St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MED ARTIS K-WIRE 01.6MMX150MM

Facility

$50.00

Service Code	HCPCS C1776
Hospital Charge Code	40208140
Hospital Revenue Code	278
Min. Negotiated Rate	$25.00
Max. Negotiated Rate	$25.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.00
Rate for Payer: Hamaspik Choice Inc Medicare	$25.00

MED ATRIAL LEAD 1M

Facility

$1,984.50

Hospital Charge Code	40004032
Hospital Revenue Code	279
Min. Negotiated Rate	$694.58
Max. Negotiated Rate	$1,587.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,091.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$992.25
Rate for Payer: Aetna Government	$992.25
Rate for Payer: Brighton Health Commercial	$1,488.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,587.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,349.46
Rate for Payer: Group Health Inc Commercial	$992.25
Rate for Payer: Group Health Inc Medicare	$694.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$992.25
Rate for Payer: Hamaspik Choice Inc Medicare	$992.25

MED AZURE S DR MRI MODEL W3DR01

Facility

$9,450.00

Service Code	HCPCS C1785
Hospital Charge Code	66573443
Hospital Revenue Code	275
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$9,922.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,197.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Brighton Health Commercial	$5,670.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,725.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,433.75
Rate for Payer: EmblemHealth Commercial	$4,725.00
Rate for Payer: Fidelis Medicare Advantage	$9,922.50
Rate for Payer: Group Health Inc Commercial	$4,725.00
Rate for Payer: Group Health Inc Medicare	$3,307.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,725.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,725.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,142.50

MED BREAST IMPLNT 650 14.6

Facility

$3,662.50

Service Code	HCPCS C1789
Hospital Charge Code	64904102
Hospital Revenue Code	278
Min. Negotiated Rate	$1,831.25
Max. Negotiated Rate	$1,831.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,831.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,831.25

MED BREAST IMPLNT 650 14.6

Facility

$3,662.50

Service Code	HCPCS C1789
Hospital Charge Code	64904102
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$3,845.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,014.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Brighton Health Commercial	$2,197.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,831.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,105.94
Rate for Payer: EmblemHealth Commercial	$1,831.25
Rate for Payer: Fidelis Medicare Advantage	$3,845.62
Rate for Payer: Group Health Inc Commercial	$1,831.25
Rate for Payer: Group Health Inc Medicare	$1,281.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,831.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,831.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,380.62

MED CAPSUREFIX NOVUS LEAD 4076-52

Facility

$900.00

Service Code	HCPCS C1898
Hospital Charge Code	66573480
Hospital Revenue Code	275
Min. Negotiated Rate	$98.92
Max. Negotiated Rate	$945.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$495.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.92
Rate for Payer: Aetna Government	$98.92
Rate for Payer: Brighton Health Commercial	$540.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$450.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$517.50
Rate for Payer: EmblemHealth Commercial	$450.00
Rate for Payer: Fidelis Medicare Advantage	$945.00
Rate for Payer: Group Health Inc Commercial	$450.00
Rate for Payer: Group Health Inc Medicare	$315.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$450.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$585.00

MED CAPSUREFIX NOVUS LEAD 4076-58

Facility

$900.00

Service Code	HCPCS C1898
Hospital Charge Code	66573479
Hospital Revenue Code	275
Min. Negotiated Rate	$98.92
Max. Negotiated Rate	$945.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$495.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.92
Rate for Payer: Aetna Government	$98.92
Rate for Payer: Brighton Health Commercial	$540.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$450.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$517.50
Rate for Payer: EmblemHealth Commercial	$450.00
Rate for Payer: Fidelis Medicare Advantage	$945.00
Rate for Payer: Group Health Inc Commercial	$450.00
Rate for Payer: Group Health Inc Medicare	$315.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$450.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$585.00

MED DOC RSN NO LOW EX

Facility

$0.01

Service Code	HCPCS G2179
Hospital Charge Code	30300307
Hospital Revenue Code	929
Max. Negotiated Rate	$94.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: United Healthcare Commercial	$94.00

MEDEBRA B-D 1X40-42 WHTE

Facility

$63.13

Hospital Charge Code	64905839
Hospital Revenue Code	270
Min. Negotiated Rate	$22.10
Max. Negotiated Rate	$50.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$34.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.56
Rate for Payer: Aetna Government	$31.56
Rate for Payer: Brighton Health Commercial	$47.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$42.93
Rate for Payer: Group Health Inc Commercial	$31.56
Rate for Payer: Group Health Inc Medicare	$22.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.56
Rate for Payer: Hamaspik Choice Inc Medicare	$31.56

MEDIA BACTEC BD CUL BLUE AEROBIC

Facility

$4.72

Hospital Charge Code	40209483
Hospital Revenue Code	270
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$3.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.36
Rate for Payer: Aetna Government	$2.36
Rate for Payer: Brighton Health Commercial	$3.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.21
Rate for Payer: Group Health Inc Commercial	$2.36
Rate for Payer: Group Health Inc Medicare	$1.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36

