Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS 29845
Min. Negotiated Rate $1,947.88
Max. Negotiated Rate $1,947.88
Rate for Payer: Cash Price $703.49
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,947.88
Rate for Payer: SOMOS Essential $1,947.88
Service Code HCPCS 29844
Min. Negotiated Rate $1,656.67
Max. Negotiated Rate $1,656.67
Rate for Payer: Cash Price $598.52
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,656.67
Rate for Payer: SOMOS Essential $1,656.67
Service Code HCPCS 29847
Min. Negotiated Rate $1,813.48
Max. Negotiated Rate $1,813.48
Rate for Payer: Cash Price $655.66
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,813.48
Rate for Payer: SOMOS Essential $1,813.48
Service Code HCPCS 27610
Min. Negotiated Rate $2,115.73
Max. Negotiated Rate $2,115.73
Rate for Payer: Cash Price $766.95
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,115.73
Rate for Payer: SOMOS Essential $2,115.73
Service Code HCPCS 26100
Min. Negotiated Rate $1,135.24
Max. Negotiated Rate $1,135.24
Rate for Payer: Cash Price $413.59
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,135.24
Rate for Payer: SOMOS Essential $1,135.24
Service Code HCPCS 26110
Min. Negotiated Rate $1,084.10
Max. Negotiated Rate $1,084.10
Rate for Payer: Cash Price $394.66
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,084.10
Rate for Payer: SOMOS Essential $1,084.10
Service Code HCPCS 26105
Min. Negotiated Rate $1,145.26
Max. Negotiated Rate $1,145.26
Rate for Payer: Cash Price $415.77
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,145.26
Rate for Payer: SOMOS Essential $1,145.26
Service Code HCPCS 25107
Min. Negotiated Rate $2,044.54
Max. Negotiated Rate $2,044.54
Rate for Payer: Cash Price $742.91
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,044.54
Rate for Payer: SOMOS Essential $2,044.54
Service Code HCPCS 24102
Min. Negotiated Rate $2,044.80
Max. Negotiated Rate $2,044.80
Rate for Payer: Cash Price $741.02
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,044.80
Rate for Payer: SOMOS Essential $2,044.80
Service Code HCPCS 24100
Min. Negotiated Rate $1,403.62
Max. Negotiated Rate $1,403.62
Rate for Payer: Cash Price $510.33
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,403.62
Rate for Payer: SOMOS Essential $1,403.62
Service Code HCPCS 23100
Min. Negotiated Rate $1,691.71
Max. Negotiated Rate $1,691.71
Rate for Payer: Cash Price $612.61
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,691.71
Rate for Payer: SOMOS Essential $1,691.71
Service Code HCPCS 23040
Min. Negotiated Rate $2,385.86
Max. Negotiated Rate $2,385.86
Rate for Payer: Cash Price $859.28
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,385.86
Rate for Payer: SOMOS Essential $2,385.86
Service Code HCPCS 27033
Min. Negotiated Rate $3,221.72
Max. Negotiated Rate $3,221.72
Rate for Payer: Cash Price $1,158.09
Rate for Payer: SOMOS CHP/HARP/Medicaid $3,221.72
Rate for Payer: SOMOS Essential $3,221.72
Service Code HCPCS 27030
Min. Negotiated Rate $3,107.11
Max. Negotiated Rate $3,107.11
Rate for Payer: Cash Price $1,116.61
Rate for Payer: SOMOS CHP/HARP/Medicaid $3,107.11
Rate for Payer: SOMOS Essential $3,107.11
Service Code HCPCS 27330
Min. Negotiated Rate $1,411.57
Max. Negotiated Rate $1,411.57
Rate for Payer: Cash Price $513.13
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,411.57
Rate for Payer: SOMOS Essential $1,411.57
Service Code HCPCS 21010
Min. Negotiated Rate $2,348.25
Max. Negotiated Rate $2,348.25
Rate for Payer: Cash Price $850.67
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,348.25
Rate for Payer: SOMOS Essential $2,348.25
Service Code HCPCS 27052
Min. Negotiated Rate $1,929.85
Max. Negotiated Rate $1,929.85
Rate for Payer: Cash Price $698.70
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,929.85
Rate for Payer: SOMOS Essential $1,929.85
Service Code HCPCS 27050
Min. Negotiated Rate $1,352.85
Max. Negotiated Rate $1,352.85
Rate for Payer: Cash Price $492.24
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,352.85
Rate for Payer: SOMOS Essential $1,352.85
Service Code HCPCS 27403
Min. Negotiated Rate $2,146.04
Max. Negotiated Rate $2,146.04
Rate for Payer: Cash Price $776.16
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,146.04
Rate for Payer: SOMOS Essential $2,146.04
Service Code HCPCS 25100
Min. Negotiated Rate $1,170.33
Max. Negotiated Rate $1,170.33
Rate for Payer: Cash Price $425.29
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,170.33
Rate for Payer: SOMOS Essential $1,170.33
Service Code HCPCS 25105
Min. Negotiated Rate $1,623.22
Max. Negotiated Rate $1,623.22
Rate for Payer: Cash Price $587.83
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,623.22
Rate for Payer: SOMOS Essential $1,623.22
Service Code HCPCS 27625
Min. Negotiated Rate $1,855.09
Max. Negotiated Rate $1,855.09
Rate for Payer: Cash Price $674.48
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,855.09
Rate for Payer: SOMOS Essential $1,855.09
Service Code HCPCS 27626
Min. Negotiated Rate $1,978.28
Max. Negotiated Rate $1,978.28
Rate for Payer: Cash Price $732.08
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,978.28
Rate for Payer: SOMOS Essential $1,978.28
Service Code HCPCS 27054
Min. Negotiated Rate $2,296.93
Max. Negotiated Rate $2,296.93
Rate for Payer: Cash Price $826.64
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,296.93
Rate for Payer: SOMOS Essential $2,296.93
Service Code HCPCS 27334
Min. Negotiated Rate $2,289.76
Max. Negotiated Rate $2,289.76
Rate for Payer: Cash Price $824.53
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,289.76
Rate for Payer: SOMOS Essential $2,289.76