St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

PACEMAKER 2

Facility

$12,095.00

Service Code	HCPCS C1785
Hospital Charge Code	40205166
Hospital Revenue Code	275
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$12,699.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,652.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Brighton Health Commercial	$7,257.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,047.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,954.62
Rate for Payer: EmblemHealth Commercial	$6,047.50
Rate for Payer: Fidelis Medicare Advantage	$12,699.75
Rate for Payer: Group Health Inc Commercial	$6,047.50
Rate for Payer: Group Health Inc Medicare	$4,233.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,047.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,047.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,861.75

PACEMAKER ADAPTA

Facility

$13,140.00

Service Code	HCPCS C1785
Hospital Charge Code	64905036
Hospital Revenue Code	275
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$13,797.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,227.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Brighton Health Commercial	$7,884.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,570.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,555.50
Rate for Payer: EmblemHealth Commercial	$6,570.00
Rate for Payer: Fidelis Medicare Advantage	$13,797.00
Rate for Payer: Group Health Inc Commercial	$6,570.00
Rate for Payer: Group Health Inc Medicare	$4,599.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,570.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,570.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,541.00

PACEMAKER DUAL-CHAMBER 27.1GM

Facility

$13,140.00

Service Code	HCPCS C2619
Hospital Charge Code	64902628
Hospital Revenue Code	278
Min. Negotiated Rate	$6,570.00
Max. Negotiated Rate	$6,570.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,570.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,570.00

PACEMAKER DUAL-CHAMBER 27.1GM

Facility

$13,140.00

Service Code	HCPCS C2619
Hospital Charge Code	64902628
Hospital Revenue Code	278
Min. Negotiated Rate	$3,302.17
Max. Negotiated Rate	$13,797.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,227.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,302.17
Rate for Payer: Aetna Government	$3,302.17
Rate for Payer: Brighton Health Commercial	$7,884.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,570.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,555.50
Rate for Payer: EmblemHealth Commercial	$6,570.00
Rate for Payer: Fidelis Medicare Advantage	$13,797.00
Rate for Payer: Group Health Inc Commercial	$6,570.00
Rate for Payer: Group Health Inc Medicare	$4,599.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,570.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,570.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,541.00

PACEMAKER INSERTION

Facility

$30,076.00

Service Code	HCPCS 33208
Hospital Charge Code	40033189
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$22,557.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22,108.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12,348.58
Rate for Payer: Aetna Government	$12,348.58
Rate for Payer: Affinity Essential Plan 1&2	$8,644.01
Rate for Payer: Affinity Essential Plan 3&4	$8,644.01
Rate for Payer: Affinity Medicaid/CHP/HARP	$8,644.01
Rate for Payer: Brighton Health Commercial	$22,557.00
Rate for Payer: Cash Price	$12,348.58
Rate for Payer: Cash Price	$12,348.58
Rate for Payer: Cash Price	$12,348.58
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12,348.58
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	$12,348.58
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$10,496.29
Rate for Payer: Fidelis Essential Plan QHP	$10,990.24
Rate for Payer: Fidelis Medicare Advantage	$12,348.58
Rate for Payer: Fidelis Qualified Health Plan	$10,990.24
Rate for Payer: Group Health Inc Commercial	$12,348.58
Rate for Payer: Group Health Inc Medicare	$12,348.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,038.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12,348.58
Rate for Payer: Healthfirst Medicare Advantage	$10,496.29
Rate for Payer: Healthfirst QHP	$12,348.58
Rate for Payer: Humana Medicare	$12,595.55
Rate for Payer: Senior Whole Health Medicare Advantage	$12,348.58
Rate for Payer: United Healthcare Commercial	$3,047.00
Rate for Payer: United Healthcare Medicare Advantage	$12,348.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12,348.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$9,878.86
Rate for Payer: Wellcare Medicare	$11,731.15

PACEMAKER INSERTION

Facility

$30,076.00

Service Code	HCPCS 33208
Hospital Charge Code	40033189
Hospital Revenue Code	360
Rate for Payer: Cash Price	$12,348.58

PACEMAKER L121-BOSTON SCIFIC

Facility

$9,500.00

Service Code	HCPCS C1785
Hospital Charge Code	66570151
Hospital Revenue Code	275
Min. Negotiated Rate	$275.42
Max. Negotiated Rate	$9,975.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,225.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$275.42
Rate for Payer: Aetna Government	$275.42
Rate for Payer: Brighton Health Commercial	$5,700.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,750.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,462.50
Rate for Payer: EmblemHealth Commercial	$4,750.00
Rate for Payer: Fidelis Medicare Advantage	$9,975.00
Rate for Payer: Group Health Inc Commercial	$4,750.00
Rate for Payer: Group Health Inc Medicare	$3,325.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,750.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,750.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,175.00

