St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NCB TAP 5.0MM X 145MM

Facility

$370.80

Service Code	HCPCS C1713
Hospital Charge Code	40006714
Hospital Revenue Code	278
Min. Negotiated Rate	$129.78
Max. Negotiated Rate	$389.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$203.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$222.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$185.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$213.21
Rate for Payer: EmblemHealth Commercial	$185.40
Rate for Payer: Fidelis Medicare Advantage	$389.34
Rate for Payer: Group Health Inc Commercial	$185.40
Rate for Payer: Group Health Inc Medicare	$129.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$185.40
Rate for Payer: Hamaspik Choice Inc Medicare	$185.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$241.02

NCB T MINUS PLATE, 52MM

Facility

$929.98

Service Code	HCPCS C1713
Hospital Charge Code	40007259
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$976.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$511.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$557.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$464.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$534.74
Rate for Payer: EmblemHealth Commercial	$464.99
Rate for Payer: Fidelis Medicare Advantage	$976.48
Rate for Payer: Group Health Inc Commercial	$464.99
Rate for Payer: Group Health Inc Medicare	$325.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$464.99
Rate for Payer: Hamaspik Choice Inc Medicare	$464.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$604.49

NCB T MINUS PLATE, 52MM

Facility

$929.98

Service Code	HCPCS C1713
Hospital Charge Code	40007259
Hospital Revenue Code	278
Min. Negotiated Rate	$464.99
Max. Negotiated Rate	$464.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$464.99
Rate for Payer: Hamaspik Choice Inc Medicare	$464.99

NCB T MINUS PLATE 7 HOLES

Facility

$929.98

Service Code	HCPCS C1713
Hospital Charge Code	40006995
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$976.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$511.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$557.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$464.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$534.74
Rate for Payer: EmblemHealth Commercial	$464.99
Rate for Payer: Fidelis Medicare Advantage	$976.48
Rate for Payer: Group Health Inc Commercial	$464.99
Rate for Payer: Group Health Inc Medicare	$325.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$464.99
Rate for Payer: Hamaspik Choice Inc Medicare	$464.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$604.49

NCB T MINUS PLATE 7 HOLES

Facility

$929.98

Service Code	HCPCS C1713
Hospital Charge Code	40006995
Hospital Revenue Code	278
Min. Negotiated Rate	$464.99
Max. Negotiated Rate	$464.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$464.99
Rate for Payer: Hamaspik Choice Inc Medicare	$464.99

NCB TROC PLT, LEFT, NARROW

Facility

$2,017.16

Service Code	HCPCS C1713
Hospital Charge Code	40007013
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,118.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,109.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,210.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,008.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,159.87
Rate for Payer: EmblemHealth Commercial	$1,008.58
Rate for Payer: Fidelis Medicare Advantage	$2,118.02
Rate for Payer: Group Health Inc Commercial	$1,008.58
Rate for Payer: Group Health Inc Medicare	$706.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,008.58
Rate for Payer: Hamaspik Choice Inc Medicare	$1,008.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,311.15

NCB TROC PLT, LEFT, NARROW

Facility

$2,017.16

Service Code	HCPCS C1713
Hospital Charge Code	40007013
Hospital Revenue Code	278
Min. Negotiated Rate	$1,008.58
Max. Negotiated Rate	$1,008.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,008.58
Rate for Payer: Hamaspik Choice Inc Medicare	$1,008.58

NCB TROC PLT, LEFT, WIDE

Facility

$2,165.48

Service Code	HCPCS C1713
Hospital Charge Code	40007014
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,273.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,191.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,299.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,082.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,245.15
Rate for Payer: EmblemHealth Commercial	$1,082.74
Rate for Payer: Fidelis Medicare Advantage	$2,273.75
Rate for Payer: Group Health Inc Commercial	$1,082.74
Rate for Payer: Group Health Inc Medicare	$757.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,082.74
Rate for Payer: Hamaspik Choice Inc Medicare	$1,082.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,407.56

NCB TROC PLT, LEFT, WIDE

Facility

$2,165.48

Service Code	HCPCS C1713
Hospital Charge Code	40007014
Hospital Revenue Code	278
Min. Negotiated Rate	$1,082.74
Max. Negotiated Rate	$1,082.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,082.74
Rate for Payer: Hamaspik Choice Inc Medicare	$1,082.74

