St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

VASOPRESSIN 20 UNITS/ML INJ

Facility

$9.00

Hospital Charge Code	41643641
Hospital Revenue Code	250
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$7.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.50
Rate for Payer: Aetna Government	$4.50
Rate for Payer: Brighton Health Commercial	$6.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.12
Rate for Payer: Group Health Inc Commercial	$4.50
Rate for Payer: Group Health Inc Medicare	$3.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.85

VAXNEUVANCE VFC-PNEUMC 15-VALENT

Facility

$0.01

Service Code	HCPCS 90671
Hospital Charge Code	41650399
Hospital Revenue Code	636
Max. Negotiated Rate	$268.77
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
Rate for Payer: SOMOS CHP/HARP/Medicaid	$268.77
Rate for Payer: SOMOS Essential	$268.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

VAXNEUVANCE VFC-PNEUMC 15-VALENT

Facility

$0.01

Service Code	HCPCS 90671
Hospital Charge Code	41640399
Hospital Revenue Code	636
Max. Negotiated Rate	$268.77
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
Rate for Payer: SOMOS CHP/HARP/Medicaid	$268.77
Rate for Payer: SOMOS Essential	$268.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

VAXNEUVANCE VFC-PNEUMC 15-VALENT

Facility

$0.01

Service Code	HCPCS 90671
Hospital Charge Code	41650399
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

VAXNEUVANCE VFC-PNEUMC 15-VALENT

Facility

$0.01

Service Code	HCPCS 90671
Hospital Charge Code	41640399
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

V BOSS 12X80 10MM

Facility

$18,136.45

Hospital Charge Code	64904427
Hospital Revenue Code	279
Min. Negotiated Rate	$6,347.76
Max. Negotiated Rate	$14,509.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,975.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9,068.22
Rate for Payer: Aetna Government	$9,068.22
Rate for Payer: Brighton Health Commercial	$13,602.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14,509.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$12,332.79
Rate for Payer: Group Health Inc Commercial	$9,068.22
Rate for Payer: Group Health Inc Medicare	$6,347.76
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,068.22
Rate for Payer: Hamaspik Choice Inc Medicare	$9,068.22

VB ROLL 11 X 14 24.5MM

Facility

$10,950.00

Hospital Charge Code	64904010
Hospital Revenue Code	279
Min. Negotiated Rate	$3,832.50
Max. Negotiated Rate	$8,760.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6,022.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,475.00
Rate for Payer: Aetna Government	$5,475.00
Rate for Payer: Brighton Health Commercial	$8,212.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8,760.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,446.00
Rate for Payer: Group Health Inc Commercial	$5,475.00
Rate for Payer: Group Health Inc Medicare	$3,832.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,475.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,475.00

VDRL CSF

Facility

$11.00

Service Code	HCPCS 86593
Hospital Charge Code	40721300
Hospital Revenue Code	300
Rate for Payer: Cash Price	$4.40

VDRL CSF

Facility

$10.68

Service Code	HCPCS 86592
Hospital Charge Code	40729707
Hospital Revenue Code	302
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$8.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.87
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.27
Rate for Payer: Aetna Government	$4.27
Rate for Payer: Brighton Health Commercial	$8.01
Rate for Payer: Cash Price	$4.27
Rate for Payer: Cash Price	$4.27
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.74
Rate for Payer: Elderplan Medicare Advantage	$4.27
Rate for Payer: EmblemHealth Commercial	$4.27
Rate for Payer: Fidelis Essential Plan Aliesa	$3.63
Rate for Payer: Fidelis Essential Plan QHP	$3.80
Rate for Payer: Fidelis Medicare Advantage	$4.27
Rate for Payer: Fidelis Qualified Health Plan	$3.80
Rate for Payer: Group Health Inc Commercial	$4.27
Rate for Payer: Group Health Inc Medicare	$4.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.34
Rate for Payer: Hamaspik Choice Inc Medicare	$4.27
Rate for Payer: Healthfirst Medicare Advantage	$4.27
Rate for Payer: Healthfirst QHP	$4.27
Rate for Payer: Senior Whole Health Medicare Advantage	$4.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.42
Rate for Payer: Wellcare Medicare	$3.84

VDRL CSF

Facility

$11.00

Service Code	HCPCS 86593
Hospital Charge Code	40721300
Hospital Revenue Code	300
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$8.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.40
Rate for Payer: Aetna Government	$4.40
Rate for Payer: Brighton Health Commercial	$8.25
Rate for Payer: Cash Price	$4.40
Rate for Payer: Cash Price	$4.40
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.91
Rate for Payer: Elderplan Medicare Advantage	$4.40
Rate for Payer: EmblemHealth Commercial	$4.40
Rate for Payer: Fidelis Essential Plan Aliesa	$3.74
Rate for Payer: Fidelis Essential Plan QHP	$3.92
Rate for Payer: Fidelis Medicare Advantage	$4.40
Rate for Payer: Fidelis Qualified Health Plan	$3.92
Rate for Payer: Group Health Inc Commercial	$4.40
Rate for Payer: Group Health Inc Medicare	$4.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4.40
Rate for Payer: Healthfirst Medicare Advantage	$4.40
Rate for Payer: Healthfirst QHP	$4.40
Rate for Payer: Senior Whole Health Medicare Advantage	$4.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.40
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3.52
Rate for Payer: Wellcare Medicare	$3.96

