Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

NEOSTIGMINE METHYLSULFATE 10 MG/10ML IV SOLN [122267]

Facility

IP

$0.99

Service Code	NDC 71288050111
Hospital Charge Code	71288050111
Hospital Revenue Code	278
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$0.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50

NEOSTIGMINE METHYLSULFATE 10 MG/10ML IV SOLN [122267]

Facility

OP

$3.12

Service Code	NDC 70121147907
Hospital Charge Code	70121147907
Hospital Revenue Code	278
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$3.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.56
Rate for Payer: Aetna Government	$1.56
Rate for Payer: Brighton Health Commercial	$1.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.79
Rate for Payer: EmblemHealth Commercial	$1.56
Rate for Payer: Fidelis Medicare Advantage	$3.28
Rate for Payer: Group Health Inc Commercial	$1.56
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.03

NEOSTIGMINE METHYLSULFATE 10 MG/10ML IV SOLN [122267]

Facility

OP

$0.99

Service Code	NDC 71288050111
Hospital Charge Code	71288050111
Hospital Revenue Code	278
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$1.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.57
Rate for Payer: EmblemHealth Commercial	$0.50
Rate for Payer: Fidelis Medicare Advantage	$1.04
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.64

NEOSTIGMINE METHYLSULFATE 10 MG/10ML IV SOLN [122267]

Facility

IP

$0.72

Service Code	NDC 42023018910
Hospital Charge Code	42023018910
Hospital Revenue Code	278
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.36
Rate for Payer: Hamaspik Choice Inc Medicare	$0.36

NEOSTIGMINE METHYLSULFATE 10 MG/10ML IV SOLN [122267]

Facility

IP

$2.25

Service Code	NDC 70700017223
Hospital Charge Code	70700017223
Hospital Revenue Code	278
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.12
Rate for Payer: Hamaspik Choice Inc Medicare	$1.12

NEOSTIGMINE METHYLSULFATE 10 MG/10ML IV SOLN [122267]

Facility

IP

$3.12

Service Code	NDC 70121147907
Hospital Charge Code	70121147907
Hospital Revenue Code	278
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$1.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56

NEOSTIGMINE METHYLSULFATE 3 MG/3ML IV SOLN [167865]

Facility

OP

$2.20

Service Code	NDC 69374093233
Hospital Charge Code	69374093233
Hospital Revenue Code	278
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$2.31
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.10
Rate for Payer: Aetna Government	$1.10
Rate for Payer: Brighton Health Commercial	$1.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.26
Rate for Payer: EmblemHealth Commercial	$1.10
Rate for Payer: Fidelis Medicare Advantage	$2.31
Rate for Payer: Group Health Inc Commercial	$1.10
Rate for Payer: Group Health Inc Medicare	$0.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.43

NEOSTIGMINE METHYLSULFATE 3 MG/3ML IV SOLN [167865]

Facility

IP

$2.20

Service Code	NDC 69374093233
Hospital Charge Code	69374093233
Hospital Revenue Code	278
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.10
Rate for Payer: Hamaspik Choice Inc Medicare	$1.10

NEPAFENAC 0.1 % OP SUSP [42486]

Facility

OP

$125.38

Service Code	NDC 00065000203
Hospital Charge Code	00065000203
Hospital Revenue Code	250
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$100.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.69
Rate for Payer: Aetna Government	$62.69
Rate for Payer: Brighton Health Commercial	$94.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.26
Rate for Payer: Group Health Inc Commercial	$62.69
Rate for Payer: Group Health Inc Medicare	$43.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.69
Rate for Payer: Hamaspik Choice Inc Medicare	$62.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$81.50

NEPAFENAC 0.5% OPHTHALMIC SUSP

Facility

OP

$194.00

Hospital Charge Code	41654289
Hospital Revenue Code	250
Min. Negotiated Rate	$67.90
Max. Negotiated Rate	$155.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$106.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$97.00
Rate for Payer: Aetna Government	$97.00
Rate for Payer: Brighton Health Commercial	$145.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.92
Rate for Payer: Group Health Inc Commercial	$97.00
Rate for Payer: Group Health Inc Medicare	$67.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.00
Rate for Payer: Hamaspik Choice Inc Medicare	$97.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$126.10

NEPAFENAC 0.5% OPHTHALMIC SUSP

Facility

OP

$194.00

Hospital Charge Code	41644289
Hospital Revenue Code	250
Min. Negotiated Rate	$67.90
Max. Negotiated Rate	$155.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$106.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$97.00
Rate for Payer: Aetna Government	$97.00
Rate for Payer: Brighton Health Commercial	$145.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$131.92
Rate for Payer: Group Health Inc Commercial	$97.00
Rate for Payer: Group Health Inc Medicare	$67.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.00
Rate for Payer: Hamaspik Choice Inc Medicare	$97.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$126.10

