St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

STR 3.5X70MM CORT SCREW

Facility

$320.00

Service Code	HCPCS C1713
Hospital Charge Code	40008251
Hospital Revenue Code	278
Min. Negotiated Rate	$112.00
Max. Negotiated Rate	$336.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$176.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$192.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$160.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.00
Rate for Payer: EmblemHealth Commercial	$160.00
Rate for Payer: Fidelis Medicare Advantage	$336.00
Rate for Payer: Group Health Inc Commercial	$160.00
Rate for Payer: Group Health Inc Medicare	$112.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$160.00
Rate for Payer: Hamaspik Choice Inc Medicare	$160.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$208.00

STR 4 HL FRACT PLT W/SPAN

Facility

$591.36

Service Code	HCPCS C1713
Hospital Charge Code	40204446
Hospital Revenue Code	278
Min. Negotiated Rate	$295.68
Max. Negotiated Rate	$295.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$295.68
Rate for Payer: Hamaspik Choice Inc Medicare	$295.68

STR 4 HL FRACT PLT W/SPAN

Facility

$591.36

Service Code	HCPCS C1713
Hospital Charge Code	40204446
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$620.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$325.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$354.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$295.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$340.03
Rate for Payer: EmblemHealth Commercial	$295.68
Rate for Payer: Fidelis Medicare Advantage	$620.93
Rate for Payer: Group Health Inc Commercial	$295.68
Rate for Payer: Group Health Inc Medicare	$206.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$295.68
Rate for Payer: Hamaspik Choice Inc Medicare	$295.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$384.38

STR 5HL L PLT 5MM ADVMT100DRT STD

Facility

$709.50

Service Code	HCPCS C1713
Hospital Charge Code	40204678
Hospital Revenue Code	278
Min. Negotiated Rate	$354.75
Max. Negotiated Rate	$354.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.75
Rate for Payer: Hamaspik Choice Inc Medicare	$354.75

STR 5HL L PLT 5MM ADVMT100DRT STD

Facility

$709.50

Service Code	HCPCS C1713
Hospital Charge Code	40204678
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$744.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$390.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$425.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$354.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$407.96
Rate for Payer: EmblemHealth Commercial	$354.75
Rate for Payer: Fidelis Medicare Advantage	$744.98
Rate for Payer: Group Health Inc Commercial	$354.75
Rate for Payer: Group Health Inc Medicare	$248.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.75
Rate for Payer: Hamaspik Choice Inc Medicare	$354.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$461.18

STR 8MM PLT 11HL LEFORT 1 ADV RT

Facility

$709.50

Service Code	HCPCS C1713
Hospital Charge Code	40204677
Hospital Revenue Code	278
Min. Negotiated Rate	$354.75
Max. Negotiated Rate	$354.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.75
Rate for Payer: Hamaspik Choice Inc Medicare	$354.75

STR 8MM PLT 11HL LEFORT 1 ADV RT

Facility

$709.50

Service Code	HCPCS C1713
Hospital Charge Code	40204677
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$744.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$390.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$425.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$354.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$407.96
Rate for Payer: EmblemHealth Commercial	$354.75
Rate for Payer: Fidelis Medicare Advantage	$744.98
Rate for Payer: Group Health Inc Commercial	$354.75
Rate for Payer: Group Health Inc Medicare	$248.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$354.75
Rate for Payer: Hamaspik Choice Inc Medicare	$354.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$461.18

STRAIGHT MINI DRILL

Facility

$487.50

Hospital Charge Code	64907192
Hospital Revenue Code	279
Min. Negotiated Rate	$170.62
Max. Negotiated Rate	$390.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$268.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$243.75
Rate for Payer: Aetna Government	$243.75
Rate for Payer: Brighton Health Commercial	$365.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$390.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$331.50
Rate for Payer: Group Health Inc Commercial	$243.75
Rate for Payer: Group Health Inc Medicare	$170.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$243.75
Rate for Payer: Hamaspik Choice Inc Medicare	$243.75

STRAP ANKLE OR FOOT

Facility

$405.08

Service Code	HCPCS 29540
Hospital Charge Code	30100015
Hospital Revenue Code	450
Rate for Payer: Cash Price	$182.22