VDRL CSF

Facility

$10.68

Service Code	HCPCS 86592
Hospital Charge Code	40729707
Hospital Revenue Code	302
Rate for Payer: Cash Price	$4.27

VECURONIUM 10 MG INJ

Facility

$10.44

Hospital Charge Code	41654419
Hospital Revenue Code	250
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$8.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Brighton Health Commercial	$7.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.10
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$3.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.22
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.79

VECURONIUM 10 MG INJ

Facility

$10.44

Hospital Charge Code	41644419
Hospital Revenue Code	250
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$8.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Brighton Health Commercial	$7.83
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.10
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$3.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.22
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.79

VECURONIUM BROMIDE 10 MG IV SOLR [11634]

Facility

$6.60

Service Code	NDC 55150023510
Hospital Charge Code	55150023510
Hospital Revenue Code	278
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.30
Rate for Payer: Hamaspik Choice Inc Medicare	$3.30

VECURONIUM BROMIDE 10 MG IV SOLR [11634]

Facility

$6.60

Service Code	NDC 55150023510
Hospital Charge Code	55150023510
Hospital Revenue Code	278
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$6.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.30
Rate for Payer: Aetna Government	$3.30
Rate for Payer: Brighton Health Commercial	$3.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.80
Rate for Payer: EmblemHealth Commercial	$3.30
Rate for Payer: Fidelis Medicare Advantage	$6.93
Rate for Payer: Group Health Inc Commercial	$3.30
Rate for Payer: Group Health Inc Medicare	$2.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.30
Rate for Payer: Hamaspik Choice Inc Medicare	$3.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.29

VECURONIUM BROMIDE 10 MG IV SOLR [11634]

Facility

$10.20

Service Code	NDC 47335093144
Hospital Charge Code	47335093144
Hospital Revenue Code	278
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.10
Rate for Payer: Hamaspik Choice Inc Medicare	$5.10

VECURONIUM BROMIDE 10 MG IV SOLR [11634]

Facility

$6.60

Service Code	NDC 55150023501
Hospital Charge Code	55150023501
Hospital Revenue Code	278
Min. Negotiated Rate	$2.31
Max. Negotiated Rate	$6.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.30
Rate for Payer: Aetna Government	$3.30
Rate for Payer: Brighton Health Commercial	$3.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.80
Rate for Payer: EmblemHealth Commercial	$3.30
Rate for Payer: Fidelis Medicare Advantage	$6.93
Rate for Payer: Group Health Inc Commercial	$3.30
Rate for Payer: Group Health Inc Medicare	$2.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.30
Rate for Payer: Hamaspik Choice Inc Medicare	$3.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.29

VECURONIUM BROMIDE 10 MG IV SOLR [11634]

Facility

$10.20

Service Code	NDC 47335093144
Hospital Charge Code	47335093144
Hospital Revenue Code	278
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$10.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.61
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.10
Rate for Payer: Aetna Government	$5.10
Rate for Payer: Brighton Health Commercial	$6.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.86
Rate for Payer: EmblemHealth Commercial	$5.10
Rate for Payer: Fidelis Medicare Advantage	$10.71
Rate for Payer: Group Health Inc Commercial	$5.10
Rate for Payer: Group Health Inc Medicare	$3.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.10
Rate for Payer: Hamaspik Choice Inc Medicare	$5.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.63

VECURONIUM BROMIDE 10 MG IV SOLR [11634]

Facility

$6.60

Service Code	NDC 55150023501
Hospital Charge Code	55150023501
Hospital Revenue Code	278
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.30
Rate for Payer: Hamaspik Choice Inc Medicare	$3.30

VEDOLIZUMAB 300MG INJ (NF) 1MG

Facility

$30.88

Service Code	HCPCS J3380
Hospital Charge Code	41649545
Hospital Revenue Code	636
Min. Negotiated Rate	$15.44
Max. Negotiated Rate	$15.44
Rate for Payer: Cash Price	$22.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.44
Rate for Payer: Hamaspik Choice Inc Medicare	$15.44

