St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

RUBELLA ANTIBODIES, IGM

Facility

$35.98

Service Code	HCPCS 86762
Hospital Charge Code	40729378
Hospital Revenue Code	300
Rate for Payer: Cash Price	$14.39

RUBELLA-SCREENING

Facility

$35.98

Service Code	HCPCS 86762
Hospital Charge Code	40614055
Hospital Revenue Code	300
Min. Negotiated Rate	$10.07
Max. Negotiated Rate	$26.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.39
Rate for Payer: Aetna Government	$14.39
Rate for Payer: Affinity Essential Plan 1&2	$10.07
Rate for Payer: Affinity Essential Plan 3&4	$10.07
Rate for Payer: Affinity Medicaid/CHP/HARP	$10.07
Rate for Payer: Brighton Health Commercial	$26.98
Rate for Payer: Cash Price	$14.39
Rate for Payer: Cash Price	$14.39
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$14.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.35
Rate for Payer: Elderplan Medicare Advantage	$14.39
Rate for Payer: EmblemHealth Commercial	$14.39
Rate for Payer: Fidelis Essential Plan Aliesa	$12.23
Rate for Payer: Fidelis Essential Plan QHP	$12.81
Rate for Payer: Fidelis Medicare Advantage	$14.39
Rate for Payer: Fidelis Qualified Health Plan	$12.81
Rate for Payer: Group Health Inc Commercial	$14.39
Rate for Payer: Group Health Inc Medicare	$14.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.99
Rate for Payer: Hamaspik Choice Inc Medicare	$14.39
Rate for Payer: Healthfirst Medicare Advantage	$14.39
Rate for Payer: Healthfirst QHP	$14.39
Rate for Payer: Humana Medicare	$14.68
Rate for Payer: Senior Whole Health Medicare Advantage	$14.39
Rate for Payer: United Healthcare Commercial	$18.22
Rate for Payer: United Healthcare Medicare Advantage	$14.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.39
Rate for Payer: Wellcare CHP/FHP/Medicaid	$11.51
Rate for Payer: Wellcare Medicare	$12.95

RUBELLA-SCREENING

Facility

$35.98

Service Code	HCPCS 86762
Hospital Charge Code	40614055
Hospital Revenue Code	300
Rate for Payer: Cash Price	$14.39

RUBEOLA ANTIBODIES, IGG

Facility

$32.20

Service Code	HCPCS 86765
Hospital Charge Code	40729379
Hospital Revenue Code	300
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$24.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.88
Rate for Payer: Aetna Government	$12.88
Rate for Payer: Affinity Essential Plan 1&2	$9.02
Rate for Payer: Affinity Essential Plan 3&4	$9.02
Rate for Payer: Affinity Medicaid/CHP/HARP	$9.02
Rate for Payer: Brighton Health Commercial	$24.15
Rate for Payer: Cash Price	$12.88
Rate for Payer: Cash Price	$12.88
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.32
Rate for Payer: Elderplan Medicare Advantage	$12.88
Rate for Payer: EmblemHealth Commercial	$12.88
Rate for Payer: Fidelis Essential Plan Aliesa	$10.95
Rate for Payer: Fidelis Essential Plan QHP	$11.46
Rate for Payer: Fidelis Medicare Advantage	$12.88
Rate for Payer: Fidelis Qualified Health Plan	$11.46
Rate for Payer: Group Health Inc Commercial	$12.88
Rate for Payer: Group Health Inc Medicare	$12.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.10
Rate for Payer: Hamaspik Choice Inc Medicare	$12.88
Rate for Payer: Healthfirst Medicare Advantage	$12.88
Rate for Payer: Healthfirst QHP	$12.88
Rate for Payer: Humana Medicare	$13.14
Rate for Payer: Senior Whole Health Medicare Advantage	$12.88
Rate for Payer: United Healthcare Commercial	$16.32
Rate for Payer: United Healthcare Medicare Advantage	$12.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.30
Rate for Payer: Wellcare Medicare	$11.59

RUBEOLA ANTIBODIES, IGG

Facility

$32.20

Service Code	HCPCS 86765
Hospital Charge Code	40729379
Hospital Revenue Code	300
Rate for Payer: Cash Price	$12.88

RUBEOLA ANTIBODIES, IGM

Facility

$32.20

Service Code	HCPCS 86765
Hospital Charge Code	40729380
Hospital Revenue Code	300
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$24.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.88
Rate for Payer: Aetna Government	$12.88
Rate for Payer: Affinity Essential Plan 1&2	$9.02
Rate for Payer: Affinity Essential Plan 3&4	$9.02
Rate for Payer: Affinity Medicaid/CHP/HARP	$9.02
Rate for Payer: Brighton Health Commercial	$24.15
Rate for Payer: Cash Price	$12.88
Rate for Payer: Cash Price	$12.88
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.32
Rate for Payer: Elderplan Medicare Advantage	$12.88
Rate for Payer: EmblemHealth Commercial	$12.88
Rate for Payer: Fidelis Essential Plan Aliesa	$10.95
Rate for Payer: Fidelis Essential Plan QHP	$11.46
Rate for Payer: Fidelis Medicare Advantage	$12.88
Rate for Payer: Fidelis Qualified Health Plan	$11.46
Rate for Payer: Group Health Inc Commercial	$12.88
Rate for Payer: Group Health Inc Medicare	$12.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.10
Rate for Payer: Hamaspik Choice Inc Medicare	$12.88
Rate for Payer: Healthfirst Medicare Advantage	$12.88
Rate for Payer: Healthfirst QHP	$12.88
Rate for Payer: Humana Medicare	$13.14
Rate for Payer: Senior Whole Health Medicare Advantage	$12.88
Rate for Payer: United Healthcare Commercial	$16.32
Rate for Payer: United Healthcare Medicare Advantage	$12.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.30
Rate for Payer: Wellcare Medicare	$11.59