PACEMAKER LEAD-MODEL 4113

Facility

$757.30

Hospital Charge Code	40202070
Hospital Revenue Code	270
Min. Negotiated Rate	$265.06
Max. Negotiated Rate	$605.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$416.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$378.65
Rate for Payer: Aetna Government	$378.65
Rate for Payer: Brighton Health Commercial	$567.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$605.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$514.96
Rate for Payer: Group Health Inc Commercial	$378.65
Rate for Payer: Group Health Inc Medicare	$265.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$378.65
Rate for Payer: Hamaspik Choice Inc Medicare	$378.65

PACEMAKER LEAD-MODEL 4133

Facility

$1,219.41

Hospital Charge Code	40202072
Hospital Revenue Code	270
Min. Negotiated Rate	$426.79
Max. Negotiated Rate	$975.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$670.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$609.71
Rate for Payer: Aetna Government	$609.71
Rate for Payer: Brighton Health Commercial	$914.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$975.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$829.20
Rate for Payer: Group Health Inc Commercial	$609.71
Rate for Payer: Group Health Inc Medicare	$426.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$609.71
Rate for Payer: Hamaspik Choice Inc Medicare	$609.71

PACEMAKER LEAD-MODEL 4150

Facility

$1,412.19

Hospital Charge Code	40202071
Hospital Revenue Code	270
Min. Negotiated Rate	$494.27
Max. Negotiated Rate	$1,129.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$776.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$706.10
Rate for Payer: Aetna Government	$706.10
Rate for Payer: Brighton Health Commercial	$1,059.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,129.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$960.29
Rate for Payer: Group Health Inc Commercial	$706.10
Rate for Payer: Group Health Inc Medicare	$494.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$706.10
Rate for Payer: Hamaspik Choice Inc Medicare	$706.10

PACEMAKER PACK SUPPLIES

Facility

$115.18

Hospital Charge Code	66524675
Hospital Revenue Code	272
Min. Negotiated Rate	$40.31
Max. Negotiated Rate	$92.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.59
Rate for Payer: Aetna Government	$57.59
Rate for Payer: Brighton Health Commercial	$86.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$92.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$78.32
Rate for Payer: Group Health Inc Commercial	$57.59
Rate for Payer: Group Health Inc Medicare	$40.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$57.59
Rate for Payer: Hamaspik Choice Inc Medicare	$57.59

PACEMAKER SINGLE, RATE-RESPONSE

Facility

$12,095.00

Service Code	HCPCS C1786
Hospital Charge Code	40204088
Hospital Revenue Code	275
Min. Negotiated Rate	$1,116.69
Max. Negotiated Rate	$12,699.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,652.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,116.69
Rate for Payer: Aetna Government	$1,116.69
Rate for Payer: Brighton Health Commercial	$7,257.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,047.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,954.62
Rate for Payer: EmblemHealth Commercial	$6,047.50
Rate for Payer: Fidelis Medicare Advantage	$12,699.75
Rate for Payer: Group Health Inc Commercial	$6,047.50
Rate for Payer: Group Health Inc Medicare	$4,233.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,047.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,047.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,861.75

PACEMAKER TOOL IMPLANT PO IS-1

Facility

$56.25

Hospital Charge Code	64902679
Hospital Revenue Code	270
Min. Negotiated Rate	$19.69
Max. Negotiated Rate	$45.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$28.12
Rate for Payer: Aetna Government	$28.12
Rate for Payer: Brighton Health Commercial	$42.19
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.25
Rate for Payer: Group Health Inc Commercial	$28.12
Rate for Payer: Group Health Inc Medicare	$19.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.12
Rate for Payer: Hamaspik Choice Inc Medicare	$28.12

PACIFIER J POP FULLTERM OR

Facility

$2.35

Hospital Charge Code	64902237
Hospital Revenue Code	270
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$1.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.18
Rate for Payer: Aetna Government	$1.18
Rate for Payer: Brighton Health Commercial	$1.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.60
Rate for Payer: Group Health Inc Commercial	$1.18
Rate for Payer: Group Health Inc Medicare	$0.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.18
Rate for Payer: Hamaspik Choice Inc Medicare	$1.18

PACIFIER J POP PREEMIE TEAL

Facility

$2.35

Hospital Charge Code	64902239
Hospital Revenue Code	270
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$1.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.18
Rate for Payer: Aetna Government	$1.18
Rate for Payer: Brighton Health Commercial	$1.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.60
Rate for Payer: Group Health Inc Commercial	$1.18
Rate for Payer: Group Health Inc Medicare	$0.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.18
Rate for Payer: Hamaspik Choice Inc Medicare	$1.18

PACIFIER J POP TEETHING CLEAR

Facility

$2.35

Hospital Charge Code	64902241
Hospital Revenue Code	270
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$1.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.18
Rate for Payer: Aetna Government	$1.18
Rate for Payer: Brighton Health Commercial	$1.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.60
Rate for Payer: Group Health Inc Commercial	$1.18
Rate for Payer: Group Health Inc Medicare	$0.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.18
Rate for Payer: Hamaspik Choice Inc Medicare	$1.18

