St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SMITH TAC ABSOR. FIX. W/SPIKES

Facility

$380.94

Hospital Charge Code	40009335
Hospital Revenue Code	272
Min. Negotiated Rate	$133.33
Max. Negotiated Rate	$304.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$209.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$190.47
Rate for Payer: Aetna Government	$190.47
Rate for Payer: Brighton Health Commercial	$285.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$304.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$259.04
Rate for Payer: Group Health Inc Commercial	$190.47
Rate for Payer: Group Health Inc Medicare	$133.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$190.47
Rate for Payer: Hamaspik Choice Inc Medicare	$190.47

SMLL BONE SAW BLDE RECIP

Facility

$58.30

Hospital Charge Code	64905360
Hospital Revenue Code	270
Min. Negotiated Rate	$20.40
Max. Negotiated Rate	$46.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.15
Rate for Payer: Aetna Government	$29.15
Rate for Payer: Brighton Health Commercial	$43.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.64
Rate for Payer: Group Health Inc Commercial	$29.15
Rate for Payer: Group Health Inc Medicare	$20.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.15
Rate for Payer: Hamaspik Choice Inc Medicare	$29.15

SMOKING CC >THAN 10MINS

Facility

$82.75

Service Code	HCPCS 99407
Hospital Charge Code	30301405
Hospital Revenue Code	942
Rate for Payer: Cash Price	$33.18

SMOKING CC >THAN 10MINS

Facility

$82.75

Service Code	HCPCS 99407
Hospital Charge Code	30301405
Hospital Revenue Code	942
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.18
Rate for Payer: Aetna Government	$33.18
Rate for Payer: Brighton Health Commercial	$62.06
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$33.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.27
Rate for Payer: Elderplan Medicare Advantage	$33.18
Rate for Payer: Fidelis Essential Plan Aliesa	$28.20
Rate for Payer: Fidelis Essential Plan QHP	$29.53
Rate for Payer: Fidelis Medicare Advantage	$33.18
Rate for Payer: Fidelis Qualified Health Plan	$29.53
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	$41.38
Rate for Payer: Hamaspik Choice Inc Medicare	$33.18
Rate for Payer: Healthfirst Medicare Advantage	$28.20
Rate for Payer: Healthfirst QHP	$33.18
Rate for Payer: Senior Whole Health Medicare Advantage	$33.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26.54
Rate for Payer: Wellcare Medicare	$31.52

SMOKING CESSATION

Facility

$82.75

Service Code	HCPCS 99406
Hospital Charge Code	42303458
Hospital Revenue Code	942
Rate for Payer: Cash Price	$33.18

SMOKING CESSATION

Facility

$82.75

Service Code	HCPCS 99406
Hospital Charge Code	42303458
Hospital Revenue Code	942
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.18
Rate for Payer: Aetna Government	$33.18
Rate for Payer: Brighton Health Commercial	$62.06
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$33.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.27
Rate for Payer: Elderplan Medicare Advantage	$33.18
Rate for Payer: Fidelis Essential Plan Aliesa	$28.20
Rate for Payer: Fidelis Essential Plan QHP	$29.53
Rate for Payer: Fidelis Medicare Advantage	$33.18
Rate for Payer: Fidelis Qualified Health Plan	$29.53
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	$41.38
Rate for Payer: Hamaspik Choice Inc Medicare	$33.18
Rate for Payer: Healthfirst Medicare Advantage	$28.20
Rate for Payer: Healthfirst QHP	$33.18
Rate for Payer: Senior Whole Health Medicare Advantage	$33.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26.54
Rate for Payer: Wellcare Medicare	$31.52

SMOKING CESSATION > 10 MIN

Facility

$82.75

Service Code	HCPCS 99407
Hospital Charge Code	42303459
Hospital Revenue Code	942
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.18
Rate for Payer: Aetna Government	$33.18
Rate for Payer: Brighton Health Commercial	$62.06
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$33.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.27
Rate for Payer: Elderplan Medicare Advantage	$33.18
Rate for Payer: Fidelis Essential Plan Aliesa	$28.20
Rate for Payer: Fidelis Essential Plan QHP	$29.53
Rate for Payer: Fidelis Medicare Advantage	$33.18
Rate for Payer: Fidelis Qualified Health Plan	$29.53
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	$41.38
Rate for Payer: Hamaspik Choice Inc Medicare	$33.18
Rate for Payer: Healthfirst Medicare Advantage	$28.20
Rate for Payer: Healthfirst QHP	$33.18
Rate for Payer: Senior Whole Health Medicare Advantage	$33.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26.54
Rate for Payer: Wellcare Medicare	$31.52

SMOKING CESSATION > 10 MIN

Facility

$82.75

Service Code	HCPCS 99407
Hospital Charge Code	42303459
Hospital Revenue Code	942
Rate for Payer: Cash Price	$33.18

