Price Transparency

Know your out-of-pocket cost for care.

search
Charge Type Setting Price  
Service Code HCPCS 19126
Min. Negotiated Rate $541.59
Max. Negotiated Rate $541.59
Rate for Payer: Cash Price $191.70
Rate for Payer: SOMOS CHP/HARP/Medicaid $541.59
Rate for Payer: SOMOS Essential $541.59
Service Code HCPCS 60605
Min. Negotiated Rate $5,502.74
Max. Negotiated Rate $5,502.74
Rate for Payer: Cash Price $1,942.68
Rate for Payer: SOMOS CHP/HARP/Medicaid $5,502.74
Rate for Payer: SOMOS Essential $5,502.74
Service Code HCPCS 60600
Min. Negotiated Rate $4,563.38
Max. Negotiated Rate $4,563.38
Rate for Payer: Cash Price $1,622.31
Rate for Payer: SOMOS CHP/HARP/Medicaid $4,563.38
Rate for Payer: SOMOS Essential $4,563.38
Service Code HCPCS 57545
Min. Negotiated Rate $2,732.00
Max. Negotiated Rate $2,732.00
Rate for Payer: Cash Price $980.91
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,732.00
Rate for Payer: SOMOS Essential $2,732.00
Service Code HCPCS 67808
Min. Negotiated Rate $1,138.83
Max. Negotiated Rate $1,138.83
Rate for Payer: Cash Price $419.16
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,138.83
Rate for Payer: SOMOS Essential $1,138.83
Service Code HCPCS 33851
Min. Negotiated Rate $4,254.28
Max. Negotiated Rate $4,254.28
Rate for Payer: Cash Price $1,511.39
Rate for Payer: SOMOS CHP/HARP/Medicaid $4,254.28
Rate for Payer: SOMOS Essential $4,254.28
Service Code HCPCS 33840
Min. Negotiated Rate $4,143.98
Max. Negotiated Rate $4,143.98
Rate for Payer: Cash Price $1,471.36
Rate for Payer: SOMOS CHP/HARP/Medicaid $4,143.98
Rate for Payer: SOMOS Essential $4,143.98
Service Code HCPCS 15922
Min. Negotiated Rate $2,617.94
Max. Negotiated Rate $2,617.94
Rate for Payer: Cash Price $942.40
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,617.94
Rate for Payer: SOMOS Essential $2,617.94
Service Code HCPCS 15920
Min. Negotiated Rate $2,135.57
Max. Negotiated Rate $2,135.57
Rate for Payer: Cash Price $755.89
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,135.57
Rate for Payer: SOMOS Essential $2,135.57
Service Code HCPCS 26596
Min. Negotiated Rate $2,730.34
Max. Negotiated Rate $2,730.34
Rate for Payer: Cash Price $980.58
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,730.34
Rate for Payer: SOMOS Essential $2,730.34
Service Code HCPCS 57555
Min. Negotiated Rate $2,032.41
Max. Negotiated Rate $2,032.41
Rate for Payer: Cash Price $730.35
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,032.41
Rate for Payer: SOMOS Essential $2,032.41
Service Code HCPCS 57556
Min. Negotiated Rate $1,929.38
Max. Negotiated Rate $1,929.38
Rate for Payer: Cash Price $693.65
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,929.38
Rate for Payer: SOMOS Essential $1,929.38
Service Code HCPCS 38555
Min. Negotiated Rate $3,479.52
Max. Negotiated Rate $3,479.52
Rate for Payer: Cash Price $1,238.99
Rate for Payer: SOMOS CHP/HARP/Medicaid $3,479.52
Rate for Payer: SOMOS Essential $3,479.52
Service Code HCPCS 38550
Min. Negotiated Rate $1,764.24
Max. Negotiated Rate $1,764.24
Rate for Payer: Cash Price $632.95
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,764.24
Rate for Payer: SOMOS Essential $1,764.24
Service Code HCPCS 26205
Min. Negotiated Rate $2,020.94
Max. Negotiated Rate $2,020.94
Rate for Payer: Cash Price $729.42
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,020.94
Rate for Payer: SOMOS Essential $2,020.94
Service Code HCPCS 26215
Min. Negotiated Rate $1,898.72
Max. Negotiated Rate $1,898.72
Rate for Payer: Cash Price $685.54
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,898.72
Rate for Payer: SOMOS Essential $1,898.72
Service Code HCPCS 28103
Min. Negotiated Rate $1,198.03
Max. Negotiated Rate $1,198.03
Rate for Payer: Cash Price $441.96
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,198.03
Rate for Payer: SOMOS Essential $1,198.03
Service Code HCPCS 27637
Min. Negotiated Rate $2,449.02
Max. Negotiated Rate $2,449.02
Rate for Payer: Cash Price $890.99
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,449.02
Rate for Payer: SOMOS Essential $2,449.02
Service Code HCPCS 27638
Min. Negotiated Rate $2,449.05
Max. Negotiated Rate $2,449.05
Rate for Payer: Cash Price $879.35
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,449.05
Rate for Payer: SOMOS Essential $2,449.05
Service Code HCPCS 23145
Min. Negotiated Rate $2,320.84
Max. Negotiated Rate $2,320.84
Rate for Payer: Cash Price $836.39
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,320.84
Rate for Payer: SOMOS Essential $2,320.84
Service Code HCPCS 23146
Min. Negotiated Rate $2,079.00
Max. Negotiated Rate $2,079.00
Rate for Payer: Cash Price $752.48
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,079.00
Rate for Payer: SOMOS Essential $2,079.00
Service Code HCPCS 24125
Min. Negotiated Rate $2,077.00
Max. Negotiated Rate $2,077.00
Rate for Payer: Cash Price $751.27
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,077.00
Rate for Payer: SOMOS Essential $2,077.00
Service Code HCPCS 24126
Min. Negotiated Rate $2,169.56
Max. Negotiated Rate $2,169.56
Rate for Payer: Cash Price $783.46
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,169.56
Rate for Payer: SOMOS Essential $2,169.56
Service Code HCPCS 28104
Min. Negotiated Rate $1,120.82
Max. Negotiated Rate $1,120.82
Rate for Payer: Cash Price $413.58
Rate for Payer: SOMOS CHP/HARP/Medicaid $1,120.82
Rate for Payer: SOMOS Essential $1,120.82
Service Code HCPCS 24116
Min. Negotiated Rate $2,860.07
Max. Negotiated Rate $2,860.07
Rate for Payer: Cash Price $1,029.99
Rate for Payer: SOMOS CHP/HARP/Medicaid $2,860.07
Rate for Payer: SOMOS Essential $2,860.07