VEDOLIZUMAB 300MG INJ (NF) 1MG

Facility

$30.88

Service Code	HCPCS J3380
Hospital Charge Code	41649545
Hospital Revenue Code	636
Min. Negotiated Rate	$15.44
Max. Negotiated Rate	$23.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.06
Rate for Payer: Aetna Government	$22.06
Rate for Payer: Brighton Health Commercial	$18.53
Rate for Payer: Cash Price	$22.06
Rate for Payer: Cash Price	$22.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$22.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.76
Rate for Payer: Elderplan Medicare Advantage	$22.06
Rate for Payer: EmblemHealth Commercial	$22.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22.06
Rate for Payer: Fidelis Essential Plan Aliesa	$22.06
Rate for Payer: Fidelis Essential Plan QHP	$23.17
Rate for Payer: Fidelis Medicare Advantage	$22.06
Rate for Payer: Fidelis Qualified Health Plan	$23.17
Rate for Payer: Group Health Inc Commercial	$22.06
Rate for Payer: Group Health Inc Medicare	$22.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.44
Rate for Payer: Hamaspik Choice Inc Medicare	$15.44
Rate for Payer: Healthfirst Medicare Advantage	$18.75
Rate for Payer: Healthfirst QHP	$22.06
Rate for Payer: Senior Whole Health Medicare Advantage	$22.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23.16
Rate for Payer: SOMOS Essential	$23.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17.65
Rate for Payer: Wellcare Medicare	$20.96

VEDOLIZUMAB 300MG INJ (NF)1MG

Facility

$30.88

Service Code	HCPCS J3380
Hospital Charge Code	41659545
Hospital Revenue Code	636
Min. Negotiated Rate	$15.44
Max. Negotiated Rate	$23.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.98
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.06
Rate for Payer: Aetna Government	$22.06
Rate for Payer: Brighton Health Commercial	$18.53
Rate for Payer: Cash Price	$22.06
Rate for Payer: Cash Price	$22.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$22.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$17.76
Rate for Payer: Elderplan Medicare Advantage	$22.06
Rate for Payer: EmblemHealth Commercial	$22.06
Rate for Payer: Fidelis CHP/HARP/Medicaid	$22.06
Rate for Payer: Fidelis Essential Plan Aliesa	$22.06
Rate for Payer: Fidelis Essential Plan QHP	$23.17
Rate for Payer: Fidelis Medicare Advantage	$22.06
Rate for Payer: Fidelis Qualified Health Plan	$23.17
Rate for Payer: Group Health Inc Commercial	$22.06
Rate for Payer: Group Health Inc Medicare	$22.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.44
Rate for Payer: Hamaspik Choice Inc Medicare	$15.44
Rate for Payer: Healthfirst Medicare Advantage	$18.75
Rate for Payer: Healthfirst QHP	$22.06
Rate for Payer: Senior Whole Health Medicare Advantage	$22.06
Rate for Payer: SOMOS CHP/HARP/Medicaid	$23.16
Rate for Payer: SOMOS Essential	$23.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$20.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17.65
Rate for Payer: Wellcare Medicare	$20.96

VEDOLIZUMAB 300MG INJ (NF)1MG

Facility

$30.88

Service Code	HCPCS J3380
Hospital Charge Code	41659545
Hospital Revenue Code	636
Min. Negotiated Rate	$15.44
Max. Negotiated Rate	$15.44
Rate for Payer: Cash Price	$22.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.44
Rate for Payer: Hamaspik Choice Inc Medicare	$15.44

VEDOLIZUMAB 300 MG IV SOLR [126219]

Facility

$10,399.90

Service Code	HCPCS J3380
Hospital Charge Code	64764030020
Hospital Revenue Code	278
Min. Negotiated Rate	$5,199.95
Max. Negotiated Rate	$5,199.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,199.95
Rate for Payer: Hamaspik Choice Inc Medicare	$5,199.95

VEDOLIZUMAB 300 MG IV SOLR [126219]

Facility

$10,399.90

Service Code	HCPCS J3380
Hospital Charge Code	64764030020
Hospital Revenue Code	278
Min. Negotiated Rate	$17.65
Max. Negotiated Rate	$6,759.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,719.94
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.06
Rate for Payer: Aetna Government	$22.06
Rate for Payer: Brighton Health Commercial	$6,239.94
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$22.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,199.95
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,979.94
Rate for Payer: Elderplan Medicare Advantage	$22.06
Rate for Payer: EmblemHealth Commercial	$5,199.95
Rate for Payer: Fidelis Medicare Advantage	$22.06
Rate for Payer: Group Health Inc Commercial	$22.06
Rate for Payer: Group Health Inc Medicare	$22.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,199.95
Rate for Payer: Hamaspik Choice Inc Medicare	$5,199.95
Rate for Payer: Healthfirst Medicare Advantage	$18.75
Rate for Payer: Healthfirst QHP	$22.06
Rate for Payer: Senior Whole Health Medicare Advantage	$22.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,759.94
Rate for Payer: Wellcare CHP/FHP/Medicaid	$17.65

Know your out-of-pocket cost for care.

All Charges