St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

TREAT SPINAL CANAL LESION

Facility

$2,459.50

Service Code	HCPCS 62282
Hospital Charge Code	30301060
Hospital Revenue Code	510
Min. Negotiated Rate	$233.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,054.06
Rate for Payer: Aetna Government	$1,054.06
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,054.06
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	$1,054.06
Rate for Payer: Fidelis Essential Plan Aliesa	$895.95
Rate for Payer: Fidelis Essential Plan QHP	$938.11
Rate for Payer: Fidelis Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Qualified Health Plan	$938.11
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,229.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,054.06
Rate for Payer: Healthfirst Medicare Advantage	$895.95
Rate for Payer: Healthfirst QHP	$1,054.06
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$1,054.06
Rate for Payer: Senior Whole Health Medicare Advantage	$1,054.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,054.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$843.25
Rate for Payer: Wellcare Medicare	$1,001.36

TREAT SPINAL CANAL LESION

Facility

$2,459.50

Service Code	HCPCS 62282
Hospital Charge Code	30301060
Hospital Revenue Code	510
Rate for Payer: Cash Price	$1,054.06

TREAT SPINAL CORD LESION

Facility

$2,459.50

Service Code	HCPCS 62281
Hospital Charge Code	30307894
Hospital Revenue Code	510
Rate for Payer: Cash Price	$1,054.06

TREAT SPINAL CORD LESION

Facility

$2,459.50

Service Code	HCPCS 62281
Hospital Charge Code	30307894
Hospital Revenue Code	510
Min. Negotiated Rate	$233.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,054.06
Rate for Payer: Aetna Government	$1,054.06
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,054.06
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	$1,054.06
Rate for Payer: Fidelis Essential Plan Aliesa	$895.95
Rate for Payer: Fidelis Essential Plan QHP	$938.11
Rate for Payer: Fidelis Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Qualified Health Plan	$938.11
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,229.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,054.06
Rate for Payer: Healthfirst Medicare Advantage	$895.95
Rate for Payer: Healthfirst QHP	$1,054.06
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$1,054.06
Rate for Payer: Senior Whole Health Medicare Advantage	$1,054.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,054.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$843.25
Rate for Payer: Wellcare Medicare	$1,001.36

TREAT THIGH FRACTURE

Facility

$1,937.90

Service Code	HCPCS 27232
Hospital Charge Code	30105363
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	$773.72
Rate for Payer: Aetna Government	$773.72
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	$968.95
Rate for Payer: Hamaspik Choice Inc Medicare	$968.95
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00

TREAT THUMB FRACTURE

Facility

$8,291.05

Service Code	HCPCS 26650
Hospital Charge Code	30300130
Hospital Revenue Code	510
Rate for Payer: Cash Price	$3,743.15

TREAT THUMB FRACTURE

Facility

$8,291.05

Service Code	HCPCS 26650
Hospital Charge Code	30300130
Hospital Revenue Code	510
Min. Negotiated Rate	$233.00
Max. Negotiated Rate	$4,145.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,743.15
Rate for Payer: Aetna Government	$3,743.15
Rate for Payer: Brighton Health Commercial	$233.00
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: 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	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
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: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$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

TREAT TIBIA FX, W/O MANIP

Facility

$653.13

Service Code	HCPCS 27750
Hospital Charge Code	30105930
Hospital Revenue Code	450
Rate for Payer: Cash Price	$272.71

TREAT TIBIA FX, W/O MANIP

Facility

$653.13

Service Code	HCPCS 27750
Hospital Charge Code	30105930
Hospital Revenue Code	450
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$272.71
Rate for Payer: Aetna Government	$272.71
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$272.71
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$272.71
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	$272.71
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis Essential Plan Aliesa	$231.80
Rate for Payer: Fidelis Essential Plan QHP	$242.71
Rate for Payer: Fidelis Medicare Advantage	$272.71
Rate for Payer: Fidelis Qualified Health Plan	$242.71
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	$326.56
Rate for Payer: Hamaspik Choice Inc Medicare	$272.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$272.71
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$272.71
Rate for Payer: Senior Whole Health Medicare Advantage	$272.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$272.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$218.17
Rate for Payer: Wellcare Medicare	$259.07

