St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

URINE_CULTURE, ROUTINE

Facility

$20.18

Service Code	HCPCS 87086
Hospital Charge Code	40628847
Hospital Revenue Code	300
Rate for Payer: Cash Price	$8.07

URINE_CULTURE, ROUTINE

Facility

$20.18

Service Code	HCPCS 87086
Hospital Charge Code	40628847
Hospital Revenue Code	300
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$15.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.07
Rate for Payer: Aetna Government	$8.07
Rate for Payer: Brighton Health Commercial	$15.14
Rate for Payer: Cash Price	$8.07
Rate for Payer: Cash Price	$8.07
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.83
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.86
Rate for Payer: Elderplan Medicare Advantage	$8.07
Rate for Payer: EmblemHealth Commercial	$8.07
Rate for Payer: Fidelis Essential Plan Aliesa	$6.86
Rate for Payer: Fidelis Essential Plan QHP	$7.18
Rate for Payer: Fidelis Medicare Advantage	$8.07
Rate for Payer: Fidelis Qualified Health Plan	$7.18
Rate for Payer: Group Health Inc Commercial	$8.07
Rate for Payer: Group Health Inc Medicare	$8.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.09
Rate for Payer: Hamaspik Choice Inc Medicare	$8.07
Rate for Payer: Healthfirst Medicare Advantage	$8.07
Rate for Payer: Healthfirst QHP	$8.07
Rate for Payer: Senior Whole Health Medicare Advantage	$8.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6.46
Rate for Payer: Wellcare Medicare	$7.26

URINE ELECTROLYTES /24 HR

Facility

$17.53

Service Code	HCPCS 80051
Hospital Charge Code	40602330
Hospital Revenue Code	301
Min. Negotiated Rate	$5.61
Max. Negotiated Rate	$13.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.01
Rate for Payer: Aetna Government	$7.01
Rate for Payer: Brighton Health Commercial	$13.15
Rate for Payer: Cash Price	$7.01
Rate for Payer: Cash Price	$7.01
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$7.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.44
Rate for Payer: Elderplan Medicare Advantage	$7.01
Rate for Payer: EmblemHealth Commercial	$7.01
Rate for Payer: Fidelis Essential Plan Aliesa	$5.96
Rate for Payer: Fidelis Essential Plan QHP	$6.24
Rate for Payer: Fidelis Medicare Advantage	$7.01
Rate for Payer: Fidelis Qualified Health Plan	$6.24
Rate for Payer: Group Health Inc Commercial	$7.01
Rate for Payer: Group Health Inc Medicare	$7.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.76
Rate for Payer: Hamaspik Choice Inc Medicare	$7.01
Rate for Payer: Healthfirst Medicare Advantage	$7.01
Rate for Payer: Healthfirst QHP	$7.01
Rate for Payer: Senior Whole Health Medicare Advantage	$7.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.61
Rate for Payer: Wellcare Medicare	$6.31

URINE ELECTROLYTES /24 HR

Facility

$17.53

Service Code	HCPCS 80051
Hospital Charge Code	40602330
Hospital Revenue Code	301
Rate for Payer: Cash Price	$7.01

URINE ELECTROLYTES SPOT

Facility

$17.53

Service Code	HCPCS 80051
Hospital Charge Code	40602325
Hospital Revenue Code	301
Rate for Payer: Cash Price	$7.01

URINE ELECTROLYTES SPOT

Facility

$17.53

Service Code	HCPCS 80051
Hospital Charge Code	40602325
Hospital Revenue Code	301
Min. Negotiated Rate	$5.61
Max. Negotiated Rate	$13.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.01
Rate for Payer: Aetna Government	$7.01
Rate for Payer: Brighton Health Commercial	$13.15
Rate for Payer: Cash Price	$7.01
Rate for Payer: Cash Price	$7.01
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$7.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.44
Rate for Payer: Elderplan Medicare Advantage	$7.01
Rate for Payer: EmblemHealth Commercial	$7.01
Rate for Payer: Fidelis Essential Plan Aliesa	$5.96
Rate for Payer: Fidelis Essential Plan QHP	$6.24
Rate for Payer: Fidelis Medicare Advantage	$7.01
Rate for Payer: Fidelis Qualified Health Plan	$6.24
Rate for Payer: Group Health Inc Commercial	$7.01
Rate for Payer: Group Health Inc Medicare	$7.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.76
Rate for Payer: Hamaspik Choice Inc Medicare	$7.01
Rate for Payer: Healthfirst Medicare Advantage	$7.01
Rate for Payer: Healthfirst QHP	$7.01
Rate for Payer: Senior Whole Health Medicare Advantage	$7.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.61
Rate for Payer: Wellcare Medicare	$6.31