MEDIA BACTEC BD CUL YELLOW ANAERO

Facility

$4.72

Hospital Charge Code	40209484
Hospital Revenue Code	270
Min. Negotiated Rate	$1.65
Max. Negotiated Rate	$3.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.36
Rate for Payer: Aetna Government	$2.36
Rate for Payer: Brighton Health Commercial	$3.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.21
Rate for Payer: Group Health Inc Commercial	$2.36
Rate for Payer: Group Health Inc Medicare	$1.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36

MEDIA BACTEC BLD CULTURE AEROBIC

Facility

$4.73

Hospital Charge Code	64902335
Hospital Revenue Code	270
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$3.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.36
Rate for Payer: Aetna Government	$2.36
Rate for Payer: Brighton Health Commercial	$3.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.22
Rate for Payer: Group Health Inc Commercial	$2.36
Rate for Payer: Group Health Inc Medicare	$1.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36

MEDIA BACTEC BLD CULTURE ANAEROBI

Facility

$4.73

Hospital Charge Code	64902336
Hospital Revenue Code	270
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$3.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.36
Rate for Payer: Aetna Government	$2.36
Rate for Payer: Brighton Health Commercial	$3.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.22
Rate for Payer: Group Health Inc Commercial	$2.36
Rate for Payer: Group Health Inc Medicare	$1.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.36
Rate for Payer: Hamaspik Choice Inc Medicare	$2.36

MEDIA BACTEC BLOOD CULTURE PEDS

Facility

$6.85

Hospital Charge Code	64902337
Hospital Revenue Code	270
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$5.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.42
Rate for Payer: Aetna Government	$3.42
Rate for Payer: Brighton Health Commercial	$5.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.66
Rate for Payer: Group Health Inc Commercial	$3.42
Rate for Payer: Group Health Inc Medicare	$2.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.42
Rate for Payer: Hamaspik Choice Inc Medicare	$3.42

MEDICAL BACK PROBLEMS WITH MCC

Facility

$42,527.02

Service Code	MSDRG 551
Min. Negotiated Rate	$14,381.86
Max. Negotiated Rate	$42,527.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25,094.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30,928.74
Rate for Payer: Aetna Government	$30,928.74
Rate for Payer: Brighton Health Commercial	$24,677.55
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$31,547.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29,390.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$24,253.98
Rate for Payer: Elderplan Medicare Advantage	$29,382.30
Rate for Payer: EmblemHealth Commercial	$14,593.80
Rate for Payer: Fidelis Medicare Advantage	$30,928.74
Rate for Payer: Group Health Inc Commercial	$30,928.74
Rate for Payer: Group Health Inc Medicare	$30,928.74
Rate for Payer: Hamaspik Choice Inc Medicare	$30,928.74
Rate for Payer: Healthfirst Medicare Advantage	$14,381.86
Rate for Payer: Humana Medicare	$42,527.02
Rate for Payer: Senior Whole Health Medicare Advantage	$30,928.74
Rate for Payer: United Healthcare Commercial	$33,845.69
Rate for Payer: United Healthcare Medicare Advantage	$30,928.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$30,928.74
Rate for Payer: Wellcare Medicare	$29,382.30

MEDICAL BACK PROBLEMS WITHOUT MCC

Facility

$28,500.85

Service Code	MSDRG 552
Min. Negotiated Rate	$8,286.02
Max. Negotiated Rate	$28,500.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14,248.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20,727.89
Rate for Payer: Aetna Government	$20,727.89
Rate for Payer: Brighton Health Commercial	$14,011.35
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$21,142.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16,687.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$13,770.86
Rate for Payer: Elderplan Medicare Advantage	$19,691.50
Rate for Payer: EmblemHealth Commercial	$8,286.02
Rate for Payer: Fidelis Medicare Advantage	$20,727.89
Rate for Payer: Group Health Inc Commercial	$20,727.89
Rate for Payer: Group Health Inc Medicare	$20,727.89
Rate for Payer: Hamaspik Choice Inc Medicare	$20,727.89
Rate for Payer: Healthfirst Medicare Advantage	$9,638.47
Rate for Payer: Humana Medicare	$28,500.85
Rate for Payer: Senior Whole Health Medicare Advantage	$20,727.89
Rate for Payer: United Healthcare Commercial	$19,216.81
Rate for Payer: United Healthcare Medicare Advantage	$20,727.89
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20,727.89
Rate for Payer: Wellcare Medicare	$19,691.50

