St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

NIPPLES PREMATURE

Facility

$0.32

Hospital Charge Code	64902352
Hospital Revenue Code	270
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.16
Rate for Payer: Aetna Government	$0.16
Rate for Payer: Brighton Health Commercial	$0.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.22
Rate for Payer: Group Health Inc Commercial	$0.16
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16
Rate for Payer: Hamaspik Choice Inc Medicare	$0.16

NIPPLES STANDARD - TWIST

Facility

$0.32

Hospital Charge Code	64902350
Hospital Revenue Code	270
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.16
Rate for Payer: Aetna Government	$0.16
Rate for Payer: Brighton Health Commercial	$0.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.22
Rate for Payer: Group Health Inc Commercial	$0.16
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.16
Rate for Payer: Hamaspik Choice Inc Medicare	$0.16

NIRSEVIMAB-ALIP 100 MG/ML IM SOSY [191736]

Facility

$623.70

Service Code	NDC 49281057415
Hospital Charge Code	49281057415
Hospital Revenue Code	250
Min. Negotiated Rate	$218.30
Max. Negotiated Rate	$498.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$343.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$311.85
Rate for Payer: Aetna Government	$311.85
Rate for Payer: Brighton Health Commercial	$467.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$498.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$424.12
Rate for Payer: Group Health Inc Commercial	$311.85
Rate for Payer: Group Health Inc Medicare	$218.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$311.85
Rate for Payer: Hamaspik Choice Inc Medicare	$311.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$405.40

NIRSEVIMAB-ALIP 50 MG/0.5ML IM SOSY [191735]

Facility

$1,247.40

Service Code	NDC 49281057515
Hospital Charge Code	49281057515
Hospital Revenue Code	250
Min. Negotiated Rate	$436.59
Max. Negotiated Rate	$997.92
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$686.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$623.70
Rate for Payer: Aetna Government	$623.70
Rate for Payer: Brighton Health Commercial	$935.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$997.92
Rate for Payer: Cigna LocalPlus Benefit Plan	$848.23
Rate for Payer: Group Health Inc Commercial	$623.70
Rate for Payer: Group Health Inc Medicare	$436.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$623.70
Rate for Payer: Hamaspik Choice Inc Medicare	$623.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$810.81

NITAZOXANIDE 100 MG/5ML PO SUSR [34708]

Facility

$10.44

Service Code	NDC 67546021221
Hospital Charge Code	67546021221
Hospital Revenue Code	250
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$8.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Brighton Health Commercial	$7.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.10
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$3.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.22
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.79

NITAZOXANIDE 20 MG./ML SUSP

Facility

$2.00

Hospital Charge Code	41653792
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Brighton Health Commercial	$1.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

NITAZOXANIDE 20 MG./ML SUSP

Facility

$2.00

Hospital Charge Code	41643792
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Brighton Health Commercial	$1.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

NITAZOXANIDE 500 MG PO TABS [39254]

Facility

$161.56

Service Code	NDC 67546011112
Hospital Charge Code	67546011112
Hospital Revenue Code	250
Min. Negotiated Rate	$56.55
Max. Negotiated Rate	$129.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$80.78
Rate for Payer: Aetna Government	$80.78
Rate for Payer: Brighton Health Commercial	$121.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$129.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$109.86
Rate for Payer: Group Health Inc Commercial	$80.78
Rate for Payer: Group Health Inc Medicare	$56.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.78
Rate for Payer: Hamaspik Choice Inc Medicare	$80.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.01

NITAZOXANIDE 500 MG TAB

Facility

$40.78

Hospital Charge Code	41643793
Hospital Revenue Code	250
Min. Negotiated Rate	$14.27
Max. Negotiated Rate	$32.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.39
Rate for Payer: Aetna Government	$20.39
Rate for Payer: Brighton Health Commercial	$30.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.73
Rate for Payer: Group Health Inc Commercial	$20.39
Rate for Payer: Group Health Inc Medicare	$14.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.39
Rate for Payer: Hamaspik Choice Inc Medicare	$20.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.51

