St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

MEDTRONIC BALLOONS NCEUPX

Facility

$337.50

Service Code	HCPCS C1725
Hospital Charge Code	66520150
Hospital Revenue Code	278
Min. Negotiated Rate	$168.75
Max. Negotiated Rate	$168.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$168.75
Rate for Payer: Hamaspik Choice Inc Medicare	$168.75

MEDTRONIC BALLOONS NCEUPX

Facility

$337.50

Service Code	HCPCS C1725
Hospital Charge Code	66520150
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$354.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$185.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$202.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$168.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$194.06
Rate for Payer: EmblemHealth Commercial	$168.75
Rate for Payer: Fidelis Medicare Advantage	$354.38
Rate for Payer: Group Health Inc Commercial	$168.75
Rate for Payer: Group Health Inc Medicare	$118.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$168.75
Rate for Payer: Hamaspik Choice Inc Medicare	$168.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$219.38

MEDTRONIC CAPSURE LEAD 4574-45

Facility

$900.00

Service Code	HCPCS C1898
Hospital Charge Code	65573447
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

MEDTRONIC CAPSURE SENSE LEAD 4574

Facility

$1,300.00

Service Code	HCPCS C1895
Hospital Charge Code	40201139
Hospital Revenue Code	278
Min. Negotiated Rate	$455.00
Max. Negotiated Rate	$1,365.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$715.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,297.97
Rate for Payer: Aetna Government	$1,297.97
Rate for Payer: Brighton Health Commercial	$780.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$747.50
Rate for Payer: EmblemHealth Commercial	$650.00
Rate for Payer: Fidelis Medicare Advantage	$1,365.00
Rate for Payer: Group Health Inc Commercial	$650.00
Rate for Payer: Group Health Inc Medicare	$455.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$650.00
Rate for Payer: Hamaspik Choice Inc Medicare	$650.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$845.00

MEDTRONIC CAPSURE SENSE LEAD 4574

Facility

$1,300.00

Service Code	HCPCS C1895
Hospital Charge Code	40201139
Hospital Revenue Code	278
Min. Negotiated Rate	$650.00
Max. Negotiated Rate	$650.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$650.00
Rate for Payer: Hamaspik Choice Inc Medicare	$650.00

MEDTRONIC CAPTURE SENSE 4074

Facility

$1,300.00

Service Code	HCPCS C1785
Hospital Charge Code	40201138
Hospital Revenue Code	275
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$1,365.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$715.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Brighton Health Commercial	$780.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$747.50
Rate for Payer: EmblemHealth Commercial	$650.00
Rate for Payer: Fidelis Medicare Advantage	$1,365.00
Rate for Payer: Group Health Inc Commercial	$650.00
Rate for Payer: Group Health Inc Medicare	$455.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$650.00
Rate for Payer: Hamaspik Choice Inc Medicare	$650.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$845.00

MEDTRONIC CAPTURE SENSE 4574-53CM

Facility

$1,500.00

Service Code	HCPCS C1895
Hospital Charge Code	40205129
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$1,575.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$825.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,297.97
Rate for Payer: Aetna Government	$1,297.97
Rate for Payer: Brighton Health Commercial	$900.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$750.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$862.50
Rate for Payer: EmblemHealth Commercial	$750.00
Rate for Payer: Fidelis Medicare Advantage	$1,575.00
Rate for Payer: Group Health Inc Commercial	$750.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$750.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$975.00

MEDTRONIC CAPTURE SENSE 4574-53CM

Facility

$1,500.00

Service Code	HCPCS C1895
Hospital Charge Code	40205129
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$750.00

MEDTRONIC CATH CARD-PERITONEAL

Facility

$239.12

Hospital Charge Code	40009350
Hospital Revenue Code	272
Min. Negotiated Rate	$83.69
Max. Negotiated Rate	$191.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$131.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$119.56
Rate for Payer: Aetna Government	$119.56
Rate for Payer: Brighton Health Commercial	$179.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$191.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$162.60
Rate for Payer: Group Health Inc Commercial	$119.56
Rate for Payer: Group Health Inc Medicare	$83.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.56
Rate for Payer: Hamaspik Choice Inc Medicare	$119.56

MEDTRONIC CATH CARD-PERITONEAL

Facility

$239.12

Service Code	HCPCS C1752
Hospital Charge Code	40203367
Hospital Revenue Code	272
Min. Negotiated Rate	$83.69
Max. Negotiated Rate	$191.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$131.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.78
Rate for Payer: Aetna Government	$98.78
Rate for Payer: Brighton Health Commercial	$179.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$191.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$162.60
Rate for Payer: Group Health Inc Commercial	$119.56
Rate for Payer: Group Health Inc Medicare	$83.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$119.56
Rate for Payer: Hamaspik Choice Inc Medicare	$119.56

