St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SURGERY TO REPAIR BROKEN WRIST

Facility

$19,280.70

Service Code	HCPCS 25608
Hospital Charge Code	30301511
Hospital Revenue Code	361
Rate for Payer: Cash Price	$8,273.12

SURGERY TO REPAIR BROKEN WRIST

Facility

$19,280.70

Service Code	HCPCS 25608
Hospital Charge Code	30301511
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$14,460.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,593.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8,273.12
Rate for Payer: Aetna Government	$8,273.12
Rate for Payer: Brighton Health Commercial	$14,460.52
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8,273.12
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	$8,273.12
Rate for Payer: EmblemHealth Commercial	$8,273.12
Rate for Payer: Fidelis Essential Plan Aliesa	$7,032.15
Rate for Payer: Fidelis Essential Plan QHP	$7,363.08
Rate for Payer: Fidelis Medicare Advantage	$8,273.12
Rate for Payer: Fidelis Qualified Health Plan	$7,363.08
Rate for Payer: Group Health Inc Commercial	$8,273.12
Rate for Payer: Group Health Inc Medicare	$8,273.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,640.35
Rate for Payer: Hamaspik Choice Inc Medicare	$8,273.12
Rate for Payer: Healthfirst Medicare Advantage	$7,032.15
Rate for Payer: Healthfirst QHP	$8,273.12
Rate for Payer: Senior Whole Health Medicare Advantage	$8,273.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,273.12
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6,618.50
Rate for Payer: Wellcare Medicare	$7,859.46

SURG EXP-IMP/UNERUP TOOTH FOR ORT

Facility

$725.00

Service Code	HCPCS D7280
Hospital Charge Code	42301705
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,018.19

SURG EXP-IMP/UNERUP TOOTH FOR ORT

Facility

$725.00

Service Code	HCPCS D7280
Hospital Charge Code	42301705
Hospital Revenue Code	361
Min. Negotiated Rate	$362.50
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$398.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,018.19
Rate for Payer: Aetna Government	$1,018.19
Rate for Payer: Brighton Health Commercial	$543.75
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,018.19
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	$1,018.19
Rate for Payer: EmblemHealth Commercial	$1,018.19
Rate for Payer: Fidelis Essential Plan Aliesa	$865.46
Rate for Payer: Fidelis Essential Plan QHP	$906.19
Rate for Payer: Fidelis Medicare Advantage	$1,018.19
Rate for Payer: Fidelis Qualified Health Plan	$906.19
Rate for Payer: Group Health Inc Commercial	$1,018.19
Rate for Payer: Group Health Inc Medicare	$1,018.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$362.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,018.19
Rate for Payer: Healthfirst Medicare Advantage	$865.46
Rate for Payer: Healthfirst QHP	$1,018.19
Rate for Payer: Senior Whole Health Medicare Advantage	$1,018.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,018.19
Rate for Payer: Wellcare CHP/FHP/Medicaid	$814.55
Rate for Payer: Wellcare Medicare	$967.28

SURG FIBRILLAR ABS

Facility

$539.89

Hospital Charge Code	64905768
Hospital Revenue Code	270
Min. Negotiated Rate	$188.96
Max. Negotiated Rate	$431.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$296.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$269.94
Rate for Payer: Aetna Government	$269.94
Rate for Payer: Brighton Health Commercial	$404.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$431.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$367.13
Rate for Payer: Group Health Inc Commercial	$269.94
Rate for Payer: Group Health Inc Medicare	$188.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$269.94
Rate for Payer: Hamaspik Choice Inc Medicare	$269.94

SURGICAL 1/2 X 2

Facility

$6.73

Hospital Charge Code	40205802
Hospital Revenue Code	270
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$5.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.36
Rate for Payer: Aetna Government	$3.36
Rate for Payer: Brighton Health Commercial	$5.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.58
Rate for Payer: Group Health Inc Commercial	$3.36
Rate for Payer: Group Health Inc Medicare	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.36
Rate for Payer: Hamaspik Choice Inc Medicare	$3.36

SURGICAL 2 X 14

Facility

$18.78

Hospital Charge Code	40205814
Hospital Revenue Code	270
Min. Negotiated Rate	$6.57
Max. Negotiated Rate	$15.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.39
Rate for Payer: Aetna Government	$9.39
Rate for Payer: Brighton Health Commercial	$14.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.77
Rate for Payer: Group Health Inc Commercial	$9.39
Rate for Payer: Group Health Inc Medicare	$6.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.39
Rate for Payer: Hamaspik Choice Inc Medicare	$9.39

