St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

THORACOTOMY TRAY

Facility

$65.21

Hospital Charge Code	40206020
Hospital Revenue Code	270
Min. Negotiated Rate	$22.82
Max. Negotiated Rate	$52.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.60
Rate for Payer: Aetna Government	$32.60
Rate for Payer: Brighton Health Commercial	$48.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.34
Rate for Payer: Group Health Inc Commercial	$32.60
Rate for Payer: Group Health Inc Medicare	$22.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.60
Rate for Payer: Hamaspik Choice Inc Medicare	$32.60

THORACOTOMY WITH EXPLORATION

Facility

$5,240.07

Service Code	HCPCS 32160
Hospital Charge Code	30106521
Hospital Revenue Code	450
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$694.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$858.42
Rate for Payer: Aetna Government	$858.42
Rate for Payer: Brighton Health Commercial	$874.00
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	$525.00
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	$2,620.04
Rate for Payer: Hamaspik Choice Inc Medicare	$2,620.04
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00

THORA DRAIN

Facility

$124.74

Hospital Charge Code	40206001
Hospital Revenue Code	270
Min. Negotiated Rate	$43.66
Max. Negotiated Rate	$99.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$68.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.37
Rate for Payer: Aetna Government	$62.37
Rate for Payer: Brighton Health Commercial	$93.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$99.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$84.82
Rate for Payer: Group Health Inc Commercial	$62.37
Rate for Payer: Group Health Inc Medicare	$43.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$62.37
Rate for Payer: Hamaspik Choice Inc Medicare	$62.37

THORANCENTESIS W/TUBE INSERTION

Facility

$1,909.65

Service Code	HCPCS 32555
Hospital Charge Code	40019459
Hospital Revenue Code	360
Min. Negotiated Rate	$581.18
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$726.47
Rate for Payer: Aetna Government	$726.47
Rate for Payer: Brighton Health Commercial	$1,432.24
Rate for Payer: Cash Price	$726.47
Rate for Payer: Cash Price	$726.47
Rate for Payer: Cash Price	$726.47
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$726.47
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	$726.47
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$617.50
Rate for Payer: Fidelis Essential Plan QHP	$646.56
Rate for Payer: Fidelis Medicare Advantage	$726.47
Rate for Payer: Fidelis Qualified Health Plan	$646.56
Rate for Payer: Group Health Inc Commercial	$726.47
Rate for Payer: Group Health Inc Medicare	$726.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.82
Rate for Payer: Hamaspik Choice Inc Medicare	$726.47
Rate for Payer: Healthfirst Medicare Advantage	$617.50
Rate for Payer: Healthfirst QHP	$726.47
Rate for Payer: Senior Whole Health Medicare Advantage	$726.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$726.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$581.18
Rate for Payer: Wellcare Medicare	$690.15

THORANCENTESIS W/TUBE INSERTION

Facility

$1,909.65

Service Code	HCPCS 32555
Hospital Charge Code	40019459
Hospital Revenue Code	360
Rate for Payer: Cash Price	$726.47

THOROCOSCOPY CONTROL TRAUMA BLEED

Facility

$2,005.43

Service Code	HCPCS 32650
Hospital Charge Code	40019632
Hospital Revenue Code	360
Min. Negotiated Rate	$701.90
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,102.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$725.76
Rate for Payer: Aetna Government	$725.76
Rate for Payer: Brighton Health Commercial	$1,504.07
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	$1,002.72
Rate for Payer: Group Health Inc Medicare	$701.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,002.72
Rate for Payer: Hamaspik Choice Inc Medicare	$1,002.72

THOROCOSCOPY REMOVAL BLOOD CLOT/F

Facility

$2,168.55

Service Code	HCPCS 32658
Hospital Charge Code	40019633
Hospital Revenue Code	360
Min. Negotiated Rate	$758.99
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,192.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$780.69
Rate for Payer: Aetna Government	$780.69
Rate for Payer: Brighton Health Commercial	$1,626.41
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	$1,084.28
Rate for Payer: Group Health Inc Medicare	$758.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,084.28
Rate for Payer: Hamaspik Choice Inc Medicare	$1,084.28