MEDTRONIC CATH PASSER

Facility

$196.00

Hospital Charge Code	40208120
Hospital Revenue Code	270
Min. Negotiated Rate	$68.60
Max. Negotiated Rate	$156.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$98.00
Rate for Payer: Aetna Government	$98.00
Rate for Payer: Brighton Health Commercial	$147.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$156.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$133.28
Rate for Payer: Group Health Inc Commercial	$98.00
Rate for Payer: Group Health Inc Medicare	$68.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$98.00
Rate for Payer: Hamaspik Choice Inc Medicare	$98.00

MEDTRONIC CATH VENT STRAIGHT REGU

Facility

$205.80

Hospital Charge Code	40203366
Hospital Revenue Code	272
Min. Negotiated Rate	$72.03
Max. Negotiated Rate	$164.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$113.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$102.90
Rate for Payer: Aetna Government	$102.90
Rate for Payer: Brighton Health Commercial	$154.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$164.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$139.94
Rate for Payer: Group Health Inc Commercial	$102.90
Rate for Payer: Group Health Inc Medicare	$72.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$102.90
Rate for Payer: Hamaspik Choice Inc Medicare	$102.90

MEDTRONIC CATH VENT STRAIGHT REGU

Facility

$205.80

Hospital Charge Code	40009349
Hospital Revenue Code	272
Min. Negotiated Rate	$72.03
Max. Negotiated Rate	$164.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$113.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$102.90
Rate for Payer: Aetna Government	$102.90
Rate for Payer: Brighton Health Commercial	$154.35
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$164.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$139.94
Rate for Payer: Group Health Inc Commercial	$102.90
Rate for Payer: Group Health Inc Medicare	$72.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$102.90
Rate for Payer: Hamaspik Choice Inc Medicare	$102.90

MEDTRON ICD EVERA XT DR DDBB1D4

Facility

$47,682.00

Service Code	HCPCS C1721
Hospital Charge Code	66573312
Hospital Revenue Code	275
Min. Negotiated Rate	$5,000.00
Max. Negotiated Rate	$50,066.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26,225.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,000.00
Rate for Payer: Aetna Government	$5,000.00
Rate for Payer: Brighton Health Commercial	$28,609.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$23,841.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$27,417.15
Rate for Payer: EmblemHealth Commercial	$23,841.00
Rate for Payer: Fidelis Medicare Advantage	$50,066.10
Rate for Payer: Group Health Inc Commercial	$23,841.00
Rate for Payer: Group Health Inc Medicare	$16,688.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$23,841.00
Rate for Payer: Hamaspik Choice Inc Medicare	$23,841.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$30,993.30

MEDTRONIC DISSECTING TOOL

Facility

$302.00

Hospital Charge Code	40205026
Hospital Revenue Code	270
Min. Negotiated Rate	$105.70
Max. Negotiated Rate	$241.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$166.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$151.00
Rate for Payer: Aetna Government	$151.00
Rate for Payer: Brighton Health Commercial	$226.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$241.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$205.36
Rate for Payer: Group Health Inc Commercial	$151.00
Rate for Payer: Group Health Inc Medicare	$105.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$151.00
Rate for Payer: Hamaspik Choice Inc Medicare	$151.00

MEDTRONIC DYNAGEN ICD 153

Facility

$35,750.00

Service Code	HCPCS C1882
Hospital Charge Code	66571575
Hospital Revenue Code	278
Min. Negotiated Rate	$4,752.01
Max. Negotiated Rate	$37,537.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19,662.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,752.01
Rate for Payer: Aetna Government	$4,752.01
Rate for Payer: Brighton Health Commercial	$21,450.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17,875.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$20,556.25
Rate for Payer: EmblemHealth Commercial	$17,875.00
Rate for Payer: Fidelis Medicare Advantage	$37,537.50
Rate for Payer: Group Health Inc Commercial	$17,875.00
Rate for Payer: Group Health Inc Medicare	$12,512.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$17,875.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$23,237.50

MEDTRONIC DYNAGEN ICD 153

Facility

$35,750.00

Service Code	HCPCS C1882
Hospital Charge Code	66571575
Hospital Revenue Code	278
Min. Negotiated Rate	$17,875.00
Max. Negotiated Rate	$17,875.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$17,875.00
Rate for Payer: Hamaspik Choice Inc Medicare	$17,875.00

MEDTRONIC EVERA ICD XT US DF1

Facility

$32,130.00

Service Code	HCPCS C1721
Hospital Charge Code	66573172
Hospital Revenue Code	275
Min. Negotiated Rate	$5,000.00
Max. Negotiated Rate	$33,736.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17,671.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,000.00
Rate for Payer: Aetna Government	$5,000.00
Rate for Payer: Brighton Health Commercial	$19,278.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16,065.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$18,474.75
Rate for Payer: EmblemHealth Commercial	$16,065.00
Rate for Payer: Fidelis Medicare Advantage	$33,736.50
Rate for Payer: Group Health Inc Commercial	$16,065.00
Rate for Payer: Group Health Inc Medicare	$11,245.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,065.00
Rate for Payer: Hamaspik Choice Inc Medicare	$16,065.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20,884.50