NCB TROC PLT, RIGHT, NARROW

Facility

$2,017.16

Service Code	HCPCS C1713
Hospital Charge Code	40007011
Hospital Revenue Code	278
Min. Negotiated Rate	$1,008.58
Max. Negotiated Rate	$1,008.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,008.58
Rate for Payer: Hamaspik Choice Inc Medicare	$1,008.58

NCB TROC PLT, RIGHT, NARROW

Facility

$2,017.16

Service Code	HCPCS C1713
Hospital Charge Code	40007011
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,118.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,109.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,210.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,008.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,159.87
Rate for Payer: EmblemHealth Commercial	$1,008.58
Rate for Payer: Fidelis Medicare Advantage	$2,118.02
Rate for Payer: Group Health Inc Commercial	$1,008.58
Rate for Payer: Group Health Inc Medicare	$706.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,008.58
Rate for Payer: Hamaspik Choice Inc Medicare	$1,008.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,311.15

NCB TROC PLT, RIGHT, WIDE

Facility

$2,165.48

Service Code	HCPCS C1713
Hospital Charge Code	40007012
Hospital Revenue Code	278
Min. Negotiated Rate	$1,082.74
Max. Negotiated Rate	$1,082.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,082.74
Rate for Payer: Hamaspik Choice Inc Medicare	$1,082.74

NCB TROC PLT, RIGHT, WIDE

Facility

$2,165.48

Service Code	HCPCS C1713
Hospital Charge Code	40007012
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,273.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,191.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,299.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,082.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,245.15
Rate for Payer: EmblemHealth Commercial	$1,082.74
Rate for Payer: Fidelis Medicare Advantage	$2,273.75
Rate for Payer: Group Health Inc Commercial	$1,082.74
Rate for Payer: Group Health Inc Medicare	$757.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,082.74
Rate for Payer: Hamaspik Choice Inc Medicare	$1,082.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,407.56

NCG 3.3 DRILL BIT, 195MM

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007541
Hospital Revenue Code	278
Min. Negotiated Rate	$88.26
Max. Negotiated Rate	$264.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$138.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$151.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$126.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.99
Rate for Payer: EmblemHealth Commercial	$126.08
Rate for Payer: Fidelis Medicare Advantage	$264.77
Rate for Payer: Group Health Inc Commercial	$126.08
Rate for Payer: Group Health Inc Medicare	$88.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$163.90

NCG 3.3 DRILL BIT, 195MM

Facility

$252.16

Service Code	HCPCS C1713
Hospital Charge Code	40007541
Hospital Revenue Code	278
Min. Negotiated Rate	$126.08
Max. Negotiated Rate	$126.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$126.08
Rate for Payer: Hamaspik Choice Inc Medicare	$126.08

NCT 11-12 STUDIES

Facility

$1,470.80

Service Code	HCPCS 95912 TC
Hospital Charge Code	30305746
Hospital Revenue Code	920
Rate for Payer: Cash Price	$619.82

NCT 11-12 STUDIES

Facility

$1,470.80

Service Code	HCPCS 95912 TC
Hospital Charge Code	30305746
Hospital Revenue Code	920
Min. Negotiated Rate	$94.00
Max. Negotiated Rate	$1,176.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$808.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$619.82
Rate for Payer: Aetna Government	$619.82
Rate for Payer: Affinity Essential Plan 1&2	$433.87
Rate for Payer: Affinity Essential Plan 3&4	$433.87
Rate for Payer: Affinity Medicaid/CHP/HARP	$433.87
Rate for Payer: Brighton Health Commercial	$1,103.10
Rate for Payer: Cash Price	$619.82
Rate for Payer: Cash Price	$619.82
Rate for Payer: Cash Price	$619.82
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$619.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,176.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,000.14
Rate for Payer: Elderplan Medicare Advantage	$619.82
Rate for Payer: EmblemHealth Commercial	$619.82
Rate for Payer: Fidelis Essential Plan Aliesa	$526.85
Rate for Payer: Fidelis Essential Plan QHP	$551.64
Rate for Payer: Fidelis Medicare Advantage	$619.82
Rate for Payer: Fidelis Qualified Health Plan	$551.64
Rate for Payer: Group Health Inc Commercial	$619.82
Rate for Payer: Group Health Inc Medicare	$619.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$735.40
Rate for Payer: Hamaspik Choice Inc Medicare	$619.82
Rate for Payer: Healthfirst Medicare Advantage	$526.85
Rate for Payer: Healthfirst QHP	$619.82
Rate for Payer: Humana Medicare	$632.22
Rate for Payer: Senior Whole Health Medicare Advantage	$619.82
Rate for Payer: United Healthcare Commercial	$94.00
Rate for Payer: United Healthcare Medicare Advantage	$619.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$619.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$495.86
Rate for Payer: Wellcare Medicare	$588.83