SURGICAL 2 X 3

Facility

$12.05

Hospital Charge Code	40205803
Hospital Revenue Code	270
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$9.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.02
Rate for Payer: Aetna Government	$6.02
Rate for Payer: Brighton Health Commercial	$9.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.19
Rate for Payer: Group Health Inc Commercial	$6.02
Rate for Payer: Group Health Inc Medicare	$4.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.02
Rate for Payer: Hamaspik Choice Inc Medicare	$6.02

SURGICAL 4 X 8

Facility

$25.52

Hospital Charge Code	40205808
Hospital Revenue Code	270
Min. Negotiated Rate	$8.93
Max. Negotiated Rate	$20.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.76
Rate for Payer: Aetna Government	$12.76
Rate for Payer: Brighton Health Commercial	$19.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.35
Rate for Payer: Group Health Inc Commercial	$12.76
Rate for Payer: Group Health Inc Medicare	$8.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.76
Rate for Payer: Hamaspik Choice Inc Medicare	$12.76

SURGICAL DISCECTOMY WITH/WITHOUT

Facility

$2,175.00

Service Code	HCPCS D7850
Hospital Charge Code	42301960
Hospital Revenue Code	361
Min. Negotiated Rate	$761.25
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,196.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,557.25
Rate for Payer: Aetna Government	$1,557.25
Rate for Payer: Brighton Health Commercial	$1,631.25
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	$1,087.50
Rate for Payer: Group Health Inc Medicare	$761.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,087.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,087.50

SURGICAL IMPLANT

Facility

$2,500.00

Hospital Charge Code	40203231
Hospital Revenue Code	272
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$2,000.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,375.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,250.00
Rate for Payer: Aetna Government	$1,250.00
Rate for Payer: Brighton Health Commercial	$1,875.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,000.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,700.00
Rate for Payer: Group Health Inc Commercial	$1,250.00
Rate for Payer: Group Health Inc Medicare	$875.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,250.00

SURGICAL PATHOLOGY GROSS EXM ONLY

Facility

$69.63

Service Code	HCPCS 88300
Hospital Charge Code	40635411
Hospital Revenue Code	310
Rate for Payer: Cash Price	$34.43

SURGICAL PATHOLOGY GROSS EXM ONLY

Facility

$69.63

Service Code	HCPCS 88300
Hospital Charge Code	40635411
Hospital Revenue Code	310
Min. Negotiated Rate	$21.44
Max. Negotiated Rate	$38.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.43
Rate for Payer: Aetna Government	$34.43
Rate for Payer: Brighton Health Commercial	$34.43
Rate for Payer: Cash Price	$34.43
Rate for Payer: Cash Price	$34.43
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$34.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.44
Rate for Payer: Elderplan Medicare Advantage	$34.43
Rate for Payer: EmblemHealth Commercial	$34.43
Rate for Payer: Fidelis Essential Plan Aliesa	$29.27
Rate for Payer: Fidelis Essential Plan QHP	$30.64
Rate for Payer: Fidelis Medicare Advantage	$34.43
Rate for Payer: Fidelis Qualified Health Plan	$30.64
Rate for Payer: Group Health Inc Commercial	$34.43
Rate for Payer: Group Health Inc Medicare	$34.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.82
Rate for Payer: Hamaspik Choice Inc Medicare	$34.43
Rate for Payer: Healthfirst Medicare Advantage	$34.43
Rate for Payer: Healthfirst QHP	$34.43
Rate for Payer: Senior Whole Health Medicare Advantage	$34.43
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.43
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27.54
Rate for Payer: Wellcare Medicare	$30.99

SURGICAL PREP OF SITE

Facility

$4,914.88

Service Code	HCPCS 15002
Hospital Charge Code	42500134
Hospital Revenue Code	361
Rate for Payer: Cash Price	$2,108.87

SURGICAL PREP OF SITE

Facility

$4,914.88

Service Code	HCPCS 15002
Hospital Charge Code	42500134
Hospital Revenue Code	361
Min. Negotiated Rate	$780.00
Max. Negotiated Rate	$3,686.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,108.87
Rate for Payer: Aetna Government	$2,108.87
Rate for Payer: Brighton Health Commercial	$3,686.16
Rate for Payer: Cash Price	$2,108.87
Rate for Payer: Cash Price	$2,108.87
Rate for Payer: Cash Price	$2,108.87
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,108.87
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	$2,108.87
Rate for Payer: EmblemHealth Commercial	$2,108.87
Rate for Payer: Fidelis Essential Plan Aliesa	$1,792.54
Rate for Payer: Fidelis Essential Plan QHP	$1,876.89
Rate for Payer: Fidelis Medicare Advantage	$2,108.87
Rate for Payer: Fidelis Qualified Health Plan	$1,876.89
Rate for Payer: Group Health Inc Commercial	$2,108.87
Rate for Payer: Group Health Inc Medicare	$2,108.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,457.44
Rate for Payer: Hamaspik Choice Inc Medicare	$2,108.87
Rate for Payer: Healthfirst Medicare Advantage	$1,792.54
Rate for Payer: Healthfirst QHP	$2,108.87
Rate for Payer: Senior Whole Health Medicare Advantage	$2,108.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,108.87
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,687.10
Rate for Payer: Wellcare Medicare	$2,003.43

