St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SURG. REDUC. OSSEOUS TUBEROSITY

Facility

$800.00

Service Code	HCPCS D7485
Hospital Charge Code	42303411
Hospital Revenue Code	361
Min. Negotiated Rate	$400.00
Max. Negotiated Rate	$6,772.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$440.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,772.21
Rate for Payer: Aetna Government	$6,772.21
Rate for Payer: Brighton Health Commercial	$600.00
Rate for Payer: Cash Price	$6,772.21
Rate for Payer: Cash Price	$6,772.21
Rate for Payer: Cash Price	$6,772.21
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6,772.21
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	$6,772.21
Rate for Payer: EmblemHealth Commercial	$6,772.21
Rate for Payer: Fidelis Essential Plan Aliesa	$5,756.38
Rate for Payer: Fidelis Essential Plan QHP	$6,027.27
Rate for Payer: Fidelis Medicare Advantage	$6,772.21
Rate for Payer: Fidelis Qualified Health Plan	$6,027.27
Rate for Payer: Group Health Inc Commercial	$6,772.21
Rate for Payer: Group Health Inc Medicare	$6,772.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$400.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,772.21
Rate for Payer: Healthfirst Medicare Advantage	$5,756.38
Rate for Payer: Healthfirst QHP	$6,772.21
Rate for Payer: Senior Whole Health Medicare Advantage	$6,772.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,772.21
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5,417.77
Rate for Payer: Wellcare Medicare	$6,433.60

SURG REDUCTION-FIBROUS TUBEROSITY

Facility

$850.00

Service Code	HCPCS D7972
Hospital Charge Code	42303454
Hospital Revenue Code	361
Min. Negotiated Rate	$205.51
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$467.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$205.51
Rate for Payer: Aetna Government	$205.51
Rate for Payer: Brighton Health Commercial	$637.50
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	$425.00
Rate for Payer: Group Health Inc Medicare	$297.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$425.00
Rate for Payer: Hamaspik Choice Inc Medicare	$425.00

SURG REM ERUP TOOTH REQ FLAP/BONE

Facility

$212.50

Service Code	HCPCS D7210
Hospital Charge Code	42301655
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,763.60

SURG REM ERUP TOOTH REQ FLAP/BONE

Facility

$212.50

Service Code	HCPCS D7210
Hospital Charge Code	42301655
Hospital Revenue Code	361
Min. Negotiated Rate	$106.25
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$116.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,763.60
Rate for Payer: Aetna Government	$1,763.60
Rate for Payer: Brighton Health Commercial	$159.38
Rate for Payer: Cash Price	$1,763.60
Rate for Payer: Cash Price	$1,763.60
Rate for Payer: Cash Price	$1,763.60
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,763.60
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	$1,763.60
Rate for Payer: EmblemHealth Commercial	$1,763.60
Rate for Payer: Fidelis Essential Plan Aliesa	$1,499.06
Rate for Payer: Fidelis Essential Plan QHP	$1,569.60
Rate for Payer: Fidelis Medicare Advantage	$1,763.60
Rate for Payer: Fidelis Qualified Health Plan	$1,569.60
Rate for Payer: Group Health Inc Commercial	$1,763.60
Rate for Payer: Group Health Inc Medicare	$1,763.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.25
Rate for Payer: Hamaspik Choice Inc Medicare	$1,763.60
Rate for Payer: Healthfirst Medicare Advantage	$1,499.06
Rate for Payer: Healthfirst QHP	$1,763.60
Rate for Payer: Senior Whole Health Medicare Advantage	$1,763.60
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,763.60
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,410.88
Rate for Payer: Wellcare Medicare	$1,675.42

SURG REM OF RESIDUAL TOOTH ROOTS

Facility

$145.00

Service Code	HCPCS D7250
Hospital Charge Code	42301680
Hospital Revenue Code	361
Rate for Payer: Cash Price	$1,018.19

SURG REM OF RESIDUAL TOOTH ROOTS

Facility

$145.00

Service Code	HCPCS D7250
Hospital Charge Code	42301680
Hospital Revenue Code	361
Min. Negotiated Rate	$72.50
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$79.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,018.19
Rate for Payer: Aetna Government	$1,018.19
Rate for Payer: Brighton Health Commercial	$108.75
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	$72.50
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

SUSPENSION OF BREAST

Facility

$15,862.45

Service Code	HCPCS 19316
Hospital Charge Code	40014221
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$11,896.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7,541.13
Rate for Payer: Aetna Government	$7,541.13
Rate for Payer: Brighton Health Commercial	$11,896.84
Rate for Payer: Cash Price	$7,541.13
Rate for Payer: Cash Price	$7,541.13
Rate for Payer: Cash Price	$7,541.13
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$7,541.13
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	$7,541.13
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$6,409.96
Rate for Payer: Fidelis Essential Plan QHP	$6,711.61
Rate for Payer: Fidelis Medicare Advantage	$7,541.13
Rate for Payer: Fidelis Qualified Health Plan	$6,711.61
Rate for Payer: Group Health Inc Commercial	$7,541.13
Rate for Payer: Group Health Inc Medicare	$7,541.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,931.22
Rate for Payer: Hamaspik Choice Inc Medicare	$7,541.13
Rate for Payer: Healthfirst Medicare Advantage	$6,409.96
Rate for Payer: Healthfirst QHP	$7,541.13
Rate for Payer: Senior Whole Health Medicare Advantage	$7,541.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7,541.13
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6,032.90
Rate for Payer: Wellcare Medicare	$7,164.07

