St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NEX COMP KNEE STEM 15MMX100MM

Facility

$3,568.00

Service Code	HCPCS C1776
Hospital Charge Code	40004698
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,746.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,962.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,140.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,784.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,051.60
Rate for Payer: EmblemHealth Commercial	$1,784.00
Rate for Payer: Fidelis Medicare Advantage	$3,746.40
Rate for Payer: Group Health Inc Commercial	$1,784.00
Rate for Payer: Group Health Inc Medicare	$1,248.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,784.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,784.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,319.20

NEX COMP KNEE STEM 15MMX100MM

Facility

$3,568.00

Service Code	HCPCS C1776
Hospital Charge Code	40004698
Hospital Revenue Code	278
Min. Negotiated Rate	$1,784.00
Max. Negotiated Rate	$1,784.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,784.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,784.00

NEX DISTAL FEM AUG BL 3 5MM

Facility

$6,320.00

Service Code	HCPCS C1776
Hospital Charge Code	40004702
Hospital Revenue Code	278
Min. Negotiated Rate	$3,160.00
Max. Negotiated Rate	$3,160.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,160.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,160.00

NEX DISTAL FEM AUG BL 3 5MM

Facility

$6,320.00

Service Code	HCPCS C1776
Hospital Charge Code	40004702
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$6,636.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,476.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$3,792.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,634.00
Rate for Payer: EmblemHealth Commercial	$3,160.00
Rate for Payer: Fidelis Medicare Advantage	$6,636.00
Rate for Payer: Group Health Inc Commercial	$3,160.00
Rate for Payer: Group Health Inc Medicare	$2,212.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,160.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,160.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,108.00

NEXGEN COMPLETE KNEE SOLUTION

Facility

$3,539.40

Service Code	HCPCS C1776
Hospital Charge Code	40202116
Hospital Revenue Code	278
Min. Negotiated Rate	$1,769.70
Max. Negotiated Rate	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.70

NEXGEN COMPLETE KNEE SOLUTION

Facility

$3,539.40

Service Code	HCPCS C1776
Hospital Charge Code	40202116
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,716.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,946.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,123.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,769.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,035.16
Rate for Payer: EmblemHealth Commercial	$1,769.70
Rate for Payer: Fidelis Medicare Advantage	$3,716.37
Rate for Payer: Group Health Inc Commercial	$1,769.70
Rate for Payer: Group Health Inc Medicare	$1,238.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,769.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1,769.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,300.61

NEXGEN KNEE POLY PATELLA

Facility

$1,506.00

Service Code	HCPCS C1776
Hospital Charge Code	40202118
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,581.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$828.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$903.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$753.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$865.95
Rate for Payer: EmblemHealth Commercial	$753.00
Rate for Payer: Fidelis Medicare Advantage	$1,581.30
Rate for Payer: Group Health Inc Commercial	$753.00
Rate for Payer: Group Health Inc Medicare	$527.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$753.00
Rate for Payer: Hamaspik Choice Inc Medicare	$753.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$978.90

NEXGEN KNEE POLY PATELLA

Facility

$1,506.00

Service Code	HCPCS C1776
Hospital Charge Code	40202118
Hospital Revenue Code	278
Min. Negotiated Rate	$753.00
Max. Negotiated Rate	$753.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$753.00
Rate for Payer: Hamaspik Choice Inc Medicare	$753.00

NEXGEN TRAB MON SZ4 12MM

Facility

$9,710.00

Hospital Charge Code	64903310
Hospital Revenue Code	279
Min. Negotiated Rate	$3,398.50
Max. Negotiated Rate	$7,768.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,340.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,855.00
Rate for Payer: Aetna Government	$4,855.00
Rate for Payer: Brighton Health Commercial	$7,282.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7,768.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,602.80
Rate for Payer: Group Health Inc Commercial	$4,855.00
Rate for Payer: Group Health Inc Medicare	$3,398.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,855.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,855.00