NEPHRECTOMY

Facility

OP

$3,412.04

Service Code	HCPCS 50220
Hospital Charge Code	40123020
Hospital Revenue Code	360
Min. Negotiated Rate	$1,194.21
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,876.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,286.99
Rate for Payer: Aetna Government	$1,286.99
Rate for Payer: Brighton Health Commercial	$2,559.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$1,706.02
Rate for Payer: Group Health Inc Medicare	$1,194.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,706.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,706.02
Rate for Payer: United Healthcare Commercial	$1,496.00

NEPHROMAX KIT

Facility

OP

$713.40

Hospital Charge Code	64905379
Hospital Revenue Code	270
Min. Negotiated Rate	$249.69
Max. Negotiated Rate	$570.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$392.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$356.70
Rate for Payer: Aetna Government	$356.70
Rate for Payer: Brighton Health Commercial	$535.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$570.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$485.11
Rate for Payer: Group Health Inc Commercial	$356.70
Rate for Payer: Group Health Inc Medicare	$249.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$356.70
Rate for Payer: Hamaspik Choice Inc Medicare	$356.70

NEPHROSTOMY DRAINAGE

Facility

OP

$2,870.78

Service Code	HCPCS 50040
Hospital Charge Code	40129881
Hospital Revenue Code	360
Min. Negotiated Rate	$1,004.77
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,578.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,126.99
Rate for Payer: Aetna Government	$1,126.99
Rate for Payer: Brighton Health Commercial	$2,153.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$1,435.39
Rate for Payer: Group Health Inc Medicare	$1,004.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,435.39
Rate for Payer: Hamaspik Choice Inc Medicare	$1,435.39
Rate for Payer: United Healthcare Commercial	$1,468.00

NERVE BLK SYMPH LUMBAR THORACIC

Facility

IP

$2,459.50

Service Code	HCPCS 64520
Hospital Charge Code	40013167
Hospital Revenue Code	360
Rate for Payer: Cash Price	$1,054.06

NERVE BLK SYMPH LUMBAR THORACIC

Facility

OP

$2,459.50

Service Code	HCPCS 64520
Hospital Charge Code	40013167
Hospital Revenue Code	360
Min. Negotiated Rate	$737.84
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,054.06
Rate for Payer: Aetna Government	$1,054.06
Rate for Payer: Affinity Essential Plan 1&2	$737.84
Rate for Payer: Affinity Essential Plan 3&4	$737.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$737.84
Rate for Payer: Brighton Health Commercial	$1,844.62
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,054.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$1,054.06
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$895.95
Rate for Payer: Fidelis Essential Plan QHP	$938.11
Rate for Payer: Fidelis Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Qualified Health Plan	$938.11
Rate for Payer: Group Health Inc Commercial	$1,054.06
Rate for Payer: Group Health Inc Medicare	$1,054.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,229.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,054.06
Rate for Payer: Healthfirst Medicare Advantage	$895.95
Rate for Payer: Healthfirst QHP	$1,054.06
Rate for Payer: Humana Medicare	$1,075.14
Rate for Payer: Senior Whole Health Medicare Advantage	$1,054.06
Rate for Payer: United Healthcare Commercial	$1,188.00
Rate for Payer: United Healthcare Medicare Advantage	$1,054.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,054.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$843.25
Rate for Payer: Wellcare Medicare	$1,001.36

NERVE BLK SYMPH LUMBAR THORACIC

Facility

IP

$174.04

Service Code	HCPCS 64520
Hospital Charge Code	30302470
Hospital Revenue Code	510
Rate for Payer: Cash Price	$1,054.06

NERVE BLK SYMPH LUMBAR THORACIC

Facility

OP

$174.04

Service Code	HCPCS 64520
Hospital Charge Code	30302470
Hospital Revenue Code	510
Min. Negotiated Rate	$87.02
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,054.06
Rate for Payer: Aetna Government	$1,054.06
Rate for Payer: Affinity Essential Plan 1&2	$737.84
Rate for Payer: Affinity Essential Plan 3&4	$737.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$737.84
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,054.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Essential Plan Aliesa	$895.95
Rate for Payer: Fidelis Essential Plan QHP	$938.11
Rate for Payer: Fidelis Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Qualified Health Plan	$938.11
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.02
Rate for Payer: Hamaspik Choice Inc Medicare	$1,054.06
Rate for Payer: Healthfirst Medicare Advantage	$895.95
Rate for Payer: Healthfirst QHP	$1,054.06
Rate for Payer: Humana Medicare	$1,075.14
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$1,054.06
Rate for Payer: Senior Whole Health Medicare Advantage	$1,054.06
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$1,054.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,054.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$843.25
Rate for Payer: Wellcare Medicare	$1,001.36

NERVE BLOCK STELLATE GANGLION

Facility

IP

$1,893.13

Service Code	HCPCS 64510
Hospital Charge Code	30302471
Hospital Revenue Code	510
Rate for Payer: Cash Price	$1,054.06

