St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

BARRIER SKIN STOMA SMALL 1-3/4

Facility

$3.40

Hospital Charge Code	64901331
Hospital Revenue Code	270
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$2.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$2.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.31
Rate for Payer: Group Health Inc Commercial	$1.70
Rate for Payer: Group Health Inc Medicare	$1.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70

BARRIER, SKIN STOMA SMALL 1-3/4

Facility

$1.20

Hospital Charge Code	40201977
Hospital Revenue Code	270
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$0.96
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.60
Rate for Payer: Aetna Government	$0.60
Rate for Payer: Brighton Health Commercial	$0.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.82
Rate for Payer: Group Health Inc Commercial	$0.60
Rate for Payer: Group Health Inc Medicare	$0.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.60
Rate for Payer: Hamaspik Choice Inc Medicare	$0.60

BARRIER SKIN STOMA X-LARG 2-3/4

Facility

$3.40

Hospital Charge Code	64901335
Hospital Revenue Code	270
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$2.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.70
Rate for Payer: Aetna Government	$1.70
Rate for Payer: Brighton Health Commercial	$2.55
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.31
Rate for Payer: Group Health Inc Commercial	$1.70
Rate for Payer: Group Health Inc Medicare	$1.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.70
Rate for Payer: Hamaspik Choice Inc Medicare	$1.70

BARRIER, SKN, 70MM, 2.75FLG, 51M

Facility

$4.00

Hospital Charge Code	64902141
Hospital Revenue Code	270
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Brighton Health Commercial	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00

BARTONELLA ANTIBODY PANEL

Facility

$25.45

Service Code	HCPCS 86611
Hospital Charge Code	40729348
Hospital Revenue Code	300
Rate for Payer: Cash Price	$10.18

BARTONELLA ANTIBODY PANEL

Facility

$25.45

Service Code	HCPCS 86611
Hospital Charge Code	40729348
Hospital Revenue Code	300
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$19.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.18
Rate for Payer: Aetna Government	$10.18
Rate for Payer: Affinity Essential Plan 1&2	$7.13
Rate for Payer: Affinity Essential Plan 3&4	$7.13
Rate for Payer: Affinity Medicaid/CHP/HARP	$7.13
Rate for Payer: Brighton Health Commercial	$19.09
Rate for Payer: Cash Price	$10.18
Rate for Payer: Cash Price	$10.18
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$10.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.68
Rate for Payer: Elderplan Medicare Advantage	$10.18
Rate for Payer: EmblemHealth Commercial	$10.18
Rate for Payer: Fidelis Essential Plan Aliesa	$8.65
Rate for Payer: Fidelis Essential Plan QHP	$9.06
Rate for Payer: Fidelis Medicare Advantage	$10.18
Rate for Payer: Fidelis Qualified Health Plan	$9.06
Rate for Payer: Group Health Inc Commercial	$10.18
Rate for Payer: Group Health Inc Medicare	$10.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.72
Rate for Payer: Hamaspik Choice Inc Medicare	$10.18
Rate for Payer: Healthfirst Medicare Advantage	$10.18
Rate for Payer: Healthfirst QHP	$10.18
Rate for Payer: Humana Medicare	$10.38
Rate for Payer: Senior Whole Health Medicare Advantage	$10.18
Rate for Payer: United Healthcare Commercial	$12.89
Rate for Payer: United Healthcare Medicare Advantage	$10.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$8.14
Rate for Payer: Wellcare Medicare	$9.16

BARTONELLA HENSELAE IGG/M

Facility

$25.45

Service Code	HCPCS 86611
Hospital Charge Code	40729849
Hospital Revenue Code	302
Rate for Payer: Cash Price	$10.18

BARTONELLA HENSELAE IGG/M

Facility

$25.45

Service Code	HCPCS 86611
Hospital Charge Code	40729849
Hospital Revenue Code	302
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$19.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.18
Rate for Payer: Aetna Government	$10.18
Rate for Payer: Affinity Essential Plan 1&2	$7.13
Rate for Payer: Affinity Essential Plan 3&4	$7.13
Rate for Payer: Affinity Medicaid/CHP/HARP	$7.13
Rate for Payer: Brighton Health Commercial	$19.09
Rate for Payer: Cash Price	$10.18
Rate for Payer: Cash Price	$10.18
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$10.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.68
Rate for Payer: Elderplan Medicare Advantage	$10.18
Rate for Payer: EmblemHealth Commercial	$10.18
Rate for Payer: Fidelis Essential Plan Aliesa	$8.65
Rate for Payer: Fidelis Essential Plan QHP	$9.06
Rate for Payer: Fidelis Medicare Advantage	$10.18
Rate for Payer: Fidelis Qualified Health Plan	$9.06
Rate for Payer: Group Health Inc Commercial	$10.18
Rate for Payer: Group Health Inc Medicare	$10.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.72
Rate for Payer: Hamaspik Choice Inc Medicare	$10.18
Rate for Payer: Healthfirst Medicare Advantage	$10.18
Rate for Payer: Healthfirst QHP	$10.18
Rate for Payer: Humana Medicare	$10.38
Rate for Payer: Senior Whole Health Medicare Advantage	$10.18
Rate for Payer: United Healthcare Commercial	$12.89
Rate for Payer: United Healthcare Medicare Advantage	$10.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$8.14
Rate for Payer: Wellcare Medicare	$9.16

