St. Barnabas Hospital

All Charges

Charge

Type

Price

VANCOMYCIN 750 MG/D5W 250 ML PREMIX

Facility IP

$17.90

Hospital Charge Code	41644659
Hospital Revenue Code	636
Min. Negotiated Rate	$8.95
Max. Negotiated Rate	$8.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.95
Rate for Payer: Hamaspik Choice Inc Medicare	$8.95

VANCOMYCIN 750 MG/D5W 250 ML PREMIX

Facility OP

$17.90

Hospital Charge Code	41654659
Hospital Revenue Code	636
Min. Negotiated Rate	$6.26
Max. Negotiated Rate	$11.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.95
Rate for Payer: Aetna Government	$8.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.29
Rate for Payer: Group Health Inc Commercial	$8.95
Rate for Payer: Group Health Inc Medicare	$6.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.95
Rate for Payer: Hamaspik Choice Inc Medicare	$8.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.64

VANCOMYCIN 750 MG INJ

Facility IP

$4.31

Service Code	HCPCS J3370
Hospital Charge Code	41655202
Hospital Revenue Code	636
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.16
Rate for Payer: Hamaspik Choice Inc Medicare	$2.16

VANCOMYCIN 750 MG INJ

Facility OP

$4.31

Service Code	HCPCS J3370
Hospital Charge Code	41645202
Hospital Revenue Code	636
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$2.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.84
Rate for Payer: Aetna Government	$2.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.48
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2.17
Rate for Payer: Group Health Inc Commercial	$2.16
Rate for Payer: Group Health Inc Medicare	$1.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.16
Rate for Payer: Hamaspik Choice Inc Medicare	$2.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.73
Rate for Payer: SOMOS Essential	$2.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.80

VANCOMYCIN 750 MG INJ

Facility IP

$4.31

Service Code	HCPCS J3370
Hospital Charge Code	41645202
Hospital Revenue Code	636
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$2.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.16
Rate for Payer: Hamaspik Choice Inc Medicare	$2.16

VANCOMYCIN 750 MG INJ

Facility OP

$4.31

Service Code	HCPCS J3370
Hospital Charge Code	41655202
Hospital Revenue Code	636
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$2.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.84
Rate for Payer: Aetna Government	$2.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.48
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2.17
Rate for Payer: Group Health Inc Commercial	$2.16
Rate for Payer: Group Health Inc Medicare	$1.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.16
Rate for Payer: Hamaspik Choice Inc Medicare	$2.16
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.73
Rate for Payer: SOMOS Essential	$2.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.80

VANCOMYCIN FLUSH 5 MG/ML INJ

Facility OP

$6.00

Hospital Charge Code	41654137
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.08
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.90

VANCOMYCIN FLUSH 5 MG/ML INJ

Facility OP

$6.00

Hospital Charge Code	41644137
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.08
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.90

VANCOMYCIN OPHTH 50MG/ML

Facility OP

$11.00

Hospital Charge Code	41656635
Hospital Revenue Code	250
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$8.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.50
Rate for Payer: Aetna Government	$5.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.48
Rate for Payer: Group Health Inc Commercial	$5.50
Rate for Payer: Group Health Inc Medicare	$3.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.15

VANCOMYCIN OPHTH 50MG/ML

Facility OP

$11.00

Hospital Charge Code	41646635
Hospital Revenue Code	250
Min. Negotiated Rate	$3.85
Max. Negotiated Rate	$8.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.50
Rate for Payer: Aetna Government	$5.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.48
Rate for Payer: Group Health Inc Commercial	$5.50
Rate for Payer: Group Health Inc Medicare	$3.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.15

VANCOMYCIN ORAL

Facility OP

$0.54

Service Code	HCPCS J3370
Hospital Charge Code	41642997
Hospital Revenue Code	636
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$2.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.84
Rate for Payer: Aetna Government	$2.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2.17
Rate for Payer: Group Health Inc Commercial	$0.27
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.73
Rate for Payer: SOMOS Essential	$2.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.35

VANCOMYCIN ORAL

Facility IP

$0.54

Service Code	HCPCS J3370
Hospital Charge Code	41652997
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27

VANCOMYCIN ORAL

Facility OP

$0.54

Service Code	HCPCS J3370
Hospital Charge Code	41652997
Hospital Revenue Code	636
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$2.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.84
Rate for Payer: Aetna Government	$2.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2.17
Rate for Payer: Group Health Inc Commercial	$0.27
Rate for Payer: Group Health Inc Medicare	$0.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.73
Rate for Payer: SOMOS Essential	$2.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.35

