St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE

Facility

$2,380.00

Service Code	CPT 49083 TC
Hospital Charge Code	3614908302
Hospital Revenue Code	361
Min. Negotiated Rate	$334.10
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$334.10
Rate for Payer: Aetna Government	$334.10
Rate for Payer: Brighton Health Commercial	$1,785.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,092.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,628.64
Rate for Payer: EmblemHealth Commercial	$1,190.00
Rate for Payer: Group Health Inc Commercial	$1,190.00
Rate for Payer: Group Health Inc Medicare	$833.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$503.39
Rate for Payer: United Healthcare Commercial	$1,409.00

HC ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE

Facility

$2,380.00

Service Code	CPT 49082 TC
Hospital Charge Code	3614908202
Hospital Revenue Code	361
Min. Negotiated Rate	$1,190.00
Max. Negotiated Rate	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,190.00

HC ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE

Facility

$2,380.00

Service Code	CPT 49082 TC
Hospital Charge Code	3614908202
Hospital Revenue Code	361
Min. Negotiated Rate	$219.35
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$219.35
Rate for Payer: Aetna Government	$219.35
Rate for Payer: Brighton Health Commercial	$1,785.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,092.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,628.64
Rate for Payer: EmblemHealth Commercial	$1,190.00
Rate for Payer: Group Health Inc Commercial	$1,190.00
Rate for Payer: Group Health Inc Medicare	$833.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,190.00
Rate for Payer: Hamaspik Choice Inc Medicare	$503.39
Rate for Payer: United Healthcare Commercial	$1,409.00

HC ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE

Facility

$17,690.00

Service Code	CPT 20982 TC
Hospital Charge Code	3612098201
Hospital Revenue Code	361
Min. Negotiated Rate	$8,845.00
Max. Negotiated Rate	$8,845.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,845.00

HC ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE

Facility

$17,690.00

Service Code	CPT 20982 TC
Hospital Charge Code	3612098201
Hospital Revenue Code	361
Min. Negotiated Rate	$2,628.64
Max. Negotiated Rate	$13,267.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,065.92
Rate for Payer: Aetna Government	$3,065.92
Rate for Payer: Brighton Health Commercial	$13,267.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,092.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,628.64
Rate for Payer: EmblemHealth Commercial	$8,845.00
Rate for Payer: Group Health Inc Commercial	$8,845.00
Rate for Payer: Group Health Inc Medicare	$6,191.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,845.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6,633.26
Rate for Payer: United Healthcare Commercial	$2,683.00

HC ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY

Facility

$25,481.00

Service Code	CPT 50593 TC
Hospital Charge Code	3615059301
Hospital Revenue Code	361
Min. Negotiated Rate	$12,740.50
Max. Negotiated Rate	$12,740.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$12,740.50

HC ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY

Facility

$25,481.00

Service Code	CPT 50593 TC
Hospital Charge Code	3615059301
Hospital Revenue Code	361
Min. Negotiated Rate	$2,546.00
Max. Negotiated Rate	$19,110.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,065.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,713.21
Rate for Payer: Aetna Government	$5,713.21
Rate for Payer: Brighton Health Commercial	$19,110.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,092.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,628.64
Rate for Payer: EmblemHealth Commercial	$12,740.50
Rate for Payer: Group Health Inc Commercial	$12,740.50
Rate for Payer: Group Health Inc Medicare	$8,918.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$12,740.50
Rate for Payer: Hamaspik Choice Inc Medicare	$6,996.29
Rate for Payer: United Healthcare Commercial	$2,546.00

HC ABLATION SUPERVENT ARRATHMOGENIC FOCUS W/CARDI BYPASS

Facility

$4,772.00

Service Code	CPT 33251
Hospital Charge Code	3613325101
Hospital Revenue Code	361
Min. Negotiated Rate	$1,496.00
Max. Negotiated Rate	$3,579.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,624.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,814.49
Rate for Payer: Aetna Government	$1,814.49
Rate for Payer: Brighton Health Commercial	$3,579.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,092.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,628.64
Rate for Payer: EmblemHealth Commercial	$2,386.00
Rate for Payer: Group Health Inc Commercial	$2,386.00
Rate for Payer: Group Health Inc Medicare	$1,670.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,386.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,386.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,906.38
Rate for Payer: United Healthcare Commercial	$1,496.00