NITAZOXANIDE 500 MG TAB

Facility

$40.78

Hospital Charge Code	41653793
Hospital Revenue Code	250
Min. Negotiated Rate	$14.27
Max. Negotiated Rate	$32.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.39
Rate for Payer: Aetna Government	$20.39
Rate for Payer: Brighton Health Commercial	$30.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.73
Rate for Payer: Group Health Inc Commercial	$20.39
Rate for Payer: Group Health Inc Medicare	$14.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.39
Rate for Payer: Hamaspik Choice Inc Medicare	$20.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.51

NITENOL K-WIRE BLOUT

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	64906012
Hospital Revenue Code	278
Min. Negotiated Rate	$96.25
Max. Negotiated Rate	$288.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$151.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$165.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$137.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$158.12
Rate for Payer: EmblemHealth Commercial	$137.50
Rate for Payer: Fidelis Medicare Advantage	$288.75
Rate for Payer: Group Health Inc Commercial	$137.50
Rate for Payer: Group Health Inc Medicare	$96.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.50
Rate for Payer: Hamaspik Choice Inc Medicare	$137.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$178.75

NITENOL K-WIRE BLOUT

Facility

$275.00

Service Code	HCPCS C1713
Hospital Charge Code	64906012
Hospital Revenue Code	278
Min. Negotiated Rate	$137.50
Max. Negotiated Rate	$137.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$137.50
Rate for Payer: Hamaspik Choice Inc Medicare	$137.50

NITHIODOTE 300MG/10ML&12.5 GM/50ML IV KIT [163127]

Facility

$3.80

Service Code	NDC 60267081200
Hospital Charge Code	60267081200
Hospital Revenue Code	278
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$1.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1.90

NITHIODOTE 300MG/10ML&12.5 GM/50ML IV KIT [163127]

Facility

$3.80

Service Code	NDC 60267081200
Hospital Charge Code	60267081200
Hospital Revenue Code	278
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$3.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.90
Rate for Payer: Aetna Government	$1.90
Rate for Payer: Brighton Health Commercial	$2.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.18
Rate for Payer: EmblemHealth Commercial	$1.90
Rate for Payer: Fidelis Medicare Advantage	$3.99
Rate for Payer: Group Health Inc Commercial	$1.90
Rate for Payer: Group Health Inc Medicare	$1.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.90
Rate for Payer: Hamaspik Choice Inc Medicare	$1.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.47

NITINOL STON RERIVAL BASKET

Facility

$661.50

Hospital Charge Code	64905156
Hospital Revenue Code	270
Min. Negotiated Rate	$231.52
Max. Negotiated Rate	$529.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$363.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$330.75
Rate for Payer: Aetna Government	$330.75
Rate for Payer: Brighton Health Commercial	$496.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$529.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$449.82
Rate for Payer: Group Health Inc Commercial	$330.75
Rate for Payer: Group Health Inc Medicare	$231.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$330.75
Rate for Payer: Hamaspik Choice Inc Medicare	$330.75

NITRO ADMINISTRATION SET

Facility

$53.87

Hospital Charge Code	40200055
Hospital Revenue Code	270
Min. Negotiated Rate	$18.85
Max. Negotiated Rate	$43.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$29.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.94
Rate for Payer: Aetna Government	$26.94
Rate for Payer: Brighton Health Commercial	$40.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$43.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.63
Rate for Payer: Group Health Inc Commercial	$26.94
Rate for Payer: Group Health Inc Medicare	$18.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.94
Rate for Payer: Hamaspik Choice Inc Medicare	$26.94

NITROFURANTOIN 100 MG CAP CRS

Facility

$2.97

Hospital Charge Code	41653465
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$2.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.48
Rate for Payer: Aetna Government	$1.48
Rate for Payer: Brighton Health Commercial	$2.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.02
Rate for Payer: Group Health Inc Commercial	$1.48
Rate for Payer: Group Health Inc Medicare	$1.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.48
Rate for Payer: Hamaspik Choice Inc Medicare	$1.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.93