NCT 1-2 STUDIES

Facility

$419.03

Service Code	HCPCS 95907 TC
Hospital Charge Code	30305741
Hospital Revenue Code	920
Rate for Payer: Cash Price	$180.64

NCT 1-2 STUDIES

Facility

$419.03

Service Code	HCPCS 95907 TC
Hospital Charge Code	30305741
Hospital Revenue Code	920
Min. Negotiated Rate	$94.00
Max. Negotiated Rate	$335.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.64
Rate for Payer: Aetna Government	$180.64
Rate for Payer: Affinity Essential Plan 1&2	$126.45
Rate for Payer: Affinity Essential Plan 3&4	$126.45
Rate for Payer: Affinity Medicaid/CHP/HARP	$126.45
Rate for Payer: Brighton Health Commercial	$314.27
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cash Price	$180.64
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$180.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$335.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.94
Rate for Payer: Elderplan Medicare Advantage	$180.64
Rate for Payer: EmblemHealth Commercial	$180.64
Rate for Payer: Fidelis Essential Plan Aliesa	$153.54
Rate for Payer: Fidelis Essential Plan QHP	$160.77
Rate for Payer: Fidelis Medicare Advantage	$180.64
Rate for Payer: Fidelis Qualified Health Plan	$160.77
Rate for Payer: Group Health Inc Commercial	$180.64
Rate for Payer: Group Health Inc Medicare	$180.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.52
Rate for Payer: Hamaspik Choice Inc Medicare	$180.64
Rate for Payer: Healthfirst Medicare Advantage	$153.54
Rate for Payer: Healthfirst QHP	$180.64
Rate for Payer: Humana Medicare	$184.25
Rate for Payer: Senior Whole Health Medicare Advantage	$180.64
Rate for Payer: United Healthcare Commercial	$94.00
Rate for Payer: United Healthcare Medicare Advantage	$180.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$180.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$144.51
Rate for Payer: Wellcare Medicare	$171.61

NCT 13 OR MORE STUDIES

Facility

$1,470.80

Service Code	HCPCS 95913 TC
Hospital Charge Code	30305747
Hospital Revenue Code	920
Min. Negotiated Rate	$94.00
Max. Negotiated Rate	$1,176.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$808.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$619.82
Rate for Payer: Aetna Government	$619.82
Rate for Payer: Affinity Essential Plan 1&2	$433.87
Rate for Payer: Affinity Essential Plan 3&4	$433.87
Rate for Payer: Affinity Medicaid/CHP/HARP	$433.87
Rate for Payer: Brighton Health Commercial	$1,103.10
Rate for Payer: Cash Price	$619.82
Rate for Payer: Cash Price	$619.82
Rate for Payer: Cash Price	$619.82
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$619.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,176.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,000.14
Rate for Payer: Elderplan Medicare Advantage	$619.82
Rate for Payer: EmblemHealth Commercial	$619.82
Rate for Payer: Fidelis Essential Plan Aliesa	$526.85
Rate for Payer: Fidelis Essential Plan QHP	$551.64
Rate for Payer: Fidelis Medicare Advantage	$619.82
Rate for Payer: Fidelis Qualified Health Plan	$551.64
Rate for Payer: Group Health Inc Commercial	$619.82
Rate for Payer: Group Health Inc Medicare	$619.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$735.40
Rate for Payer: Hamaspik Choice Inc Medicare	$619.82
Rate for Payer: Healthfirst Medicare Advantage	$526.85
Rate for Payer: Healthfirst QHP	$619.82
Rate for Payer: Humana Medicare	$632.22
Rate for Payer: Senior Whole Health Medicare Advantage	$619.82
Rate for Payer: United Healthcare Commercial	$94.00
Rate for Payer: United Healthcare Medicare Advantage	$619.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$619.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$495.86
Rate for Payer: Wellcare Medicare	$588.83