HC ABLATION SUPERVENT ARRATHMOGENIC FOCUS W/CARDI BYPASS

Facility

$4,772.00

Service Code	CPT 33251
Hospital Charge Code	3613325101
Hospital Revenue Code	361
Min. Negotiated Rate	$2,386.00
Max. Negotiated Rate	$2,386.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,386.00

HC ABLATION SUPERVENT ARRATHMOGENIC FOCUS W/O CARDI BYPASS

Facility

$4,337.00

Service Code	CPT 33250
Hospital Charge Code	3613325001
Hospital Revenue Code	361
Min. Negotiated Rate	$1,496.00
Max. Negotiated Rate	$3,252.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,385.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,643.08
Rate for Payer: Aetna Government	$1,643.08
Rate for Payer: Brighton Health Commercial	$3,252.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,092.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,628.64
Rate for Payer: EmblemHealth Commercial	$2,168.50
Rate for Payer: Group Health Inc Commercial	$2,168.50
Rate for Payer: Group Health Inc Medicare	$1,517.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,168.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2,168.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,692.75
Rate for Payer: United Healthcare Commercial	$1,496.00

HC ABLATION SUPERVENT ARRATHMOGENIC FOCUS W/O CARDI BYPASS

Facility

$4,337.00

Service Code	CPT 33250
Hospital Charge Code	3613325001
Hospital Revenue Code	361
Min. Negotiated Rate	$2,168.50
Max. Negotiated Rate	$2,168.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,168.50

HC ABLAT,OPEN,1+ LIVER TUMOR(S),PERCUT RF

Facility

$14,640.00

Service Code	CPT 47382 TC
Hospital Charge Code	3614738201
Hospital Revenue Code	361
Min. Negotiated Rate	$871.45
Max. Negotiated Rate	$10,980.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,387.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$871.45
Rate for Payer: Aetna Government	$871.45
Rate for Payer: Brighton Health Commercial	$10,980.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,092.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,628.64
Rate for Payer: EmblemHealth Commercial	$7,320.00
Rate for Payer: Group Health Inc Commercial	$7,320.00
Rate for Payer: Group Health Inc Medicare	$5,124.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,320.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,860.32
Rate for Payer: United Healthcare Commercial	$2,546.00

HC ABLAT,OPEN,1+ LIVER TUMOR(S),PERCUT RF

Facility

$14,640.00

Service Code	CPT 47382 TC
Hospital Charge Code	3614738201
Hospital Revenue Code	361
Min. Negotiated Rate	$7,320.00
Max. Negotiated Rate	$7,320.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$7,320.00

HC ABSCESS DRAINAGE UNDER X-RAY - CT GUIDANCE FOR ABSCESS DRAIN

Facility

$453.00

Service Code	CPT 75989 TC
Hospital Charge Code	3527598901
Hospital Revenue Code	352
Min. Negotiated Rate	$58.90
Max. Negotiated Rate	$362.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$249.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$64.95
Rate for Payer: Aetna Government	$64.95
Rate for Payer: Brighton Health Commercial	$339.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$362.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$308.04
Rate for Payer: EmblemHealth Commercial	$58.90
Rate for Payer: Group Health Inc Commercial	$226.50
Rate for Payer: Group Health Inc Medicare	$158.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.50
Rate for Payer: Hamaspik Choice Inc Medicare	$226.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$58.90
Rate for Payer: Healthfirst Essential Plan	$195.79
Rate for Payer: Wellcare CHP/FHP/Medicaid	$87.02

HC ABSCESS DRAINAGE UNDER X-RAY - CT GUIDANCE FOR ABSCESS DRAIN

Facility

$453.00

Service Code	CPT 75989 TC
Hospital Charge Code	3527598901
Hospital Revenue Code	352
Min. Negotiated Rate	$226.50
Max. Negotiated Rate	$226.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.50

HC ABSCESS DRAINAGE UNDER X-RAY - US GUIDED ABSCESS DRAIN

Facility

$453.00

Service Code	CPT 75989 TC
Hospital Charge Code	4027598901
Hospital Revenue Code	402
Min. Negotiated Rate	$226.50
Max. Negotiated Rate	$226.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.50