NEX KNEE CONSTRAIN CONDYL

Facility

$13,123.12

Service Code	HCPCS C1776
Hospital Charge Code	40008323
Hospital Revenue Code	278
Min. Negotiated Rate	$6,561.56
Max. Negotiated Rate	$6,561.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,561.56
Rate for Payer: Hamaspik Choice Inc Medicare	$6,561.56

NEX KNEE CONSTRAIN CONDYL

Facility

$13,123.12

Service Code	HCPCS C1776
Hospital Charge Code	40008323
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$13,779.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,217.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$7,873.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,561.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,545.79
Rate for Payer: EmblemHealth Commercial	$6,561.56
Rate for Payer: Fidelis Medicare Advantage	$13,779.28
Rate for Payer: Group Health Inc Commercial	$6,561.56
Rate for Payer: Group Health Inc Medicare	$4,593.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,561.56
Rate for Payer: Hamaspik Choice Inc Medicare	$6,561.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,530.03

NEX LCCK ART GREEN/E,F

Facility

$6,848.00

Service Code	HCPCS C1776
Hospital Charge Code	40004703
Hospital Revenue Code	278
Min. Negotiated Rate	$3,424.00
Max. Negotiated Rate	$3,424.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,424.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,424.00

NEX LCCK ART GREEN/E,F

Facility

$6,848.00

Service Code	HCPCS C1776
Hospital Charge Code	40004703
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$7,190.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,766.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,108.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,424.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,937.60
Rate for Payer: EmblemHealth Commercial	$3,424.00
Rate for Payer: Fidelis Medicare Advantage	$7,190.40
Rate for Payer: Group Health Inc Commercial	$3,424.00
Rate for Payer: Group Health Inc Medicare	$2,396.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,424.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,424.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,451.20

N. GONORRHOEAE DNA AMP PROB

Facility

$87.73

Service Code	HCPCS 87591
Hospital Charge Code	30305606
Hospital Revenue Code	306
Min. Negotiated Rate	$24.56
Max. Negotiated Rate	$65.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.09
Rate for Payer: Aetna Government	$35.09
Rate for Payer: Affinity Essential Plan 1&2	$24.56
Rate for Payer: Affinity Essential Plan 3&4	$24.56
Rate for Payer: Affinity Medicaid/CHP/HARP	$24.56
Rate for Payer: Brighton Health Commercial	$65.80
Rate for Payer: Cash Price	$35.09
Rate for Payer: Cash Price	$35.09
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$35.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.20
Rate for Payer: Elderplan Medicare Advantage	$35.09
Rate for Payer: EmblemHealth Commercial	$35.09
Rate for Payer: Fidelis Essential Plan Aliesa	$29.83
Rate for Payer: Fidelis Essential Plan QHP	$31.23
Rate for Payer: Fidelis Medicare Advantage	$35.09
Rate for Payer: Fidelis Qualified Health Plan	$31.23
Rate for Payer: Group Health Inc Commercial	$35.09
Rate for Payer: Group Health Inc Medicare	$35.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.86
Rate for Payer: Hamaspik Choice Inc Medicare	$35.09
Rate for Payer: Healthfirst Medicare Advantage	$35.09
Rate for Payer: Healthfirst QHP	$35.09
Rate for Payer: Humana Medicare	$35.79
Rate for Payer: Senior Whole Health Medicare Advantage	$35.09
Rate for Payer: United Healthcare Commercial	$44.45
Rate for Payer: United Healthcare Medicare Advantage	$35.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28.07
Rate for Payer: Wellcare Medicare	$31.58

N. GONORRHOEAE DNA AMP PROB

Facility

$87.73

Service Code	HCPCS 87591
Hospital Charge Code	30305606
Hospital Revenue Code	306
Rate for Payer: Cash Price	$35.09

N.GONORRHOEAE DNA AMP PROB

Facility

$87.73

Service Code	HCPCS 87591
Hospital Charge Code	40619615
Hospital Revenue Code	300
Rate for Payer: Cash Price	$35.09

