St. Barnabas Hospital

All Charges

Charge

Type

Price

BLUE DIALYZERS

Facility OP

$52.45

Hospital Charge Code	42905311
Hospital Revenue Code	801
Min. Negotiated Rate	$18.36
Max. Negotiated Rate	$41.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.22
Rate for Payer: Aetna Government	$26.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.67
Rate for Payer: Group Health Inc Commercial	$26.22
Rate for Payer: Group Health Inc Medicare	$18.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$26.22
Rate for Payer: Hamaspik Choice Inc Medicare	$26.22

BLUE RELOAD 45MM

Facility OP

$330.31

Hospital Charge Code	64905157
Hospital Revenue Code	270
Min. Negotiated Rate	$115.61
Max. Negotiated Rate	$264.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$181.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$165.16
Rate for Payer: Aetna Government	$165.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$264.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$224.61
Rate for Payer: Group Health Inc Commercial	$165.16
Rate for Payer: Group Health Inc Medicare	$115.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.16
Rate for Payer: Hamaspik Choice Inc Medicare	$165.16

BMI DOC ONL FUP NOT COMPLTD

Facility OP

$0.01

Service Code	HCPCS G9716
Hospital Charge Code	30307875
Hospital Revenue Code	510
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
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	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

BMI NOT DOC MEDRSN PTREF

Facility OP

$0.01

Service Code	HCPCS G2181
Hospital Charge Code	30300309
Hospital Revenue Code	929
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

BMM TREPHINE

Facility OP

$1,275.00

Hospital Charge Code	64903621
Hospital Revenue Code	279
Min. Negotiated Rate	$446.25
Max. Negotiated Rate	$1,020.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$701.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$637.50
Rate for Payer: Aetna Government	$637.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,020.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$867.00
Rate for Payer: Group Health Inc Commercial	$637.50
Rate for Payer: Group Health Inc Medicare	$446.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$637.50
Rate for Payer: Hamaspik Choice Inc Medicare	$637.50

BMS AB MINI VISION 2.0X8-12-15

Facility IP

$1,950.00

Service Code	HCPCS C1876
Hospital Charge Code	66528910
Hospital Revenue Code	278
Min. Negotiated Rate	$975.00
Max. Negotiated Rate	$975.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$975.00
Rate for Payer: Hamaspik Choice Inc Medicare	$975.00

BMS AB MINI VISION 2.0X8-12-15

Facility OP

$1,950.00

Service Code	HCPCS C1876
Hospital Charge Code	66528910
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$2,047.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,072.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$975.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,121.25
Rate for Payer: Fidelis Medicare Advantage	$2,047.50
Rate for Payer: Group Health Inc Commercial	$975.00
Rate for Payer: Group Health Inc Medicare	$682.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$975.00
Rate for Payer: Hamaspik Choice Inc Medicare	$975.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,267.50

B.M.W. GUIDE WIRE 0.014 X 190

Facility OP

$150.00

Service Code	HCPCS C1769
Hospital Charge Code	66524669
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$157.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$86.25
Rate for Payer: Fidelis Medicare Advantage	$157.50
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$97.50

B.M.W. GUIDE WIRE 0.014 X 190

Facility IP

$150.00

Service Code	HCPCS C1769
Hospital Charge Code	66524669
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

B.M.W. GUIDE WIRE 0.014 X 300

Facility OP

$150.00

Service Code	HCPCS C1769
Hospital Charge Code	66524671
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$157.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$86.25
Rate for Payer: Fidelis Medicare Advantage	$157.50
Rate for Payer: Group Health Inc Commercial	$75.00
Rate for Payer: Group Health Inc Medicare	$52.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$97.50

B.M.W. GUIDE WIRE 0.014 X 300

Facility IP

$150.00

Service Code	HCPCS C1769
Hospital Charge Code	66524671
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$75.00
Rate for Payer: Hamaspik Choice Inc Medicare	$75.00

