	$154.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$220.00
Rate for Payer: Hamaspik Choice Inc Medicare	$220.00

DRILLBIT 2.5MM 2.0MMX40MM

Facility

$188.00

Service Code	HCPCS C1713
Hospital Charge Code	40202239
Hospital Revenue Code	278
Min. Negotiated Rate	$94.00
Max. Negotiated Rate	$94.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.00
Rate for Payer: Hamaspik Choice Inc Medicare	$94.00

DRILLBIT 2.5MM 2.0MMX40MM

Facility

$188.00

Service Code	HCPCS C1713
Hospital Charge Code	40202239
Hospital Revenue Code	278
Min. Negotiated Rate	$65.80
Max. Negotiated Rate	$197.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$103.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$112.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$94.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$108.10
Rate for Payer: EmblemHealth Commercial	$94.00
Rate for Payer: Fidelis Medicare Advantage	$197.40
Rate for Payer: Group Health Inc Commercial	$94.00
Rate for Payer: Group Health Inc Medicare	$65.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$94.00
Rate for Payer: Hamaspik Choice Inc Medicare	$94.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$122.20

DRILL BIT 2.6MM

Facility

$368.00

Hospital Charge Code	40205524
Hospital Revenue Code	270
Min. Negotiated Rate	$128.80
Max. Negotiated Rate	$294.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$184.00
Rate for Payer: Aetna Government	$184.00
Rate for Payer: Brighton Health Commercial	$276.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$294.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$250.24
Rate for Payer: Group Health Inc Commercial	$184.00
Rate for Payer: Group Health Inc Medicare	$128.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00

DRILL BIT 3.1 MM

Facility

$210.00

Hospital Charge Code	40200656
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

DRILL BIT 3.2MM

Facility

$210.00

Hospital Charge Code	40200657
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

DRILL BIT 3.5MM

Facility

$197.40

Hospital Charge Code	40205545
Hospital Revenue Code	270
Min. Negotiated Rate	$69.09
Max. Negotiated Rate	$157.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$108.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.70
Rate for Payer: Aetna Government	$98.70
Rate for Payer: Brighton Health Commercial	$148.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$157.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$134.23
Rate for Payer: Group Health Inc Commercial	$98.70
Rate for Payer: Group Health Inc Medicare	$69.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.70
Rate for Payer: Hamaspik Choice Inc Medicare	$98.70

DRILL BIT 3.6MM

Facility

$197.40

Hospital Charge Code	40202142
Hospital Revenue Code	270
Min. Negotiated Rate	$69.09
Max. Negotiated Rate	$157.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$108.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.70
Rate for Payer: Aetna Government	$98.70
Rate for Payer: Brighton Health Commercial	$148.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$157.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$134.23
Rate for Payer: Group Health Inc Commercial	$98.70
Rate for Payer: Group Health Inc Medicare	$69.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.70
Rate for Payer: Hamaspik Choice Inc Medicare	$98.70

DRILL BIT 4.5

Facility

$146.00

Hospital Charge Code	40202143
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 BIT 4.5

Facility

$130.50

Service Code	HCPCS C1713
Hospital Charge Code	40200501
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

DRILL BIT 4.5

Facility

$130.50

Service Code	HCPCS C1713
Hospital Charge Code	40200501
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

DRILL BIT,AO DIA 2.6MMX135MM

Facility

$530.00

Hospital Charge Code	40005850
Hospital Revenue Code	272
Min. Negotiated Rate	$185.50
Max. Negotiated Rate	$424.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$291.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.00
Rate for Payer: Aetna Government	$265.00
Rate for Payer: Brighton Health Commercial	$397.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$424.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$360.40
Rate for Payer: Group Health Inc Commercial	$265.00
Rate for Payer: Group Health Inc Medicare	$185.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$265.00
Rate for Payer: Hamaspik Choice Inc Medicare	$265.00

DRILL BIT/GUIDE

Facility

$316.22

Hospital Charge Code	40203089
Hospital Revenue Code	272
Min. Negotiated Rate	$110.68
Max. Negotiated Rate	$252.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$173.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$158.11
Rate for Payer: Aetna Government	$158.11
Rate for Payer: Brighton Health Commercial	$237.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$252.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$215.03
Rate for Payer: Group Health Inc Commercial	$158.11
Rate for Payer: Group Health Inc Medicare	$110.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$158.11
Rate for Payer: Hamaspik Choice Inc Medicare	$158.11

DRILL BIT J LATCH 12M

Facility

$300.00

Service Code	HCPCS C1776
Hospital Charge Code	40202434
Hospital Revenue Code	278
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00