STRAP ANKLE OR FOOT

Facility

$405.08

Service Code	HCPCS 29540
Hospital Charge Code	30100015
Hospital Revenue Code	450
Min. Negotiated Rate	$145.78
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$182.22
Rate for Payer: Aetna Government	$182.22
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$182.22
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$182.22
Rate for Payer: Cash Price	$182.22
Rate for Payer: Cash Price	$182.22
Rate for Payer: Cash Price	$182.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$182.22
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	$182.22
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis Essential Plan Aliesa	$154.89
Rate for Payer: Fidelis Essential Plan QHP	$162.18
Rate for Payer: Fidelis Medicare Advantage	$182.22
Rate for Payer: Fidelis Qualified Health Plan	$162.18
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	$202.54
Rate for Payer: Hamaspik Choice Inc Medicare	$182.22
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$182.22
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$182.22
Rate for Payer: Senior Whole Health Medicare Advantage	$182.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$182.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$145.78
Rate for Payer: Wellcare Medicare	$173.11

STRAP HEAD CPAP

Facility

$15.90

Hospital Charge Code	64902267
Hospital Revenue Code	270
Min. Negotiated Rate	$5.56
Max. Negotiated Rate	$12.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.95
Rate for Payer: Aetna Government	$7.95
Rate for Payer: Brighton Health Commercial	$11.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.81
Rate for Payer: Group Health Inc Commercial	$7.95
Rate for Payer: Group Health Inc Medicare	$5.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.95
Rate for Payer: Hamaspik Choice Inc Medicare	$7.95

STRAP KNEE CHO-PAT LGE 14.5-16.5

Facility

$31.95

Hospital Charge Code	64902837
Hospital Revenue Code	270
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$25.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.98
Rate for Payer: Aetna Government	$15.98
Rate for Payer: Brighton Health Commercial	$23.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.73
Rate for Payer: Group Health Inc Commercial	$15.98
Rate for Payer: Group Health Inc Medicare	$11.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.98
Rate for Payer: Hamaspik Choice Inc Medicare	$15.98

STRAP KNEE CHO-PAT MED 12.5-14.5

Facility

$31.95

Hospital Charge Code	64902850
Hospital Revenue Code	270
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$25.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.98
Rate for Payer: Aetna Government	$15.98
Rate for Payer: Brighton Health Commercial	$23.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.73
Rate for Payer: Group Health Inc Commercial	$15.98
Rate for Payer: Group Health Inc Medicare	$11.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.98
Rate for Payer: Hamaspik Choice Inc Medicare	$15.98

STRAP KNEE CHO-PAT SM 10-12-1/2

Facility

$31.95

Hospital Charge Code	64902848
Hospital Revenue Code	270
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$25.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.98
Rate for Payer: Aetna Government	$15.98
Rate for Payer: Brighton Health Commercial	$23.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.73
Rate for Payer: Group Health Inc Commercial	$15.98
Rate for Payer: Group Health Inc Medicare	$11.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.98
Rate for Payer: Hamaspik Choice Inc Medicare	$15.98

STRAP KNEE CHO-PAT XSM 10-12-1/2

Facility

$31.95

Hospital Charge Code	64902846
Hospital Revenue Code	270
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$25.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.98
Rate for Payer: Aetna Government	$15.98
Rate for Payer: Brighton Health Commercial	$23.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.73
Rate for Payer: Group Health Inc Commercial	$15.98
Rate for Payer: Group Health Inc Medicare	$11.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.98
Rate for Payer: Hamaspik Choice Inc Medicare	$15.98

STRAPPING OF ANKLE

Facility

$405.08

Service Code	HCPCS 29540
Hospital Charge Code	30301129
Hospital Revenue Code	510
Rate for Payer: Cash Price	$182.22

STRAPPING OF ANKLE

Facility

$405.08

Service Code	HCPCS 29540
Hospital Charge Code	30301129
Hospital Revenue Code	510
Min. Negotiated Rate	$145.78
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$182.22
Rate for Payer: Aetna Government	$182.22
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$182.22
Rate for Payer: Cash Price	$182.22
Rate for Payer: Cash Price	$182.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$182.22
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	$182.22
Rate for Payer: Fidelis Essential Plan Aliesa	$154.89
Rate for Payer: Fidelis Essential Plan QHP	$162.18
Rate for Payer: Fidelis Medicare Advantage	$182.22
Rate for Payer: Fidelis Qualified Health Plan	$162.18
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	$202.54
Rate for Payer: Hamaspik Choice Inc Medicare	$182.22
Rate for Payer: Healthfirst Medicare Advantage	$154.89
Rate for Payer: Healthfirst QHP	$182.22
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$182.22
Rate for Payer: Senior Whole Health Medicare Advantage	$182.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$182.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$145.78
Rate for Payer: Wellcare Medicare	$173.11