URINE LOW MEASUREMENT

Facility

$315.67

Service Code	HCPCS 51736 TC
Hospital Charge Code	30306417
Hospital Revenue Code	510
Min. Negotiated Rate	$157.84
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$173.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$157.84
Rate for Payer: Aetna Government	$157.84
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$147.72
Rate for Payer: Cash Price	$147.72
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: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$157.84
Rate for Payer: Hamaspik Choice Inc Medicare	$157.84

URINE LOW MEASUREMENT

Facility

$315.67

Service Code	HCPCS 51736 TC
Hospital Charge Code	30306417
Hospital Revenue Code	510
Rate for Payer: Cash Price	$147.72

URINE PREGNANCY TEST

Facility

$21.53

Service Code	HCPCS 81025
Hospital Charge Code	30301273
Hospital Revenue Code	300
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$322.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.61
Rate for Payer: Aetna Government	$8.61
Rate for Payer: Amida Care Medicaid	$3.22
Rate for Payer: Brighton Health Commercial	$16.15
Rate for Payer: Cash Price	$8.61
Rate for Payer: Cash Price	$8.61
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.51
Rate for Payer: Elderplan Medicare Advantage	$8.61
Rate for Payer: EmblemHealth Commercial	$8.61
Rate for Payer: Fidelis CHP/HARP/Medicaid	$322.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3.22
Rate for Payer: Fidelis Essential Plan QHP	$3.22
Rate for Payer: Fidelis Medicare Advantage	$8.61
Rate for Payer: Fidelis Qualified Health Plan	$3.38
Rate for Payer: Group Health Inc Commercial	$8.61
Rate for Payer: Group Health Inc Medicare	$8.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.22
Rate for Payer: Hamaspik Choice Inc Medicare	$8.61
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3.22
Rate for Payer: Healthfirst Essential Plan	$7.24
Rate for Payer: Healthfirst Medicare Advantage	$8.61
Rate for Payer: Healthfirst QHP	$3.22
Rate for Payer: Senior Whole Health Medicare Advantage	$8.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3.22
Rate for Payer: SOMOS Essential	$3.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.61
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6.89
Rate for Payer: Wellcare Medicare	$7.75

URINE PREGNANCY TEST

Facility

$21.53

Service Code	HCPCS 81025
Hospital Charge Code	30301295
Hospital Revenue Code	300
Min. Negotiated Rate	$3.22
Max. Negotiated Rate	$322.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.61
Rate for Payer: Aetna Government	$8.61
Rate for Payer: Amida Care Medicaid	$3.22
Rate for Payer: Brighton Health Commercial	$16.15
Rate for Payer: Cash Price	$8.61
Rate for Payer: Cash Price	$8.61
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.51
Rate for Payer: Elderplan Medicare Advantage	$8.61
Rate for Payer: EmblemHealth Commercial	$8.61
Rate for Payer: Fidelis CHP/HARP/Medicaid	$322.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3.22
Rate for Payer: Fidelis Essential Plan QHP	$3.22
Rate for Payer: Fidelis Medicare Advantage	$8.61
Rate for Payer: Fidelis Qualified Health Plan	$3.38
Rate for Payer: Group Health Inc Commercial	$8.61
Rate for Payer: Group Health Inc Medicare	$8.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.22
Rate for Payer: Hamaspik Choice Inc Medicare	$8.61
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3.22
Rate for Payer: Healthfirst Essential Plan	$7.24
Rate for Payer: Healthfirst Medicare Advantage	$8.61
Rate for Payer: Healthfirst QHP	$3.22
Rate for Payer: Senior Whole Health Medicare Advantage	$8.61
Rate for Payer: SOMOS CHP/HARP/Medicaid	$3.22
Rate for Payer: SOMOS Essential	$3.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.61
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6.89
Rate for Payer: Wellcare Medicare	$7.75