PACIFIER PREEMIE MULTICOLORED

Facility

$7.88

Hospital Charge Code	64902992
Hospital Revenue Code	270
Min. Negotiated Rate	$2.76
Max. Negotiated Rate	$6.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.94
Rate for Payer: Aetna Government	$3.94
Rate for Payer: Brighton Health Commercial	$5.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.36
Rate for Payer: Group Health Inc Commercial	$3.94
Rate for Payer: Group Health Inc Medicare	$2.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.94
Rate for Payer: Hamaspik Choice Inc Medicare	$3.94

PACK, ANGIO TRAY

Facility

$573.00

Hospital Charge Code	64901820
Hospital Revenue Code	270
Min. Negotiated Rate	$200.55
Max. Negotiated Rate	$458.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$315.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$286.50
Rate for Payer: Aetna Government	$286.50
Rate for Payer: Brighton Health Commercial	$429.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$458.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$389.64
Rate for Payer: Group Health Inc Commercial	$286.50
Rate for Payer: Group Health Inc Medicare	$200.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$286.50
Rate for Payer: Hamaspik Choice Inc Medicare	$286.50

PACK ARTHROSCOPY

Facility

$124.30

Hospital Charge Code	64901430
Hospital Revenue Code	270
Min. Negotiated Rate	$43.51
Max. Negotiated Rate	$99.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.15
Rate for Payer: Aetna Government	$62.15
Rate for Payer: Brighton Health Commercial	$93.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$99.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.52
Rate for Payer: Group Health Inc Commercial	$62.15
Rate for Payer: Group Health Inc Medicare	$43.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.15
Rate for Payer: Hamaspik Choice Inc Medicare	$62.15

PACK BASIC FOR GENERAL SURGERY

Facility

$17.26

Hospital Charge Code	64901304
Hospital Revenue Code	270
Min. Negotiated Rate	$6.04
Max. Negotiated Rate	$13.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.63
Rate for Payer: Aetna Government	$8.63
Rate for Payer: Brighton Health Commercial	$12.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.74
Rate for Payer: Group Health Inc Commercial	$8.63
Rate for Payer: Group Health Inc Medicare	$6.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.63
Rate for Payer: Hamaspik Choice Inc Medicare	$8.63

PACK CATARACT CUSTOM

Facility

$680.90

Hospital Charge Code	64902463
Hospital Revenue Code	270
Min. Negotiated Rate	$238.31
Max. Negotiated Rate	$544.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$374.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$340.45
Rate for Payer: Aetna Government	$340.45
Rate for Payer: Brighton Health Commercial	$510.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$544.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$463.01
Rate for Payer: Group Health Inc Commercial	$340.45
Rate for Payer: Group Health Inc Medicare	$238.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$340.45
Rate for Payer: Hamaspik Choice Inc Medicare	$340.45

PACK, COLD INSTANT, ST 5.75X9

Facility

$0.70

Hospital Charge Code	64901913
Hospital Revenue Code	270
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.35
Rate for Payer: Aetna Government	$0.35
Rate for Payer: Brighton Health Commercial	$0.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.48
Rate for Payer: Group Health Inc Commercial	$0.35
Rate for Payer: Group Health Inc Medicare	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.35
Rate for Payer: Hamaspik Choice Inc Medicare	$0.35

PACK COMPRESS COLD

Facility

$0.80

Hospital Charge Code	40209458
Hospital Revenue Code	270
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.40
Rate for Payer: Aetna Government	$0.40
Rate for Payer: Brighton Health Commercial	$0.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.54
Rate for Payer: Group Health Inc Commercial	$0.40
Rate for Payer: Group Health Inc Medicare	$0.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.40
Rate for Payer: Hamaspik Choice Inc Medicare	$0.40

PACK COMPRESS HOT

Facility

$0.80

Hospital Charge Code	40209459
Hospital Revenue Code	270
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$0.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.40
Rate for Payer: Aetna Government	$0.40
Rate for Payer: Brighton Health Commercial	$0.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.54
Rate for Payer: Group Health Inc Commercial	$0.40
Rate for Payer: Group Health Inc Medicare	$0.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.40
Rate for Payer: Hamaspik Choice Inc Medicare	$0.40

PACK C-SECTION

Facility

$155.43

Hospital Charge Code	64901432
Hospital Revenue Code	270
Min. Negotiated Rate	$54.40
Max. Negotiated Rate	$124.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$77.72
Rate for Payer: Aetna Government	$77.72
Rate for Payer: Brighton Health Commercial	$116.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$124.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$105.69
Rate for Payer: Group Health Inc Commercial	$77.72
Rate for Payer: Group Health Inc Medicare	$54.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.72
Rate for Payer: Hamaspik Choice Inc Medicare	$77.72

Know your out-of-pocket cost for care.

All Charges