Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Hospital Charge Code 41645758
Hospital Revenue Code 250
Min. Negotiated Rate $1.05
Max. Negotiated Rate $2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1.50
Rate for Payer: Aetna Government $1.50
Rate for Payer: Brighton Health Commercial $2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2.40
Rate for Payer: Cigna LocalPlus Benefit Plan $2.04
Rate for Payer: Group Health Inc Commercial $1.50
Rate for Payer: Group Health Inc Medicare $1.05
Rate for Payer: Hamaspik Choice Inc Medicaid $1.50
Rate for Payer: Hamaspik Choice Inc Medicare $1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $1.95
Service Code HCPCS 96116
Hospital Charge Code 30400096
Hospital Revenue Code 918
Rate for Payer: Cash Price $362.98
Service Code HCPCS 96116
Hospital Charge Code 30400096
Hospital Revenue Code 918
Min. Negotiated Rate $261.16
Max. Negotiated Rate $26,116.00
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 $587.61
Rate for Payer: Affinity Essential Plan 3&4 $587.61
Rate for Payer: Affinity Medicaid/CHP/HARP $261.16
Rate for Payer: Amida Care Medicaid $261.16
Rate for Payer: Brighton Health Commercial $574.94
Rate for Payer: Carelon Behavioral Health HARP/QHP $263.54
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 CHP/HARP/Medicaid $26,116.00
Rate for Payer: Fidelis Essential Plan Aliesa $261.16
Rate for Payer: Fidelis Essential Plan QHP $261.16
Rate for Payer: Fidelis Medicare Advantage $362.98
Rate for Payer: Fidelis Qualified Health Plan $274.22
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 $261.16
Rate for Payer: Hamaspik Choice Inc Medicare $362.98
Rate for Payer: Healthfirst CHP/FHP/Medicaid $261.16
Rate for Payer: Healthfirst Essential Plan $587.61
Rate for Payer: Healthfirst Medicare Advantage $308.53
Rate for Payer: Healthfirst QHP $261.16
Rate for Payer: Humana Medicare $370.24
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid $263.54
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) $592.96
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) $592.96
Rate for Payer: Optum Medicaid $263.54
Rate for Payer: Senior Whole Health Medicare Advantage $362.98
Rate for Payer: SOMOS CHP/HARP/Medicaid $261.16
Rate for Payer: SOMOS Essential $587.61
Rate for Payer: United Healthcare Commercial $383.29
Rate for Payer: United Healthcare Essential Plan 1&2 $587.61
Rate for Payer: United Healthcare Essential Plan 3&4 $287.28
Rate for Payer: United Healthcare Medicaid $261.16
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
Service Code HCPCS 96116
Hospital Charge Code 30303123
Hospital Revenue Code 918
Rate for Payer: Cash Price $362.98
Service Code HCPCS 96116
Hospital Charge Code 30303123
Hospital Revenue Code 918
Min. Negotiated Rate $261.16
Max. Negotiated Rate $26,116.00
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 $587.61
Rate for Payer: Affinity Essential Plan 3&4 $587.61
Rate for Payer: Affinity Medicaid/CHP/HARP $261.16
Rate for Payer: Amida Care Medicaid $261.16
Rate for Payer: Brighton Health Commercial $574.94
Rate for Payer: Carelon Behavioral Health HARP/QHP $263.54
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 CHP/HARP/Medicaid $26,116.00
Rate for Payer: Fidelis Essential Plan Aliesa $261.16
Rate for Payer: Fidelis Essential Plan QHP $261.16
Rate for Payer: Fidelis Medicare Advantage $362.98
Rate for Payer: Fidelis Qualified Health Plan $274.22
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 $261.16
Rate for Payer: Hamaspik Choice Inc Medicare $362.98
Rate for Payer: Healthfirst CHP/FHP/Medicaid $261.16
Rate for Payer: Healthfirst Essential Plan $587.61
Rate for Payer: Healthfirst Medicare Advantage $308.53
Rate for Payer: Healthfirst QHP $261.16
Rate for Payer: Humana Medicare $370.24
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid $263.54
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) $592.96
