St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

VALPROATE SODIUM 100 MG/ML IV SOLN [20887]

Facility

$1.61

Service Code	NDC 63323049401
Hospital Charge Code	63323049401
Hospital Revenue Code	278
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$1.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.80
Rate for Payer: Aetna Government	$0.80
Rate for Payer: Brighton Health Commercial	$0.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.92
Rate for Payer: EmblemHealth Commercial	$0.80
Rate for Payer: Fidelis Medicare Advantage	$1.69
Rate for Payer: Group Health Inc Commercial	$0.80
Rate for Payer: Group Health Inc Medicare	$0.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80
Rate for Payer: Hamaspik Choice Inc Medicare	$0.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.05

VALPROATE SODIUM 100 MG/ML IV SOLN [20887]

Facility

$4.15

Service Code	NDC 00143978510
Hospital Charge Code	00143978510
Hospital Revenue Code	278
Min. Negotiated Rate	$2.07
Max. Negotiated Rate	$2.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.07
Rate for Payer: Hamaspik Choice Inc Medicare	$2.07

VALPROATE SODIUM 100 MG/ML IV SOLN [20887]

Facility

$0.49

Service Code	NDC 63323049416
Hospital Charge Code	63323049416
Hospital Revenue Code	278
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25

VALPROATE SODIUM 100 MG/ML IV SOLN [20887]

Facility

$4.15

Service Code	NDC 00143978510
Hospital Charge Code	00143978510
Hospital Revenue Code	278
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$4.36
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.07
Rate for Payer: Aetna Government	$2.07
Rate for Payer: Brighton Health Commercial	$2.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.39
Rate for Payer: EmblemHealth Commercial	$2.07
Rate for Payer: Fidelis Medicare Advantage	$4.36
Rate for Payer: Group Health Inc Commercial	$2.07
Rate for Payer: Group Health Inc Medicare	$1.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.07
Rate for Payer: Hamaspik Choice Inc Medicare	$2.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.70

VALPROATE SODIUM 250MG/5ML SYRUP

Facility

$1.00

Hospital Charge Code	41643817
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: Brighton Health Commercial	$0.75
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

VALPROATE SODIUM 250MG/5ML SYRUP

Facility

$1.00

Hospital Charge Code	41653817
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: Brighton Health Commercial	$0.75
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

VALPROATE SODIUM 250 MG/5 ML SYRUP 5 ML

Facility

$0.93

Hospital Charge Code	41643740
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.47
Rate for Payer: Aetna Government	$0.47
Rate for Payer: Brighton Health Commercial	$0.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.63
Rate for Payer: Group Health Inc Commercial	$0.47
Rate for Payer: Group Health Inc Medicare	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.47
Rate for Payer: Hamaspik Choice Inc Medicare	$0.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.60

VALPROATE SODIUM 250 MG/5 ML SYRUP 5 ML

Facility

$0.93

Hospital Charge Code	41653740
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.47
Rate for Payer: Aetna Government	$0.47
Rate for Payer: Brighton Health Commercial	$0.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.63
Rate for Payer: Group Health Inc Commercial	$0.47
Rate for Payer: Group Health Inc Medicare	$0.33
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.47
Rate for Payer: Hamaspik Choice Inc Medicare	$0.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.60

VALPROATE SODIUM 500 MG INJ

Facility

$4.94

Hospital Charge Code	41642210
Hospital Revenue Code	250
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$3.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.47
Rate for Payer: Aetna Government	$2.47
Rate for Payer: Brighton Health Commercial	$3.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.36
Rate for Payer: Group Health Inc Commercial	$2.47
Rate for Payer: Group Health Inc Medicare	$1.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.47
Rate for Payer: Hamaspik Choice Inc Medicare	$2.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.21

VALPROATE SODIUM 500 MG INJ

Facility

$4.94

Hospital Charge Code	41652210
Hospital Revenue Code	250
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$3.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.47
Rate for Payer: Aetna Government	$2.47
Rate for Payer: Brighton Health Commercial	$3.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.36
Rate for Payer: Group Health Inc Commercial	$2.47
Rate for Payer: Group Health Inc Medicare	$1.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.47
Rate for Payer: Hamaspik Choice Inc Medicare	$2.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.21

VALPROIC ACID

Facility

$33.85

Service Code	HCPCS 80164
Hospital Charge Code	40602588
Hospital Revenue Code	301
Rate for Payer: Cash Price	$13.54