HC ABSCESS DRAINAGE UNDER X-RAY - US GUIDED ABSCESS DRAIN

Facility

$453.00

Service Code	CPT 75989 TC
Hospital Charge Code	4027598901
Hospital Revenue Code	402
Min. Negotiated Rate	$58.90
Max. Negotiated Rate	$362.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$249.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$64.95
Rate for Payer: Aetna Government	$64.95
Rate for Payer: Brighton Health Commercial	$339.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$362.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$308.04
Rate for Payer: EmblemHealth Commercial	$58.90
Rate for Payer: Group Health Inc Commercial	$226.50
Rate for Payer: Group Health Inc Medicare	$158.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.50
Rate for Payer: Hamaspik Choice Inc Medicare	$226.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$58.90
Rate for Payer: Healthfirst Essential Plan	$195.79
Rate for Payer: Wellcare CHP/FHP/Medicaid	$87.02

HC ACETYLCHOLINESTERASE ASSAY - ACETYLCHOLINESTERASE

Facility

$30.00

Service Code	CPT 82013
Hospital Charge Code	3018201301
Hospital Revenue Code	301
Min. Negotiated Rate	$8.60
Max. Negotiated Rate	$27.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.29
Rate for Payer: Aetna Government	$12.29
Rate for Payer: Affinity Essential Plan 1&2	$8.60
Rate for Payer: Affinity Essential Plan 3&4	$8.60
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.60
Rate for Payer: Brighton Health Commercial	$22.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.29
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.98
Rate for Payer: Elderplan Medicare Advantage	$12.29
Rate for Payer: EmblemHealth Commercial	$12.29
Rate for Payer: Fidelis CHP/HARP/Medicaid	$11.06
Rate for Payer: Fidelis Essential Plan Aliesa	$10.45
Rate for Payer: Fidelis Essential Plan QHP	$10.94
Rate for Payer: Fidelis Medicare Advantage	$12.29
Rate for Payer: Fidelis Qualified Health Plan	$10.94
Rate for Payer: Group Health Inc Commercial	$12.29
Rate for Payer: Group Health Inc Medicare	$12.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.29
Rate for Payer: Hamaspik Choice Inc Medicare	$12.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$12.29
Rate for Payer: Healthfirst Essential Plan	$27.65
Rate for Payer: Healthfirst Medicare Advantage	$12.29
Rate for Payer: Healthfirst QHP	$12.29
Rate for Payer: Humana Medicare	$12.54
Rate for Payer: Senior Whole Health Medicare Advantage	$12.29
Rate for Payer: United Healthcare Commercial	$14.15
Rate for Payer: United Healthcare Medicare Advantage	$12.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.29
Rate for Payer: Wellcare CHP/FHP/Medicaid	$12.29
Rate for Payer: Wellcare Medicare	$11.06

HC ACETYLCHOLINESTERASE ASSAY - ACETYLCHOLINESTERASE

Facility

$30.00

Service Code	CPT 82013
Hospital Charge Code	3018201301
Hospital Revenue Code	301
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.00

HC ACETYLCHOLN RCPTR BLCKG ANTB

Facility

$68.00

Service Code	CPT 86042
Hospital Charge Code	3018604201
Hospital Revenue Code	301
Min. Negotiated Rate	$34.00
Max. Negotiated Rate	$34.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.00

HC ACETYLCHOLN RCPTR BLCKG ANTB

Facility

$68.00

Service Code	CPT 86042
Hospital Charge Code	3018604201
Hospital Revenue Code	301
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$54.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.40
Rate for Payer: Aetna Government	$18.40
Rate for Payer: Affinity Essential Plan 1&2	$12.88
Rate for Payer: Affinity Essential Plan 3&4	$12.88
Rate for Payer: Affinity Medicaid/CHP/HARP	$12.88
Rate for Payer: Brighton Health Commercial	$51.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$18.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$54.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.24
Rate for Payer: Elderplan Medicare Advantage	$18.40
Rate for Payer: EmblemHealth Commercial	$18.40
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16.56
Rate for Payer: Fidelis Essential Plan Aliesa	$15.64
Rate for Payer: Fidelis Essential Plan QHP	$16.38
Rate for Payer: Fidelis Medicare Advantage	$18.40
Rate for Payer: Fidelis Qualified Health Plan	$16.38
Rate for Payer: Group Health Inc Commercial	$18.40
Rate for Payer: Group Health Inc Medicare	$18.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.40
Rate for Payer: Hamaspik Choice Inc Medicare	$18.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$11.40
Rate for Payer: Healthfirst Essential Plan	$25.65
Rate for Payer: Healthfirst Medicare Advantage	$18.40
Rate for Payer: Healthfirst QHP	$18.40
Rate for Payer: Humana Medicare	$18.77
Rate for Payer: Senior Whole Health Medicare Advantage	$18.40
Rate for Payer: United Healthcare Medicare Advantage	$18.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.40
Rate for Payer: Wellcare CHP/FHP/Medicaid	$11.40
Rate for Payer: Wellcare Medicare	$16.56