B-NATRIURETIC PEPTIDE

Facility OP

$98.15

Service Code	HCPCS 83880
Hospital Charge Code	40602037
Hospital Revenue Code	300
Min. Negotiated Rate	$31.41
Max. Negotiated Rate	$53.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$39.26
Rate for Payer: Aetna Government	$39.26
Rate for Payer: Cash Price	$39.26
Rate for Payer: Cash Price	$39.26
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$39.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$45.66
Rate for Payer: Elderplan Medicare Advantage	$39.26
Rate for Payer: EmblemHealth Commercial	$39.26
Rate for Payer: Fidelis CHP/HARP/Medicaid	$35.33
Rate for Payer: Fidelis Essential Plan Aliesa	$33.37
Rate for Payer: Fidelis Essential Plan QHP	$34.94
Rate for Payer: Fidelis Medicare Advantage	$39.26
Rate for Payer: Fidelis Qualified Health Plan	$34.94
Rate for Payer: Group Health Inc Commercial	$39.26
Rate for Payer: Group Health Inc Medicare	$39.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.08
Rate for Payer: Hamaspik Choice Inc Medicare	$39.26
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$39.26
Rate for Payer: Healthfirst Medicare Advantage	$39.26
Rate for Payer: Healthfirst QHP	$39.26
Rate for Payer: Senior Whole Health Medicare Advantage	$39.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$39.26
Rate for Payer: Wellcare CHP/FHP/Medicaid	$31.41
Rate for Payer: Wellcare Medicare	$35.33

BODY EXTERNAL FIX ELBOW F

Facility OP

$8,206.25

Hospital Charge Code	64904130
Hospital Revenue Code	270
Min. Negotiated Rate	$2,872.19
Max. Negotiated Rate	$6,565.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,513.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,103.12
Rate for Payer: Aetna Government	$4,103.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,565.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,580.25
Rate for Payer: Group Health Inc Commercial	$4,103.12
Rate for Payer: Group Health Inc Medicare	$2,872.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,103.12
Rate for Payer: Hamaspik Choice Inc Medicare	$4,103.12

BODY FLUID CELL COUNT

Facility OP

$11.80

Service Code	HCPCS 89050
Hospital Charge Code	40621595
Hospital Revenue Code	300
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$7.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.72
Rate for Payer: Aetna Government	$4.72
Rate for Payer: Cash Price	$4.72
Rate for Payer: Cash Price	$4.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.35
Rate for Payer: Elderplan Medicare Advantage	$4.72
Rate for Payer: EmblemHealth Commercial	$4.72
Rate for Payer: Fidelis CHP/HARP/Medicaid	$4.25
Rate for Payer: Fidelis Essential Plan Aliesa	$4.01
Rate for Payer: Fidelis Essential Plan QHP	$4.20
Rate for Payer: Fidelis Medicare Advantage	$4.72
Rate for Payer: Fidelis Qualified Health Plan	$4.20
Rate for Payer: Group Health Inc Commercial	$4.72
Rate for Payer: Group Health Inc Medicare	$4.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.90
Rate for Payer: Hamaspik Choice Inc Medicare	$4.72
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.72
Rate for Payer: Healthfirst Medicare Advantage	$4.72
Rate for Payer: Healthfirst QHP	$4.72
Rate for Payer: Senior Whole Health Medicare Advantage	$4.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.78
Rate for Payer: Wellcare Medicare	$4.25

BODY FLUID CELL COUNT-CSF

Facility OP

$11.80

Service Code	HCPCS 89050
Hospital Charge Code	40621596
Hospital Revenue Code	300
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$7.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.72
Rate for Payer: Aetna Government	$4.72
Rate for Payer: Cash Price	$4.72
Rate for Payer: Cash Price	$4.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.35
Rate for Payer: Elderplan Medicare Advantage	$4.72
Rate for Payer: EmblemHealth Commercial	$4.72
Rate for Payer: Fidelis CHP/HARP/Medicaid	$4.25
Rate for Payer: Fidelis Essential Plan Aliesa	$4.01
Rate for Payer: Fidelis Essential Plan QHP	$4.20
Rate for Payer: Fidelis Medicare Advantage	$4.72
Rate for Payer: Fidelis Qualified Health Plan	$4.20
Rate for Payer: Group Health Inc Commercial	$4.72
Rate for Payer: Group Health Inc Medicare	$4.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.90
Rate for Payer: Hamaspik Choice Inc Medicare	$4.72
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.72
Rate for Payer: Healthfirst Medicare Advantage	$4.72
Rate for Payer: Healthfirst QHP	$4.72
Rate for Payer: Senior Whole Health Medicare Advantage	$4.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.78
Rate for Payer: Wellcare Medicare	$4.25