NCT 13 OR MORE STUDIES

Facility

$1,470.80

Service Code	HCPCS 95913 TC
Hospital Charge Code	30305747
Hospital Revenue Code	920
Rate for Payer: Cash Price	$619.82

NCT 3-4 STUDIES

Facility

$766.58

Service Code	HCPCS 95908 TC
Hospital Charge Code	30305742
Hospital Revenue Code	920
Rate for Payer: Cash Price	$362.98

NCT 3-4 STUDIES

Facility

$766.58

Service Code	HCPCS 95908 TC
Hospital Charge Code	30305742
Hospital Revenue Code	920
Min. Negotiated Rate	$94.00
Max. Negotiated Rate	$613.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$362.98
Rate for Payer: Aetna Government	$362.98
Rate for Payer: Affinity Essential Plan 1&2	$254.09
Rate for Payer: Affinity Essential Plan 3&4	$254.09
Rate for Payer: Affinity Medicaid/CHP/HARP	$254.09
Rate for Payer: Brighton Health Commercial	$574.94
Rate for Payer: Cash Price	$362.98
Rate for Payer: Cash Price	$362.98
Rate for Payer: Cash Price	$362.98
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$362.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$613.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$521.27
Rate for Payer: Elderplan Medicare Advantage	$362.98
Rate for Payer: EmblemHealth Commercial	$362.98
Rate for Payer: Fidelis Essential Plan Aliesa	$308.53
Rate for Payer: Fidelis Essential Plan QHP	$323.05
Rate for Payer: Fidelis Medicare Advantage	$362.98
Rate for Payer: Fidelis Qualified Health Plan	$323.05
Rate for Payer: Group Health Inc Commercial	$362.98
Rate for Payer: Group Health Inc Medicare	$362.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.29
Rate for Payer: Hamaspik Choice Inc Medicare	$362.98
Rate for Payer: Healthfirst Medicare Advantage	$308.53
Rate for Payer: Healthfirst QHP	$362.98
Rate for Payer: Humana Medicare	$370.24
Rate for Payer: Senior Whole Health Medicare Advantage	$362.98
Rate for Payer: United Healthcare Commercial	$94.00
Rate for Payer: United Healthcare Medicare Advantage	$362.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$362.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$290.38
Rate for Payer: Wellcare Medicare	$344.83

NCT 5-6 STUDIES

Facility

$766.58

Service Code	HCPCS 95909 TC
Hospital Charge Code	30305743
Hospital Revenue Code	920
Rate for Payer: Cash Price	$362.98

NCT 5-6 STUDIES

Facility

$766.58

Service Code	HCPCS 95909 TC
Hospital Charge Code	30305743
Hospital Revenue Code	920
Min. Negotiated Rate	$94.00
Max. Negotiated Rate	$613.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$362.98
Rate for Payer: Aetna Government	$362.98
Rate for Payer: Affinity Essential Plan 1&2	$254.09
Rate for Payer: Affinity Essential Plan 3&4	$254.09
Rate for Payer: Affinity Medicaid/CHP/HARP	$254.09
Rate for Payer: Brighton Health Commercial	$574.94
Rate for Payer: Cash Price	$362.98
Rate for Payer: Cash Price	$362.98
Rate for Payer: Cash Price	$362.98
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$362.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$613.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$521.27
Rate for Payer: Elderplan Medicare Advantage	$362.98
Rate for Payer: EmblemHealth Commercial	$362.98
Rate for Payer: Fidelis Essential Plan Aliesa	$308.53
Rate for Payer: Fidelis Essential Plan QHP	$323.05
Rate for Payer: Fidelis Medicare Advantage	$362.98
Rate for Payer: Fidelis Qualified Health Plan	$323.05
Rate for Payer: Group Health Inc Commercial	$362.98
Rate for Payer: Group Health Inc Medicare	$362.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.29
Rate for Payer: Hamaspik Choice Inc Medicare	$362.98
Rate for Payer: Healthfirst Medicare Advantage	$308.53
Rate for Payer: Healthfirst QHP	$362.98
Rate for Payer: Humana Medicare	$370.24
Rate for Payer: Senior Whole Health Medicare Advantage	$362.98
Rate for Payer: United Healthcare Commercial	$94.00
Rate for Payer: United Healthcare Medicare Advantage	$362.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$362.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$290.38
Rate for Payer: Wellcare Medicare	$344.83

Know your out-of-pocket cost for care.

All Charges