SMOKING CESSATION CLASS

Facility

$20.00

Service Code	HCPCS S9453
Hospital Charge Code	30305715
Hospital Revenue Code	942
Min. Negotiated Rate	$9.43
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.43
Rate for Payer: Aetna Government	$9.43
Rate for Payer: Brighton Health Commercial	$15.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.60
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	$10.00
Rate for Payer: Hamaspik Choice Inc Medicare	$10.00

SMOKING CESSATION COUNSELING

Facility

$82.75

Service Code	HCPCS 99406
Hospital Charge Code	30300036
Hospital Revenue Code	942
Rate for Payer: Cash Price	$33.18

SMOKING CESSATION COUNSELING

Facility

$82.75

Service Code	HCPCS 99406
Hospital Charge Code	30300036
Hospital Revenue Code	942
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.18
Rate for Payer: Aetna Government	$33.18
Rate for Payer: Brighton Health Commercial	$62.06
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$33.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.27
Rate for Payer: Elderplan Medicare Advantage	$33.18
Rate for Payer: Fidelis Essential Plan Aliesa	$28.20
Rate for Payer: Fidelis Essential Plan QHP	$29.53
Rate for Payer: Fidelis Medicare Advantage	$33.18
Rate for Payer: Fidelis Qualified Health Plan	$29.53
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	$41.38
Rate for Payer: Hamaspik Choice Inc Medicare	$33.18
Rate for Payer: Healthfirst Medicare Advantage	$28.20
Rate for Payer: Healthfirst QHP	$33.18
Rate for Payer: Senior Whole Health Medicare Advantage	$33.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26.54
Rate for Payer: Wellcare Medicare	$31.52

SMOKING CESSATION COUNSELING

Facility

$82.75

Service Code	HCPCS 99406
Hospital Charge Code	30400036
Hospital Revenue Code	510
Rate for Payer: Cash Price	$33.18

SMOKING CESSATION COUNSELING

Facility

$82.75

Service Code	HCPCS 99406
Hospital Charge Code	30400036
Hospital Revenue Code	510
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.18
Rate for Payer: Aetna Government	$33.18
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$33.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Elderplan Medicare Advantage	$33.18
Rate for Payer: Fidelis Essential Plan Aliesa	$28.20
Rate for Payer: Fidelis Essential Plan QHP	$29.53
Rate for Payer: Fidelis Medicare Advantage	$33.18
Rate for Payer: Fidelis Qualified Health Plan	$29.53
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	$41.38
Rate for Payer: Hamaspik Choice Inc Medicare	$33.18
Rate for Payer: Healthfirst Medicare Advantage	$28.20
Rate for Payer: Healthfirst QHP	$33.18
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$33.18
Rate for Payer: Senior Whole Health Medicare Advantage	$33.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26.54
Rate for Payer: Wellcare Medicare	$31.52

SMOKING CESSATION COUNSELING.

Facility

$82.75

Service Code	HCPCS 99406
Hospital Charge Code	30400123
Hospital Revenue Code	942
Min. Negotiated Rate	$26.54
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$45.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.18
Rate for Payer: Aetna Government	$33.18
Rate for Payer: Brighton Health Commercial	$62.06
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Cash Price	$33.18
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$33.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$66.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$56.27
Rate for Payer: Elderplan Medicare Advantage	$33.18
Rate for Payer: Fidelis Essential Plan Aliesa	$28.20
Rate for Payer: Fidelis Essential Plan QHP	$29.53
Rate for Payer: Fidelis Medicare Advantage	$33.18
Rate for Payer: Fidelis Qualified Health Plan	$29.53
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	$41.38
Rate for Payer: Hamaspik Choice Inc Medicare	$33.18
Rate for Payer: Healthfirst Medicare Advantage	$28.20
Rate for Payer: Healthfirst QHP	$33.18
Rate for Payer: Senior Whole Health Medicare Advantage	$33.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$26.54
Rate for Payer: Wellcare Medicare	$31.52

SMOKING CESSATION COUNSELING.

Facility

$82.75

Service Code	HCPCS 99406
Hospital Charge Code	30400123
Hospital Revenue Code	942
Rate for Payer: Cash Price	$33.18

SMOOTH MUSCLE ANTIBODY T

Facility

$30.13

Service Code	HCPCS 86256
Hospital Charge Code	30303372
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$22.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.05
Rate for Payer: Aetna Government	$12.05
Rate for Payer: Brighton Health Commercial	$22.60
Rate for Payer: Cash Price	$12.05
Rate for Payer: Cash Price	$12.05
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.20
Rate for Payer: Elderplan Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$12.05
Rate for Payer: Fidelis Essential Plan Aliesa	$10.24
Rate for Payer: Fidelis Essential Plan QHP	$10.72
Rate for Payer: Fidelis Medicare Advantage	$12.05
Rate for Payer: Fidelis Qualified Health Plan	$10.72
Rate for Payer: Group Health Inc Commercial	$12.05
Rate for Payer: Group Health Inc Medicare	$12.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.06
Rate for Payer: Hamaspik Choice Inc Medicare	$12.05
Rate for Payer: Healthfirst Medicare Advantage	$12.05
Rate for Payer: Healthfirst QHP	$12.05
Rate for Payer: Senior Whole Health Medicare Advantage	$12.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.05
Rate for Payer: Wellcare CHP/FHP/Medicaid	$9.64
Rate for Payer: Wellcare Medicare	$10.84