MEDICAL/SURG INTRAOCULAR LENS

Facility

$207.33

Service Code	HCPCS C1780
Hospital Charge Code	40209327
Hospital Revenue Code	276
Min. Negotiated Rate	$2.26
Max. Negotiated Rate	$217.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$114.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.26
Rate for Payer: Aetna Government	$2.26
Rate for Payer: Brighton Health Commercial	$124.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$165.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$140.98
Rate for Payer: EmblemHealth Commercial	$103.66
Rate for Payer: Fidelis Medicare Advantage	$217.70
Rate for Payer: Group Health Inc Commercial	$103.66
Rate for Payer: Group Health Inc Medicare	$72.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$103.66
Rate for Payer: Hamaspik Choice Inc Medicare	$103.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$134.76

MEDICARE ADMINISTRATION FLU

Facility

$63.73

Hospital Charge Code	40501006
Hospital Revenue Code	940
Min. Negotiated Rate	$22.31
Max. Negotiated Rate	$50.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.86
Rate for Payer: Aetna Government	$31.86
Rate for Payer: Brighton Health Commercial	$47.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$43.34
Rate for Payer: Group Health Inc Commercial	$31.86
Rate for Payer: Group Health Inc Medicare	$22.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.86
Rate for Payer: Hamaspik Choice Inc Medicare	$31.86
Rate for Payer: United Healthcare Commercial	$31.86

MEDICARE ADMINISTRATION PNUEMO

Facility

$63.73

Hospital Charge Code	40501007
Hospital Revenue Code	940
Min. Negotiated Rate	$22.31
Max. Negotiated Rate	$50.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.86
Rate for Payer: Aetna Government	$31.86
Rate for Payer: Brighton Health Commercial	$47.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$50.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$43.34
Rate for Payer: Group Health Inc Commercial	$31.86
Rate for Payer: Group Health Inc Medicare	$22.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$31.86
Rate for Payer: Hamaspik Choice Inc Medicare	$31.86
Rate for Payer: United Healthcare Commercial	$31.86

MEDICATION,SECONDARY,CLEAR 10ML

Facility

$2.06

Hospital Charge Code	64901299
Hospital Revenue Code	270
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$1.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.03
Rate for Payer: Aetna Government	$1.03
Rate for Payer: Brighton Health Commercial	$1.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.40
Rate for Payer: Group Health Inc Commercial	$1.03
Rate for Payer: Group Health Inc Medicare	$0.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.03
Rate for Payer: Hamaspik Choice Inc Medicare	$1.03

MED IMPLNT LOOP RECORD #LINQSYS

Facility

$10,590.00

Service Code	HCPCS C1764
Hospital Charge Code	66573446
Hospital Revenue Code	278
Min. Negotiated Rate	$3,706.50
Max. Negotiated Rate	$11,119.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,824.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,126.13
Rate for Payer: Aetna Government	$4,126.13
Rate for Payer: Brighton Health Commercial	$6,354.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,295.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,089.25
Rate for Payer: EmblemHealth Commercial	$5,295.00
Rate for Payer: Fidelis Medicare Advantage	$11,119.50
Rate for Payer: Group Health Inc Commercial	$5,295.00
Rate for Payer: Group Health Inc Medicare	$3,706.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,295.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,883.50

MED IMPLNT LOOP RECORD #LINQSYS

Facility

$10,590.00

Service Code	HCPCS C1764
Hospital Charge Code	66573446
Hospital Revenue Code	278
Min. Negotiated Rate	$5,295.00
Max. Negotiated Rate	$5,295.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,295.00

MED INTRODUCER VI

Facility

$311.85

Service Code	HCPCS C2629
Hospital Charge Code	40004042
Hospital Revenue Code	278
Min. Negotiated Rate	$109.15
Max. Negotiated Rate	$327.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$171.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$142.97
Rate for Payer: Aetna Government	$142.97
Rate for Payer: Brighton Health Commercial	$187.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$179.31
Rate for Payer: EmblemHealth Commercial	$155.92
Rate for Payer: Fidelis Medicare Advantage	$327.44
Rate for Payer: Group Health Inc Commercial	$155.92
Rate for Payer: Group Health Inc Medicare	$109.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$155.92
Rate for Payer: Hamaspik Choice Inc Medicare	$155.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$202.70

MED INTRODUCER VI

Facility

$311.85

Service Code	HCPCS C2629
Hospital Charge Code	40004042
Hospital Revenue Code	278
Min. Negotiated Rate	$155.92
Max. Negotiated Rate	$155.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$155.92
Rate for Payer: Hamaspik Choice Inc Medicare	$155.92

MEDITRAY BASKET MID SIZE

Facility

$216.03

Hospital Charge Code	64905548
Hospital Revenue Code	270
Min. Negotiated Rate	$75.61
Max. Negotiated Rate	$172.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$118.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$108.02
Rate for Payer: Aetna Government	$108.02
Rate for Payer: Brighton Health Commercial	$162.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$172.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$146.90
Rate for Payer: Group Health Inc Commercial	$108.02
Rate for Payer: Group Health Inc Medicare	$75.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$108.02
Rate for Payer: Hamaspik Choice Inc Medicare	$108.02

Know your out-of-pocket cost for care.

All Charges