BASEPLATE TIBIAL

Facility

$11,175.00

Service Code	HCPCS C1776
Hospital Charge Code	64907259
Hospital Revenue Code	278
Min. Negotiated Rate	$5,587.50
Max. Negotiated Rate	$5,587.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,587.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5,587.50

BASEPLATE TIBIAL

Facility

$11,175.00

Service Code	HCPCS C1776
Hospital Charge Code	64907259
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$11,733.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,146.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$6,705.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,587.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,425.62
Rate for Payer: EmblemHealth Commercial	$5,587.50
Rate for Payer: Fidelis Medicare Advantage	$11,733.75
Rate for Payer: Group Health Inc Commercial	$5,587.50
Rate for Payer: Group Health Inc Medicare	$3,911.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,587.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5,587.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,263.75

BASEPLATE TIBIAL CEMENTED SZ 6

Facility

$3,935.25

Service Code	HCPCS C1713
Hospital Charge Code	64903667
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,132.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,164.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,361.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,967.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,262.77
Rate for Payer: EmblemHealth Commercial	$1,967.62
Rate for Payer: Fidelis Medicare Advantage	$4,132.01
Rate for Payer: Group Health Inc Commercial	$1,967.62
Rate for Payer: Group Health Inc Medicare	$1,377.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,967.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,967.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,557.91

BASEPLATE TIBIAL CEMENTED SZ 6

Facility

$3,935.25

Service Code	HCPCS C1713
Hospital Charge Code	64903667
Hospital Revenue Code	278
Min. Negotiated Rate	$1,967.62
Max. Negotiated Rate	$1,967.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,967.62
Rate for Payer: Hamaspik Choice Inc Medicare	$1,967.62

BASEPLATE TIBIAL CEMENT SZ3

Facility

$3,935.00

Service Code	HCPCS C1713
Hospital Charge Code	64903266
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$4,131.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,164.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$2,361.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,967.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,262.62
Rate for Payer: EmblemHealth Commercial	$1,967.50
Rate for Payer: Fidelis Medicare Advantage	$4,131.75
Rate for Payer: Group Health Inc Commercial	$1,967.50
Rate for Payer: Group Health Inc Medicare	$1,377.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,967.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,967.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,557.75

BASEPLATE TIBIAL CEMENT SZ3

Facility

$3,935.00

Service Code	HCPCS C1713
Hospital Charge Code	64903266
Hospital Revenue Code	278
Min. Negotiated Rate	$1,967.50
Max. Negotiated Rate	$1,967.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,967.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,967.50

BASIC METABOLIC PANEL

Facility

$21.15

Service Code	HCPCS 80048
Hospital Charge Code	40602506
Hospital Revenue Code	301
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$15.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.46
Rate for Payer: Aetna Government	$8.46
Rate for Payer: Affinity Essential Plan 1&2	$5.92
Rate for Payer: Affinity Essential Plan 3&4	$5.92
Rate for Payer: Affinity Medicaid/CHP/HARP	$5.92
Rate for Payer: Brighton Health Commercial	$15.86
Rate for Payer: Cash Price	$8.46
Rate for Payer: Cash Price	$8.46
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.38
Rate for Payer: Elderplan Medicare Advantage	$8.46
Rate for Payer: EmblemHealth Commercial	$8.46
Rate for Payer: Fidelis Essential Plan Aliesa	$7.19
Rate for Payer: Fidelis Essential Plan QHP	$7.53
Rate for Payer: Fidelis Medicare Advantage	$8.46
Rate for Payer: Fidelis Qualified Health Plan	$7.53
Rate for Payer: Group Health Inc Commercial	$8.46
Rate for Payer: Group Health Inc Medicare	$8.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.58
Rate for Payer: Hamaspik Choice Inc Medicare	$8.46
Rate for Payer: Healthfirst Medicare Advantage	$8.46
Rate for Payer: Healthfirst QHP	$8.46
Rate for Payer: Humana Medicare	$8.63
Rate for Payer: Senior Whole Health Medicare Advantage	$8.46
Rate for Payer: United Healthcare Commercial	$10.72
Rate for Payer: United Healthcare Medicare Advantage	$8.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6.77
Rate for Payer: Wellcare Medicare	$7.61

BASIC METABOLIC PANEL

Facility

$21.15

Service Code	HCPCS 80048
Hospital Charge Code	40602506
Hospital Revenue Code	301
Rate for Payer: Cash Price	$8.46