NITROFURANTOIN 100 MG CAP CRS

Facility

$2.97

Hospital Charge Code	41643465
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$2.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.48
Rate for Payer: Aetna Government	$1.48
Rate for Payer: Brighton Health Commercial	$2.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.02
Rate for Payer: Group Health Inc Commercial	$1.48
Rate for Payer: Group Health Inc Medicare	$1.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.48
Rate for Payer: Hamaspik Choice Inc Medicare	$1.48
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.93

NITROFURANTOIN 25 MG/5ML PO SUSP [10723]

Facility

$3.18

Service Code	NDC 43386045011
Hospital Charge Code	43386045011
Hospital Revenue Code	250
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$2.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.59
Rate for Payer: Aetna Government	$1.59
Rate for Payer: Brighton Health Commercial	$2.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.16
Rate for Payer: Group Health Inc Commercial	$1.59
Rate for Payer: Group Health Inc Medicare	$1.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.59
Rate for Payer: Hamaspik Choice Inc Medicare	$1.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.06

NITROFURANTOIN 25 MG/5ML PO SUSP [10723]

Facility

$12.46

Service Code	NDC 70408023932
Hospital Charge Code	70408023932
Hospital Revenue Code	250
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$9.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.23
Rate for Payer: Aetna Government	$6.23
Rate for Payer: Brighton Health Commercial	$9.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.47
Rate for Payer: Group Health Inc Commercial	$6.23
Rate for Payer: Group Health Inc Medicare	$4.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.23
Rate for Payer: Hamaspik Choice Inc Medicare	$6.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.10

NITROFURANTOIN 25 MG/5 ML SUSP

Facility

$4.06

Hospital Charge Code	41655262
Hospital Revenue Code	250
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$3.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.03
Rate for Payer: Aetna Government	$2.03
Rate for Payer: Brighton Health Commercial	$3.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.76
Rate for Payer: Group Health Inc Commercial	$2.03
Rate for Payer: Group Health Inc Medicare	$1.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.03
Rate for Payer: Hamaspik Choice Inc Medicare	$2.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.64

NITROFURANTOIN 25 MG/5 ML SUSP

Facility

$4.06

Hospital Charge Code	41645262
Hospital Revenue Code	250
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$3.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.23
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.03
Rate for Payer: Aetna Government	$2.03
Rate for Payer: Brighton Health Commercial	$3.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.76
Rate for Payer: Group Health Inc Commercial	$2.03
Rate for Payer: Group Health Inc Medicare	$1.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.03
Rate for Payer: Hamaspik Choice Inc Medicare	$2.03
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.64

NITROFURANTOIN 50 MG CAP CRS

Facility

$2.46

Hospital Charge Code	41643464
Hospital Revenue Code	250
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$1.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.23
Rate for Payer: Aetna Government	$1.23
Rate for Payer: Brighton Health Commercial	$1.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.67
Rate for Payer: Group Health Inc Commercial	$1.23
Rate for Payer: Group Health Inc Medicare	$0.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.23
Rate for Payer: Hamaspik Choice Inc Medicare	$1.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.60

NITROFURANTOIN 50 MG CAP CRS

Facility

$2.46

Hospital Charge Code	41653464
Hospital Revenue Code	250
Min. Negotiated Rate	$0.86
Max. Negotiated Rate	$1.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.23
Rate for Payer: Aetna Government	$1.23
Rate for Payer: Brighton Health Commercial	$1.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.67
Rate for Payer: Group Health Inc Commercial	$1.23
Rate for Payer: Group Health Inc Medicare	$0.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.23
Rate for Payer: Hamaspik Choice Inc Medicare	$1.23
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.60

NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS [5595]

Facility

$2.27

Service Code	NDC 47781030701
Hospital Charge Code	47781030701
Hospital Revenue Code	250
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$1.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.14
Rate for Payer: Aetna Government	$1.14
Rate for Payer: Brighton Health Commercial	$1.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.54
Rate for Payer: Group Health Inc Commercial	$1.14
Rate for Payer: Group Health Inc Medicare	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.14
Rate for Payer: Hamaspik Choice Inc Medicare	$1.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.48

Know your out-of-pocket cost for care.

All Charges