St. Barnabas Hospital

All Charges

Charge

Type

Price

CALCIUM GLUBIONATE 23 MG/ML SYRUP PEDIAT

Facility OP

$1.00

Hospital Charge Code	41653544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

CALCIUM GLUBIONATE 23 MG/ML SYRUP PEDIAT

Facility OP

$1.00

Hospital Charge Code	41643544
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

CALCIUM GLUCONATE 100 MG/ML INJ 10 ML

Facility IP

$4.08

Service Code	HCPCS J0610
Hospital Charge Code	41650213
Hospital Revenue Code	636
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.04
Rate for Payer: Hamaspik Choice Inc Medicare	$2.04

CALCIUM GLUCONATE 100 MG/ML INJ 10 ML

Facility OP

$4.08

Service Code	HCPCS J0610
Hospital Charge Code	41650213
Hospital Revenue Code	636
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$4.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.13
Rate for Payer: Aetna Government	$4.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.35
Rate for Payer: Group Health Inc Commercial	$2.04
Rate for Payer: Group Health Inc Medicare	$1.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.04
Rate for Payer: Hamaspik Choice Inc Medicare	$2.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.65

CALCIUM GLUCONATE 100 MG/ML INJ 10 ML

Facility OP

$4.08

Service Code	HCPCS J0610
Hospital Charge Code	41640213
Hospital Revenue Code	636
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$4.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.13
Rate for Payer: Aetna Government	$4.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.35
Rate for Payer: Group Health Inc Commercial	$2.04
Rate for Payer: Group Health Inc Medicare	$1.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.04
Rate for Payer: Hamaspik Choice Inc Medicare	$2.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.65

CALCIUM GLUCONATE 100 MG/ML INJ 10 ML

Facility IP

$4.08

Service Code	HCPCS J0610
Hospital Charge Code	41640213
Hospital Revenue Code	636
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.04
Rate for Payer: Hamaspik Choice Inc Medicare	$2.04

CALCIUM GLUCONATE 100 MG/ML INJ 50 ML

Facility OP

$1.29

Service Code	HCPCS J0610
Hospital Charge Code	41651038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$4.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.13
Rate for Payer: Aetna Government	$4.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.74
Rate for Payer: Group Health Inc Commercial	$0.65
Rate for Payer: Group Health Inc Medicare	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.84

CALCIUM GLUCONATE 100 MG/ML INJ 50 ML

Facility IP

$1.29

Service Code	HCPCS J0610
Hospital Charge Code	41651038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$0.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65

CALCIUM GLUCONATE 100 MG/ML INJ 50 ML

Facility OP

$1.29

Service Code	HCPCS J0610
Hospital Charge Code	41641038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$4.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.13
Rate for Payer: Aetna Government	$4.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.74
Rate for Payer: Group Health Inc Commercial	$0.65
Rate for Payer: Group Health Inc Medicare	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.84

CALCIUM GLUCONATE 100 MG/ML INJ 50 ML

Facility IP

$1.29

Service Code	HCPCS J0610
Hospital Charge Code	41641038
Hospital Revenue Code	636
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$0.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65

CALCIUM GLUCONATE 500 MG TAB

Facility OP

$1.00

Hospital Charge Code	41640649
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

CALCIUM GLUCONATE 500 MG TAB

Facility OP

$1.00

Hospital Charge Code	41650649
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

CALCIUM, IONIZED

Facility OP

$34.20

Service Code	HCPCS 82330
Hospital Charge Code	40602466
Hospital Revenue Code	301
Min. Negotiated Rate	$10.94
Max. Negotiated Rate	$21.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.68
Rate for Payer: Aetna Government	$13.68
Rate for Payer: Cash Price	$13.68
Rate for Payer: Cash Price	$13.68
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$13.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.38
Rate for Payer: Elderplan Medicare Advantage	$13.68
Rate for Payer: EmblemHealth Commercial	$13.68
Rate for Payer: Fidelis CHP/HARP/Medicaid	$12.31
Rate for Payer: Fidelis Essential Plan Aliesa	$11.63
Rate for Payer: Fidelis Essential Plan QHP	$12.18
Rate for Payer: Fidelis Medicare Advantage	$13.68
Rate for Payer: Fidelis Qualified Health Plan	$12.18
Rate for Payer: Group Health Inc Commercial	$13.68
Rate for Payer: Group Health Inc Medicare	$13.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.10
Rate for Payer: Hamaspik Choice Inc Medicare	$13.68
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$13.68
Rate for Payer: Healthfirst Medicare Advantage	$13.68
Rate for Payer: Healthfirst QHP	$13.68
Rate for Payer: Senior Whole Health Medicare Advantage	$13.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.68
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.94
Rate for Payer: Wellcare Medicare	$12.31

CALDWELL LUC

Facility OP

$14,691.05

Service Code	HCPCS 31030
Hospital Charge Code	40108810
Hospital Revenue Code	360
Min. Negotiated Rate	$562.66
Max. Negotiated Rate	$7,345.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,772.21
Rate for Payer: Aetna Government	$6,772.21
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	$1,505.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$562.66
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	$7,345.52
Rate for Payer: Hamaspik Choice Inc Medicare	$6,772.21
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$625.18
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

CAL GLUC 2000/MGD5W 100ML-20MG U

Facility OP

$6.00

Hospital Charge Code	41647158
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.08
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.90

CAL GLUC 2000MG/D5W 100ML-20MG U

Facility OP

$6.00

Hospital Charge Code	41657158
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.08
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.90

CAL GLUC 2000MG NS 100ML-20MG/ML

Facility OP

$6.00

Hospital Charge Code	41647162
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.08
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.90

CAL GLUC 2000MG NS 100ML-20MG/ML

Facility OP

$6.00

Hospital Charge Code	41657162
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.08
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.90

CAL GLUC 5000MG/D5W 500ML PER 10

Facility OP

$7.00

Hospital Charge Code	41657157
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

CAL GLUC 5000MG/D5W 500ML PER 10

Facility OP

$7.00

Hospital Charge Code	41647157
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

CAL GLUC 5000MG NS 500ML-10MG/ML

Facility OP

$7.00

Hospital Charge Code	41647161
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

CAL GLUC 5000MG NS 500ML-10MG/ML

Facility OP

$7.00

Hospital Charge Code	41657161
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

CALIBRATED DRILL 4.3MM LONG

Facility IP

$237.60

Service Code	HCPCS C1713
Hospital Charge Code	40006463
Hospital Revenue Code	278
Min. Negotiated Rate	$118.80
Max. Negotiated Rate	$118.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.80
Rate for Payer: Hamaspik Choice Inc Medicare	$118.80

CALIBRATED DRILL 4.3MM LONG

Facility OP

$237.60

Service Code	HCPCS C1713
Hospital Charge Code	40006463
Hospital Revenue Code	278
Min. Negotiated Rate	$83.16
Max. Negotiated Rate	$249.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$130.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$118.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$136.62
Rate for Payer: Fidelis Medicare Advantage	$249.48
Rate for Payer: Group Health Inc Commercial	$118.80
Rate for Payer: Group Health Inc Medicare	$83.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.80
Rate for Payer: Hamaspik Choice Inc Medicare	$118.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$154.44

CALIBRATED DRILL 4.3MM SHORT

Facility IP

$237.60

Service Code	HCPCS C1713
Hospital Charge Code	40006470
Hospital Revenue Code	278
Min. Negotiated Rate	$118.80
Max. Negotiated Rate	$118.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$118.80
Rate for Payer: Hamaspik Choice Inc Medicare	$118.80

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