St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

SYNTHES WIRE CERCLAGE 291.06

Facility

$155.70

Service Code	HCPCS C1713
Hospital Charge Code	40205213
Hospital Revenue Code	278
Min. Negotiated Rate	$54.50
Max. Negotiated Rate	$163.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$93.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$77.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$89.53
Rate for Payer: EmblemHealth Commercial	$77.85
Rate for Payer: Fidelis Medicare Advantage	$163.48
Rate for Payer: Group Health Inc Commercial	$77.85
Rate for Payer: Group Health Inc Medicare	$54.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.85
Rate for Payer: Hamaspik Choice Inc Medicare	$77.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$101.20

SYNTHES WIRE CERCLAGE 291.06

Facility

$155.70

Service Code	HCPCS C1713
Hospital Charge Code	40205213
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$77.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.85
Rate for Payer: Hamaspik Choice Inc Medicare	$77.85

SYNTHES WIRE CERCLAGE W/EYE291.01

Facility

$155.70

Service Code	HCPCS C1713
Hospital Charge Code	40205211
Hospital Revenue Code	278
Min. Negotiated Rate	$54.50
Max. Negotiated Rate	$163.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$85.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$93.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$77.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$89.53
Rate for Payer: EmblemHealth Commercial	$77.85
Rate for Payer: Fidelis Medicare Advantage	$163.48
Rate for Payer: Group Health Inc Commercial	$77.85
Rate for Payer: Group Health Inc Medicare	$54.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.85
Rate for Payer: Hamaspik Choice Inc Medicare	$77.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$101.20

SYNTHES WIRE CERCLAGE W/EYE291.01

Facility

$155.70

Service Code	HCPCS C1713
Hospital Charge Code	40205211
Hospital Revenue Code	278
Min. Negotiated Rate	$77.85
Max. Negotiated Rate	$77.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.85
Rate for Payer: Hamaspik Choice Inc Medicare	$77.85

SYNTHES Y PLT 1X3 H 0.5MM THICK

Facility

$548.00

Service Code	HCPCS C1713
Hospital Charge Code	40205304
Hospital Revenue Code	278
Min. Negotiated Rate	$274.00
Max. Negotiated Rate	$274.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.00
Rate for Payer: Hamaspik Choice Inc Medicare	$274.00

SYNTHES Y PLT 1X3 H 0.5MM THICK

Facility

$548.00

Service Code	HCPCS C1713
Hospital Charge Code	40205304
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$575.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$301.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$328.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$274.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$315.10
Rate for Payer: EmblemHealth Commercial	$274.00
Rate for Payer: Fidelis Medicare Advantage	$575.40
Rate for Payer: Group Health Inc Commercial	$274.00
Rate for Payer: Group Health Inc Medicare	$191.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$274.00
Rate for Payer: Hamaspik Choice Inc Medicare	$274.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$356.20

SYNTHETIC SENTENCE ID TEST

Facility

$101.25

Service Code	HCPCS 92576
Hospital Charge Code	42004510
Hospital Revenue Code	471
Min. Negotiated Rate	$37.10
Max. Negotiated Rate	$81.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$46.38
Rate for Payer: Aetna Government	$46.38
Rate for Payer: Brighton Health Commercial	$75.94
Rate for Payer: Cash Price	$46.38
Rate for Payer: Cash Price	$46.38
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$46.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.85
Rate for Payer: Elderplan Medicare Advantage	$46.38
Rate for Payer: EmblemHealth Commercial	$46.38
Rate for Payer: Fidelis Essential Plan Aliesa	$39.42
Rate for Payer: Fidelis Essential Plan QHP	$41.28
Rate for Payer: Fidelis Medicare Advantage	$46.38
Rate for Payer: Fidelis Qualified Health Plan	$41.28
Rate for Payer: Group Health Inc Commercial	$46.38
Rate for Payer: Group Health Inc Medicare	$46.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.62
Rate for Payer: Hamaspik Choice Inc Medicare	$46.38
Rate for Payer: Healthfirst Medicare Advantage	$39.42
Rate for Payer: Healthfirst QHP	$46.38
Rate for Payer: Senior Whole Health Medicare Advantage	$46.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46.38
Rate for Payer: Wellcare CHP/FHP/Medicaid	$37.10
Rate for Payer: Wellcare Medicare	$44.06