HC ACETYLCHOLN RCPTR BNDNG ANTB

Facility

$68.00

Service Code	CPT 86041
Hospital Charge Code	3018604101
Hospital Revenue Code	301
Min. Negotiated Rate	$11.40
Max. Negotiated Rate	$54.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.40
Rate for Payer: Aetna Government	$18.40
Rate for Payer: Affinity Essential Plan 1&2	$12.88
Rate for Payer: Affinity Essential Plan 3&4	$12.88
Rate for Payer: Affinity Medicaid/CHP/HARP	$12.88
Rate for Payer: Brighton Health Commercial	$51.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$18.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$54.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.24
Rate for Payer: Elderplan Medicare Advantage	$18.40
Rate for Payer: EmblemHealth Commercial	$18.40
Rate for Payer: Fidelis CHP/HARP/Medicaid	$16.56
Rate for Payer: Fidelis Essential Plan Aliesa	$15.64
Rate for Payer: Fidelis Essential Plan QHP	$16.38
Rate for Payer: Fidelis Medicare Advantage	$18.40
Rate for Payer: Fidelis Qualified Health Plan	$16.38
Rate for Payer: Group Health Inc Commercial	$18.40
Rate for Payer: Group Health Inc Medicare	$18.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.40
Rate for Payer: Hamaspik Choice Inc Medicare	$18.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$11.40
Rate for Payer: Healthfirst Essential Plan	$25.65
Rate for Payer: Healthfirst Medicare Advantage	$18.40
Rate for Payer: Healthfirst QHP	$18.40
Rate for Payer: Humana Medicare	$18.77
Rate for Payer: Senior Whole Health Medicare Advantage	$18.40
Rate for Payer: United Healthcare Medicare Advantage	$18.40
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.40
Rate for Payer: Wellcare CHP/FHP/Medicaid	$11.40
Rate for Payer: Wellcare Medicare	$16.56

HC ACETYLCHOLN RCPTR BNDNG ANTB

Facility

$68.00

Service Code	CPT 86041
Hospital Charge Code	3018604101
Hospital Revenue Code	301
Min. Negotiated Rate	$34.00
Max. Negotiated Rate	$34.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.00

HC ACETYLCHOLN RCPTR MODLG ANTB

Facility

$68.00

Service Code	CPT 86043
Hospital Charge Code	3018604301
Hospital Revenue Code	301
Min. Negotiated Rate	$34.00
Max. Negotiated Rate	$34.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.00

HC ACETYLCHOLN RCPTR MODLG ANTB

Facility

$68.00

Service Code	CPT 86043
Hospital Charge Code	3018604301
Hospital Revenue Code	301
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$54.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.05
Rate for Payer: Aetna Government	$12.05
Rate for Payer: Affinity Essential Plan 1&2	$8.44
Rate for Payer: Affinity Essential Plan 3&4	$8.44
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.44
Rate for Payer: Brighton Health Commercial	$51.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$54.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.24
Rate for Payer: Elderplan Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$12.05
Rate for Payer: Fidelis CHP/HARP/Medicaid	$10.85
Rate for Payer: Fidelis Essential Plan Aliesa	$10.24
Rate for Payer: Fidelis Essential Plan QHP	$10.72
Rate for Payer: Fidelis Medicare Advantage	$12.05
Rate for Payer: Fidelis Qualified Health Plan	$10.72
Rate for Payer: Group Health Inc Commercial	$12.05
Rate for Payer: Group Health Inc Medicare	$12.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.05
Rate for Payer: Hamaspik Choice Inc Medicare	$12.05
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$7.23
Rate for Payer: Healthfirst Essential Plan	$16.27
Rate for Payer: Healthfirst Medicare Advantage	$12.05
Rate for Payer: Healthfirst QHP	$12.05
Rate for Payer: Humana Medicare	$12.29
Rate for Payer: Senior Whole Health Medicare Advantage	$12.05
Rate for Payer: United Healthcare Medicare Advantage	$12.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.05
Rate for Payer: Wellcare CHP/FHP/Medicaid	$7.23
Rate for Payer: Wellcare Medicare	$10.85

Know your out-of-pocket cost for care.

All Charges