St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MAGNESIUM SULFATE 50 % IJ SOLN [4720]

Facility

$0.72

Service Code	HCPCS J3475
Hospital Charge Code	63323006441
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$0.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.49
Rate for Payer: Group Health Inc Commercial	$0.36
Rate for Payer: Group Health Inc Medicare	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36
Rate for Payer: Hamaspik Choice Inc Medicare	$0.36
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$0.64
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$0.68
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$0.68
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$0.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.47

MAGNESIUM SULFATE 5 GRAMS/10 ML INJ

Facility

$0.31

Service Code	HCPCS J3475
Hospital Charge Code	41650706
Hospital Revenue Code	636
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$0.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.18
Rate for Payer: Group Health Inc Commercial	$0.16
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16
Rate for Payer: Hamaspik Choice Inc Medicare	$0.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.68
Rate for Payer: SOMOS Essential	$0.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.20

MAGNESIUM SULFATE 5 GRAMS/10 ML INJ

Facility

$0.31

Service Code	HCPCS J3475
Hospital Charge Code	41640706
Hospital Revenue Code	636
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16
Rate for Payer: Hamaspik Choice Inc Medicare	$0.16

MAGNESIUM SULFATE 5 GRAMS/10 ML INJ

Facility

$0.31

Service Code	HCPCS J3475
Hospital Charge Code	41640706
Hospital Revenue Code	636
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$0.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.18
Rate for Payer: Group Health Inc Commercial	$0.16
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16
Rate for Payer: Hamaspik Choice Inc Medicare	$0.16
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.68
Rate for Payer: SOMOS Essential	$0.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.20

MAGNESIUM SULFATE 5 GRAMS/10 ML INJ

Facility

$0.31

Service Code	HCPCS J3475
Hospital Charge Code	41650706
Hospital Revenue Code	636
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16
Rate for Payer: Hamaspik Choice Inc Medicare	$0.16

MAGNESIUM SULFATE IN D5W 1-5 GM/100ML-% IV SOLN [137043]

Facility

$0.10

Service Code	HCPCS J3475
Hospital Charge Code	63323010800
Hospital Revenue Code	278
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05

MAGNESIUM SULFATE IN D5W 1-5 GM/100ML-% IV SOLN [137043]

Facility

$0.10

Service Code	HCPCS J3475
Hospital Charge Code	63323010801
Hospital Revenue Code	278
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05

MAGNESIUM SULFATE IN D5W 1-5 GM/100ML-% IV SOLN [137043]

Facility

$0.10

Service Code	HCPCS J3475
Hospital Charge Code	63323010801
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.06
Rate for Payer: EmblemHealth Commercial	$0.05
Rate for Payer: Fidelis Medicare Advantage	$0.10
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.06

MAGNESIUM SULFATE IN D5W 1-5 GM/100ML-% IV SOLN [137043]

Facility

$0.10

Service Code	HCPCS J3475
Hospital Charge Code	63323010800
Hospital Revenue Code	278
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.06
Rate for Payer: EmblemHealth Commercial	$0.05
Rate for Payer: Fidelis Medicare Advantage	$0.10
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.06

MAG SULFATE 20G WATER/500ML-500MG

Facility

$10.57

Service Code	HCPCS J3475
Hospital Charge Code	41648414
Hospital Revenue Code	636
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$6.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$6.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.08
Rate for Payer: Group Health Inc Commercial	$5.28
Rate for Payer: Group Health Inc Medicare	$3.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.28
Rate for Payer: Hamaspik Choice Inc Medicare	$5.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.68
Rate for Payer: SOMOS Essential	$0.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.87

MAG SULFATE 20G WATER/500ML-500MG

Facility

$10.57

Service Code	HCPCS J3475
Hospital Charge Code	41648414
Hospital Revenue Code	636
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$5.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.28
Rate for Payer: Hamaspik Choice Inc Medicare	$5.28

MAG SULFATE 20G WATER/500ML-500MG

Facility

$10.57

Service Code	HCPCS J3475
Hospital Charge Code	41658414
Hospital Revenue Code	636
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$6.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$6.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.08
Rate for Payer: Group Health Inc Commercial	$5.28
Rate for Payer: Group Health Inc Medicare	$3.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.28
Rate for Payer: Hamaspik Choice Inc Medicare	$5.28
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.68
Rate for Payer: SOMOS Essential	$0.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.87

MAG SULFATE 20G WATER/500ML-500MG

Facility

$10.57

Service Code	HCPCS J3475
Hospital Charge Code	41658414
Hospital Revenue Code	636
Min. Negotiated Rate	$5.28
Max. Negotiated Rate	$5.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.28
Rate for Payer: Hamaspik Choice Inc Medicare	$5.28