SMOOTH MUSCLE ANTIBODY T

Facility

$30.13

Service Code	HCPCS 86256
Hospital Charge Code	30303372
Hospital Revenue Code	302
Rate for Payer: Cash Price	$12.05

S.M.P. CATH SET ASH SPLIT 14FX28C

Facility

$860.00

Hospital Charge Code	40009324
Hospital Revenue Code	272
Min. Negotiated Rate	$301.00
Max. Negotiated Rate	$688.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$473.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$430.00
Rate for Payer: Aetna Government	$430.00
Rate for Payer: Brighton Health Commercial	$645.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$688.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$584.80
Rate for Payer: Group Health Inc Commercial	$430.00
Rate for Payer: Group Health Inc Medicare	$301.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$430.00
Rate for Payer: Hamaspik Choice Inc Medicare	$430.00

S.M.P. CATH SET ASH SPLIT 14FX28C

Facility

$860.00

Hospital Charge Code	40203342
Hospital Revenue Code	272
Min. Negotiated Rate	$301.00
Max. Negotiated Rate	$688.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$473.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$430.00
Rate for Payer: Aetna Government	$430.00
Rate for Payer: Brighton Health Commercial	$645.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$688.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$584.80
Rate for Payer: Group Health Inc Commercial	$430.00
Rate for Payer: Group Health Inc Medicare	$301.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$430.00
Rate for Payer: Hamaspik Choice Inc Medicare	$430.00

SNARE COLD ROUND

Facility

$32.50

Hospital Charge Code	64906818
Hospital Revenue Code	270
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$26.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.25
Rate for Payer: Aetna Government	$16.25
Rate for Payer: Brighton Health Commercial	$24.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.10
Rate for Payer: Group Health Inc Commercial	$16.25
Rate for Payer: Group Health Inc Medicare	$11.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.25
Rate for Payer: Hamaspik Choice Inc Medicare	$16.25

SNARE POLY 2.4MM MED OVAL

Facility

$47.84

Hospital Charge Code	64906816
Hospital Revenue Code	270
Min. Negotiated Rate	$16.74
Max. Negotiated Rate	$38.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.92
Rate for Payer: Aetna Government	$23.92
Rate for Payer: Brighton Health Commercial	$35.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$38.27
Rate for Payer: Cigna LocalPlus Benefit Plan	$32.53
Rate for Payer: Group Health Inc Commercial	$23.92
Rate for Payer: Group Health Inc Medicare	$16.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.92
Rate for Payer: Hamaspik Choice Inc Medicare	$23.92

SNARE POLY 2.4MM SM OVAL

Facility

$18.86

Hospital Charge Code	64906815
Hospital Revenue Code	270
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$15.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.43
Rate for Payer: Aetna Government	$9.43
Rate for Payer: Brighton Health Commercial	$14.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.82
Rate for Payer: Group Health Inc Commercial	$9.43
Rate for Payer: Group Health Inc Medicare	$6.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.43
Rate for Payer: Hamaspik Choice Inc Medicare	$9.43

SNARE ROTATING 20MM , MINI STD

Facility

$103.00

Hospital Charge Code	40209779
Hospital Revenue Code	270
Min. Negotiated Rate	$36.05
Max. Negotiated Rate	$82.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$56.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.50
Rate for Payer: Aetna Government	$51.50
Rate for Payer: Brighton Health Commercial	$77.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$82.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$70.04
Rate for Payer: Group Health Inc Commercial	$51.50
Rate for Payer: Group Health Inc Medicare	$36.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.50
Rate for Payer: Hamaspik Choice Inc Medicare	$51.50

SNARE ROTATING MICRO OVAL 13MM

Facility

$126.06

Hospital Charge Code	64903946
Hospital Revenue Code	270
Min. Negotiated Rate	$44.12
Max. Negotiated Rate	$100.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$69.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.03
Rate for Payer: Aetna Government	$63.03
Rate for Payer: Brighton Health Commercial	$94.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$100.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$85.72
Rate for Payer: Group Health Inc Commercial	$63.03
Rate for Payer: Group Health Inc Medicare	$44.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$63.03
Rate for Payer: Hamaspik Choice Inc Medicare	$63.03

SNARE SHRT THR STD OV 30MM 40BX

Facility

$66.31

Hospital Charge Code	64904458
Hospital Revenue Code	270
Min. Negotiated Rate	$23.21
Max. Negotiated Rate	$53.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$36.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$33.16
Rate for Payer: Aetna Government	$33.16
Rate for Payer: Brighton Health Commercial	$49.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$53.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$45.09
Rate for Payer: Group Health Inc Commercial	$33.16
Rate for Payer: Group Health Inc Medicare	$23.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.16
Rate for Payer: Hamaspik Choice Inc Medicare	$33.16

Know your out-of-pocket cost for care.

All Charges