St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

UA,MICROSCOPY

Facility

$10.05

Service Code	HCPCS 81000
Hospital Charge Code	30301319
Hospital Revenue Code	300
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$7.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.02
Rate for Payer: Aetna Government	$4.02
Rate for Payer: Affinity Essential Plan 1&2	$2.81
Rate for Payer: Affinity Essential Plan 3&4	$2.81
Rate for Payer: Affinity Medicaid/CHP/HARP	$2.81
Rate for Payer: Brighton Health Commercial	$7.54
Rate for Payer: Cash Price	$4.02
Rate for Payer: Cash Price	$4.02
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.26
Rate for Payer: Elderplan Medicare Advantage	$4.02
Rate for Payer: EmblemHealth Commercial	$4.02
Rate for Payer: Fidelis Essential Plan Aliesa	$3.42
Rate for Payer: Fidelis Essential Plan QHP	$3.58
Rate for Payer: Fidelis Medicare Advantage	$4.02
Rate for Payer: Fidelis Qualified Health Plan	$3.58
Rate for Payer: Group Health Inc Commercial	$4.02
Rate for Payer: Group Health Inc Medicare	$4.02
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.02
Rate for Payer: Hamaspik Choice Inc Medicare	$4.02
Rate for Payer: Healthfirst Medicare Advantage	$4.02
Rate for Payer: Healthfirst QHP	$4.02
Rate for Payer: Humana Medicare	$4.10
Rate for Payer: Senior Whole Health Medicare Advantage	$4.02
Rate for Payer: United Healthcare Commercial	$4.00
Rate for Payer: United Healthcare Medicare Advantage	$4.02
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.22
Rate for Payer: Wellcare Medicare	$3.62

UA,MICROSCOPY

Facility

$10.05

Service Code	HCPCS 81000
Hospital Charge Code	30301319
Hospital Revenue Code	300
Rate for Payer: Cash Price	$4.02

UCC

Facility

$99.23

Hospital Charge Code	40206305
Hospital Revenue Code	270
Min. Negotiated Rate	$34.73
Max. Negotiated Rate	$79.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$54.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$49.62
Rate for Payer: Aetna Government	$49.62
Rate for Payer: Brighton Health Commercial	$74.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$79.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$67.48
Rate for Payer: Group Health Inc Commercial	$49.62
Rate for Payer: Group Health Inc Medicare	$34.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$49.62
Rate for Payer: Hamaspik Choice Inc Medicare	$49.62

UHR U BI/PLR COMP 44X28MM

Facility

$3,070.00

Service Code	HCPCS C1776
Hospital Charge Code	40205362
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,223.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,688.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,842.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,535.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,765.25
Rate for Payer: EmblemHealth Commercial	$1,535.00
Rate for Payer: Fidelis Medicare Advantage	$3,223.50
Rate for Payer: Group Health Inc Commercial	$1,535.00
Rate for Payer: Group Health Inc Medicare	$1,074.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,535.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,535.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,995.50

UHR U BI/PLR COMP 44X28MM

Facility

$3,070.00

Service Code	HCPCS C1776
Hospital Charge Code	40205362
Hospital Revenue Code	278
Min. Negotiated Rate	$1,535.00
Max. Negotiated Rate	$1,535.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,535.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,535.00

UHR UNI H BI/PLR COMP42MMX26MM

Facility

$2,950.00

Service Code	HCPCS C1776
Hospital Charge Code	40205345
Hospital Revenue Code	278
Min. Negotiated Rate	$1,475.00
Max. Negotiated Rate	$1,475.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,475.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,475.00

UHR UNI H BI/PLR COMP42MMX26MM

Facility

$2,950.00

Service Code	HCPCS C1776
Hospital Charge Code	40205345
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,097.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,622.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,770.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,475.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,696.25
Rate for Payer: EmblemHealth Commercial	$1,475.00
Rate for Payer: Fidelis Medicare Advantage	$3,097.50
Rate for Payer: Group Health Inc Commercial	$1,475.00
Rate for Payer: Group Health Inc Medicare	$1,032.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,475.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,475.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,917.50