SYNTHETIC SENTENCE ID TEST

Facility

$101.25

Service Code	HCPCS 92576
Hospital Charge Code	42004510
Hospital Revenue Code	471
Rate for Payer: Cash Price	$46.38

SYNTH GRAFT- MANDIBLE/FACIAL BONE

Facility

$4,253.00

Service Code	HCPCS D7995
Hospital Charge Code	42303332
Hospital Revenue Code	361
Min. Negotiated Rate	$136.23
Max. Negotiated Rate	$3,189.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,339.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$136.23
Rate for Payer: Aetna Government	$136.23
Rate for Payer: Brighton Health Commercial	$3,189.75
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	$2,126.50
Rate for Payer: Group Health Inc Medicare	$1,488.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,126.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,126.50

SYNVIC-ONE (NF) 48MG/6ML-PER 1MG

Facility

$1,797.00

Service Code	HCPCS J7325
Hospital Charge Code	41647165
Hospital Revenue Code	636
Min. Negotiated Rate	$898.50
Max. Negotiated Rate	$898.50
Rate for Payer: Cash Price	$9.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$898.50
Rate for Payer: Hamaspik Choice Inc Medicare	$898.50

SYNVIC-ONE (NF) 48MG/6ML-PER 1MG

Facility

$1,797.00

Service Code	HCPCS J7325
Hospital Charge Code	41647165
Hospital Revenue Code	636
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$1,168.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$988.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.12
Rate for Payer: Aetna Government	$9.12
Rate for Payer: Brighton Health Commercial	$1,078.20
Rate for Payer: Cash Price	$9.12
Rate for Payer: Cash Price	$9.12
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$9.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$898.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,033.28
Rate for Payer: Elderplan Medicare Advantage	$9.12
Rate for Payer: EmblemHealth Commercial	$9.12
Rate for Payer: Fidelis CHP/HARP/Medicaid	$9.12
Rate for Payer: Fidelis Essential Plan Aliesa	$9.12
Rate for Payer: Fidelis Essential Plan QHP	$9.58
Rate for Payer: Fidelis Medicare Advantage	$9.12
Rate for Payer: Fidelis Qualified Health Plan	$9.58
Rate for Payer: Group Health Inc Commercial	$9.12
Rate for Payer: Group Health Inc Medicare	$9.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$898.50
Rate for Payer: Hamaspik Choice Inc Medicare	$898.50
Rate for Payer: Healthfirst Medicare Advantage	$7.75
Rate for Payer: Healthfirst QHP	$9.12
Rate for Payer: Senior Whole Health Medicare Advantage	$9.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9.41
Rate for Payer: SOMOS Essential	$9.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,168.05
Rate for Payer: Wellcare CHP/FHP/Medicaid	$7.30
Rate for Payer: Wellcare Medicare	$8.67