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) $592.96
Rate for Payer: Optum Medicaid $263.54
Rate for Payer: Senior Whole Health Medicare Advantage $362.98
Rate for Payer: SOMOS CHP/HARP/Medicaid $261.16
Rate for Payer: SOMOS Essential $587.61
Rate for Payer: United Healthcare Commercial $383.29
Rate for Payer: United Healthcare Essential Plan 1&2 $587.61
Rate for Payer: United Healthcare Essential Plan 3&4 $287.28
Rate for Payer: United Healthcare Medicaid $261.16
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
Hospital Charge Code 64902738
Hospital Revenue Code 270
Min. Negotiated Rate $181.12
Max. Negotiated Rate $414.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $284.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $258.75
Rate for Payer: Aetna Government $258.75
Rate for Payer: Brighton Health Commercial $388.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $414.00
Rate for Payer: Cigna LocalPlus Benefit Plan $351.90
Rate for Payer: Group Health Inc Commercial $258.75
Rate for Payer: Group Health Inc Medicare $181.12
Rate for Payer: Hamaspik Choice Inc Medicaid $258.75
Rate for Payer: Hamaspik Choice Inc Medicare $258.75
Service Code HCPCS C9361
Hospital Charge Code 64904218
Hospital Revenue Code 278
Min. Negotiated Rate $1,922.78
Max. Negotiated Rate $1,922.78
Rate for Payer: Hamaspik Choice Inc Medicaid $1,922.78
Rate for Payer: Hamaspik Choice Inc Medicare $1,922.78
Service Code HCPCS C9361
Hospital Charge Code 64904218
Hospital Revenue Code 278
Min. Negotiated Rate $143.89
Max. Negotiated Rate $4,037.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2,115.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $143.89
Rate for Payer: Aetna Government $143.89
Rate for Payer: Brighton Health Commercial $2,307.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1,922.78
Rate for Payer: Cigna LocalPlus Benefit Plan $2,211.19
Rate for Payer: EmblemHealth Commercial $1,922.78
Rate for Payer: Fidelis Medicare Advantage $4,037.83
Rate for Payer: Group Health Inc Commercial $1,922.78
Rate for Payer: Group Health Inc Medicare $1,345.94
Rate for Payer: Hamaspik Choice Inc Medicaid $1,922.78
Rate for Payer: Hamaspik Choice Inc Medicare $1,922.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2,499.61
Service Code HCPCS C9361
Hospital Charge Code 64905431
Hospital Revenue Code 278
Min. Negotiated Rate $1,922.78
Max. Negotiated Rate $1,922.78
Rate for Payer: Hamaspik Choice Inc Medicaid $1,922.78
Rate for Payer: Hamaspik Choice Inc Medicare $1,922.78
Service Code HCPCS C9361
Hospital Charge Code 64905431
Hospital Revenue Code 278
Min. Negotiated Rate $143.89
Max. Negotiated Rate $4,037.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2,115.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $143.89
Rate for Payer: Aetna Government $143.89
Rate for Payer: Brighton Health Commercial $2,307.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1,922.78
Rate for Payer: Cigna LocalPlus Benefit Plan $2,211.19
Rate for Payer: EmblemHealth Commercial $1,922.78
Rate for Payer: Fidelis Medicare Advantage $4,037.83
Rate for Payer: Group Health Inc Commercial $1,922.78
Rate for Payer: Group Health Inc Medicare $1,345.94
Rate for Payer: Hamaspik Choice Inc Medicaid $1,922.78
Rate for Payer: Hamaspik Choice Inc Medicare $1,922.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2,499.61
Service Code HCPCS C9361
Hospital Charge Code 64905429
Hospital Revenue Code 278
Min. Negotiated Rate $143.89
Max. Negotiated Rate $4,037.83
Rate for Payer: 1199SEIU National Benefit Fund Commercial $2,115.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $143.89
Rate for Payer: Aetna Government $143.89
Rate for Payer: Brighton Health Commercial $2,307.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $1,922.78
Rate for Payer: Cigna LocalPlus Benefit Plan $2,211.19
Rate for Payer: EmblemHealth Commercial $1,922.78