N.GONORRHOEAE DNA AMP PROB

Facility

$87.73

Service Code	HCPCS 87591
Hospital Charge Code	40619615
Hospital Revenue Code	300
Min. Negotiated Rate	$24.56
Max. Negotiated Rate	$65.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.09
Rate for Payer: Aetna Government	$35.09
Rate for Payer: Affinity Essential Plan 1&2	$24.56
Rate for Payer: Affinity Essential Plan 3&4	$24.56
Rate for Payer: Affinity Medicaid/CHP/HARP	$24.56
Rate for Payer: Brighton Health Commercial	$65.80
Rate for Payer: Cash Price	$35.09
Rate for Payer: Cash Price	$35.09
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$35.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.20
Rate for Payer: Elderplan Medicare Advantage	$35.09
Rate for Payer: EmblemHealth Commercial	$35.09
Rate for Payer: Fidelis Essential Plan Aliesa	$29.83
Rate for Payer: Fidelis Essential Plan QHP	$31.23
Rate for Payer: Fidelis Medicare Advantage	$35.09
Rate for Payer: Fidelis Qualified Health Plan	$31.23
Rate for Payer: Group Health Inc Commercial	$35.09
Rate for Payer: Group Health Inc Medicare	$35.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.86
Rate for Payer: Hamaspik Choice Inc Medicare	$35.09
Rate for Payer: Healthfirst Medicare Advantage	$35.09
Rate for Payer: Healthfirst QHP	$35.09
Rate for Payer: Humana Medicare	$35.79
Rate for Payer: Senior Whole Health Medicare Advantage	$35.09
Rate for Payer: United Healthcare Commercial	$44.45
Rate for Payer: United Healthcare Medicare Advantage	$35.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28.07
Rate for Payer: Wellcare Medicare	$31.58

NIACIN 100 MG PO TABS [5539]

Facility

$0.45

Service Code	NDC 50268058215
Hospital Charge Code	50268058215
Hospital Revenue Code	250
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$0.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Brighton Health Commercial	$0.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.36
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Group Health Inc Commercial	$0.23
Rate for Payer: Group Health Inc Medicare	$0.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.23
Rate for Payer: Hamaspik Choice Inc Medicare	$0.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.29

NIACIN 100MG TABLET

Facility

$0.94

Hospital Charge Code	41650341
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.47
Rate for Payer: Aetna Government	$0.47
Rate for Payer: Brighton Health Commercial	$0.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.64
Rate for Payer: Group Health Inc Commercial	$0.47
Rate for Payer: Group Health Inc Medicare	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.47
Rate for Payer: Hamaspik Choice Inc Medicare	$0.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.61

NIACIN 100MG TABLET

Facility

$0.94

Hospital Charge Code	41640341
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.47
Rate for Payer: Aetna Government	$0.47
Rate for Payer: Brighton Health Commercial	$0.71
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.64
Rate for Payer: Group Health Inc Commercial	$0.47
Rate for Payer: Group Health Inc Medicare	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.47
Rate for Payer: Hamaspik Choice Inc Medicare	$0.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.61

NIACIN 250 MG TAB

Facility

$0.07

Hospital Charge Code	41653588
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

NIACIN 250 MG TAB

Facility

$0.07

Hospital Charge Code	41643588
Hospital Revenue Code	250
Min. Negotiated Rate	$0.02
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

NIACIN 500 MG PO TABS [5542]

Facility

$0.03

Service Code	NDC 00904227260
Hospital Charge Code	00904227260
Hospital Revenue Code	250
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.02
Rate for Payer: Aetna Government	$0.02
Rate for Payer: Brighton Health Commercial	$0.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.02
Rate for Payer: Group Health Inc Commercial	$0.02
Rate for Payer: Group Health Inc Medicare	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.02
Rate for Payer: Hamaspik Choice Inc Medicare	$0.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.02

NIACIN 500 MG TAB

Facility

$1.00

Hospital Charge Code	41645323
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
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	$0.65

NIACIN 500 MG TAB

Facility

$1.00

Hospital Charge Code	41655323
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
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	$0.65

Know your out-of-pocket cost for care.

All Charges