SYNVISC-ONE (NF) 48NG/6ML-PER 1MG

Facility

$1,797.00

Service Code	HCPCS J7325
Hospital Charge Code	41657165
Hospital Revenue Code	636
Min. Negotiated Rate	$7.30
Max. Negotiated Rate	$1,168.05
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$988.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.12
Rate for Payer: Aetna Government	$9.12
Rate for Payer: Brighton Health Commercial	$1,078.20
Rate for Payer: Cash Price	$9.12
Rate for Payer: Cash Price	$9.12
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$9.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$898.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,033.28
Rate for Payer: Elderplan Medicare Advantage	$9.12
Rate for Payer: EmblemHealth Commercial	$9.12
Rate for Payer: Fidelis CHP/HARP/Medicaid	$9.12
Rate for Payer: Fidelis Essential Plan Aliesa	$9.12
Rate for Payer: Fidelis Essential Plan QHP	$9.58
Rate for Payer: Fidelis Medicare Advantage	$9.12
Rate for Payer: Fidelis Qualified Health Plan	$9.58
Rate for Payer: Group Health Inc Commercial	$9.12
Rate for Payer: Group Health Inc Medicare	$9.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$898.50
Rate for Payer: Hamaspik Choice Inc Medicare	$898.50
Rate for Payer: Healthfirst Medicare Advantage	$7.75
Rate for Payer: Healthfirst QHP	$9.12
Rate for Payer: Senior Whole Health Medicare Advantage	$9.12
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9.41
Rate for Payer: SOMOS Essential	$9.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,168.05
Rate for Payer: Wellcare CHP/FHP/Medicaid	$7.30
Rate for Payer: Wellcare Medicare	$8.67

SYNVISC-ONE (NF) 48NG/6ML-PER 1MG

Facility

$1,797.00

Service Code	HCPCS J7325
Hospital Charge Code	41657165
Hospital Revenue Code	636
Min. Negotiated Rate	$898.50
Max. Negotiated Rate	$898.50
Rate for Payer: Cash Price	$9.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$898.50
Rate for Payer: Hamaspik Choice Inc Medicare	$898.50

SYPHILIS (T.PALLIDUM)SCREEN W/REF

Facility

$33.10

Service Code	HCPCS 86780
Hospital Charge Code	40721420
Hospital Revenue Code	300
Rate for Payer: Cash Price	$13.24

SYPHILIS (T.PALLIDUM)SCREEN W/REF

Facility

$33.10

Service Code	HCPCS 86780
Hospital Charge Code	40721420
Hospital Revenue Code	300
Min. Negotiated Rate	$10.59
Max. Negotiated Rate	$24.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.24
Rate for Payer: Aetna Government	$13.24
Rate for Payer: Brighton Health Commercial	$24.82
Rate for Payer: Cash Price	$13.24
Rate for Payer: Cash Price	$13.24
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$13.24
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.05
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.81
Rate for Payer: Elderplan Medicare Advantage	$13.24
Rate for Payer: EmblemHealth Commercial	$13.24
Rate for Payer: Fidelis Essential Plan Aliesa	$11.25
Rate for Payer: Fidelis Essential Plan QHP	$11.78
Rate for Payer: Fidelis Medicare Advantage	$13.24
Rate for Payer: Fidelis Qualified Health Plan	$11.78
Rate for Payer: Group Health Inc Commercial	$13.24
Rate for Payer: Group Health Inc Medicare	$13.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.55
Rate for Payer: Hamaspik Choice Inc Medicare	$13.24
Rate for Payer: Healthfirst Medicare Advantage	$13.24
Rate for Payer: Healthfirst QHP	$13.24
Rate for Payer: Senior Whole Health Medicare Advantage	$13.24
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.24
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.59
Rate for Payer: Wellcare Medicare	$11.92

SYRINGE 10ML W/LUERLOCK TIP

Facility

$0.16

Hospital Charge Code	64902016
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$0.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.11
Rate for Payer: Group Health Inc Commercial	$0.08
Rate for Payer: Group Health Inc Medicare	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.08
Rate for Payer: Hamaspik Choice Inc Medicare	$0.08

SYRINGE 1ML 30GX1/2 HYPO ECLIPSE

Facility

$0.77

Hospital Charge Code	64903256
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$0.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.39
Rate for Payer: Aetna Government	$0.39
Rate for Payer: Brighton Health Commercial	$0.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.52
Rate for Payer: Group Health Inc Commercial	$0.39
Rate for Payer: Group Health Inc Medicare	$0.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.39
Rate for Payer: Hamaspik Choice Inc Medicare	$0.39