Rate for Payer: Fidelis Medicare Advantage $4,037.83
Rate for Payer: Group Health Inc Commercial $1,922.78
Rate for Payer: Group Health Inc Medicare $1,345.94
Rate for Payer: Hamaspik Choice Inc Medicaid $1,922.78
Rate for Payer: Hamaspik Choice Inc Medicare $1,922.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2,499.61
Service Code HCPCS C9361
Hospital Charge Code 64905429
Hospital Revenue Code 278
Min. Negotiated Rate $1,922.78
Max. Negotiated Rate $1,922.78
Rate for Payer: Hamaspik Choice Inc Medicaid $1,922.78
Rate for Payer: Hamaspik Choice Inc Medicare $1,922.78
Hospital Charge Code 64907046
Hospital Revenue Code 279
Min. Negotiated Rate $1,224.81
Max. Negotiated Rate $2,799.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,924.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $1,749.72
Rate for Payer: Aetna Government $1,749.72
Rate for Payer: Brighton Health Commercial $2,624.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $2,799.56
Rate for Payer: Cigna LocalPlus Benefit Plan $2,379.63
Rate for Payer: Group Health Inc Commercial $1,749.72
Rate for Payer: Group Health Inc Medicare $1,224.81
Rate for Payer: Hamaspik Choice Inc Medicaid $1,749.72
Rate for Payer: Hamaspik Choice Inc Medicare $1,749.72
Service Code MSDRG 123
Min. Negotiated Rate $6,894.30
Max. Negotiated Rate $25,406.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial $11,854.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $18,477.23
Rate for Payer: Aetna Government $18,477.23
Rate for Payer: Brighton Health Commercial $11,658.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $18,846.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $13,884.28
Rate for Payer: Cigna LocalPlus Benefit Plan $11,457.90
Rate for Payer: Elderplan Medicare Advantage $17,553.37
Rate for Payer: EmblemHealth Commercial $6,894.30
Rate for Payer: Fidelis Medicare Advantage $18,477.23
Rate for Payer: Group Health Inc Commercial $18,477.23
Rate for Payer: Group Health Inc Medicare $18,477.23
Rate for Payer: Hamaspik Choice Inc Medicare $18,477.23
Rate for Payer: Healthfirst Medicare Advantage $8,591.91
Rate for Payer: Humana Medicare $25,406.19
Rate for Payer: Senior Whole Health Medicare Advantage $18,477.23
Rate for Payer: United Healthcare Commercial $15,989.15
Rate for Payer: United Healthcare Medicare Advantage $18,477.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $18,477.23
Rate for Payer: Wellcare Medicare $17,553.37
Service Code HCPCS 64704
Hospital Charge Code 40021765
Hospital Revenue Code 360
Rate for Payer: Cash Price $2,232.80
Service Code HCPCS 64704
Hospital Charge Code 40021765
Hospital Revenue Code 360
Min. Negotiated Rate $1,412.00
Max. Negotiated Rate $3,905.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $2,232.80
Rate for Payer: Aetna Government $2,232.80
Rate for Payer: Affinity Essential Plan 1&2 $1,562.96
Rate for Payer: Affinity Essential Plan 3&4 $1,562.96
Rate for Payer: Affinity Medicaid/CHP/HARP $1,562.96
Rate for Payer: Brighton Health Commercial $3,905.61
Rate for Payer: Cash Price $2,232.80
Rate for Payer: Cash Price $2,232.80
Rate for Payer: Cash Price $2,232.80
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $2,232.80
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 $2,232.80
Rate for Payer: EmblemHealth Commercial $1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa $1,897.88
Rate for Payer: Fidelis Essential Plan QHP $1,987.19
Rate for Payer: Fidelis Medicare Advantage $2,232.80
Rate for Payer: Fidelis Qualified Health Plan $1,987.19
Rate for Payer: Group Health Inc Commercial $2,232.80
Rate for Payer: Group Health Inc Medicare $2,232.80
Rate for Payer: Hamaspik Choice Inc Medicaid $2,603.74
Rate for Payer: Hamaspik Choice Inc Medicare $2,232.80
Rate for Payer: Healthfirst Medicare Advantage $1,897.88
Rate for Payer: Healthfirst QHP $2,232.80
Rate for Payer: Humana Medicare $2,277.46