VANCOMYCIN ORAL

Facility IP

$0.54

Service Code	HCPCS J3370
Hospital Charge Code	41642997
Hospital Revenue Code	636
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$0.27

VANCOMYCIN ORAL SOL 125MG/5ML

Facility IP

$2.00

Service Code	HCPCS J3370
Hospital Charge Code	41657103
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

VANCOMYCIN ORAL SOL 125MG/5ML

Facility OP

$2.00

Hospital Charge Code	41647103
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: 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

VANCOMYCIN ORAL SOL 125MG/5ML

Facility OP

$2.00

Service Code	HCPCS J3370
Hospital Charge Code	41657103
Hospital Revenue Code	636
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$2.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.84
Rate for Payer: Aetna Government	$2.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2.17
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: Healthfirst CHP/FHP/Medicaid	$2.41
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.73
Rate for Payer: SOMOS Essential	$2.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

VANCOMYCIN PEAK

Facility OP

$33.85

Service Code	HCPCS 80202
Hospital Charge Code	40602600
Hospital Revenue Code	301
Min. Negotiated Rate	$10.83
Max. Negotiated Rate	$21.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.54
Rate for Payer: Aetna Government	$13.54
Rate for Payer: Cash Price	$13.54
Rate for Payer: Cash Price	$13.54
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$13.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.22
Rate for Payer: Elderplan Medicare Advantage	$13.54
Rate for Payer: EmblemHealth Commercial	$13.54
Rate for Payer: Fidelis CHP/HARP/Medicaid	$12.19
Rate for Payer: Fidelis Essential Plan Aliesa	$11.51
Rate for Payer: Fidelis Essential Plan QHP	$12.05
Rate for Payer: Fidelis Medicare Advantage	$13.54
Rate for Payer: Fidelis Qualified Health Plan	$12.05
Rate for Payer: Group Health Inc Commercial	$13.54
Rate for Payer: Group Health Inc Medicare	$13.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.92
Rate for Payer: Hamaspik Choice Inc Medicare	$13.54
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$13.54
Rate for Payer: Healthfirst Medicare Advantage	$13.54
Rate for Payer: Healthfirst QHP	$13.54
Rate for Payer: Senior Whole Health Medicare Advantage	$13.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.54
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.83
Rate for Payer: Wellcare Medicare	$12.19

VANCOMYCIN TROUGH

Facility OP

$33.85

Service Code	HCPCS 80202
Hospital Charge Code	40602595
Hospital Revenue Code	301
Min. Negotiated Rate	$10.83
Max. Negotiated Rate	$21.53
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.54
Rate for Payer: Aetna Government	$13.54
Rate for Payer: Cash Price	$13.54
Rate for Payer: Cash Price	$13.54
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$13.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.22
Rate for Payer: Elderplan Medicare Advantage	$13.54
Rate for Payer: EmblemHealth Commercial	$13.54
Rate for Payer: Fidelis CHP/HARP/Medicaid	$12.19
Rate for Payer: Fidelis Essential Plan Aliesa	$11.51
Rate for Payer: Fidelis Essential Plan QHP	$12.05
Rate for Payer: Fidelis Medicare Advantage	$13.54
Rate for Payer: Fidelis Qualified Health Plan	$12.05
Rate for Payer: Group Health Inc Commercial	$13.54
Rate for Payer: Group Health Inc Medicare	$13.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.92
Rate for Payer: Hamaspik Choice Inc Medicare	$13.54
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$13.54
Rate for Payer: Healthfirst Medicare Advantage	$13.54
Rate for Payer: Healthfirst QHP	$13.54
Rate for Payer: Senior Whole Health Medicare Advantage	$13.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.54
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.83
Rate for Payer: Wellcare Medicare	$12.19

VANCO ORAL SOL 125MG/5ML

Facility OP

$2.00

Hospital Charge Code	41655873
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: 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

VANCO ORAL SOL 125MG/5ML

Facility OP

$2.00

Hospital Charge Code	41645873
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: 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

VANCO ORAL SOL 250MG/10ML

Facility OP

$3.00

Hospital Charge Code	41655875
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

VANCO ORAL SOL 250MG/10ML SOL

Facility OP

$3.00

Hospital Charge Code	41645875
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

VANCO ORAL SOL 500MG/20ML

Facility OP

$5.00

Hospital Charge Code	41655877
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$4.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.50
Rate for Payer: Aetna Government	$2.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.40
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

VANCO ORAL SOL 500MG/20ML

Facility OP

$5.00

Hospital Charge Code	41645877
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$4.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.50
Rate for Payer: Aetna Government	$2.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.40
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

Price Transparency.

All Charges