SURGICAL REPOSITIONING OF TEETH

Facility

$362.50

Service Code	HCPCS D7290
Hospital Charge Code	42301725
Hospital Revenue Code	361
Min. Negotiated Rate	$97.60
Max. Negotiated Rate	$9,760.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$199.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$110.12
Rate for Payer: Aetna Government	$110.12
Rate for Payer: Amida Care Medicaid	$97.60
Rate for Payer: Brighton Health Commercial	$271.88
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: Fidelis CHP/HARP/Medicaid	$9,760.00
Rate for Payer: Fidelis Essential Plan Aliesa	$97.60
Rate for Payer: Fidelis Essential Plan QHP	$97.60
Rate for Payer: Fidelis Qualified Health Plan	$102.48
Rate for Payer: Group Health Inc Commercial	$181.25
Rate for Payer: Group Health Inc Medicare	$126.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.60
Rate for Payer: Hamaspik Choice Inc Medicare	$181.25
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$97.60
Rate for Payer: Healthfirst Essential Plan	$219.60
Rate for Payer: Healthfirst QHP	$97.60
Rate for Payer: SOMOS CHP/HARP/Medicaid	$97.60
Rate for Payer: SOMOS Essential	$219.60
Rate for Payer: Wellcare CHP/FHP/Medicaid	$97.60

SURGICAL SPLINT

Facility

$1,066.00

Service Code	HCPCS D5988
Hospital Charge Code	42301405
Hospital Revenue Code	361
Min. Negotiated Rate	$533.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$586.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,018.19
Rate for Payer: Aetna Government	$1,018.19
Rate for Payer: Brighton Health Commercial	$799.50
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Cash Price	$1,018.19
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,018.19
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	$1,018.19
Rate for Payer: EmblemHealth Commercial	$1,018.19
Rate for Payer: Fidelis Essential Plan Aliesa	$865.46
Rate for Payer: Fidelis Essential Plan QHP	$906.19
Rate for Payer: Fidelis Medicare Advantage	$1,018.19
Rate for Payer: Fidelis Qualified Health Plan	$906.19
Rate for Payer: Group Health Inc Commercial	$1,018.19
Rate for Payer: Group Health Inc Medicare	$1,018.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$533.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,018.19
Rate for Payer: Healthfirst Medicare Advantage	$865.46
Rate for Payer: Healthfirst QHP	$1,018.19
Rate for Payer: Senior Whole Health Medicare Advantage	$1,018.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,018.19
Rate for Payer: Wellcare CHP/FHP/Medicaid	$814.55
Rate for Payer: Wellcare Medicare	$967.28

SURGICAL SPLINT

Facility

$1,066.00

Service Code	HCPCS D5988
Hospital Charge Code	42301405
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,018.19

SURGICAL STENT

Facility

$666.00

Service Code	HCPCS D5982
Hospital Charge Code	42301375
Hospital Revenue Code	361
Min. Negotiated Rate	$163.15
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$366.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$163.15
Rate for Payer: Aetna Government	$163.15
Rate for Payer: Brighton Health Commercial	$499.50
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	$333.00
Rate for Payer: Group Health Inc Medicare	$233.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$333.00
Rate for Payer: Hamaspik Choice Inc Medicare	$333.00

SURGICAL SUPPLY 100-499

Facility

$430.09

Hospital Charge Code	40203106
Hospital Revenue Code	272
Min. Negotiated Rate	$150.53
Max. Negotiated Rate	$344.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$236.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$215.04
Rate for Payer: Aetna Government	$215.04
Rate for Payer: Brighton Health Commercial	$322.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$344.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$292.46
Rate for Payer: Group Health Inc Commercial	$215.04
Rate for Payer: Group Health Inc Medicare	$150.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$215.04
Rate for Payer: Hamaspik Choice Inc Medicare	$215.04

