St. Barnabas Hospital

All Charges

Charge

Type

Price

SERIES A STANDAR PATELLA28MMX8MM

Facility OP

$2,208.00

Service Code	HCPCS C1776
Hospital Charge Code	40209935
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,318.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,214.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,104.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,269.60
Rate for Payer: Fidelis Medicare Advantage	$2,318.40
Rate for Payer: Group Health Inc Commercial	$1,104.00
Rate for Payer: Group Health Inc Medicare	$772.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,104.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,104.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,435.20

SERIES A STANDAR PATELLA28MMX8MM

Facility IP

$2,208.00

Service Code	HCPCS C1776
Hospital Charge Code	40209935
Hospital Revenue Code	278
Min. Negotiated Rate	$1,104.00
Max. Negotiated Rate	$1,104.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,104.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,104.00

SERIES A STANDAR PATELLA31MMX8MM

Facility OP

$1,228.00

Service Code	HCPCS C1776
Hospital Charge Code	40209968
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,289.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$675.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$614.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$706.10
Rate for Payer: Fidelis Medicare Advantage	$1,289.40
Rate for Payer: Group Health Inc Commercial	$614.00
Rate for Payer: Group Health Inc Medicare	$429.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$614.00
Rate for Payer: Hamaspik Choice Inc Medicare	$614.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$798.20

SERIES A STANDAR PATELLA31MMX8MM

Facility IP

$1,228.00

Service Code	HCPCS C1776
Hospital Charge Code	40209968
Hospital Revenue Code	278
Min. Negotiated Rate	$614.00
Max. Negotiated Rate	$614.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$614.00
Rate for Payer: Hamaspik Choice Inc Medicare	$614.00

SERIES A STD PATELLA 31MMX8MM

Facility IP

$1,228.00

Service Code	HCPCS C1776
Hospital Charge Code	40202330
Hospital Revenue Code	278
Min. Negotiated Rate	$614.00
Max. Negotiated Rate	$614.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$614.00
Rate for Payer: Hamaspik Choice Inc Medicare	$614.00

SERIES A STD PATELLA 31MMX8MM

Facility OP

$1,228.00

Service Code	HCPCS C1776
Hospital Charge Code	40202330
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,289.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$675.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$614.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$706.10
Rate for Payer: Fidelis Medicare Advantage	$1,289.40
Rate for Payer: Group Health Inc Commercial	$614.00
Rate for Payer: Group Health Inc Medicare	$429.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$614.00
Rate for Payer: Hamaspik Choice Inc Medicare	$614.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$798.20

SEROTININ RELEASE ASSAY

Facility OP

$60.23

Service Code	HCPCS 82542
Hospital Charge Code	40609057
Hospital Revenue Code	300
Min. Negotiated Rate	$19.27
Max. Negotiated Rate	$33.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$24.09
Rate for Payer: Aetna Government	$24.09
Rate for Payer: Cash Price	$24.09
Rate for Payer: Cash Price	$24.09
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$24.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.29
Rate for Payer: Elderplan Medicare Advantage	$24.09
Rate for Payer: EmblemHealth Commercial	$24.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$21.68
Rate for Payer: Fidelis Essential Plan Aliesa	$20.48
Rate for Payer: Fidelis Essential Plan QHP	$21.44
Rate for Payer: Fidelis Medicare Advantage	$24.09
Rate for Payer: Fidelis Qualified Health Plan	$21.44
Rate for Payer: Group Health Inc Commercial	$24.09
Rate for Payer: Group Health Inc Medicare	$24.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.12
Rate for Payer: Hamaspik Choice Inc Medicare	$24.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$24.09
Rate for Payer: Healthfirst Medicare Advantage	$24.09
Rate for Payer: Healthfirst QHP	$24.09
Rate for Payer: Senior Whole Health Medicare Advantage	$24.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$24.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$19.27
Rate for Payer: Wellcare Medicare	$21.68

SEROTONIN SERUM

Facility OP

$77.45

Service Code	HCPCS 84260
Hospital Charge Code	40609741
Hospital Revenue Code	301
Min. Negotiated Rate	$24.78
Max. Negotiated Rate	$49.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$42.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.98
Rate for Payer: Aetna Government	$30.98
Rate for Payer: Cash Price	$30.98
Rate for Payer: Cash Price	$30.98
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$30.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$49.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$41.66
Rate for Payer: Elderplan Medicare Advantage	$30.98
Rate for Payer: EmblemHealth Commercial	$30.98
Rate for Payer: Fidelis CHP/HARP/Medicaid	$27.88
Rate for Payer: Fidelis Essential Plan Aliesa	$26.33
Rate for Payer: Fidelis Essential Plan QHP	$27.57
Rate for Payer: Fidelis Medicare Advantage	$30.98
Rate for Payer: Fidelis Qualified Health Plan	$27.57
Rate for Payer: Group Health Inc Commercial	$30.98
Rate for Payer: Group Health Inc Medicare	$30.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$38.72
Rate for Payer: Hamaspik Choice Inc Medicare	$30.98
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$30.98
Rate for Payer: Healthfirst Medicare Advantage	$30.98
Rate for Payer: Healthfirst QHP	$30.98
Rate for Payer: Senior Whole Health Medicare Advantage	$30.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$30.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$24.78
Rate for Payer: Wellcare Medicare	$27.88

