St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

DRILL TWIST 1.9

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64905272
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 TWIST 1.9MM DIA. AO

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64905612
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 TWIST 1.9MM DIA. AO

Facility

$150.00

Hospital Charge Code	40005927
Hospital Revenue Code	272
Min. Negotiated Rate	$52.50
Max. Negotiated Rate	$120.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$75.00
Rate for Payer: Aetna Government	$75.00
Rate for Payer: Brighton Health Commercial	$112.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$120.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$102.00
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

DRILL TWIST 1.9MM DIA. AO

Facility

$187.50

Service Code	HCPCS C1713
Hospital Charge Code	64905612
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 TWIST 1.9X 35MM STRYKER

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	64901519
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.00
Rate for Payer: Hamaspik Choice Inc Medicare	$165.00

DRILL TWIST 1.9X 35MM STRYKER

Facility

$330.00

Service Code	HCPCS C1713
Hospital Charge Code	64901519
Hospital Revenue Code	278
Min. Negotiated Rate	$115.50
Max. Negotiated Rate	$346.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$198.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$165.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$189.75
Rate for Payer: EmblemHealth Commercial	$165.00
Rate for Payer: Fidelis Medicare Advantage	$346.50
Rate for Payer: Group Health Inc Commercial	$165.00
Rate for Payer: Group Health Inc Medicare	$115.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.00
Rate for Payer: Hamaspik Choice Inc Medicare	$165.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$214.50

DRILL TWIST 1.9X 70MM

Facility

$248.00

Service Code	HCPCS C1776
Hospital Charge Code	40205079
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 1.9X 70MM

Facility

$248.00

Service Code	HCPCS C1776
Hospital Charge Code	40205079
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 1.9X70MM

Facility

$322.50

Service Code	HCPCS C1713
Hospital Charge Code	64901336
Hospital Revenue Code	278
Min. Negotiated Rate	$161.25
Max. Negotiated Rate	$161.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$161.25
Rate for Payer: Hamaspik Choice Inc Medicare	$161.25

DRILL TWIST 1.9X70MM

Facility

$248.00

Service Code	HCPCS C1713
Hospital Charge Code	40205001
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 1.9X70MM

Facility

$322.50

Service Code	HCPCS C1713
Hospital Charge Code	64901336
Hospital Revenue Code	278
Min. Negotiated Rate	$112.88
Max. Negotiated Rate	$338.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$177.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$193.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$161.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$185.44
Rate for Payer: EmblemHealth Commercial	$161.25
Rate for Payer: Fidelis Medicare Advantage	$338.62
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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$209.62

DRILL TWIST 1.9X70MM

Facility

$248.00

Service Code	HCPCS C1713
Hospital Charge Code	40205001
Hospital Revenue Code	278
Min. Negotiated Rate	$86.80
Max. Negotiated Rate	$260.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$136.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
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 1.9 X 8MM

Facility

$277.03

Service Code	HCPCS C1713
Hospital Charge Code	64901962
Hospital Revenue Code	278
Min. Negotiated Rate	$138.52
Max. Negotiated Rate	$138.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.52
Rate for Payer: Hamaspik Choice Inc Medicare	$138.52

DRILL TWIST 1.9 X 8MM

Facility

$277.03

Service Code	HCPCS C1713
Hospital Charge Code	64901962
Hospital Revenue Code	278
Min. Negotiated Rate	$96.96
Max. Negotiated Rate	$290.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$152.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$166.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$138.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$159.29
Rate for Payer: EmblemHealth Commercial	$138.52
Rate for Payer: Fidelis Medicare Advantage	$290.88
Rate for Payer: Group Health Inc Commercial	$138.52
Rate for Payer: Group Health Inc Medicare	$96.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$138.52
Rate for Payer: Hamaspik Choice Inc Medicare	$138.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$180.07

DRILL TWIST 3.5MDIA195ML QU700353

Facility

$104.50

Service Code	HCPCS C1713
Hospital Charge Code	64906442
Hospital Revenue Code	278
Min. Negotiated Rate	$36.58
Max. Negotiated Rate	$134.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$62.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$60.09
Rate for Payer: EmblemHealth Commercial	$52.25
Rate for Payer: Fidelis Medicare Advantage	$109.72
Rate for Payer: Group Health Inc Commercial	$52.25
Rate for Payer: Group Health Inc Medicare	$36.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.25
Rate for Payer: Hamaspik Choice Inc Medicare	$52.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$67.92