SUSPENSION OF BREAST

Facility

$15,862.45

Service Code	HCPCS 19316
Hospital Charge Code	40014221
Hospital Revenue Code	360
Rate for Payer: Cash Price	$7,541.13

SUSPENSION OF TESTIS

Facility

$9,417.43

Service Code	HCPCS 54640
Hospital Charge Code	40124282
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$7,063.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,000.83
Rate for Payer: Aetna Government	$4,000.83
Rate for Payer: Brighton Health Commercial	$7,063.07
Rate for Payer: Cash Price	$4,000.83
Rate for Payer: Cash Price	$4,000.83
Rate for Payer: Cash Price	$4,000.83
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4,000.83
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	$4,000.83
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,400.71
Rate for Payer: Fidelis Essential Plan QHP	$3,560.74
Rate for Payer: Fidelis Medicare Advantage	$4,000.83
Rate for Payer: Fidelis Qualified Health Plan	$3,560.74
Rate for Payer: Group Health Inc Commercial	$4,000.83
Rate for Payer: Group Health Inc Medicare	$4,000.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,708.72
Rate for Payer: Hamaspik Choice Inc Medicare	$4,000.83
Rate for Payer: Healthfirst Medicare Advantage	$3,400.71
Rate for Payer: Healthfirst QHP	$4,000.83
Rate for Payer: Senior Whole Health Medicare Advantage	$4,000.83
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,000.83
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,200.66
Rate for Payer: Wellcare Medicare	$3,800.79

SUSPENSION OF TESTIS

Facility

$9,417.43

Service Code	HCPCS 54640
Hospital Charge Code	40124282
Hospital Revenue Code	360
Rate for Payer: Cash Price	$4,000.83

SUSPENSORY,LARGE,W LEG STRAP

Facility

$21.38

Hospital Charge Code	64901026
Hospital Revenue Code	270
Min. Negotiated Rate	$7.48
Max. Negotiated Rate	$17.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.69
Rate for Payer: Aetna Government	$10.69
Rate for Payer: Brighton Health Commercial	$16.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.54
Rate for Payer: Group Health Inc Commercial	$10.69
Rate for Payer: Group Health Inc Medicare	$7.48
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.69
Rate for Payer: Hamaspik Choice Inc Medicare	$10.69

SUSPENSORY SUPPORTS

Facility

$12.05

Hospital Charge Code	40205920
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

Suspensory X-large

Facility

$38.99

Hospital Charge Code	40205930
Hospital Revenue Code	270
Min. Negotiated Rate	$13.65
Max. Negotiated Rate	$31.19
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.50
Rate for Payer: Aetna Government	$19.50
Rate for Payer: Brighton Health Commercial	$29.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$31.19
Rate for Payer: Cigna LocalPlus Benefit Plan	$26.51
Rate for Payer: Group Health Inc Commercial	$19.50
Rate for Payer: Group Health Inc Medicare	$13.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$19.50
Rate for Payer: Hamaspik Choice Inc Medicare	$19.50

SUT STRATAFX SPIRAL PDO 2XMO

Facility

$41.41

Hospital Charge Code	40008265
Hospital Revenue Code	272
Min. Negotiated Rate	$14.49
Max. Negotiated Rate	$33.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.70
Rate for Payer: Aetna Government	$20.70
Rate for Payer: Brighton Health Commercial	$31.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.16
Rate for Payer: Group Health Inc Commercial	$20.70
Rate for Payer: Group Health Inc Medicare	$14.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.70
Rate for Payer: Hamaspik Choice Inc Medicare	$20.70

SUTURABLE DURAL REGEN MATRIX

Facility

$2,518.08

Hospital Charge Code	40209712
Hospital Revenue Code	272
Min. Negotiated Rate	$881.33
Max. Negotiated Rate	$2,014.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,384.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,259.04
Rate for Payer: Aetna Government	$1,259.04
Rate for Payer: Brighton Health Commercial	$1,888.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,014.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,712.29
Rate for Payer: Group Health Inc Commercial	$1,259.04
Rate for Payer: Group Health Inc Medicare	$881.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,259.04
Rate for Payer: Hamaspik Choice Inc Medicare	$1,259.04

SUTURE ABSORB 0 18 DYED

Facility

$793.53

Hospital Charge Code	64905889
Hospital Revenue Code	270
Min. Negotiated Rate	$277.74
Max. Negotiated Rate	$634.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$436.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$396.76
Rate for Payer: Aetna Government	$396.76
Rate for Payer: Brighton Health Commercial	$595.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$634.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$539.60
Rate for Payer: Group Health Inc Commercial	$396.76
Rate for Payer: Group Health Inc Medicare	$277.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$396.76
Rate for Payer: Hamaspik Choice Inc Medicare	$396.76