TREAT TIBIA SHAFT W/OR W/0 FX

Facility

$653.13

Service Code	HCPCS 27750
Hospital Charge Code	30305380
Hospital Revenue Code	510
Min. Negotiated Rate	$218.17
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$272.71
Rate for Payer: Aetna Government	$272.71
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$272.71
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	$272.71
Rate for Payer: Fidelis Essential Plan Aliesa	$231.80
Rate for Payer: Fidelis Essential Plan QHP	$242.71
Rate for Payer: Fidelis Medicare Advantage	$272.71
Rate for Payer: Fidelis Qualified Health Plan	$242.71
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$326.56
Rate for Payer: Hamaspik Choice Inc Medicare	$272.71
Rate for Payer: Healthfirst Medicare Advantage	$231.80
Rate for Payer: Healthfirst QHP	$272.71
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$272.71
Rate for Payer: Senior Whole Health Medicare Advantage	$272.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$272.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$218.17
Rate for Payer: Wellcare Medicare	$259.07

TREAT TIBIA SHAFT W/OR W/0 FX

Facility

$653.13

Service Code	HCPCS 27750
Hospital Charge Code	30305380
Hospital Revenue Code	510
Rate for Payer: Cash Price	$272.71

TREAT TOE DISLOCATION

Facility

$696.08

Service Code	HCPCS 28665
Hospital Charge Code	40023267
Hospital Revenue Code	360
Rate for Payer: Cash Price	$310.57

TREAT TOE DISLOCATION

Facility

$696.08

Service Code	HCPCS 28665
Hospital Charge Code	30306401
Hospital Revenue Code	510
Rate for Payer: Cash Price	$310.57

TREAT TOE DISLOCATION

Facility

$696.08

Service Code	HCPCS 28665
Hospital Charge Code	30306401
Hospital Revenue Code	510
Min. Negotiated Rate	$233.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$310.57
Rate for Payer: Aetna Government	$310.57
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$310.57
Rate for Payer: Cash Price	$310.57
Rate for Payer: Cash Price	$310.57
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$310.57
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	$310.57
Rate for Payer: Fidelis Essential Plan Aliesa	$263.98
Rate for Payer: Fidelis Essential Plan QHP	$276.41
Rate for Payer: Fidelis Medicare Advantage	$310.57
Rate for Payer: Fidelis Qualified Health Plan	$276.41
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$348.04
Rate for Payer: Hamaspik Choice Inc Medicare	$310.57
Rate for Payer: Healthfirst Medicare Advantage	$263.98
Rate for Payer: Healthfirst QHP	$310.57
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$310.57
Rate for Payer: Senior Whole Health Medicare Advantage	$310.57
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$310.57
Rate for Payer: Wellcare CHP/FHP/Medicaid	$248.46
Rate for Payer: Wellcare Medicare	$295.04

TREAT TOE DISLOCATION

Facility

$696.08

Service Code	HCPCS 28665
Hospital Charge Code	40023267
Hospital Revenue Code	360
Min. Negotiated Rate	$248.46
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$310.57
Rate for Payer: Aetna Government	$310.57
Rate for Payer: Brighton Health Commercial	$522.06
Rate for Payer: Cash Price	$310.57
Rate for Payer: Cash Price	$310.57
Rate for Payer: Cash Price	$310.57
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$310.57
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	$310.57
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$263.98
Rate for Payer: Fidelis Essential Plan QHP	$276.41
Rate for Payer: Fidelis Medicare Advantage	$310.57
Rate for Payer: Fidelis Qualified Health Plan	$276.41
Rate for Payer: Group Health Inc Commercial	$310.57
Rate for Payer: Group Health Inc Medicare	$310.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$348.04
Rate for Payer: Hamaspik Choice Inc Medicare	$310.57
Rate for Payer: Healthfirst Medicare Advantage	$263.98
Rate for Payer: Healthfirst QHP	$310.57
Rate for Payer: Senior Whole Health Medicare Advantage	$310.57
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$310.57
Rate for Payer: Wellcare CHP/FHP/Medicaid	$248.46
Rate for Payer: Wellcare Medicare	$295.04

TREAT TOE DISLOCATION W/O ANESTH

Facility

$653.13

Service Code	HCPCS 28630
Hospital Charge Code	30105139
Hospital Revenue Code	450
Rate for Payer: Cash Price	$272.71