STRAPPING OF ELBOW OR WRIST

Facility

$101.25

Service Code	HCPCS 29260
Hospital Charge Code	30301128
Hospital Revenue Code	510
Min. Negotiated Rate	$50.62
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.74
Rate for Payer: Aetna Government	$70.74
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$70.74
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	$70.74
Rate for Payer: Fidelis Essential Plan Aliesa	$60.13
Rate for Payer: Fidelis Essential Plan QHP	$62.96
Rate for Payer: Fidelis Medicare Advantage	$70.74
Rate for Payer: Fidelis Qualified Health Plan	$62.96
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	$50.62
Rate for Payer: Hamaspik Choice Inc Medicare	$70.74
Rate for Payer: Healthfirst Medicare Advantage	$60.13
Rate for Payer: Healthfirst QHP	$70.74
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$70.74
Rate for Payer: Senior Whole Health Medicare Advantage	$70.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.74
Rate for Payer: Wellcare CHP/FHP/Medicaid	$56.59
Rate for Payer: Wellcare Medicare	$67.20

STRAPPING OF ELBOW OR WRIST

Facility

$101.25

Service Code	HCPCS 29260
Hospital Charge Code	30301128
Hospital Revenue Code	510
Rate for Payer: Cash Price	$70.74

STRAPPING OF HAND OR FINGER

Facility

$101.25

Service Code	HCPCS 29280
Hospital Charge Code	30301144
Hospital Revenue Code	510
Min. Negotiated Rate	$50.62
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.74
Rate for Payer: Aetna Government	$70.74
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$70.74
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	$70.74
Rate for Payer: Fidelis Essential Plan Aliesa	$60.13
Rate for Payer: Fidelis Essential Plan QHP	$62.96
Rate for Payer: Fidelis Medicare Advantage	$70.74
Rate for Payer: Fidelis Qualified Health Plan	$62.96
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	$50.62
Rate for Payer: Hamaspik Choice Inc Medicare	$70.74
Rate for Payer: Healthfirst Medicare Advantage	$60.13
Rate for Payer: Healthfirst QHP	$70.74
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$70.74
Rate for Payer: Senior Whole Health Medicare Advantage	$70.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.74
Rate for Payer: Wellcare CHP/FHP/Medicaid	$56.59
Rate for Payer: Wellcare Medicare	$67.20

STRAPPING OF HAND OR FINGER

Facility

$101.25

Service Code	HCPCS 29280
Hospital Charge Code	30301144
Hospital Revenue Code	510
Rate for Payer: Cash Price	$70.74

STRAPPING OF SHOULDER

Facility

$330.23

Service Code	HCPCS 29240
Hospital Charge Code	30301127
Hospital Revenue Code	510
Rate for Payer: Cash Price	$147.72

STRAPPING OF SHOULDER

Facility

$330.23

Service Code	HCPCS 29240
Hospital Charge Code	30301127
Hospital Revenue Code	510
Min. Negotiated Rate	$118.18
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$147.72
Rate for Payer: Aetna Government	$147.72
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$147.72
Rate for Payer: Cash Price	$147.72
Rate for Payer: Cash Price	$147.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$147.72
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	$147.72
Rate for Payer: Fidelis Essential Plan Aliesa	$125.56
Rate for Payer: Fidelis Essential Plan QHP	$131.47
Rate for Payer: Fidelis Medicare Advantage	$147.72
Rate for Payer: Fidelis Qualified Health Plan	$131.47
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	$165.12
Rate for Payer: Hamaspik Choice Inc Medicare	$147.72
Rate for Payer: Healthfirst Medicare Advantage	$125.56
Rate for Payer: Healthfirst QHP	$147.72
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$147.72
Rate for Payer: Senior Whole Health Medicare Advantage	$147.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$147.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$118.18
Rate for Payer: Wellcare Medicare	$140.33

STRAPPING OF TOE

Facility

$170.35

Service Code	HCPCS 29550
Hospital Charge Code	30106513
Hospital Revenue Code	450
Min. Negotiated Rate	$56.59
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.74
Rate for Payer: Aetna Government	$70.74
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$70.74
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$70.74
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	$70.74
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis Essential Plan Aliesa	$60.13
Rate for Payer: Fidelis Essential Plan QHP	$62.96
Rate for Payer: Fidelis Medicare Advantage	$70.74
Rate for Payer: Fidelis Qualified Health Plan	$62.96
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	$85.18
Rate for Payer: Hamaspik Choice Inc Medicare	$70.74
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$70.74
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$70.74
Rate for Payer: Senior Whole Health Medicare Advantage	$70.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.74
Rate for Payer: Wellcare CHP/FHP/Medicaid	$56.59
Rate for Payer: Wellcare Medicare	$67.20

STRAPPING OF TOE

Facility

$170.35

Service Code	HCPCS 29550
Hospital Charge Code	30106513
Hospital Revenue Code	450
Rate for Payer: Cash Price	$70.74

Know your out-of-pocket cost for care.

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