BOLT CONNECTION 16MM S&N

Facility OP

$16.75

Hospital Charge Code	64904184
Hospital Revenue Code	270
Min. Negotiated Rate	$5.86
Max. Negotiated Rate	$13.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.38
Rate for Payer: Aetna Government	$8.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.39
Rate for Payer: Group Health Inc Commercial	$8.38
Rate for Payer: Group Health Inc Medicare	$5.86
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.38
Rate for Payer: Hamaspik Choice Inc Medicare	$8.38

BOLT EXTERNAL FIX 1.5MM-2MM1

Facility OP

$287.50

Hospital Charge Code	64905267
Hospital Revenue Code	270
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$230.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$158.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$143.75
Rate for Payer: Aetna Government	$143.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: Group Health Inc Commercial	$143.75
Rate for Payer: Group Health Inc Medicare	$100.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.75
Rate for Payer: Hamaspik Choice Inc Medicare	$143.75

BOLT EXTERNAL FIX 1.5MM-2MM2

Facility OP

$287.50

Hospital Charge Code	64905269
Hospital Revenue Code	270
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$230.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$158.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$143.75
Rate for Payer: Aetna Government	$143.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: Group Health Inc Commercial	$143.75
Rate for Payer: Group Health Inc Medicare	$100.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.75
Rate for Payer: Hamaspik Choice Inc Medicare	$143.75

BOLT EXTERNAL FIX 1.5MM-2MM3

Facility OP

$287.50

Hospital Charge Code	64905757
Hospital Revenue Code	270
Min. Negotiated Rate	$100.62
Max. Negotiated Rate	$230.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$158.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$143.75
Rate for Payer: Aetna Government	$143.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$230.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$195.50
Rate for Payer: Group Health Inc Commercial	$143.75
Rate for Payer: Group Health Inc Medicare	$100.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$143.75
Rate for Payer: Hamaspik Choice Inc Medicare	$143.75

BOLT EXTERNAL FIX 1.5MM-2MM4

Facility OP

$875.00

Hospital Charge Code	64905761
Hospital Revenue Code	270
Min. Negotiated Rate	$306.25
Max. Negotiated Rate	$700.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$481.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$437.50
Rate for Payer: Aetna Government	$437.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$595.00
Rate for Payer: Group Health Inc Commercial	$437.50
Rate for Payer: Group Health Inc Medicare	$306.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.50
Rate for Payer: Hamaspik Choice Inc Medicare	$437.50

BOLT EXTERNAL FIX 30MML THRE

Facility OP

$600.00

Hospital Charge Code	64905273
Hospital Revenue Code	270
Min. Negotiated Rate	$210.00
Max. Negotiated Rate	$480.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$330.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$300.00
Rate for Payer: Aetna Government	$300.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$480.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$408.00
Rate for Payer: Group Health Inc Commercial	$300.00
Rate for Payer: Group Health Inc Medicare	$210.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$300.00

BOLT EXTERNAL FIX 6MM DIA 40

Facility OP

$60.00

Hospital Charge Code	64905265
Hospital Revenue Code	270
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00

BOLT EXTERNAL FIX LONG F/3MM

Facility OP

$1,150.00

Hospital Charge Code	64905759
Hospital Revenue Code	270
Min. Negotiated Rate	$402.50
Max. Negotiated Rate	$920.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$632.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$575.00
Rate for Payer: Aetna Government	$575.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$920.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$782.00
Rate for Payer: Group Health Inc Commercial	$575.00
Rate for Payer: Group Health Inc Medicare	$402.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$575.00
Rate for Payer: Hamaspik Choice Inc Medicare	$575.00

BOLT, HINGE MD

Facility OP

$162.65

Service Code	HCPCS C1713
Hospital Charge Code	64907408
Hospital Revenue Code	278
Min. Negotiated Rate	$56.93
Max. Negotiated Rate	$170.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$89.46
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	$81.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$93.52
Rate for Payer: Fidelis Medicare Advantage	$170.78
Rate for Payer: Group Health Inc Commercial	$81.32
Rate for Payer: Group Health Inc Medicare	$56.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.32
Rate for Payer: Hamaspik Choice Inc Medicare	$81.32
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$105.72

BOLT, HINGE MD

Facility IP

$162.65

Service Code	HCPCS C1713
Hospital Charge Code	64907408
Hospital Revenue Code	278
Min. Negotiated Rate	$81.32
Max. Negotiated Rate	$81.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.32
Rate for Payer: Hamaspik Choice Inc Medicare	$81.32

Price Transparency.

All Charges