SERRATO POLYAXIAL SCREW 5.0X35MM

Facility OP

$2,332.79

Service Code	HCPCS C1713
Hospital Charge Code	40208510
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,449.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,283.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,341.35
Rate for Payer: Fidelis Medicare Advantage	$2,449.43
Rate for Payer: Group Health Inc Commercial	$1,166.40
Rate for Payer: Group Health Inc Medicare	$816.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.40
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,516.31

SERRATO POLYAXIAL SCREW 5.0X35MM

Facility IP

$2,332.79

Service Code	HCPCS C1713
Hospital Charge Code	40208510
Hospital Revenue Code	278
Min. Negotiated Rate	$1,166.40
Max. Negotiated Rate	$1,166.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.40
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.40

SERRATO POLYAXIAL SCREW 5.5X30MM

Facility IP

$2,333.00

Service Code	HCPCS C1713
Hospital Charge Code	40208511
Hospital Revenue Code	278
Min. Negotiated Rate	$1,166.50
Max. Negotiated Rate	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.50

SERRATO POLYAXIAL SCREW 5.5X30MM

Facility OP

$2,333.00

Service Code	HCPCS C1713
Hospital Charge Code	40208511
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,449.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,283.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,341.48
Rate for Payer: Fidelis Medicare Advantage	$2,449.65
Rate for Payer: Group Health Inc Commercial	$1,166.50
Rate for Payer: Group Health Inc Medicare	$816.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,516.45

SERRATO POLYAXIAL SCREW 5.5X35MM

Facility OP

$2,333.00

Service Code	HCPCS C1713
Hospital Charge Code	40208513
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,449.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,283.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,341.48
Rate for Payer: Fidelis Medicare Advantage	$2,449.65
Rate for Payer: Group Health Inc Commercial	$1,166.50
Rate for Payer: Group Health Inc Medicare	$816.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,516.45

SERRATO POLYAXIAL SCREW 5.5X35MM

Facility IP

$2,333.00

Service Code	HCPCS C1713
Hospital Charge Code	40208513
Hospital Revenue Code	278
Min. Negotiated Rate	$1,166.50
Max. Negotiated Rate	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.50

SERRATO POLYAXIAL SCREW 6.0X35MM

Facility OP

$2,333.00

Service Code	HCPCS C1713
Hospital Charge Code	40208512
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,449.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,283.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,341.48
Rate for Payer: Fidelis Medicare Advantage	$2,449.65
Rate for Payer: Group Health Inc Commercial	$1,166.50
Rate for Payer: Group Health Inc Medicare	$816.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,516.45

SERRATO POLYAXIAL SCREW 6.0X35MM

Facility IP

$2,333.00

Service Code	HCPCS C1713
Hospital Charge Code	40208512
Hospital Revenue Code	278
Min. Negotiated Rate	$1,166.50
Max. Negotiated Rate	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.50

SERRATO POLYAXIAL SCREW 6.0X40MM

Facility OP

$2,333.00

Service Code	HCPCS C1713
Hospital Charge Code	40208514
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,449.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,283.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,341.48
Rate for Payer: Fidelis Medicare Advantage	$2,449.65
Rate for Payer: Group Health Inc Commercial	$1,166.50
Rate for Payer: Group Health Inc Medicare	$816.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,516.45

SERRATO POLYAXIAL SCREW 6.0X40MM

Facility IP

$2,333.00

Service Code	HCPCS C1713
Hospital Charge Code	40208514
Hospital Revenue Code	278
Min. Negotiated Rate	$1,166.50
Max. Negotiated Rate	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,166.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,166.50

SERTRALINE 100 MG TAB

Facility OP

$1.00

Hospital Charge Code	41640819
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: 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

SERTRALINE 100 MG TAB

Facility OP

$1.00

Hospital Charge Code	41650819
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: 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

SERTRALINE 25 MG TAB

Facility OP

$0.27

Hospital Charge Code	41642724
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.18
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.18

SERTRALINE 25 MG TAB

Facility OP

$0.27

Hospital Charge Code	41652724
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.18
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.18

SERTRALINE 50 MG TAB

Facility OP

$1.00

Hospital Charge Code	41640237
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: 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

SERTRALINE 50 MG TAB

Facility OP

$1.00

Hospital Charge Code	41650237
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: 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

SESAMOIDECTOMY

Facility OP

$8,291.05

Service Code	HCPCS 28315
Hospital Charge Code	40082740
Hospital Revenue Code	360
Min. Negotiated Rate	$353.65
Max. Negotiated Rate	$4,145.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,743.15
Rate for Payer: Aetna Government	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,743.15
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	$3,743.15
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$353.65
Rate for Payer: Fidelis Essential Plan Aliesa	$3,181.68
Rate for Payer: Fidelis Essential Plan QHP	$3,331.40
Rate for Payer: Fidelis Medicare Advantage	$3,743.15
Rate for Payer: Fidelis Qualified Health Plan	$3,331.40
Rate for Payer: Group Health Inc Commercial	$3,743.15
Rate for Payer: Group Health Inc Medicare	$3,743.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,145.52
Rate for Payer: Hamaspik Choice Inc Medicare	$3,743.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$392.94
Rate for Payer: Healthfirst Medicare Advantage	$3,181.68
Rate for Payer: Healthfirst QHP	$3,743.15
Rate for Payer: Senior Whole Health Medicare Advantage	$3,743.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,743.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,994.52
Rate for Payer: Wellcare Medicare	$3,555.99

Price Transparency.

All Charges