UHR UNIV BIPOLAR COMPO 50MMX28MM

Facility

$2,268.00

Service Code	HCPCS C1776
Hospital Charge Code	40209866
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.00
Max. Negotiated Rate	$1,134.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,134.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,134.00

UHR UNIV BIPOLAR COMPO 50MMX28MM

Facility

$2,268.00

Service Code	HCPCS C1776
Hospital Charge Code	40209866
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,381.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,247.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,360.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,134.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,304.10
Rate for Payer: EmblemHealth Commercial	$1,134.00
Rate for Payer: Fidelis Medicare Advantage	$2,381.40
Rate for Payer: Group Health Inc Commercial	$1,134.00
Rate for Payer: Group Health Inc Medicare	$793.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,134.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,134.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,474.20

UHR UNIV HEAD BI/P COMP 41MMX26MM

Facility

$3,010.00

Service Code	HCPCS C1776
Hospital Charge Code	40205472
Hospital Revenue Code	278
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$1,505.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,505.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,505.00

UHR UNIV HEAD BI/P COMP 41MMX26MM

Facility

$3,010.00

Service Code	HCPCS C1776
Hospital Charge Code	40205472
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,160.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,655.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,806.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,505.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,730.75
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Medicare Advantage	$3,160.50
Rate for Payer: Group Health Inc Commercial	$1,505.00
Rate for Payer: Group Health Inc Medicare	$1,053.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,505.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,505.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,956.50

UHR UNIV HEAD BI/PLR CMP 48MMX28

Facility

$2,836.00

Service Code	HCPCS C1776
Hospital Charge Code	40205241
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,977.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,559.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,701.60
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,418.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,630.70
Rate for Payer: EmblemHealth Commercial	$1,418.00
Rate for Payer: Fidelis Medicare Advantage	$2,977.80
Rate for Payer: Group Health Inc Commercial	$1,418.00
Rate for Payer: Group Health Inc Medicare	$992.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,418.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,418.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,843.40

UHR UNIV HEAD BI/PLR CMP 48MMX28

Facility

$2,836.00

Service Code	HCPCS C1776
Hospital Charge Code	40205241
Hospital Revenue Code	278
Min. Negotiated Rate	$1,418.00
Max. Negotiated Rate	$1,418.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,418.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,418.00

UHR UNIV HEAD BI/PLR COMP 45MMX28

Facility

$3,010.00

Service Code	HCPCS C1776
Hospital Charge Code	40205604
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,160.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,655.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,806.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,505.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,730.75
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Medicare Advantage	$3,160.50
Rate for Payer: Group Health Inc Commercial	$1,505.00
Rate for Payer: Group Health Inc Medicare	$1,053.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,505.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,505.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,956.50

UHR UNIV HEAD BI/PLR COMP 45MMX28

Facility

$3,010.00

Service Code	HCPCS C1776
Hospital Charge Code	40205604
Hospital Revenue Code	278
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$1,505.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,505.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,505.00

UHR UNVSL HEAD BIPLR COMP 43X26MM

Facility

$2,140.80

Service Code	HCPCS C1776
Hospital Charge Code	40209939
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,247.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,177.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,284.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,070.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,230.96
Rate for Payer: EmblemHealth Commercial	$1,070.40
Rate for Payer: Fidelis Medicare Advantage	$2,247.84
Rate for Payer: Group Health Inc Commercial	$1,070.40
Rate for Payer: Group Health Inc Medicare	$749.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,070.40
Rate for Payer: Hamaspik Choice Inc Medicare	$1,070.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,391.52

UHR UNVSL HEAD BIPLR COMP 43X26MM

Facility

$2,140.80

Service Code	HCPCS C1776
Hospital Charge Code	40209939
Hospital Revenue Code	278
Min. Negotiated Rate	$1,070.40
Max. Negotiated Rate	$1,070.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,070.40
Rate for Payer: Hamaspik Choice Inc Medicare	$1,070.40