URINE PREGNANCY TEST

Facility

$21.53

Service Code	HCPCS 81025
Hospital Charge Code	30301295
Hospital Revenue Code	300
Rate for Payer: Cash Price	$8.61

URINE PREGNANCY TEST

Facility

$21.53

Service Code	HCPCS 81025
Hospital Charge Code	30301273
Hospital Revenue Code	300
Rate for Payer: Cash Price	$8.61

URINE SPECIMAN

Facility

$6.94

Hospital Charge Code	64905489
Hospital Revenue Code	270
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$5.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.82
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.47
Rate for Payer: Aetna Government	$3.47
Rate for Payer: Brighton Health Commercial	$5.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.72
Rate for Payer: Group Health Inc Commercial	$3.47
Rate for Payer: Group Health Inc Medicare	$2.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.47
Rate for Payer: Hamaspik Choice Inc Medicare	$3.47

URINE UREA NITROGEN /DAY

Facility

$13.90

Service Code	HCPCS 84540
Hospital Charge Code	40602270
Hospital Revenue Code	301
Rate for Payer: Cash Price	$5.56

URINE UREA NITROGEN /DAY

Facility

$13.90

Service Code	HCPCS 84540
Hospital Charge Code	40602270
Hospital Revenue Code	301
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$10.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.56
Rate for Payer: Aetna Government	$5.56
Rate for Payer: Brighton Health Commercial	$10.42
Rate for Payer: Cash Price	$5.56
Rate for Payer: Cash Price	$5.56
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.38
Rate for Payer: Elderplan Medicare Advantage	$5.56
Rate for Payer: EmblemHealth Commercial	$5.56
Rate for Payer: Fidelis Essential Plan Aliesa	$4.73
Rate for Payer: Fidelis Essential Plan QHP	$4.95
Rate for Payer: Fidelis Medicare Advantage	$5.56
Rate for Payer: Fidelis Qualified Health Plan	$4.95
Rate for Payer: Group Health Inc Commercial	$5.56
Rate for Payer: Group Health Inc Medicare	$5.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.95
Rate for Payer: Hamaspik Choice Inc Medicare	$5.56
Rate for Payer: Healthfirst Medicare Advantage	$5.56
Rate for Payer: Healthfirst QHP	$5.56
Rate for Payer: Senior Whole Health Medicare Advantage	$5.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.45
Rate for Payer: Wellcare Medicare	$5.00

URINE UREA NITROGEN RANDOM

Facility

$13.90

Service Code	HCPCS 84540
Hospital Charge Code	40602265
Hospital Revenue Code	301
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$10.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.56
Rate for Payer: Aetna Government	$5.56
Rate for Payer: Brighton Health Commercial	$10.42
Rate for Payer: Cash Price	$5.56
Rate for Payer: Cash Price	$5.56
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.38
Rate for Payer: Elderplan Medicare Advantage	$5.56
Rate for Payer: EmblemHealth Commercial	$5.56
Rate for Payer: Fidelis Essential Plan Aliesa	$4.73
Rate for Payer: Fidelis Essential Plan QHP	$4.95
Rate for Payer: Fidelis Medicare Advantage	$5.56
Rate for Payer: Fidelis Qualified Health Plan	$4.95
Rate for Payer: Group Health Inc Commercial	$5.56
Rate for Payer: Group Health Inc Medicare	$5.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.95
Rate for Payer: Hamaspik Choice Inc Medicare	$5.56
Rate for Payer: Healthfirst Medicare Advantage	$5.56
Rate for Payer: Healthfirst QHP	$5.56
Rate for Payer: Senior Whole Health Medicare Advantage	$5.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.45
Rate for Payer: Wellcare Medicare	$5.00