VALPROIC ACID

Facility

$33.85

Service Code	HCPCS 80164
Hospital Charge Code	40602588
Hospital Revenue Code	301
Min. Negotiated Rate	$10.83
Max. Negotiated Rate	$25.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.62
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.54
Rate for Payer: Aetna Government	$13.54
Rate for Payer: Brighton Health Commercial	$25.39
Rate for Payer: Cash Price	$13.54
Rate for Payer: Cash Price	$13.54
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$13.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.53
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.22
Rate for Payer: Elderplan Medicare Advantage	$13.54
Rate for Payer: EmblemHealth Commercial	$13.54
Rate for Payer: Fidelis Essential Plan Aliesa	$11.51
Rate for Payer: Fidelis Essential Plan QHP	$12.05
Rate for Payer: Fidelis Medicare Advantage	$13.54
Rate for Payer: Fidelis Qualified Health Plan	$12.05
Rate for Payer: Group Health Inc Commercial	$13.54
Rate for Payer: Group Health Inc Medicare	$13.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.92
Rate for Payer: Hamaspik Choice Inc Medicare	$13.54
Rate for Payer: Healthfirst Medicare Advantage	$13.54
Rate for Payer: Healthfirst QHP	$13.54
Rate for Payer: Senior Whole Health Medicare Advantage	$13.54
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.54
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10.83
Rate for Payer: Wellcare Medicare	$12.19

VALPROIC ACID 250 MG/5ML PO SOLN [107838]

Facility

$0.27

Service Code	NDC 00121135010
Hospital Charge Code	00121135010
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$0.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.18
Rate for Payer: Group Health Inc Commercial	$0.13
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.17

VALPROIC ACID 250 MG/5ML PO SOLN [107838]

Facility

$0.15

Service Code	NDC 00121067585
Hospital Charge Code	00121067585
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.08
Rate for Payer: Aetna Government	$0.08
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: Group Health Inc Commercial	$0.08
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.08
Rate for Payer: Hamaspik Choice Inc Medicare	$0.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.10

VALPROIC ACID 250 MG/5ML PO SOLN [107838]

Facility

$0.11

Service Code	NDC 50383079216
Hospital Charge Code	50383079216
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.05
Rate for Payer: Aetna Government	$0.05
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

VALPROIC ACID 250 MG/5ML PO SOLN [107838]

Facility

$0.10

Service Code	NDC 60687026256
Hospital Charge Code	60687026256
Hospital Revenue Code	250
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.06
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.05
Rate for Payer: Aetna Government	$0.05
Rate for Payer: Brighton Health Commercial	$0.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.07
Rate for Payer: Group Health Inc Commercial	$0.05
Rate for Payer: Group Health Inc Medicare	$0.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.05
Rate for Payer: Hamaspik Choice Inc Medicare	$0.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.07

VALPROIC ACID 250 MG/5ML PO SOLN [107838]

Facility

$0.15

Service Code	NDC 68094019362
Hospital Charge Code	68094019362
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.10

VALPROIC ACID 250 MG/5ML PO SOLN [107838]

Facility

$0.30

Service Code	NDC 00121467505
Hospital Charge Code	00121467505
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.15
Rate for Payer: Aetna Government	$0.15
Rate for Payer: Brighton Health Commercial	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
Rate for Payer: Group Health Inc Commercial	$0.15
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.20

VALPROIC ACID 250 MG/5ML PO SOLN [107838]

Facility

$0.27

Service Code	NDC 00121135000
Hospital Charge Code	00121135000
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$0.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.13
Rate for Payer: Aetna Government	$0.13
Rate for Payer: Brighton Health Commercial	$0.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.18
Rate for Payer: Group Health Inc Commercial	$0.13
Rate for Payer: Group Health Inc Medicare	$0.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.13
Rate for Payer: Hamaspik Choice Inc Medicare	$0.13
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.17

VALPROIC ACID 250 MG/5ML PO SOLN [107838]

Facility

$0.15

Service Code	NDC 68094019361
Hospital Charge Code	68094019361
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.10

VALPROIC ACID 250 MG/5ML PO SOLN [107838]

Facility

$0.30

Service Code	NDC 00121467500
Hospital Charge Code	00121467500
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.15
Rate for Payer: Aetna Government	$0.15
Rate for Payer: Brighton Health Commercial	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
Rate for Payer: Group Health Inc Commercial	$0.15
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.20

VALPROIC ACID 250 MG CAP

Facility

$1.00

Hospital Charge Code	41652230
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: Brighton Health Commercial	$0.75
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

VALPROIC ACID 250 MG CAP

Facility

$1.00

Hospital Charge Code	41642230
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: Brighton Health Commercial	$0.75
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

VALPROIC ACID 250 MG PO CAPS [8429]

Facility

$0.84

Service Code	NDC 69452015020
Hospital Charge Code	69452015020
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$0.67
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.42
Rate for Payer: Aetna Government	$0.42
Rate for Payer: Brighton Health Commercial	$0.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.57
Rate for Payer: Group Health Inc Commercial	$0.42
Rate for Payer: Group Health Inc Medicare	$0.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.42
Rate for Payer: Hamaspik Choice Inc Medicare	$0.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.55

VALVE BACKCHECK

Facility

$7.20

Hospital Charge Code	64907319
Hospital Revenue Code	270
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$5.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.60
Rate for Payer: Aetna Government	$3.60
Rate for Payer: Brighton Health Commercial	$5.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.90
Rate for Payer: Group Health Inc Commercial	$3.60
Rate for Payer: Group Health Inc Medicare	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60

Know your out-of-pocket cost for care.

All Charges