St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

DRILL SURG CANNUL 2.1MM DIA 005S

Facility

$242.20

Service Code	HCPCS C1713
Hospital Charge Code	64906704
Hospital Revenue Code	278
Min. Negotiated Rate	$121.10
Max. Negotiated Rate	$121.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.10
Rate for Payer: Hamaspik Choice Inc Medicare	$121.10

DRILL SURG CANNUL 2.1MM DIA 005S

Facility

$242.20

Service Code	HCPCS C1713
Hospital Charge Code	64906704
Hospital Revenue Code	278
Min. Negotiated Rate	$84.77
Max. Negotiated Rate	$254.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$133.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$145.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$121.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$139.26
Rate for Payer: EmblemHealth Commercial	$121.10
Rate for Payer: Fidelis Medicare Advantage	$254.31
Rate for Payer: Group Health Inc Commercial	$121.10
Rate for Payer: Group Health Inc Medicare	$84.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$121.10
Rate for Payer: Hamaspik Choice Inc Medicare	$121.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$157.43

DRILL SURGICAL TWIST 4.5MM DIA

Facility

$322.50

Hospital Charge Code	64905068
Hospital Revenue Code	270
Min. Negotiated Rate	$112.88
Max. Negotiated Rate	$258.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$177.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$161.25
Rate for Payer: Aetna Government	$161.25
Rate for Payer: Brighton Health Commercial	$241.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$258.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$219.30
Rate for Payer: Group Health Inc Commercial	$161.25
Rate for Payer: Group Health Inc Medicare	$112.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$161.25
Rate for Payer: Hamaspik Choice Inc Medicare	$161.25

DRILL SURG SOLD F/LAG SCREW 3026S

Facility

$328.00

Service Code	HCPCS C1713
Hospital Charge Code	64906661
Hospital Revenue Code	278
Min. Negotiated Rate	$164.00
Max. Negotiated Rate	$164.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$164.00
Rate for Payer: Hamaspik Choice Inc Medicare	$164.00

DRILL SURG SOLD F/LAG SCREW 3026S

Facility

$328.00

Service Code	HCPCS C1713
Hospital Charge Code	64906661
Hospital Revenue Code	278
Min. Negotiated Rate	$114.80
Max. Negotiated Rate	$344.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$180.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$196.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$164.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$188.60
Rate for Payer: EmblemHealth Commercial	$164.00
Rate for Payer: Fidelis Medicare Advantage	$344.40
Rate for Payer: Group Health Inc Commercial	$164.00
Rate for Payer: Group Health Inc Medicare	$114.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$164.00
Rate for Payer: Hamaspik Choice Inc Medicare	$164.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$213.20

DRILL SURG TWIST 1.6 35MM

Facility

$294.75

Service Code	HCPCS C1713
Hospital Charge Code	64905086
Hospital Revenue Code	278
Min. Negotiated Rate	$103.16
Max. Negotiated Rate	$309.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$162.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$176.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$147.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$169.48
Rate for Payer: EmblemHealth Commercial	$147.38
Rate for Payer: Fidelis Medicare Advantage	$309.49
Rate for Payer: Group Health Inc Commercial	$147.38
Rate for Payer: Group Health Inc Medicare	$103.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$147.38
Rate for Payer: Hamaspik Choice Inc Medicare	$147.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$191.59

DRILL SURG TWIST 1.6 35MM

Facility

$294.75

Service Code	HCPCS C1713
Hospital Charge Code	64905086
Hospital Revenue Code	278
Min. Negotiated Rate	$147.38
Max. Negotiated Rate	$147.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$147.38
Rate for Payer: Hamaspik Choice Inc Medicare	$147.38

DRILL SURG TWIST 1.9MM DIA

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64903190
Hospital Revenue Code	278
Min. Negotiated Rate	$65.62
Max. Negotiated Rate	$196.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$103.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$93.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$107.81
Rate for Payer: EmblemHealth Commercial	$93.75
Rate for Payer: Fidelis Medicare Advantage	$196.88
Rate for Payer: Group Health Inc Commercial	$93.75
Rate for Payer: Group Health Inc Medicare	$65.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.75
Rate for Payer: Hamaspik Choice Inc Medicare	$93.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$121.88

DRILL SURG TWIST 1.9MM DIA

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64903190
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.75
Rate for Payer: Hamaspik Choice Inc Medicare	$93.75

DRILL TW / 1.6 5MM STOP

Facility

$251.88

Service Code	HCPCS C1713
Hospital Charge Code	64904485
Hospital Revenue Code	278
Min. Negotiated Rate	$125.94
Max. Negotiated Rate	$125.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$125.94
Rate for Payer: Hamaspik Choice Inc Medicare	$125.94

DRILL TW / 1.6 5MM STOP

Facility

$251.88

Service Code	HCPCS C1713
Hospital Charge Code	64904485
Hospital Revenue Code	278
Min. Negotiated Rate	$88.16
Max. Negotiated Rate	$264.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$125.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.83
Rate for Payer: EmblemHealth Commercial	$125.94
Rate for Payer: Fidelis Medicare Advantage	$264.47
Rate for Payer: Group Health Inc Commercial	$125.94
Rate for Payer: Group Health Inc Medicare	$88.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$125.94
Rate for Payer: Hamaspik Choice Inc Medicare	$125.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.72

DRILL TW / 1.6 85MM 26

Facility

$273.53

Service Code	HCPCS C1713
Hospital Charge Code	64904483
Hospital Revenue Code	278
Min. Negotiated Rate	$95.74
Max. Negotiated Rate	$287.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$150.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$164.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$136.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$157.28
Rate for Payer: EmblemHealth Commercial	$136.76
Rate for Payer: Fidelis Medicare Advantage	$287.21
Rate for Payer: Group Health Inc Commercial	$136.76
Rate for Payer: Group Health Inc Medicare	$95.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.76
Rate for Payer: Hamaspik Choice Inc Medicare	$136.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$177.79