SURGICAL SUPPLY 500-1000

Facility

$1,357.77

Hospital Charge Code	40203107
Hospital Revenue Code	272
Min. Negotiated Rate	$475.22
Max. Negotiated Rate	$1,086.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$746.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$678.88
Rate for Payer: Aetna Government	$678.88
Rate for Payer: Brighton Health Commercial	$1,018.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,086.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$923.28
Rate for Payer: Group Health Inc Commercial	$678.88
Rate for Payer: Group Health Inc Medicare	$475.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$678.88
Rate for Payer: Hamaspik Choice Inc Medicare	$678.88

Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric

Facility

$3,246.99

Service Code	CPT 46275
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$3,246.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,246.99
Rate for Payer: Aetna Government	$3,246.99
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,246.99
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	$3,246.99
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$2,759.94
Rate for Payer: Fidelis Essential Plan QHP	$2,889.82
Rate for Payer: Fidelis Medicare Advantage	$3,246.99
Rate for Payer: Fidelis Qualified Health Plan	$2,889.82
Rate for Payer: Group Health Inc Commercial	$3,246.99
Rate for Payer: Group Health Inc Medicare	$3,246.99
Rate for Payer: Hamaspik Choice Inc Medicare	$3,246.99
Rate for Payer: Healthfirst Medicare Advantage	$2,759.94
Rate for Payer: Healthfirst QHP	$3,246.99
Rate for Payer: Senior Whole Health Medicare Advantage	$3,246.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,246.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,597.59
Rate for Payer: Wellcare Medicare	$3,084.64

Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage

Facility

$3,246.99

Service Code	CPT 46285
Hospital Revenue Code	360
Min. Negotiated Rate	$1,412.00
Max. Negotiated Rate	$3,246.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,246.99
Rate for Payer: Aetna Government	$3,246.99
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,246.99
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	$3,246.99
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$2,759.94
Rate for Payer: Fidelis Essential Plan QHP	$2,889.82
Rate for Payer: Fidelis Medicare Advantage	$3,246.99
Rate for Payer: Fidelis Qualified Health Plan	$2,889.82
Rate for Payer: Group Health Inc Commercial	$3,246.99
Rate for Payer: Group Health Inc Medicare	$3,246.99
Rate for Payer: Hamaspik Choice Inc Medicare	$3,246.99
Rate for Payer: Healthfirst Medicare Advantage	$2,759.94
Rate for Payer: Healthfirst QHP	$3,246.99
Rate for Payer: Senior Whole Health Medicare Advantage	$3,246.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,246.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,597.59
Rate for Payer: Wellcare Medicare	$3,084.64

Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous

Facility

$3,246.99

Service Code	CPT 46270
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$3,246.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,246.99
Rate for Payer: Aetna Government	$3,246.99
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,246.99
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	$3,246.99
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$2,759.94
Rate for Payer: Fidelis Essential Plan QHP	$2,889.82
Rate for Payer: Fidelis Medicare Advantage	$3,246.99
Rate for Payer: Fidelis Qualified Health Plan	$2,889.82
Rate for Payer: Group Health Inc Commercial	$3,246.99
Rate for Payer: Group Health Inc Medicare	$3,246.99
Rate for Payer: Hamaspik Choice Inc Medicare	$3,246.99
Rate for Payer: Healthfirst Medicare Advantage	$2,759.94
Rate for Payer: Healthfirst QHP	$3,246.99
Rate for Payer: Senior Whole Health Medicare Advantage	$3,246.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,246.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,597.59
Rate for Payer: Wellcare Medicare	$3,084.64

Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, suprasphincteric, extrasphincteric or multiple, including placement of seton, when performed

Facility

$3,246.99

Service Code	CPT 46280
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$3,246.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,246.99
Rate for Payer: Aetna Government	$3,246.99
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,246.99
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	$3,246.99
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$2,759.94
Rate for Payer: Fidelis Essential Plan QHP	$2,889.82
Rate for Payer: Fidelis Medicare Advantage	$3,246.99
Rate for Payer: Fidelis Qualified Health Plan	$2,889.82
Rate for Payer: Group Health Inc Commercial	$3,246.99
Rate for Payer: Group Health Inc Medicare	$3,246.99
Rate for Payer: Hamaspik Choice Inc Medicare	$3,246.99
Rate for Payer: Healthfirst Medicare Advantage	$2,759.94
Rate for Payer: Healthfirst QHP	$3,246.99
Rate for Payer: Senior Whole Health Medicare Advantage	$3,246.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,246.99
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,597.59
Rate for Payer: Wellcare Medicare	$3,084.64

Know your out-of-pocket cost for care.

All Charges