ULIPRISTAL ACETATE 30 MG PO TABS [106079]

Facility

$46.50

Service Code	NDC 73302045601
Hospital Charge Code	73302045601
Hospital Revenue Code	250
Min. Negotiated Rate	$16.28
Max. Negotiated Rate	$37.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.25
Rate for Payer: Aetna Government	$23.25
Rate for Payer: Brighton Health Commercial	$34.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$37.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$31.62
Rate for Payer: Group Health Inc Commercial	$23.25
Rate for Payer: Group Health Inc Medicare	$16.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.25
Rate for Payer: Hamaspik Choice Inc Medicare	$23.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$30.22

ULTRA,SCROTUM,PROS VOLBRACHYTXPLN

Facility

$339.45

Service Code	HCPCS 76873 TC
Hospital Charge Code	66541306
Hospital Revenue Code	402
Min. Negotiated Rate	$77.02
Max. Negotiated Rate	$192.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$127.14
Rate for Payer: Aetna Government	$127.14
Rate for Payer: Affinity Essential Plan 1&2	$89.00
Rate for Payer: Affinity Essential Plan 3&4	$89.00
Rate for Payer: Affinity Medicaid/CHP/HARP	$89.00
Rate for Payer: Brighton Health Commercial	$127.14
Rate for Payer: Cash Price	$127.14
Rate for Payer: Cash Price	$127.14
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$127.14
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$192.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$163.05
Rate for Payer: Elderplan Medicare Advantage	$127.14
Rate for Payer: EmblemHealth Commercial	$89.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$108.07
Rate for Payer: Fidelis Essential Plan Aliesa	$108.07
Rate for Payer: Fidelis Essential Plan QHP	$113.15
Rate for Payer: Fidelis Medicare Advantage	$127.14
Rate for Payer: Fidelis Qualified Health Plan	$113.15
Rate for Payer: Group Health Inc Commercial	$114.43
Rate for Payer: Group Health Inc Medicare	$114.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.72
Rate for Payer: Hamaspik Choice Inc Medicare	$127.14
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$114.43
Rate for Payer: Healthfirst Medicare Advantage	$127.14
Rate for Payer: Healthfirst QHP	$127.14
Rate for Payer: Humana Medicare	$129.68
Rate for Payer: Senior Whole Health Medicare Advantage	$127.14
Rate for Payer: United Healthcare Commercial	$77.02
Rate for Payer: United Healthcare Medicare Advantage	$127.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$127.14
Rate for Payer: Wellcare CHP/FHP/Medicaid	$101.71
Rate for Payer: Wellcare Medicare	$120.78

ULTRA,SCROTUM,PROS VOLBRACHYTXPLN

Facility

$339.45

Service Code	HCPCS 76873 TC
Hospital Charge Code	66541306
Hospital Revenue Code	402
Rate for Payer: Cash Price	$127.14

ULTRASONIC GUIDE ASPIRATION OVA

Facility

$346.84

Service Code	HCPCS 76948 TC
Hospital Charge Code	66541310
Hospital Revenue Code	402
Min. Negotiated Rate	$31.10
Max. Negotiated Rate	$277.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$190.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.10
Rate for Payer: Aetna Government	$31.10
Rate for Payer: Brighton Health Commercial	$260.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$277.47
Rate for Payer: Cigna LocalPlus Benefit Plan	$235.85
Rate for Payer: Group Health Inc Commercial	$173.42
Rate for Payer: Group Health Inc Medicare	$121.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$173.42
Rate for Payer: Hamaspik Choice Inc Medicare	$173.42

ULTRASONIC NEBULZR TRTMNT

Facility

$557.18

Service Code	HCPCS 94664
Hospital Charge Code	40303000
Hospital Revenue Code	410
Rate for Payer: Cash Price	$246.65