NERVE BLOCK STELLATE GANGLION

Facility

OP

$1,893.13

Service Code	HCPCS 64510
Hospital Charge Code	30302471
Hospital Revenue Code	510
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,054.06
Rate for Payer: Aetna Government	$1,054.06
Rate for Payer: Affinity Essential Plan 1&2	$737.84
Rate for Payer: Affinity Essential Plan 3&4	$737.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$737.84
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,054.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Essential Plan Aliesa	$895.95
Rate for Payer: Fidelis Essential Plan QHP	$938.11
Rate for Payer: Fidelis Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Qualified Health Plan	$938.11
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$946.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1,054.06
Rate for Payer: Healthfirst Medicare Advantage	$895.95
Rate for Payer: Healthfirst QHP	$1,054.06
Rate for Payer: Humana Medicare	$1,075.14
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$1,054.06
Rate for Payer: Senior Whole Health Medicare Advantage	$1,054.06
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$1,054.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,054.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$843.25
Rate for Payer: Wellcare Medicare	$1,001.36

NERVE BLOCK STELLATE GANGLION

Facility

IP

$2,459.50

Service Code	HCPCS 64510
Hospital Charge Code	40004244
Hospital Revenue Code	360
Rate for Payer: Cash Price	$1,054.06

NERVE BLOCK STELLATE GANGLION

Facility

OP

$2,459.50

Service Code	HCPCS 64510
Hospital Charge Code	40004244
Hospital Revenue Code	360
Min. Negotiated Rate	$737.84
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,054.06
Rate for Payer: Aetna Government	$1,054.06
Rate for Payer: Affinity Essential Plan 1&2	$737.84
Rate for Payer: Affinity Essential Plan 3&4	$737.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$737.84
Rate for Payer: Brighton Health Commercial	$1,844.62
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,054.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$1,054.06
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$895.95
Rate for Payer: Fidelis Essential Plan QHP	$938.11
Rate for Payer: Fidelis Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Qualified Health Plan	$938.11
Rate for Payer: Group Health Inc Commercial	$1,054.06
Rate for Payer: Group Health Inc Medicare	$1,054.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,229.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,054.06
Rate for Payer: Healthfirst Medicare Advantage	$895.95
Rate for Payer: Healthfirst QHP	$1,054.06
Rate for Payer: Humana Medicare	$1,075.14
Rate for Payer: Senior Whole Health Medicare Advantage	$1,054.06
Rate for Payer: United Healthcare Commercial	$1,188.00
Rate for Payer: United Healthcare Medicare Advantage	$1,054.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,054.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$843.25
Rate for Payer: Wellcare Medicare	$1,001.36

NERVE BLOCK SYMPH GANGLION

Facility

IP

$792.83

Service Code	HCPCS 64505
Hospital Charge Code	40013168
Hospital Revenue Code	360
Rate for Payer: Cash Price	$342.51

NERVE BLOCK SYMPH GANGLION

Facility

OP

$792.83

Service Code	HCPCS 64505
Hospital Charge Code	40013168
Hospital Revenue Code	360
Min. Negotiated Rate	$239.76
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$342.51
Rate for Payer: Aetna Government	$342.51
Rate for Payer: Affinity Essential Plan 1&2	$239.76
Rate for Payer: Affinity Essential Plan 3&4	$239.76
Rate for Payer: Affinity Medicaid/CHP/HARP	$239.76
Rate for Payer: Brighton Health Commercial	$594.62
Rate for Payer: Cash Price	$342.51
Rate for Payer: Cash Price	$342.51
Rate for Payer: Cash Price	$342.51
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$342.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$342.51
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$291.13
Rate for Payer: Fidelis Essential Plan QHP	$304.83
Rate for Payer: Fidelis Medicare Advantage	$342.51
Rate for Payer: Fidelis Qualified Health Plan	$304.83
Rate for Payer: Group Health Inc Commercial	$342.51
Rate for Payer: Group Health Inc Medicare	$342.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$396.42
Rate for Payer: Hamaspik Choice Inc Medicare	$342.51
Rate for Payer: Healthfirst Medicare Advantage	$291.13
Rate for Payer: Healthfirst QHP	$342.51
Rate for Payer: Humana Medicare	$349.36
Rate for Payer: Senior Whole Health Medicare Advantage	$342.51
Rate for Payer: United Healthcare Commercial	$1,113.00
Rate for Payer: United Healthcare Medicare Advantage	$342.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$342.51
Rate for Payer: Wellcare CHP/FHP/Medicaid	$274.01
Rate for Payer: Wellcare Medicare	$325.38

NERVE BLOCK SYMPH GANGLION

Facility

IP

$792.83

Service Code	HCPCS 64505
Hospital Charge Code	30302472
Hospital Revenue Code	510
Rate for Payer: Cash Price	$342.51