URINE UREA NITROGEN RANDOM

Facility

$13.90

Service Code	HCPCS 84540
Hospital Charge Code	40602265
Hospital Revenue Code	301
Rate for Payer: Cash Price	$5.56

URI NEW RX ANTIBIOTIC 30D

Facility

$0.01

Service Code	HCPCS G2174
Hospital Charge Code	30300302
Hospital Revenue Code	929
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

URI W COMORB 12M OTH DX

Facility

$0.01

Service Code	HCPCS G2173
Hospital Charge Code	30300301
Hospital Revenue Code	929
Max. Negotiated Rate	$0.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

URO DRN TUBE ADAPTER

Facility

$19.80

Hospital Charge Code	40005169
Hospital Revenue Code	272
Min. Negotiated Rate	$6.93
Max. Negotiated Rate	$15.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.90
Rate for Payer: Aetna Government	$9.90
Rate for Payer: Brighton Health Commercial	$14.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.46
Rate for Payer: Group Health Inc Commercial	$9.90
Rate for Payer: Group Health Inc Medicare	$6.93
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.90
Rate for Payer: Hamaspik Choice Inc Medicare	$9.90

UROLOGY SURGERY PROCEDURE

Facility

$711.45

Service Code	HCPCS 53899
Hospital Charge Code	40004141
Hospital Revenue Code	360
Min. Negotiated Rate	$228.65
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$285.81
Rate for Payer: Aetna Government	$285.81
Rate for Payer: Brighton Health Commercial	$533.59
Rate for Payer: Cash Price	$285.81
Rate for Payer: Cash Price	$285.81
Rate for Payer: Cash Price	$285.81
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$285.81
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	$285.81
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$242.94
Rate for Payer: Fidelis Essential Plan QHP	$254.37
Rate for Payer: Fidelis Medicare Advantage	$285.81
Rate for Payer: Fidelis Qualified Health Plan	$254.37
Rate for Payer: Group Health Inc Commercial	$285.81
Rate for Payer: Group Health Inc Medicare	$285.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$355.72
Rate for Payer: Hamaspik Choice Inc Medicare	$285.81
Rate for Payer: Healthfirst Medicare Advantage	$242.94
Rate for Payer: Healthfirst QHP	$285.81
Rate for Payer: Senior Whole Health Medicare Advantage	$285.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$285.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$228.65
Rate for Payer: Wellcare Medicare	$271.52

UROLOGY SURGERY PROCEDURE

Facility

$711.45

Service Code	HCPCS 53899
Hospital Charge Code	40004141
Hospital Revenue Code	360
Rate for Payer: Cash Price	$285.81

UROLOK II ADAPTOR

Facility

$36.00

Hospital Charge Code	40201007
Hospital Revenue Code	270
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$28.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.00
Rate for Payer: Aetna Government	$18.00
Rate for Payer: Brighton Health Commercial	$27.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$28.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.48
Rate for Payer: Group Health Inc Commercial	$18.00
Rate for Payer: Group Health Inc Medicare	$12.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.00
Rate for Payer: Hamaspik Choice Inc Medicare	$18.00

UROMAX 20

Facility

$927.50

Hospital Charge Code	64903048
Hospital Revenue Code	270
Min. Negotiated Rate	$324.62
Max. Negotiated Rate	$742.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$510.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$463.75
Rate for Payer: Aetna Government	$463.75
Rate for Payer: Brighton Health Commercial	$695.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$742.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$630.70
Rate for Payer: Group Health Inc Commercial	$463.75
Rate for Payer: Group Health Inc Medicare	$324.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$463.75
Rate for Payer: Hamaspik Choice Inc Medicare	$463.75

URO SHEATH

Facility

$12.05

Hospital Charge Code	40206390
Hospital Revenue Code	270
Min. Negotiated Rate	$4.22
Max. Negotiated Rate	$9.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.02
Rate for Payer: Aetna Government	$6.02
Rate for Payer: Brighton Health Commercial	$9.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.19
Rate for Payer: Group Health Inc Commercial	$6.02
Rate for Payer: Group Health Inc Medicare	$4.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.02
Rate for Payer: Hamaspik Choice Inc Medicare	$6.02

Know your out-of-pocket cost for care.

All Charges