RUBEOLA ANTIBODIES, IGM

Facility

$32.20

Service Code	HCPCS 86765
Hospital Charge Code	40729380
Hospital Revenue Code	300
Rate for Payer: Cash Price	$12.88

RUN-THROUGH NS GUIDE WIRE

Facility

$170.00

Service Code	HCPCS C1769
Hospital Charge Code	66526605
Hospital Revenue Code	278
Min. Negotiated Rate	$85.00
Max. Negotiated Rate	$85.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00

RUN-THROUGH NS GUIDE WIRE

Facility

$170.00

Service Code	HCPCS C1769
Hospital Charge Code	66526605
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$178.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$93.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$102.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$85.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$97.75
Rate for Payer: EmblemHealth Commercial	$85.00
Rate for Payer: Fidelis Medicare Advantage	$178.50
Rate for Payer: Group Health Inc Commercial	$85.00
Rate for Payer: Group Health Inc Medicare	$59.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.00
Rate for Payer: Hamaspik Choice Inc Medicare	$85.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$110.50

RUSCH CATHETER 14FR 2WAY 5CC

Facility

$52.66

Hospital Charge Code	64905183
Hospital Revenue Code	279
Min. Negotiated Rate	$18.43
Max. Negotiated Rate	$42.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.33
Rate for Payer: Aetna Government	$26.33
Rate for Payer: Brighton Health Commercial	$39.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.81
Rate for Payer: Group Health Inc Commercial	$26.33
Rate for Payer: Group Health Inc Medicare	$18.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.33
Rate for Payer: Hamaspik Choice Inc Medicare	$26.33

RUSCH CATHETHER 12 FR. 2 WAY

Facility

$52.66

Hospital Charge Code	64905181
Hospital Revenue Code	279
Min. Negotiated Rate	$18.43
Max. Negotiated Rate	$42.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.33
Rate for Payer: Aetna Government	$26.33
Rate for Payer: Brighton Health Commercial	$39.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.81
Rate for Payer: Group Health Inc Commercial	$26.33
Rate for Payer: Group Health Inc Medicare	$18.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.33
Rate for Payer: Hamaspik Choice Inc Medicare	$26.33

RVS EYELASHES BY OTH THN FORCEPS

Facility

$794.85

Service Code	HCPCS 67825
Hospital Charge Code	30305361
Hospital Revenue Code	510
Rate for Payer: Cash Price	$336.88

RVS EYELASHES BY OTH THN FORCEPS

Facility

$794.85

Service Code	HCPCS 67825
Hospital Charge Code	30305361
Hospital Revenue Code	510
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$336.88
Rate for Payer: Aetna Government	$336.88
Rate for Payer: Affinity Essential Plan 1&2	$235.82
Rate for Payer: Affinity Essential Plan 3&4	$235.82
Rate for Payer: Affinity Medicaid/CHP/HARP	$235.82
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$336.88
Rate for Payer: Cash Price	$336.88
Rate for Payer: Cash Price	$336.88
Rate for Payer: Cash Price	$336.88
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$336.88
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	$336.88
Rate for Payer: Fidelis Essential Plan Aliesa	$286.35
Rate for Payer: Fidelis Essential Plan QHP	$299.82
Rate for Payer: Fidelis Medicare Advantage	$336.88
Rate for Payer: Fidelis Qualified Health Plan	$299.82
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$397.42
Rate for Payer: Hamaspik Choice Inc Medicare	$336.88
Rate for Payer: Healthfirst Medicare Advantage	$286.35
Rate for Payer: Healthfirst QHP	$336.88
Rate for Payer: Humana Medicare	$343.62
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$336.88
Rate for Payer: Senior Whole Health Medicare Advantage	$336.88
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$336.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$336.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$269.50
Rate for Payer: Wellcare Medicare	$320.04

RVW MEDS BY RX/DR IN RCRD

Facility

$10.00

Service Code	HCPCS 1160F
Hospital Charge Code	30305811
Hospital Revenue Code	969
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$7.50
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: Group Health Inc Commercial	$5.00
Rate for Payer: Group Health Inc Medicare	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5.00

RX90 CEMENTED FEMORAL 11.0X125MM

Facility

$4,640.00

Service Code	HCPCS C1776
Hospital Charge Code	40202209
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,872.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,552.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,784.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,320.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,668.00
Rate for Payer: EmblemHealth Commercial	$2,320.00
Rate for Payer: Fidelis Medicare Advantage	$4,872.00
Rate for Payer: Group Health Inc Commercial	$2,320.00
Rate for Payer: Group Health Inc Medicare	$1,624.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,320.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,016.00