SYRINGE,30ML,LUER-LOK TIP,DISP

Facility

$0.50

Hospital Charge Code	64901917
Hospital Revenue Code	270
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$0.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.34
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25

SYRINGE,30ML,W/ENFIT CONNECTOR

Facility

$91.25

Hospital Charge Code	64903716
Hospital Revenue Code	270
Min. Negotiated Rate	$31.94
Max. Negotiated Rate	$73.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$50.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.62
Rate for Payer: Aetna Government	$45.62
Rate for Payer: Brighton Health Commercial	$68.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$73.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$62.05
Rate for Payer: Group Health Inc Commercial	$45.62
Rate for Payer: Group Health Inc Medicare	$31.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.62
Rate for Payer: Hamaspik Choice Inc Medicare	$45.62

SYRINGE,3ML,LUER-LOK TIP,SCALE

Facility

$0.09

Hospital Charge Code	64902033
Hospital Revenue Code	270
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.07
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.05
Rate for Payer: Aetna Government	$0.05
Rate for Payer: Brighton Health Commercial	$0.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.06
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05

SYRINGE 50CC FEEDING TRAY

Facility

$17.01

Hospital Charge Code	40205960
Hospital Revenue Code	270
Min. Negotiated Rate	$5.95
Max. Negotiated Rate	$13.61
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.36
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.50
Rate for Payer: Aetna Government	$8.50
Rate for Payer: Brighton Health Commercial	$12.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.61
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.57
Rate for Payer: Group Health Inc Commercial	$8.50
Rate for Payer: Group Health Inc Medicare	$5.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.50
Rate for Payer: Hamaspik Choice Inc Medicare	$8.50

SYRINGE,5ML,WITH ENFIT CONNECTOR

Facility

$112.50

Hospital Charge Code	64903711
Hospital Revenue Code	270
Min. Negotiated Rate	$39.38
Max. Negotiated Rate	$90.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$56.25
Rate for Payer: Aetna Government	$56.25
Rate for Payer: Brighton Health Commercial	$84.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$90.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$76.50
Rate for Payer: Group Health Inc Commercial	$56.25
Rate for Payer: Group Health Inc Medicare	$39.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$56.25
Rate for Payer: Hamaspik Choice Inc Medicare	$56.25

SYRINGE,60ML,ENFIT CONNECTOR

Facility

$121.25

Hospital Charge Code	64903719
Hospital Revenue Code	270
Min. Negotiated Rate	$42.44
Max. Negotiated Rate	$97.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$60.62
Rate for Payer: Aetna Government	$60.62
Rate for Payer: Brighton Health Commercial	$90.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$97.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$82.45
Rate for Payer: Group Health Inc Commercial	$60.62
Rate for Payer: Group Health Inc Medicare	$42.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.62
Rate for Payer: Hamaspik Choice Inc Medicare	$60.62

SYRINGE ABG W/HEPARIN&VACUUM 1ML

Facility

$0.62

Hospital Charge Code	64903255
Hospital Revenue Code	270
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.34
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.31
Rate for Payer: Aetna Government	$0.31
Rate for Payer: Brighton Health Commercial	$0.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.42
Rate for Payer: Group Health Inc Commercial	$0.31
Rate for Payer: Group Health Inc Medicare	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.31
Rate for Payer: Hamaspik Choice Inc Medicare	$0.31

SYRINGE ARTERIAL BL SUB

Facility

$2.52

Hospital Charge Code	64901799
Hospital Revenue Code	270
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$2.02
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.26
Rate for Payer: Aetna Government	$1.26
Rate for Payer: Brighton Health Commercial	$1.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.71
Rate for Payer: Group Health Inc Commercial	$1.26
Rate for Payer: Group Health Inc Medicare	$0.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.26
Rate for Payer: Hamaspik Choice Inc Medicare	$1.26

Know your out-of-pocket cost for care.

All Charges