ULTRASONIC NEBULZR TRTMNT

Facility

$557.18

Service Code	HCPCS 94664
Hospital Charge Code	30103248
Hospital Revenue Code	410
Min. Negotiated Rate	$132.45
Max. Negotiated Rate	$417.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$306.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$246.65
Rate for Payer: Aetna Government	$246.65
Rate for Payer: Affinity Essential Plan 1&2	$172.66
Rate for Payer: Affinity Essential Plan 3&4	$172.66
Rate for Payer: Affinity Medicaid/CHP/HARP	$172.66
Rate for Payer: Brighton Health Commercial	$417.88
Rate for Payer: Cash Price	$246.65
Rate for Payer: Cash Price	$246.65
Rate for Payer: Cash Price	$246.65
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$246.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.45
Rate for Payer: Elderplan Medicare Advantage	$246.65
Rate for Payer: EmblemHealth Commercial	$246.65
Rate for Payer: Fidelis Essential Plan Aliesa	$209.65
Rate for Payer: Fidelis Essential Plan QHP	$219.52
Rate for Payer: Fidelis Medicare Advantage	$246.65
Rate for Payer: Fidelis Qualified Health Plan	$219.52
Rate for Payer: Group Health Inc Commercial	$246.65
Rate for Payer: Group Health Inc Medicare	$246.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$278.59
Rate for Payer: Hamaspik Choice Inc Medicare	$246.65
Rate for Payer: Healthfirst Medicare Advantage	$209.65
Rate for Payer: Healthfirst QHP	$246.65
Rate for Payer: Humana Medicare	$251.58
Rate for Payer: Senior Whole Health Medicare Advantage	$246.65
Rate for Payer: United Healthcare Commercial	$278.59
Rate for Payer: United Healthcare Medicare Advantage	$246.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$246.65
Rate for Payer: Wellcare CHP/FHP/Medicaid	$197.32
Rate for Payer: Wellcare Medicare	$234.32

ULTRASONIC NEBULZR TRTMNT

Facility

$557.18

Service Code	HCPCS 94664
Hospital Charge Code	30103248
Hospital Revenue Code	410
Rate for Payer: Cash Price	$246.65

ULTRASONIC NEBULZR TRTMNT

Facility

$557.18

Service Code	HCPCS 94664
Hospital Charge Code	40303000
Hospital Revenue Code	410
Min. Negotiated Rate	$132.45
Max. Negotiated Rate	$417.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$306.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$246.65
Rate for Payer: Aetna Government	$246.65
Rate for Payer: Affinity Essential Plan 1&2	$172.66
Rate for Payer: Affinity Essential Plan 3&4	$172.66
Rate for Payer: Affinity Medicaid/CHP/HARP	$172.66
Rate for Payer: Brighton Health Commercial	$417.88
Rate for Payer: Cash Price	$246.65
Rate for Payer: Cash Price	$246.65
Rate for Payer: Cash Price	$246.65
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$246.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$155.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.45
Rate for Payer: Elderplan Medicare Advantage	$246.65
Rate for Payer: EmblemHealth Commercial	$246.65
Rate for Payer: Fidelis Essential Plan Aliesa	$209.65
Rate for Payer: Fidelis Essential Plan QHP	$219.52
Rate for Payer: Fidelis Medicare Advantage	$246.65
Rate for Payer: Fidelis Qualified Health Plan	$219.52
Rate for Payer: Group Health Inc Commercial	$246.65
Rate for Payer: Group Health Inc Medicare	$246.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$278.59
Rate for Payer: Hamaspik Choice Inc Medicare	$246.65
Rate for Payer: Healthfirst Medicare Advantage	$209.65
Rate for Payer: Healthfirst QHP	$246.65
Rate for Payer: Humana Medicare	$251.58
Rate for Payer: Senior Whole Health Medicare Advantage	$246.65
Rate for Payer: United Healthcare Commercial	$278.59
Rate for Payer: United Healthcare Medicare Advantage	$246.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$246.65
Rate for Payer: Wellcare CHP/FHP/Medicaid	$197.32
Rate for Payer: Wellcare Medicare	$234.32

Know your out-of-pocket cost for care.

All Charges