DRILL TWIST 3.5MDIA195ML QU700353

Facility

$104.50

Service Code	HCPCS C1713
Hospital Charge Code	64906442
Hospital Revenue Code	278
Min. Negotiated Rate	$52.25
Max. Negotiated Rate	$52.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.25
Rate for Payer: Hamaspik Choice Inc Medicare	$52.25

DRILL TWST 1.5 DIA X 50MM CYL

Facility

$367.50

Service Code	HCPCS C1713
Hospital Charge Code	64901731
Hospital Revenue Code	278
Min. Negotiated Rate	$128.62
Max. Negotiated Rate	$385.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$220.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$183.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$211.31
Rate for Payer: EmblemHealth Commercial	$183.75
Rate for Payer: Fidelis Medicare Advantage	$385.88
Rate for Payer: Group Health Inc Commercial	$183.75
Rate for Payer: Group Health Inc Medicare	$128.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$183.75
Rate for Payer: Hamaspik Choice Inc Medicare	$183.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$238.88

DRILL TWST 1.5 DIA X 50MM CYL

Facility

$367.50

Service Code	HCPCS C1713
Hospital Charge Code	64901731
Hospital Revenue Code	278
Min. Negotiated Rate	$183.75
Max. Negotiated Rate	$183.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$183.75
Rate for Payer: Hamaspik Choice Inc Medicare	$183.75

DRIVER AO CONNECGT POLY LOCK

Facility

$335.00

Hospital Charge Code	64907052
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

DRIVER AO SQR TIP 2.0MM

Facility

$268.00

Service Code	HCPCS C1713
Hospital Charge Code	64906912
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

DRIVER AO SQR TIP 2.0MM

Facility

$268.00

Service Code	HCPCS C1713
Hospital Charge Code	64906912
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: Brighton Health Commercial	$160.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$134.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$154.10
Rate for Payer: EmblemHealth Commercial	$134.00
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

DRIVER HEXALOBE

Facility

$487.50

Hospital Charge Code	64907396
Hospital Revenue Code	270
Min. Negotiated Rate	$170.62
Max. Negotiated Rate	$390.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$243.75
Rate for Payer: Aetna Government	$243.75
Rate for Payer: Brighton Health Commercial	$365.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$390.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$331.50
Rate for Payer: Group Health Inc Commercial	$243.75
Rate for Payer: Group Health Inc Medicare	$170.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$243.75

DRIVER REDUCT 2.5

Facility

$985.00

Hospital Charge Code	64907508
Hospital Revenue Code	270
Min. Negotiated Rate	$344.75
Max. Negotiated Rate	$788.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$541.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$492.50
Rate for Payer: Aetna Government	$492.50
Rate for Payer: Brighton Health Commercial	$738.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$788.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$669.80
Rate for Payer: Group Health Inc Commercial	$492.50
Rate for Payer: Group Health Inc Medicare	$344.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$492.50
Rate for Payer: Hamaspik Choice Inc Medicare	$492.50

DRIVER UNIVERSAL T10

Facility

$268.00

Hospital Charge Code	64906913
Hospital Revenue Code	270
Min. Negotiated Rate	$93.80
Max. Negotiated Rate	$214.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$147.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.00
Rate for Payer: Aetna Government	$134.00
Rate for Payer: Brighton Health Commercial	$201.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$214.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$182.24
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

DRIVE TARGATING

Facility

$407.50

Hospital Charge Code	64904054
Hospital Revenue Code	270
Min. Negotiated Rate	$142.62
Max. Negotiated Rate	$326.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$224.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$203.75
Rate for Payer: Aetna Government	$203.75
Rate for Payer: Brighton Health Commercial	$305.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$326.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$277.10
Rate for Payer: Group Health Inc Commercial	$203.75
Rate for Payer: Group Health Inc Medicare	$142.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$203.75
Rate for Payer: Hamaspik Choice Inc Medicare	$203.75

Know your out-of-pocket cost for care.

All Charges