RX90 CEMENTED FEMORAL 11.0X125MM

Facility

$4,640.00

Service Code	HCPCS C1776
Hospital Charge Code	40202209
Hospital Revenue Code	278
Min. Negotiated Rate	$2,320.00
Max. Negotiated Rate	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,320.00

RX90 CEMENTED FEMORAL 13.0X35MM

Facility

$4,640.00

Service Code	HCPCS C1776
Hospital Charge Code	40209911
Hospital Revenue Code	278
Min. Negotiated Rate	$2,320.00
Max. Negotiated Rate	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,320.00

RX90 CEMENTED FEMORAL 13.0X35MM

Facility

$4,640.00

Service Code	HCPCS C1776
Hospital Charge Code	40209911
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,872.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,552.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,784.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,320.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,668.00
Rate for Payer: EmblemHealth Commercial	$2,320.00
Rate for Payer: Fidelis Medicare Advantage	$4,872.00
Rate for Payer: Group Health Inc Commercial	$2,320.00
Rate for Payer: Group Health Inc Medicare	$1,624.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,320.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,016.00

RX90 CEMENTED FEMORAL 9.0X115MM

Facility

$4,640.00

Service Code	HCPCS C1776
Hospital Charge Code	40202211
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,872.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,552.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,784.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,320.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,668.00
Rate for Payer: EmblemHealth Commercial	$2,320.00
Rate for Payer: Fidelis Medicare Advantage	$4,872.00
Rate for Payer: Group Health Inc Commercial	$2,320.00
Rate for Payer: Group Health Inc Medicare	$1,624.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,320.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,016.00

RX90 CEMENTED FEMORAL 9.0X115MM

Facility

$4,640.00

Service Code	HCPCS C1776
Hospital Charge Code	40202211
Hospital Revenue Code	278
Min. Negotiated Rate	$2,320.00
Max. Negotiated Rate	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,320.00

RX90 CEMENTED FEMORAL 9.0X35MM

Facility

$4,640.00

Service Code	HCPCS C1776
Hospital Charge Code	40209912
Hospital Revenue Code	278
Min. Negotiated Rate	$2,320.00
Max. Negotiated Rate	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,320.00

RX90 CEMENTED FEMORAL 9.0X35MM

Facility

$4,640.00

Service Code	HCPCS C1776
Hospital Charge Code	40209912
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,872.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,552.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,784.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,320.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,668.00
Rate for Payer: EmblemHealth Commercial	$2,320.00
Rate for Payer: Fidelis Medicare Advantage	$4,872.00
Rate for Payer: Group Health Inc Commercial	$2,320.00
Rate for Payer: Group Health Inc Medicare	$1,624.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,320.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,016.00

RX90 CENTRAL SLEEVE FEMOR13X1.5MM

Facility

$640.00

Service Code	HCPCS C1776
Hospital Charge Code	40209996
Hospital Revenue Code	278
Min. Negotiated Rate	$320.00
Max. Negotiated Rate	$320.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$320.00

RX90 CENTRAL SLEEVE FEMOR13X1.5MM

Facility

$640.00

Service Code	HCPCS C1776
Hospital Charge Code	40209996
Hospital Revenue Code	278
Min. Negotiated Rate	$224.00
Max. Negotiated Rate	$672.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$352.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$384.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$320.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$368.00
Rate for Payer: EmblemHealth Commercial	$320.00
Rate for Payer: Fidelis Medicare Advantage	$672.00
Rate for Payer: Group Health Inc Commercial	$320.00
Rate for Payer: Group Health Inc Medicare	$224.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$320.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$416.00

RX CL ELBOW DISLOC W/O ANESTHESIA

Facility

$653.13

Service Code	HCPCS 24600
Hospital Charge Code	30103304
Hospital Revenue Code	450
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$272.71
Rate for Payer: Aetna Government	$272.71
Rate for Payer: Affinity Essential Plan 1&2	$190.90
Rate for Payer: Affinity Essential Plan 3&4	$190.90
Rate for Payer: Affinity Medicaid/CHP/HARP	$190.90
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$272.71
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$272.71
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	$272.71
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis Essential Plan Aliesa	$231.80
Rate for Payer: Fidelis Essential Plan QHP	$242.71
Rate for Payer: Fidelis Medicare Advantage	$272.71
Rate for Payer: Fidelis Qualified Health Plan	$242.71
Rate for Payer: Group Health Inc Commercial	$525.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$326.56
Rate for Payer: Hamaspik Choice Inc Medicare	$272.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$272.71
Rate for Payer: Humana Medicare	$278.16
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$272.71
Rate for Payer: Senior Whole Health Medicare Advantage	$272.71
Rate for Payer: United Healthcare Commercial	$569.00
Rate for Payer: United Healthcare Medicare Advantage	$272.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$272.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$218.17
Rate for Payer: Wellcare Medicare	$259.07

Know your out-of-pocket cost for care.

All Charges