MAG SULFATE 2G/WATER 50ML-500MG

Facility

$3.26

Service Code	HCPCS J3475
Hospital Charge Code	41648402
Hospital Revenue Code	636
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$1.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.63
Rate for Payer: Hamaspik Choice Inc Medicare	$1.63

MAG SULFATE 2G/WATER 50ML-500MG

Facility

$3.26

Service Code	HCPCS J3475
Hospital Charge Code	41648402
Hospital Revenue Code	636
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$2.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$1.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.87
Rate for Payer: Group Health Inc Commercial	$1.63
Rate for Payer: Group Health Inc Medicare	$1.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.63
Rate for Payer: Hamaspik Choice Inc Medicare	$1.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.68
Rate for Payer: SOMOS Essential	$0.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.12

MAG SULFATE 2G/WATER 50ML-500MG

Facility

$3.26

Service Code	HCPCS J3475
Hospital Charge Code	41658402
Hospital Revenue Code	636
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$2.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Brighton Health Commercial	$1.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.87
Rate for Payer: Group Health Inc Commercial	$1.63
Rate for Payer: Group Health Inc Medicare	$1.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.63
Rate for Payer: Hamaspik Choice Inc Medicare	$1.63
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.68
Rate for Payer: SOMOS Essential	$0.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.12

MAG SULFATE 2G/WATER 50ML-500MG

Facility

$3.26

Service Code	HCPCS J3475
Hospital Charge Code	41658402
Hospital Revenue Code	636
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$1.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.63
Rate for Payer: Hamaspik Choice Inc Medicare	$1.63

MAIN FOUR PRIVATE

Facility

$4,209.70

Hospital Charge Code	30000030
Hospital Revenue Code	126
Min. Negotiated Rate	$933.00
Max. Negotiated Rate	$1,043.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$933.00
Rate for Payer: Optum Commercial/Medicare	$1,043.00
Rate for Payer: Optum Medicaid	$1,043.00

MAIN FOUR SEMI-PRIVATE

Facility

$4,093.10

Hospital Charge Code	30000031
Hospital Revenue Code	126
Min. Negotiated Rate	$933.00
Max. Negotiated Rate	$1,043.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$933.00
Rate for Payer: Optum Commercial/Medicare	$1,043.00
Rate for Payer: Optum Medicaid	$1,043.00

MAIN FOUR WARD

Facility

$4,093.10

Hospital Charge Code	30000032
Hospital Revenue Code	126
Min. Negotiated Rate	$933.00
Max. Negotiated Rate	$1,043.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$933.00
Rate for Payer: Optum Commercial/Medicare	$1,043.00
Rate for Payer: Optum Medicaid	$1,043.00

MAJOR BLADDER PROCEDURES WITH CC

Facility

$62,273.48

Service Code	MSDRG 654
Min. Negotiated Rate	$21,059.76
Max. Negotiated Rate	$62,273.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$40,364.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45,289.80
Rate for Payer: Aetna Government	$45,289.80
Rate for Payer: Brighton Health Commercial	$39,693.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$46,195.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47,273.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$39,012.44
Rate for Payer: Elderplan Medicare Advantage	$43,025.31
Rate for Payer: EmblemHealth Commercial	$23,474.10
Rate for Payer: Fidelis Medicare Advantage	$45,289.80
Rate for Payer: Group Health Inc Commercial	$45,289.80
Rate for Payer: Group Health Inc Medicare	$45,289.80
Rate for Payer: Hamaspik Choice Inc Medicare	$45,289.80
Rate for Payer: Healthfirst Medicare Advantage	$21,059.76
Rate for Payer: Humana Medicare	$62,273.48
Rate for Payer: Senior Whole Health Medicare Advantage	$45,289.80
Rate for Payer: United Healthcare Commercial	$54,440.66
Rate for Payer: United Healthcare Medicare Advantage	$45,289.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$45,289.80
Rate for Payer: Wellcare Medicare	$43,025.31