Rate for Payer: Senior Whole Health Medicare Advantage $2,232.80
Rate for Payer: United Healthcare Commercial $1,468.00
Rate for Payer: United Healthcare Medicare Advantage $2,232.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2,232.80
Rate for Payer: Wellcare CHP/FHP/Medicaid $1,786.24
Rate for Payer: Wellcare Medicare $2,121.16
Service Code HCPCS 95940
Hospital Charge Code 40209000
Hospital Revenue Code 920
Min. Negotiated Rate $28.47
Max. Negotiated Rate $94.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $54.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $28.47
Rate for Payer: Aetna Government $28.47
Rate for Payer: Brighton Health Commercial $74.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $79.38
Rate for Payer: Cigna LocalPlus Benefit Plan $67.48
Rate for Payer: Group Health Inc Commercial $49.62
Rate for Payer: Group Health Inc Medicare $34.73
Rate for Payer: Hamaspik Choice Inc Medicaid $49.62
Rate for Payer: Hamaspik Choice Inc Medicare $49.62
Rate for Payer: United Healthcare Commercial $94.00
Service Code CPT 64721
Hospital Revenue Code 360
Min. Negotiated Rate $1,468.00
Max. Negotiated Rate $2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $2,232.80
Rate for Payer: Aetna Government $2,232.80
Rate for Payer: Affinity Essential Plan 1&2 $1,562.96
Rate for Payer: Affinity Essential Plan 3&4 $1,562.96
Rate for Payer: Affinity Medicaid/CHP/HARP $1,562.96
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $2,232.80
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 $2,232.80
Rate for Payer: EmblemHealth Commercial $1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa $1,897.88
Rate for Payer: Fidelis Essential Plan QHP $1,987.19
Rate for Payer: Fidelis Medicare Advantage $2,232.80
Rate for Payer: Fidelis Qualified Health Plan $1,987.19
Rate for Payer: Group Health Inc Commercial $2,232.80
Rate for Payer: Group Health Inc Medicare $2,232.80
Rate for Payer: Hamaspik Choice Inc Medicare $2,232.80
Rate for Payer: Healthfirst Medicare Advantage $1,897.88
Rate for Payer: Healthfirst QHP $2,232.80
Rate for Payer: Humana Medicare $2,277.46
Rate for Payer: Senior Whole Health Medicare Advantage $2,232.80
Rate for Payer: United Healthcare Commercial $1,468.00
Rate for Payer: United Healthcare Medicare Advantage $2,232.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $2,232.80
Rate for Payer: Wellcare CHP/FHP/Medicaid $1,786.24
Rate for Payer: Wellcare Medicare $2,121.16
Service Code MSDRG 882
Min. Negotiated Rate $905.00
Max. Negotiated Rate $20,760.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial $1,859.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $20,353.47
Rate for Payer: Aetna Government $20,353.47
Rate for Payer: Brighton Health Commercial $13,619.85
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $20,760.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $16,220.77
Rate for Payer: Cigna LocalPlus Benefit Plan $13,386.08
Rate for Payer: Elderplan Medicare Advantage $19,335.80
Rate for Payer: EmblemHealth Commercial $905.00
Rate for Payer: Fidelis Medicare Advantage $20,353.47
Rate for Payer: Group Health Inc Commercial $20,353.47
Rate for Payer: Group Health Inc Medicare $20,353.47
Rate for Payer: Hamaspik Choice Inc Medicare $20,353.47
Rate for Payer: Healthfirst Medicare Advantage $9,464.36
Rate for Payer: Senior Whole Health Medicare Advantage $20,353.47
Rate for Payer: United Healthcare Commercial $18,679.86
Rate for Payer: United Healthcare Medicare Advantage $20,353.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $20,353.47
Rate for Payer: Wellcare Medicare $19,335.80
Service Code HCPCS C1816
Hospital Charge Code 64902664
Hospital Revenue Code 278
Min. Negotiated Rate $14,031.25
Max. Negotiated Rate $14,031.25
Rate for Payer: Hamaspik Choice Inc Medicaid $14,031.25
Rate for Payer: Hamaspik Choice Inc Medicare $14,031.25
Service Code HCPCS C1816
Hospital Charge Code 64902664