BASKET 3/4 SIZE

Facility

$257.25

Hospital Charge Code	64903484
Hospital Revenue Code	270
Min. Negotiated Rate	$90.04
Max. Negotiated Rate	$205.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$141.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$128.62
Rate for Payer: Aetna Government	$128.62
Rate for Payer: Brighton Health Commercial	$192.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$205.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$174.93
Rate for Payer: Group Health Inc Commercial	$128.62
Rate for Payer: Group Health Inc Medicare	$90.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$128.62
Rate for Payer: Hamaspik Choice Inc Medicare	$128.62

BASKET HALF SIZE

Facility

$246.75

Hospital Charge Code	64903480
Hospital Revenue Code	270
Min. Negotiated Rate	$86.36
Max. Negotiated Rate	$197.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$135.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$123.38
Rate for Payer: Aetna Government	$123.38
Rate for Payer: Brighton Health Commercial	$185.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$197.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$167.79
Rate for Payer: Group Health Inc Commercial	$123.38
Rate for Payer: Group Health Inc Medicare	$86.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$123.38
Rate for Payer: Hamaspik Choice Inc Medicare	$123.38

BASKET RETRIEV 1.9 ZERO TIP

Facility

$512.50

Hospital Charge Code	64905747
Hospital Revenue Code	270
Min. Negotiated Rate	$179.38
Max. Negotiated Rate	$410.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$281.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$256.25
Rate for Payer: Aetna Government	$256.25
Rate for Payer: Brighton Health Commercial	$384.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$410.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$348.50
Rate for Payer: Group Health Inc Commercial	$256.25
Rate for Payer: Group Health Inc Medicare	$179.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$256.25
Rate for Payer: Hamaspik Choice Inc Medicare	$256.25

BASKET SEGURA

Facility

$549.38

Hospital Charge Code	64907139
Hospital Revenue Code	270
Min. Negotiated Rate	$192.28
Max. Negotiated Rate	$439.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$302.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$274.69
Rate for Payer: Aetna Government	$274.69
Rate for Payer: Brighton Health Commercial	$412.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$439.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$373.58
Rate for Payer: Group Health Inc Commercial	$274.69
Rate for Payer: Group Health Inc Medicare	$192.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.69
Rate for Payer: Hamaspik Choice Inc Medicare	$274.69

BASKT NIT ZERO-TP 4W 1.9F 120CM

Facility

$543.75

Hospital Charge Code	64904543
Hospital Revenue Code	270
Min. Negotiated Rate	$190.31
Max. Negotiated Rate	$435.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$299.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$271.88
Rate for Payer: Aetna Government	$271.88
Rate for Payer: Brighton Health Commercial	$407.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$435.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$369.75
Rate for Payer: Group Health Inc Commercial	$271.88
Rate for Payer: Group Health Inc Medicare	$190.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$271.88
Rate for Payer: Hamaspik Choice Inc Medicare	$271.88

BATTERY PACK REUSEABLE

Facility

$2,750.00

Hospital Charge Code	64907078
Hospital Revenue Code	270
Min. Negotiated Rate	$962.50
Max. Negotiated Rate	$2,200.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,512.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,375.00
Rate for Payer: Aetna Government	$1,375.00
Rate for Payer: Brighton Health Commercial	$2,062.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,200.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,870.00
Rate for Payer: Group Health Inc Commercial	$1,375.00
Rate for Payer: Group Health Inc Medicare	$962.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,375.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,375.00

BATTERY VARISPEED

Facility

$285.00

Hospital Charge Code	64906326
Hospital Revenue Code	270
Min. Negotiated Rate	$99.75
Max. Negotiated Rate	$228.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$156.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$142.50
Rate for Payer: Aetna Government	$142.50
Rate for Payer: Brighton Health Commercial	$213.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$228.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$193.80
Rate for Payer: Group Health Inc Commercial	$142.50
Rate for Payer: Group Health Inc Medicare	$99.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$142.50
Rate for Payer: Hamaspik Choice Inc Medicare	$142.50

BAX CYSTO/BLADDER IRRIG SET

Facility

$160.00

Hospital Charge Code	40204265
Hospital Revenue Code	272
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$128.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$88.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$80.00
Rate for Payer: Aetna Government	$80.00
Rate for Payer: Brighton Health Commercial	$120.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$128.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$108.80
Rate for Payer: Group Health Inc Commercial	$80.00
Rate for Payer: Group Health Inc Medicare	$56.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$80.00
Rate for Payer: Hamaspik Choice Inc Medicare	$80.00

BAX FLOSEAL HEMO MATRIX 10 ML

Facility

$470.46

Hospital Charge Code	40008308
Hospital Revenue Code	272
Min. Negotiated Rate	$164.66
Max. Negotiated Rate	$376.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$258.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$235.23
Rate for Payer: Aetna Government	$235.23
Rate for Payer: Brighton Health Commercial	$352.84
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$376.37
Rate for Payer: Cigna LocalPlus Benefit Plan	$319.91
Rate for Payer: Group Health Inc Commercial	$235.23
Rate for Payer: Group Health Inc Medicare	$164.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$235.23
Rate for Payer: Hamaspik Choice Inc Medicare	$235.23

Know your out-of-pocket cost for care.

All Charges