TREAT TOE DISLOCATION W/O ANESTH

Facility

$653.13

Service Code	HCPCS 28630
Hospital Charge Code	30105139
Hospital Revenue Code	450
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$272.71
Rate for Payer: Aetna Government	$272.71
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$272.71
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$272.71
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	$272.71
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis Essential Plan Aliesa	$231.80
Rate for Payer: Fidelis Essential Plan QHP	$242.71
Rate for Payer: Fidelis Medicare Advantage	$272.71
Rate for Payer: Fidelis Qualified Health Plan	$242.71
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	$326.56
Rate for Payer: Hamaspik Choice Inc Medicare	$272.71
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$272.71
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$272.71
Rate for Payer: Senior Whole Health Medicare Advantage	$272.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$272.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$218.17
Rate for Payer: Wellcare Medicare	$259.07

TREAT TOE FRACTURE

Facility

$8,291.05

Service Code	HCPCS 28525
Hospital Charge Code	40089925
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$6,218.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
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

TREAT TOE FRACTURE

Facility

$8,291.05

Service Code	HCPCS 28525
Hospital Charge Code	40089925
Hospital Revenue Code	360
Rate for Payer: Cash Price	$3,743.15

TREAT TOE TX, EACH

Facility

$8,291.05

Service Code	HCPCS 28525
Hospital Charge Code	30105929
Hospital Revenue Code	450
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$4,145.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,743.15
Rate for Payer: Aetna Government	$3,743.15
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$3,743.15
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$3,743.15
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	$525.00
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	$525.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,145.52
Rate for Payer: Hamaspik Choice Inc Medicare	$3,743.15
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$3,743.15
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$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

TREAT TOE TX, EACH

Facility

$8,291.05

Service Code	HCPCS 28525
Hospital Charge Code	30105929
Hospital Revenue Code	450
Rate for Payer: Cash Price	$3,743.15

TREAT ULNAR FRACTURE

Facility

$653.13

Service Code	HCPCS 24670
Hospital Charge Code	30302004
Hospital Revenue Code	510
Rate for Payer: Cash Price	$272.71

TREAT ULNAR FRACTURE

Facility

$653.13

Service Code	HCPCS 24670
Hospital Charge Code	40029003
Hospital Revenue Code	360
Rate for Payer: Cash Price	$272.71

TREAT ULNAR FRACTURE

Facility

$653.13

Service Code	HCPCS 24670
Hospital Charge Code	40029003
Hospital Revenue Code	360
Min. Negotiated Rate	$218.17
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$272.71
Rate for Payer: Aetna Government	$272.71
Rate for Payer: Brighton Health Commercial	$489.85
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$272.71
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	$272.71
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$231.80
Rate for Payer: Fidelis Essential Plan QHP	$242.71
Rate for Payer: Fidelis Medicare Advantage	$272.71
Rate for Payer: Fidelis Qualified Health Plan	$242.71
Rate for Payer: Group Health Inc Commercial	$272.71
Rate for Payer: Group Health Inc Medicare	$272.71
Rate for Payer: Hamaspik Choice Inc Medicaid	$326.56
Rate for Payer: Hamaspik Choice Inc Medicare	$272.71
Rate for Payer: Healthfirst Medicare Advantage	$231.80
Rate for Payer: Healthfirst QHP	$272.71
Rate for Payer: Senior Whole Health Medicare Advantage	$272.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$272.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$218.17
Rate for Payer: Wellcare Medicare	$259.07

TREAT ULNAR FRACTURE

Facility

$653.13

Service Code	HCPCS 24670
Hospital Charge Code	30302004
Hospital Revenue Code	510
Min. Negotiated Rate	$218.17
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$272.71
Rate for Payer: Aetna Government	$272.71
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Cash Price	$272.71
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$272.71
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	$272.71
Rate for Payer: Fidelis Essential Plan Aliesa	$231.80
Rate for Payer: Fidelis Essential Plan QHP	$242.71
Rate for Payer: Fidelis Medicare Advantage	$272.71
Rate for Payer: Fidelis Qualified Health Plan	$242.71
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$326.56
Rate for Payer: Hamaspik Choice Inc Medicare	$272.71
Rate for Payer: Healthfirst Medicare Advantage	$231.80
Rate for Payer: Healthfirst QHP	$272.71
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$272.71
Rate for Payer: Senior Whole Health Medicare Advantage	$272.71
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$272.71
Rate for Payer: Wellcare CHP/FHP/Medicaid	$218.17
Rate for Payer: Wellcare Medicare	$259.07

Know your out-of-pocket cost for care.

All Charges