MAJOR BLADDER PROCEDURES WITH MCC

Facility

$113,300.41

Service Code	MSDRG 653
Min. Negotiated Rate	$38,316.14
Max. Negotiated Rate	$113,300.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$79,823.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$82,400.30
Rate for Payer: Aetna Government	$82,400.30
Rate for Payer: Brighton Health Commercial	$78,497.20
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$84,048.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$93,487.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$77,149.86
Rate for Payer: Elderplan Medicare Advantage	$78,280.28
Rate for Payer: EmblemHealth Commercial	$46,421.60
Rate for Payer: Fidelis Medicare Advantage	$82,400.30
Rate for Payer: Group Health Inc Commercial	$82,400.30
Rate for Payer: Group Health Inc Medicare	$82,400.30
Rate for Payer: Hamaspik Choice Inc Medicare	$82,400.30
Rate for Payer: Healthfirst Medicare Advantage	$38,316.14
Rate for Payer: Humana Medicare	$113,300.41
Rate for Payer: Senior Whole Health Medicare Advantage	$82,400.30
Rate for Payer: United Healthcare Commercial	$107,660.26
Rate for Payer: United Healthcare Medicare Advantage	$82,400.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$82,400.30
Rate for Payer: Wellcare Medicare	$78,280.28

MAJOR BLADDER PROCEDURES WITHOUT CC/MCC

Facility

$50,266.56

Service Code	MSDRG 655
Min. Negotiated Rate	$16,999.24
Max. Negotiated Rate	$50,266.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31,079.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$36,557.50
Rate for Payer: Aetna Government	$36,557.50
Rate for Payer: Brighton Health Commercial	$30,563.10
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$37,288.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36,399.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$30,038.51
Rate for Payer: Elderplan Medicare Advantage	$34,729.62
Rate for Payer: EmblemHealth Commercial	$18,074.40
Rate for Payer: Fidelis Medicare Advantage	$36,557.50
Rate for Payer: Group Health Inc Commercial	$36,557.50
Rate for Payer: Group Health Inc Medicare	$36,557.50
Rate for Payer: Hamaspik Choice Inc Medicare	$36,557.50
Rate for Payer: Healthfirst Medicare Advantage	$16,999.24
Rate for Payer: Humana Medicare	$50,266.56
Rate for Payer: Senior Whole Health Medicare Advantage	$36,557.50
Rate for Payer: United Healthcare Commercial	$41,917.82
Rate for Payer: United Healthcare Medicare Advantage	$36,557.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36,557.50
Rate for Payer: Wellcare Medicare	$34,729.62

MAJOR CHEST PROCEDURES WITH CC

Facility

$58,705.91

Service Code	MSDRG 164
Min. Negotiated Rate	$19,853.27
Max. Negotiated Rate	$58,705.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37,605.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$42,695.21
Rate for Payer: Aetna Government	$42,695.21
Rate for Payer: Brighton Health Commercial	$36,980.80
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$43,549.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44,042.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$36,346.06
Rate for Payer: Elderplan Medicare Advantage	$40,560.45
Rate for Payer: EmblemHealth Commercial	$21,869.70
Rate for Payer: Fidelis Medicare Advantage	$42,695.21
Rate for Payer: Group Health Inc Commercial	$42,695.21
Rate for Payer: Group Health Inc Medicare	$42,695.21
Rate for Payer: Hamaspik Choice Inc Medicare	$42,695.21
Rate for Payer: Healthfirst Medicare Advantage	$19,853.27
Rate for Payer: Humana Medicare	$58,705.91
Rate for Payer: Senior Whole Health Medicare Advantage	$42,695.21
Rate for Payer: United Healthcare Commercial	$50,719.80
Rate for Payer: United Healthcare Medicare Advantage	$42,695.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$42,695.21
Rate for Payer: Wellcare Medicare	$40,560.45

MAJOR CHEST PROCEDURES WITH MCC

Facility

$99,953.08

Service Code	MSDRG 163
Min. Negotiated Rate	$33,802.31
Max. Negotiated Rate	$99,953.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$69,502.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$72,693.15
Rate for Payer: Aetna Government	$72,693.15
Rate for Payer: Brighton Health Commercial	$68,347.20
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$74,147.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81,399.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$67,174.08
Rate for Payer: Elderplan Medicare Advantage	$69,058.49
Rate for Payer: EmblemHealth Commercial	$40,419.10
Rate for Payer: Fidelis Medicare Advantage	$72,693.15
Rate for Payer: Group Health Inc Commercial	$72,693.15
Rate for Payer: Group Health Inc Medicare	$72,693.15
Rate for Payer: Hamaspik Choice Inc Medicare	$72,693.15
Rate for Payer: Healthfirst Medicare Advantage	$33,802.31
Rate for Payer: Humana Medicare	$99,953.08
Rate for Payer: Senior Whole Health Medicare Advantage	$72,693.15
Rate for Payer: United Healthcare Commercial	$93,739.36
Rate for Payer: United Healthcare Medicare Advantage	$72,693.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$72,693.15
Rate for Payer: Wellcare Medicare	$69,058.49

Know your out-of-pocket cost for care.

All Charges