DRILL TW / 1.6 85MM 26

Facility

$273.53

Service Code	HCPCS C1713
Hospital Charge Code	64904483
Hospital Revenue Code	278
Min. Negotiated Rate	$136.76
Max. Negotiated Rate	$136.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$136.76
Rate for Payer: Hamaspik Choice Inc Medicare	$136.76

DRILL TWIST 1.1X50MM 5MM STOP

Facility

$327.08

Service Code	HCPCS C1713
Hospital Charge Code	64901723
Hospital Revenue Code	278
Min. Negotiated Rate	$114.48
Max. Negotiated Rate	$343.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$179.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$196.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$163.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$188.07
Rate for Payer: EmblemHealth Commercial	$163.54
Rate for Payer: Fidelis Medicare Advantage	$343.43
Rate for Payer: Group Health Inc Commercial	$163.54
Rate for Payer: Group Health Inc Medicare	$114.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.54
Rate for Payer: Hamaspik Choice Inc Medicare	$163.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$212.60

DRILL TWIST 1.1X50MM 5MM STOP

Facility

$327.08

Service Code	HCPCS C1713
Hospital Charge Code	64901723
Hospital Revenue Code	278
Min. Negotiated Rate	$163.54
Max. Negotiated Rate	$163.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.54
Rate for Payer: Hamaspik Choice Inc Medicare	$163.54

DRILL TWIST 1.5

Facility

$347.50

Service Code	HCPCS C1713
Hospital Charge Code	64901806
Hospital Revenue Code	278
Min. Negotiated Rate	$173.75
Max. Negotiated Rate	$173.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.75
Rate for Payer: Hamaspik Choice Inc Medicare	$173.75

DRILL TWIST 1.5

Facility

$347.50

Service Code	HCPCS C1713
Hospital Charge Code	64901806
Hospital Revenue Code	278
Min. Negotiated Rate	$121.62
Max. Negotiated Rate	$364.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$208.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$173.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$199.81
Rate for Payer: EmblemHealth Commercial	$173.75
Rate for Payer: Fidelis Medicare Advantage	$364.88
Rate for Payer: Group Health Inc Commercial	$173.75
Rate for Payer: Group Health Inc Medicare	$121.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.75
Rate for Payer: Hamaspik Choice Inc Medicare	$173.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$225.88

DRILL TWIST 1.5 X 115MM

Facility

$248.00

Service Code	HCPCS C1776
Hospital Charge Code	40205068
Hospital Revenue Code	278
Min. Negotiated Rate	$86.80
Max. Negotiated Rate	$339.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$148.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$124.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$142.60
Rate for Payer: EmblemHealth Commercial	$124.00
Rate for Payer: Fidelis Medicare Advantage	$260.40
Rate for Payer: Group Health Inc Commercial	$124.00
Rate for Payer: Group Health Inc Medicare	$86.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$124.00
Rate for Payer: Hamaspik Choice Inc Medicare	$124.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$161.20

DRILL TWIST 1.5 X 115MM

Facility

$248.00

Service Code	HCPCS C1776
Hospital Charge Code	40205068
Hospital Revenue Code	278
Min. Negotiated Rate	$124.00
Max. Negotiated Rate	$124.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$124.00
Rate for Payer: Hamaspik Choice Inc Medicare	$124.00

DRILL TWIST 1.5 X 115MM A

Facility

$327.08

Service Code	HCPCS C1713
Hospital Charge Code	64901978
Hospital Revenue Code	278
Min. Negotiated Rate	$114.48
Max. Negotiated Rate	$343.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$179.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$196.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$163.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$188.07
Rate for Payer: EmblemHealth Commercial	$163.54
Rate for Payer: Fidelis Medicare Advantage	$343.43
Rate for Payer: Group Health Inc Commercial	$163.54
Rate for Payer: Group Health Inc Medicare	$114.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.54
Rate for Payer: Hamaspik Choice Inc Medicare	$163.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$212.60

DRILL TWIST 1.5 X 115MM A

Facility

$327.08

Service Code	HCPCS C1713
Hospital Charge Code	64901978
Hospital Revenue Code	278
Min. Negotiated Rate	$163.54
Max. Negotiated Rate	$163.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.54
Rate for Payer: Hamaspik Choice Inc Medicare	$163.54

DRILL TWIST 1.6M 7MM STOP CHUK

Facility

$264.25

Service Code	HCPCS C1713
Hospital Charge Code	64901463
Hospital Revenue Code	278
Min. Negotiated Rate	$132.12
Max. Negotiated Rate	$132.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$132.12
Rate for Payer: Hamaspik Choice Inc Medicare	$132.12

DRILL TWIST 1.6M 7MM STOP CHUK

Facility

$264.25

Service Code	HCPCS C1713
Hospital Charge Code	64901463
Hospital Revenue Code	278
Min. Negotiated Rate	$92.49
Max. Negotiated Rate	$277.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$145.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$158.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$132.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$151.94
Rate for Payer: EmblemHealth Commercial	$132.12
Rate for Payer: Fidelis Medicare Advantage	$277.46
Rate for Payer: Group Health Inc Commercial	$132.12
Rate for Payer: Group Health Inc Medicare	$92.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$132.12
Rate for Payer: Hamaspik Choice Inc Medicare	$132.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$171.76

DRILL TWIST 1.6X 5MM

Facility

$220.00

Hospital Charge Code	40200663
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 TWIST 1.9

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64905272
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$93.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$93.75
Rate for Payer: Hamaspik Choice Inc Medicare	$93.75

Know your out-of-pocket cost for care.

All Charges