Hospital Revenue Code 278
Min. Negotiated Rate $9,821.88
Max. Negotiated Rate $29,465.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial $15,434.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $15,310.20
Rate for Payer: Aetna Government $15,310.20
Rate for Payer: Brighton Health Commercial $16,837.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $14,031.25
Rate for Payer: Cigna LocalPlus Benefit Plan $16,135.94
Rate for Payer: EmblemHealth Commercial $14,031.25
Rate for Payer: Fidelis Medicare Advantage $29,465.62
Rate for Payer: Group Health Inc Commercial $14,031.25
Rate for Payer: Group Health Inc Medicare $9,821.88
Rate for Payer: Hamaspik Choice Inc Medicaid $14,031.25
Rate for Payer: Hamaspik Choice Inc Medicare $14,031.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $18,240.62
Hospital Charge Code 40204300
Hospital Revenue Code 270
Min. Negotiated Rate $30.02
Max. Negotiated Rate $68.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial $47.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $42.88
Rate for Payer: Aetna Government $42.88
Rate for Payer: Brighton Health Commercial $64.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $68.61
Rate for Payer: Cigna LocalPlus Benefit Plan $58.32
Rate for Payer: Group Health Inc Commercial $42.88
Rate for Payer: Group Health Inc Medicare $30.02
Rate for Payer: Hamaspik Choice Inc Medicaid $42.88
Rate for Payer: Hamaspik Choice Inc Medicare $42.88
Hospital Charge Code 40204100
Hospital Revenue Code 270
Min. Negotiated Rate $14.14
Max. Negotiated Rate $32.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial $22.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $20.20
Rate for Payer: Aetna Government $20.20
Rate for Payer: Brighton Health Commercial $30.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $32.32
Rate for Payer: Cigna LocalPlus Benefit Plan $27.47
Rate for Payer: Group Health Inc Commercial $20.20
Rate for Payer: Group Health Inc Medicare $14.14
Rate for Payer: Hamaspik Choice Inc Medicaid $20.20
Rate for Payer: Hamaspik Choice Inc Medicare $20.20
Service Code HCPCS 86021
Hospital Charge Code 40729895
Hospital Revenue Code 302
Rate for Payer: Cash Price $15.05
Service Code HCPCS 86021
Hospital Charge Code 40729895
Hospital Revenue Code 302
Min. Negotiated Rate $10.54
Max. Negotiated Rate $28.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial $20.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper $15.05
Rate for Payer: Aetna Government $15.05
Rate for Payer: Affinity Essential Plan 1&2 $10.54
Rate for Payer: Affinity Essential Plan 3&4 $10.54
Rate for Payer: Affinity Medicaid/CHP/HARP $10.54
Rate for Payer: Brighton Health Commercial $28.22
Rate for Payer: Cash Price $15.05
Rate for Payer: Cash Price $15.05
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus $15.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access $23.92
Rate for Payer: Cigna LocalPlus Benefit Plan $20.24
Rate for Payer: Elderplan Medicare Advantage $15.05
Rate for Payer: EmblemHealth Commercial $15.05
Rate for Payer: Fidelis Essential Plan Aliesa $12.79
Rate for Payer: Fidelis Essential Plan QHP $13.39
Rate for Payer: Fidelis Medicare Advantage $15.05
Rate for Payer: Fidelis Qualified Health Plan $13.39
Rate for Payer: Group Health Inc Commercial $15.05
Rate for Payer: Group Health Inc Medicare $15.05
Rate for Payer: Hamaspik Choice Inc Medicaid $18.82
Rate for Payer: Hamaspik Choice Inc Medicare $15.05
Rate for Payer: Healthfirst Medicare Advantage $15.05
Rate for Payer: Healthfirst QHP $15.05
Rate for Payer: Humana Medicare $15.35
Rate for Payer: Senior Whole Health Medicare Advantage $15.05
Rate for Payer: United Healthcare Commercial $19.07
Rate for Payer: United Healthcare Medicare Advantage $15.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual $15.05
Rate for Payer: Wellcare CHP/FHP/Medicaid $12.04
Rate for Payer: Wellcare Medicare $13.54