THOROCOSCOPY REPAIR STERNUM

Facility

$8,291.05

Service Code	HCPCS 21743
Hospital Charge Code	40029634
Hospital Revenue Code	360
Rate for Payer: Cash Price	$3,743.15

THOROCOSCOPY REPAIR STERNUM

Facility

$8,291.05

Service Code	HCPCS 21743
Hospital Charge Code	40029634
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$6,218.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,743.15
Rate for Payer: Aetna Government	$3,743.15
Rate for Payer: Brighton Health Commercial	$6,218.29
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,743.15
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	$3,743.15
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,181.68
Rate for Payer: Fidelis Essential Plan QHP	$3,331.40
Rate for Payer: Fidelis Medicare Advantage	$3,743.15
Rate for Payer: Fidelis Qualified Health Plan	$3,331.40
Rate for Payer: Group Health Inc Commercial	$3,743.15
Rate for Payer: Group Health Inc Medicare	$3,743.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,145.52
Rate for Payer: Hamaspik Choice Inc Medicare	$3,743.15
Rate for Payer: Healthfirst Medicare Advantage	$3,181.68
Rate for Payer: Healthfirst QHP	$3,743.15
Rate for Payer: Senior Whole Health Medicare Advantage	$3,743.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,743.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,994.52
Rate for Payer: Wellcare Medicare	$3,555.99

THOROCOTOMY LUNG BIOPSY

Facility

$3,423.26

Service Code	HCPCS 32100
Hospital Charge Code	40043206
Hospital Revenue Code	360
Min. Negotiated Rate	$883.48
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,882.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$883.48
Rate for Payer: Aetna Government	$883.48
Rate for Payer: Brighton Health Commercial	$2,567.44
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	$1,711.63
Rate for Payer: Group Health Inc Medicare	$1,198.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,711.63
Rate for Payer: Hamaspik Choice Inc Medicare	$1,711.63

THOROCOTOMY REM. BULLAE

Facility

$3,423.26

Service Code	HCPCS 32141
Hospital Charge Code	40043205
Hospital Revenue Code	360
Min. Negotiated Rate	$1,198.14
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,882.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,667.05
Rate for Payer: Aetna Government	$1,667.05
Rate for Payer: Brighton Health Commercial	$2,567.44
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	$1,711.63
Rate for Payer: Group Health Inc Medicare	$1,198.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,711.63
Rate for Payer: Hamaspik Choice Inc Medicare	$1,711.63

THOROCOTOMY REM. CYST

Facility

$3,423.26

Service Code	HCPCS 32140
Hospital Charge Code	40043204
Hospital Revenue Code	360
Min. Negotiated Rate	$1,090.94
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,882.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,090.94
Rate for Payer: Aetna Government	$1,090.94
Rate for Payer: Brighton Health Commercial	$2,567.44
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	$1,711.63
Rate for Payer: Group Health Inc Medicare	$1,198.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,711.63
Rate for Payer: Hamaspik Choice Inc Medicare	$1,711.63

THREADED 32 GUIDE PIN

Facility

$337.50

Hospital Charge Code	64906021
Hospital Revenue Code	270
Min. Negotiated Rate	$118.12
Max. Negotiated Rate	$270.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$185.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$168.75
Rate for Payer: Aetna Government	$168.75
Rate for Payer: Brighton Health Commercial	$253.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$270.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$229.50
Rate for Payer: Group Health Inc Commercial	$168.75
Rate for Payer: Group Health Inc Medicare	$118.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$168.75
Rate for Payer: Hamaspik Choice Inc Medicare	$168.75

THREADED GUIDE PIN 3.2MM

Facility

$368.00

Service Code	HCPCS C1713
Hospital Charge Code	40006163
Hospital Revenue Code	278
Min. Negotiated Rate	$184.00
Max. Negotiated Rate	$184.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00