SUTURE ANCHOR BCO 7X 19.5MM

Facility

$1,087.50

Service Code	HCPCS C1713
Hospital Charge Code	64905254
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,141.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$598.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$652.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$543.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$625.31
Rate for Payer: EmblemHealth Commercial	$543.75
Rate for Payer: Fidelis Medicare Advantage	$1,141.88
Rate for Payer: Group Health Inc Commercial	$543.75
Rate for Payer: Group Health Inc Medicare	$380.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$543.75
Rate for Payer: Hamaspik Choice Inc Medicare	$543.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$706.88

SUTURE ANCHOR BCO 7X 19.5MM

Facility

$1,087.50

Service Code	HCPCS C1713
Hospital Charge Code	64905254
Hospital Revenue Code	278
Min. Negotiated Rate	$543.75
Max. Negotiated Rate	$543.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$543.75
Rate for Payer: Hamaspik Choice Inc Medicare	$543.75

SUTURE ANCHOR BIOCMP CORKSCW

Facility

$862.50

Service Code	HCPCS C1713
Hospital Charge Code	64903185
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$431.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$431.25
Rate for Payer: Hamaspik Choice Inc Medicare	$431.25

SUTURE ANCHOR BIOCMP CORKSCW

Facility

$862.50

Service Code	HCPCS C1713
Hospital Charge Code	64903185
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$905.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$474.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$517.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$431.25
Rate for Payer: Cigna LocalPlus Benefit Plan	$495.94
Rate for Payer: EmblemHealth Commercial	$431.25
Rate for Payer: Fidelis Medicare Advantage	$905.62
Rate for Payer: Group Health Inc Commercial	$431.25
Rate for Payer: Group Health Inc Medicare	$301.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$431.25
Rate for Payer: Hamaspik Choice Inc Medicare	$431.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$560.62

SUTURE AORTA/GRT VESSELS,W/SHUNT/

Facility

$3,522.93

Service Code	HCPCS 33321
Hospital Charge Code	40034330
Hospital Revenue Code	360
Min. Negotiated Rate	$1,233.03
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,937.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,381.04
Rate for Payer: Aetna Government	$1,381.04
Rate for Payer: Brighton Health Commercial	$2,642.20
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: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$1,761.46
Rate for Payer: Group Health Inc Medicare	$1,233.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,761.46
Rate for Payer: Hamaspik Choice Inc Medicare	$1,761.46

SUTURE, BARBED 0 PDO 36CMX36CM

Facility

$886.60

Hospital Charge Code	64906103
Hospital Revenue Code	270
Min. Negotiated Rate	$310.31
Max. Negotiated Rate	$709.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$487.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$443.30
Rate for Payer: Aetna Government	$443.30
Rate for Payer: Brighton Health Commercial	$664.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$709.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$602.89
Rate for Payer: Group Health Inc Commercial	$443.30
Rate for Payer: Group Health Inc Medicare	$310.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$443.30
Rate for Payer: Hamaspik Choice Inc Medicare	$443.30

SUTURE, BARBED 1 PDO 24CMX24CM

Facility

$566.65

Hospital Charge Code	64906101
Hospital Revenue Code	270
Min. Negotiated Rate	$198.33
Max. Negotiated Rate	$453.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$311.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$283.32
Rate for Payer: Aetna Government	$283.32
Rate for Payer: Brighton Health Commercial	$424.99
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$453.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$385.32
Rate for Payer: Group Health Inc Commercial	$283.32
Rate for Payer: Group Health Inc Medicare	$198.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$283.32
Rate for Payer: Hamaspik Choice Inc Medicare	$283.32

SUTURE, BARBED 2 PDO 36CMX36CM

Facility

$925.15

Hospital Charge Code	64906102
Hospital Revenue Code	270
Min. Negotiated Rate	$323.80
Max. Negotiated Rate	$740.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$508.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$462.58
Rate for Payer: Aetna Government	$462.58
Rate for Payer: Brighton Health Commercial	$693.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$740.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$629.10
Rate for Payer: Group Health Inc Commercial	$462.58
Rate for Payer: Group Health Inc Medicare	$323.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$462.58
Rate for Payer: Hamaspik Choice Inc Medicare	$462.58

SUTURE BIOSYN

Facility

$5.70

Hospital Charge Code	64907070
Hospital Revenue Code	270
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$4.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.85
Rate for Payer: Aetna Government	$2.85
Rate for Payer: Brighton Health Commercial	$4.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.88
Rate for Payer: Group Health Inc Commercial	$2.85
Rate for Payer: Group Health Inc Medicare	$2.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.85
Rate for Payer: Hamaspik Choice Inc Medicare	$2.85

Know your out-of-pocket cost for care.

All Charges