DRILL BIT J LATCH 12M

Facility

$300.00

Service Code	HCPCS C1776
Hospital Charge Code	40202434
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$180.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$150.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$172.50
Rate for Payer: EmblemHealth Commercial	$150.00
Rate for Payer: Fidelis Medicare Advantage	$315.00
Rate for Payer: Group Health Inc Commercial	$150.00
Rate for Payer: Group Health Inc Medicare	$105.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$150.00
Rate for Payer: Hamaspik Choice Inc Medicare	$150.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$195.00

DRILL BIT/STOP HALL END 1.1X4MM

Facility

$288.00

Hospital Charge Code	40200202
Hospital Revenue Code	270
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$230.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$158.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$144.00
Rate for Payer: Aetna Government	$144.00
Rate for Payer: Brighton Health Commercial	$216.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.84
Rate for Payer: Group Health Inc Commercial	$144.00
Rate for Payer: Group Health Inc Medicare	$100.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$144.00
Rate for Payer: Hamaspik Choice Inc Medicare	$144.00

DRILL BIT/ STOP HEX COUP 1.1X4MM

Facility

$137.00

Hospital Charge Code	40200204
Hospital Revenue Code	270
Min. Negotiated Rate	$47.95
Max. Negotiated Rate	$109.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$75.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$68.50
Rate for Payer: Aetna Government	$68.50
Rate for Payer: Brighton Health Commercial	$102.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$109.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.16
Rate for Payer: Group Health Inc Commercial	$68.50
Rate for Payer: Group Health Inc Medicare	$47.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$68.50
Rate for Payer: Hamaspik Choice Inc Medicare	$68.50

DRILL BONE

Facility

$1,620.00

Hospital Charge Code	64907403
Hospital Revenue Code	272
Min. Negotiated Rate	$567.00
Max. Negotiated Rate	$1,296.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$891.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$810.00
Rate for Payer: Aetna Government	$810.00
Rate for Payer: Brighton Health Commercial	$1,215.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,296.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,101.60
Rate for Payer: Group Health Inc Commercial	$810.00
Rate for Payer: Group Health Inc Medicare	$567.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$810.00
Rate for Payer: Hamaspik Choice Inc Medicare	$810.00

DRILL CANN 2.1MM

Facility

$400.00

Service Code	HCPCS C1776
Hospital Charge Code	40202436
Hospital Revenue Code	278
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$420.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$220.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$240.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$230.00
Rate for Payer: EmblemHealth Commercial	$200.00
Rate for Payer: Fidelis Medicare Advantage	$420.00
Rate for Payer: Group Health Inc Commercial	$200.00
Rate for Payer: Group Health Inc Medicare	$140.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$260.00

DRILL CANN 2.1MM

Facility

$400.00

Service Code	HCPCS C1776
Hospital Charge Code	40202436
Hospital Revenue Code	278
Min. Negotiated Rate	$200.00
Max. Negotiated Rate	$200.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$200.00
Rate for Payer: Hamaspik Choice Inc Medicare	$200.00

DRILL CANN 3.5MM

Facility

$367.00

Service Code	HCPCS C1713
Hospital Charge Code	40205085
Hospital Revenue Code	278
Min. Negotiated Rate	$183.50
Max. Negotiated Rate	$183.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$183.50
Rate for Payer: Hamaspik Choice Inc Medicare	$183.50

DRILL CANN 3.5MM

Facility

$367.00

Service Code	HCPCS C1713
Hospital Charge Code	40205085
Hospital Revenue Code	278
Min. Negotiated Rate	$128.45
Max. Negotiated Rate	$385.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$201.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$220.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$183.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$211.02
Rate for Payer: EmblemHealth Commercial	$183.50
Rate for Payer: Fidelis Medicare Advantage	$385.35
Rate for Payer: Group Health Inc Commercial	$183.50
Rate for Payer: Group Health Inc Medicare	$128.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$183.50
Rate for Payer: Hamaspik Choice Inc Medicare	$183.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$238.55

DRILL, CANN AO 2.3X120MM

Facility

$393.93

Hospital Charge Code	40004429
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: Brighton Health Commercial	$295.45
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 CANN DIST 2.7

Facility

$1,037.50

Service Code	HCPCS C1713
Hospital Charge Code	64907470
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,089.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$570.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$622.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$518.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$596.56
Rate for Payer: EmblemHealth Commercial	$518.75
Rate for Payer: Fidelis Medicare Advantage	$1,089.38
Rate for Payer: Group Health Inc Commercial	$518.75
Rate for Payer: Group Health Inc Medicare	$363.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$518.75
Rate for Payer: Hamaspik Choice Inc Medicare	$518.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$674.38

DRILL CANN DIST 2.7

Facility

$1,037.50

Service Code	HCPCS C1713
Hospital Charge Code	64907470
Hospital Revenue Code	278
Min. Negotiated Rate	$518.75
Max. Negotiated Rate	$518.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$518.75
Rate for Payer: Hamaspik Choice Inc Medicare	$518.75

Know your out-of-pocket cost for care.

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