THREADED GUIDE PIN 3.2MM

Facility

$368.00

Service Code	HCPCS C1713
Hospital Charge Code	40006163
Hospital Revenue Code	278
Min. Negotiated Rate	$128.80
Max. Negotiated Rate	$386.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$202.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$220.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$184.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$211.60
Rate for Payer: EmblemHealth Commercial	$184.00
Rate for Payer: Fidelis Medicare Advantage	$386.40
Rate for Payer: Group Health Inc Commercial	$184.00
Rate for Payer: Group Health Inc Medicare	$128.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$184.00
Rate for Payer: Hamaspik Choice Inc Medicare	$184.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$239.20

THROAT SCREEN

Facility

$21.55

Service Code	HCPCS 87070
Hospital Charge Code	40614060
Hospital Revenue Code	306
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$16.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.62
Rate for Payer: Aetna Government	$8.62
Rate for Payer: Brighton Health Commercial	$16.16
Rate for Payer: Cash Price	$8.62
Rate for Payer: Cash Price	$8.62
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.59
Rate for Payer: Elderplan Medicare Advantage	$8.62
Rate for Payer: EmblemHealth Commercial	$8.62
Rate for Payer: Fidelis Essential Plan Aliesa	$7.33
Rate for Payer: Fidelis Essential Plan QHP	$7.67
Rate for Payer: Fidelis Medicare Advantage	$8.62
Rate for Payer: Fidelis Qualified Health Plan	$7.67
Rate for Payer: Group Health Inc Commercial	$8.62
Rate for Payer: Group Health Inc Medicare	$8.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.78
Rate for Payer: Hamaspik Choice Inc Medicare	$8.62
Rate for Payer: Healthfirst Medicare Advantage	$8.62
Rate for Payer: Healthfirst QHP	$8.62
Rate for Payer: Senior Whole Health Medicare Advantage	$8.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.62
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6.90
Rate for Payer: Wellcare Medicare	$7.76

THROAT SCREEN

Facility

$21.55

Service Code	HCPCS 87070
Hospital Charge Code	40614060
Hospital Revenue Code	306
Rate for Payer: Cash Price	$8.62

THROAT SURGERY PROCEDURE

Facility

$616.78

Service Code	HCPCS 42999
Hospital Charge Code	40109202
Hospital Revenue Code	360
Min. Negotiated Rate	$225.98
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$282.47
Rate for Payer: Aetna Government	$282.47
Rate for Payer: Brighton Health Commercial	$462.58
Rate for Payer: Cash Price	$282.47
Rate for Payer: Cash Price	$282.47
Rate for Payer: Cash Price	$282.47
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$282.47
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	$282.47
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$240.10
Rate for Payer: Fidelis Essential Plan QHP	$251.40
Rate for Payer: Fidelis Medicare Advantage	$282.47
Rate for Payer: Fidelis Qualified Health Plan	$251.40
Rate for Payer: Group Health Inc Commercial	$282.47
Rate for Payer: Group Health Inc Medicare	$282.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$308.39
Rate for Payer: Hamaspik Choice Inc Medicare	$282.47
Rate for Payer: Healthfirst Medicare Advantage	$240.10
Rate for Payer: Healthfirst QHP	$282.47
Rate for Payer: Senior Whole Health Medicare Advantage	$282.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$282.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$225.98
Rate for Payer: Wellcare Medicare	$268.35

THROAT SURGERY PROCEDURE

Facility

$616.78

Service Code	HCPCS 42999
Hospital Charge Code	40109202
Hospital Revenue Code	360
Rate for Payer: Cash Price	$282.47