MEDTRONIC EVERA MRI XT DDMB1D4

Facility

$32,130.00

Service Code	HCPCS C1721
Hospital Charge Code	66573163
Hospital Revenue Code	275
Min. Negotiated Rate	$5,000.00
Max. Negotiated Rate	$33,736.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17,671.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,000.00
Rate for Payer: Aetna Government	$5,000.00
Rate for Payer: Brighton Health Commercial	$19,278.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16,065.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$18,474.75
Rate for Payer: EmblemHealth Commercial	$16,065.00
Rate for Payer: Fidelis Medicare Advantage	$33,736.50
Rate for Payer: Group Health Inc Commercial	$16,065.00
Rate for Payer: Group Health Inc Medicare	$11,245.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,065.00
Rate for Payer: Hamaspik Choice Inc Medicare	$16,065.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20,884.50

MEDTRONIC EVEREST 30 INFLA DEVICE

Facility

$236.00

Hospital Charge Code	66522091
Hospital Revenue Code	270
Min. Negotiated Rate	$82.60
Max. Negotiated Rate	$188.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$129.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.00
Rate for Payer: Aetna Government	$118.00
Rate for Payer: Brighton Health Commercial	$177.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$188.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$160.48
Rate for Payer: Group Health Inc Commercial	$118.00
Rate for Payer: Group Health Inc Medicare	$82.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.00
Rate for Payer: Hamaspik Choice Inc Medicare	$118.00

MEDTRONIC ICD EVERA MRIXT DVMB1D4

Facility

$72,000.00

Service Code	HCPCS C1722
Hospital Charge Code	66572923
Hospital Revenue Code	275
Min. Negotiated Rate	$3,988.80
Max. Negotiated Rate	$75,600.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39,600.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,988.80
Rate for Payer: Aetna Government	$3,988.80
Rate for Payer: Brighton Health Commercial	$43,200.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$36,000.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$41,400.00
Rate for Payer: EmblemHealth Commercial	$36,000.00
Rate for Payer: Fidelis Medicare Advantage	$75,600.00
Rate for Payer: Group Health Inc Commercial	$36,000.00
Rate for Payer: Group Health Inc Medicare	$25,200.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$36,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$36,000.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46,800.00

MEDTRONIC INTERSTIM NEUROSTIMULAT

Facility

$23,360.00

Service Code	HCPCS L8686
Hospital Charge Code	40009998
Hospital Revenue Code	274
Min. Negotiated Rate	$2,895.10
Max. Negotiated Rate	$24,528.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12,848.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,895.10
Rate for Payer: Aetna Government	$2,895.10
Rate for Payer: Brighton Health Commercial	$14,016.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11,680.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13,432.00
Rate for Payer: EmblemHealth Commercial	$11,680.00
Rate for Payer: Fidelis Medicare Advantage	$24,528.00
Rate for Payer: Group Health Inc Commercial	$11,680.00
Rate for Payer: Group Health Inc Medicare	$8,176.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$11,680.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15,184.00

MEDTRONIC LEAD CAPSURE

Facility

$1,300.00

Service Code	HCPCS C1785
Hospital Charge Code	40201142
Hospital Revenue Code	278
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$1,365.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$715.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Brighton Health Commercial	$780.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$650.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$747.50
Rate for Payer: EmblemHealth Commercial	$650.00
Rate for Payer: Fidelis Medicare Advantage	$1,365.00
Rate for Payer: Group Health Inc Commercial	$650.00
Rate for Payer: Group Health Inc Medicare	$455.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$650.00
Rate for Payer: Hamaspik Choice Inc Medicare	$650.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$845.00

MEDTRONIC LEAD CAPSURE

Facility

$1,300.00

Service Code	HCPCS C1785
Hospital Charge Code	40201142
Hospital Revenue Code	278
Min. Negotiated Rate	$650.00
Max. Negotiated Rate	$650.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$650.00
Rate for Payer: Hamaspik Choice Inc Medicare	$650.00

MEDTRONIC NERVE LOCATOR

Facility

$100.80

Hospital Charge Code	40206012
Hospital Revenue Code	270
Min. Negotiated Rate	$35.28
Max. Negotiated Rate	$80.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$50.40
Rate for Payer: Aetna Government	$50.40
Rate for Payer: Brighton Health Commercial	$75.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.54
Rate for Payer: Group Health Inc Commercial	$50.40
Rate for Payer: Group Health Inc Medicare	$35.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.40
Rate for Payer: Hamaspik Choice Inc Medicare	$50.40

Know your out-of-pocket cost for care.

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