St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

DRILL CANNLTD POLY 2.0

Facility

$335.00

Hospital Charge Code	64907051
Hospital Revenue Code	270
Min. Negotiated Rate	$117.25
Max. Negotiated Rate	$268.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$184.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$167.50
Rate for Payer: Aetna Government	$167.50
Rate for Payer: Brighton Health Commercial	$251.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$268.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$227.80
Rate for Payer: Group Health Inc Commercial	$167.50
Rate for Payer: Group Health Inc Medicare	$117.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$167.50
Rate for Payer: Hamaspik Choice Inc Medicare	$167.50

DRILL CANNULATED 4MM (AR-8973-40S

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	64906563
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$315.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$165.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
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 CANNULATED 4MM (AR-8973-40S

Facility

$300.00

Service Code	HCPCS C1713
Hospital Charge Code	64906563
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 CORKSCREW KNOTLESS

Facility

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64907365
Hospital Revenue Code	278
Min. Negotiated Rate	$91.88
Max. Negotiated Rate	$275.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$157.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$131.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.94
Rate for Payer: EmblemHealth Commercial	$131.25
Rate for Payer: Fidelis Medicare Advantage	$275.62
Rate for Payer: Group Health Inc Commercial	$131.25
Rate for Payer: Group Health Inc Medicare	$91.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$170.62

DRILL CORKSCREW KNOTLESS

Facility

$262.50

Service Code	HCPCS C1713
Hospital Charge Code	64907365
Hospital Revenue Code	278
Min. Negotiated Rate	$131.25
Max. Negotiated Rate	$131.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.25
Rate for Payer: Hamaspik Choice Inc Medicare	$131.25

DRILL CROWN 04

Facility

$1,283.00

Service Code	HCPCS C1713
Hospital Charge Code	40005911
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,347.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$705.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$769.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$641.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$737.72
Rate for Payer: EmblemHealth Commercial	$641.50
Rate for Payer: Fidelis Medicare Advantage	$1,347.15
Rate for Payer: Group Health Inc Commercial	$641.50
Rate for Payer: Group Health Inc Medicare	$449.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$641.50
Rate for Payer: Hamaspik Choice Inc Medicare	$641.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$833.95

DRILL CROWN 04

Facility

$1,283.00

Service Code	HCPCS C1713
Hospital Charge Code	40005911
Hospital Revenue Code	278
Min. Negotiated Rate	$641.50
Max. Negotiated Rate	$641.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$641.50
Rate for Payer: Hamaspik Choice Inc Medicare	$641.50

DRILL DEEPDGUIDE DIA 2.0MM L30MM

Facility

$310.31

Service Code	HCPCS C1713
Hospital Charge Code	64906392
Hospital Revenue Code	278
Min. Negotiated Rate	$155.16
Max. Negotiated Rate	$155.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$155.16
Rate for Payer: Hamaspik Choice Inc Medicare	$155.16

DRILL DEEPDGUIDE DIA 2.0MM L30MM

Facility

$310.31

Service Code	HCPCS C1713
Hospital Charge Code	64906392
Hospital Revenue Code	278
Min. Negotiated Rate	$108.61
Max. Negotiated Rate	$325.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$170.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$186.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$178.43
Rate for Payer: EmblemHealth Commercial	$155.16
Rate for Payer: Fidelis Medicare Advantage	$325.83
Rate for Payer: Group Health Inc Commercial	$155.16
Rate for Payer: Group Health Inc Medicare	$108.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$155.16
Rate for Payer: Hamaspik Choice Inc Medicare	$155.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$201.70

DRILL END 1.6X115MM

Facility

$219.29

Service Code	HCPCS C1713
Hospital Charge Code	64906226
Hospital Revenue Code	278
Min. Negotiated Rate	$76.75
Max. Negotiated Rate	$230.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$120.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$131.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$109.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$126.09
Rate for Payer: EmblemHealth Commercial	$109.64
Rate for Payer: Fidelis Medicare Advantage	$230.25
Rate for Payer: Group Health Inc Commercial	$109.64
Rate for Payer: Group Health Inc Medicare	$76.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.64
Rate for Payer: Hamaspik Choice Inc Medicare	$109.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$142.54

DRILL END 1.6X115MM

Facility

$219.29

Service Code	HCPCS C1713
Hospital Charge Code	64906226
Hospital Revenue Code	278
Min. Negotiated Rate	$109.64
Max. Negotiated Rate	$109.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$109.64
Rate for Payer: Hamaspik Choice Inc Medicare	$109.64

DRILL FIXED

Facility

$1,041.25

Hospital Charge Code	64907343
Hospital Revenue Code	279
Min. Negotiated Rate	$364.44
Max. Negotiated Rate	$833.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$572.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$520.62
Rate for Payer: Aetna Government	$520.62
Rate for Payer: Brighton Health Commercial	$780.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$833.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$708.05
Rate for Payer: Group Health Inc Commercial	$520.62
Rate for Payer: Group Health Inc Medicare	$364.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$520.62
Rate for Payer: Hamaspik Choice Inc Medicare	$520.62

DRILL FLEX 8MM 88088

Facility

$1,317.52

Hospital Charge Code	64906736
Hospital Revenue Code	279
Min. Negotiated Rate	$461.13
Max. Negotiated Rate	$1,054.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$724.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$658.76
Rate for Payer: Aetna Government	$658.76
Rate for Payer: Brighton Health Commercial	$988.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,054.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$895.91
Rate for Payer: Group Health Inc Commercial	$658.76
Rate for Payer: Group Health Inc Medicare	$461.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$658.76
Rate for Payer: Hamaspik Choice Inc Medicare	$658.76

DRILL FLEX ANCHOR-C 10M-48328810

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64906583
Hospital Revenue Code	278
Min. Negotiated Rate	$500.00
Max. Negotiated Rate	$500.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$500.00
Rate for Payer: Hamaspik Choice Inc Medicare	$500.00

DRILL FLEX ANCHOR-C 10M-48328810

Facility

$1,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64906583
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,050.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$550.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$600.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$500.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$575.00
Rate for Payer: EmblemHealth Commercial	$500.00
Rate for Payer: Fidelis Medicare Advantage	$1,050.00
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$650.00

DRILL FLIPCUTTER

Facility

$1,037.50

Hospital Charge Code	64907429
Hospital Revenue Code	279
Min. Negotiated Rate	$363.12
Max. Negotiated Rate	$830.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$570.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$518.75
Rate for Payer: Aetna Government	$518.75
Rate for Payer: Brighton Health Commercial	$778.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$830.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$705.50
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

DRILL FREEHAND(2351-4218S)

Facility

$406.00

Hospital Charge Code	64906344
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: Brighton Health Commercial	$304.50
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

DRILL FREEHAND (2351-4236S)

Facility

$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: Brighton Health Commercial	$304.50
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

$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

DRILLFREE MAXIDRVE MINISCRW

Facility

$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: Brighton Health Commercial	$97.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.44
Rate for Payer: EmblemHealth Commercial	$81.25
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

DRILL GRAY PT 4.0MX200M-50852040

Facility

$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: Brighton Health Commercial	$98.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$82.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$94.30
Rate for Payer: EmblemHealth Commercial	$82.00
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 GRAY PT 4.0MX200M-50852040

Facility

$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 GUIDE

Facility

$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: Brighton Health Commercial	$1,317.75
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

$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: Brighton Health Commercial	$210.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$175.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$201.25
Rate for Payer: EmblemHealth Commercial	$175.00
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 BLOCK FOR HIL 5HOLES

Facility

$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

Know your out-of-pocket cost for care.

All Charges