THROMBECTOMY FEMORAL ARTERY

Facility

$13,920.70

Service Code	HCPCS 34201
Hospital Charge Code	40033215
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$10,440.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,354.94
Rate for Payer: Aetna Government	$6,354.94
Rate for Payer: Brighton Health Commercial	$10,440.52
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6,354.94
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	$6,354.94
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$5,401.70
Rate for Payer: Fidelis Essential Plan QHP	$5,655.90
Rate for Payer: Fidelis Medicare Advantage	$6,354.94
Rate for Payer: Fidelis Qualified Health Plan	$5,655.90
Rate for Payer: Group Health Inc Commercial	$6,354.94
Rate for Payer: Group Health Inc Medicare	$6,354.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.35
Rate for Payer: Hamaspik Choice Inc Medicare	$6,354.94
Rate for Payer: Healthfirst Medicare Advantage	$5,401.70
Rate for Payer: Healthfirst QHP	$6,354.94
Rate for Payer: Senior Whole Health Medicare Advantage	$6,354.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,354.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5,083.95
Rate for Payer: Wellcare Medicare	$6,037.19

THROMBECTOMY FEMORAL ARTERY

Facility

$13,920.70

Service Code	HCPCS 34201
Hospital Charge Code	40033215
Hospital Revenue Code	360
Rate for Payer: Cash Price	$6,354.94

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$15,004.15

Service Code	HCPCS 36904
Hospital Charge Code	40034518
Hospital Revenue Code	361
Rate for Payer: Cash Price	$6,609.72

THROMBECTOMY/LYSIS DIALYS CIRC

Facility

$15,004.15

Service Code	HCPCS 36904
Hospital Charge Code	40034518
Hospital Revenue Code	361
Min. Negotiated Rate	$342.00
Max. Negotiated Rate	$11,253.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,609.72
Rate for Payer: Aetna Government	$6,609.72
Rate for Payer: Brighton Health Commercial	$11,253.11
Rate for Payer: Cash Price	$6,609.72
Rate for Payer: Cash Price	$6,609.72
Rate for Payer: Cash Price	$6,609.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6,609.72
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	$6,609.72
Rate for Payer: EmblemHealth Commercial	$6,609.72
Rate for Payer: Fidelis Essential Plan Aliesa	$5,618.26
Rate for Payer: Fidelis Essential Plan QHP	$5,882.65
Rate for Payer: Fidelis Medicare Advantage	$6,609.72
Rate for Payer: Fidelis Qualified Health Plan	$5,882.65
Rate for Payer: Group Health Inc Commercial	$6,609.72
Rate for Payer: Group Health Inc Medicare	$6,609.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,502.08
Rate for Payer: Hamaspik Choice Inc Medicare	$6,609.72
Rate for Payer: Healthfirst Medicare Advantage	$5,618.26
Rate for Payer: Healthfirst QHP	$6,609.72
Rate for Payer: Senior Whole Health Medicare Advantage	$6,609.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,609.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5,287.78
Rate for Payer: Wellcare Medicare	$6,279.23

THROMBECTOMY PERONEAL ARTERY

Facility

$13,920.70

Service Code	HCPCS 34203
Hospital Charge Code	40033213
Hospital Revenue Code	360
Rate for Payer: Cash Price	$6,354.94

THROMBECTOMY PERONEAL ARTERY

Facility

$13,920.70

Service Code	HCPCS 34203
Hospital Charge Code	40033213
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$10,440.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,354.94
Rate for Payer: Aetna Government	$6,354.94
Rate for Payer: Brighton Health Commercial	$10,440.52
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6,354.94
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	$6,354.94
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$5,401.70
Rate for Payer: Fidelis Essential Plan QHP	$5,655.90
Rate for Payer: Fidelis Medicare Advantage	$6,354.94
Rate for Payer: Fidelis Qualified Health Plan	$5,655.90
Rate for Payer: Group Health Inc Commercial	$6,354.94
Rate for Payer: Group Health Inc Medicare	$6,354.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.35
Rate for Payer: Hamaspik Choice Inc Medicare	$6,354.94
Rate for Payer: Healthfirst Medicare Advantage	$5,401.70
Rate for Payer: Healthfirst QHP	$6,354.94
Rate for Payer: Senior Whole Health Medicare Advantage	$6,354.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,354.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5,083.95
Rate for Payer: Wellcare Medicare	$6,037.19

Know your out-of-pocket cost for care.

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