St. Barnabas Hospital

All Charges

Charge

Type

Price

CC WIRES STANDARD J-TIP .025 150C

Facility IP

$35.00

Service Code	HCPCS C1725
Hospital Charge Code	66528802
Hospital Revenue Code	278
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50

CC WIRES STANDARD J-TIP .025 150C

Facility OP

$35.00

Service Code	HCPCS C1725
Hospital Charge Code	66528802
Hospital Revenue Code	278
Min. Negotiated Rate	$12.25
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.12
Rate for Payer: Fidelis Medicare Advantage	$36.75
Rate for Payer: Group Health Inc Commercial	$17.50
Rate for Payer: Group Health Inc Medicare	$12.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.75

CC WIRES STANDARD J-TIP.025 260C

Facility OP

$35.00

Service Code	HCPCS C1725
Hospital Charge Code	66528801
Hospital Revenue Code	278
Min. Negotiated Rate	$12.25
Max. Negotiated Rate	$44.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$20.12
Rate for Payer: Fidelis Medicare Advantage	$36.75
Rate for Payer: Group Health Inc Commercial	$17.50
Rate for Payer: Group Health Inc Medicare	$12.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$22.75

CC WIRES STANDARD J-TIP.025 260C

Facility IP

$35.00

Service Code	HCPCS C1725
Hospital Charge Code	66528801
Hospital Revenue Code	278
Min. Negotiated Rate	$17.50
Max. Negotiated Rate	$17.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.50
Rate for Payer: Hamaspik Choice Inc Medicare	$17.50

CC XIENCE XPEDITION 33MM-38MM

Facility OP

$2,900.00

Service Code	HCPCS C1874
Hospital Charge Code	66526893
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$3,045.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,595.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,450.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,667.50
Rate for Payer: Fidelis Medicare Advantage	$3,045.00
Rate for Payer: Group Health Inc Commercial	$1,450.00
Rate for Payer: Group Health Inc Medicare	$1,015.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,450.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,885.00

CC XIENCE XPEDITION 33MM-38MM

Facility IP

$2,900.00

Service Code	HCPCS C1874
Hospital Charge Code	66526893
Hospital Revenue Code	278
Min. Negotiated Rate	$1,450.00
Max. Negotiated Rate	$1,450.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,450.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,450.00

CC XIENCE XPEDITION 8MM-28MM

Facility IP

$2,850.00

Service Code	HCPCS C1874
Hospital Charge Code	66526892
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,425.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,425.00

CC XIENCE XPEDITION 8MM-28MM

Facility OP

$2,850.00

Service Code	HCPCS C1874
Hospital Charge Code	66526892
Hospital Revenue Code	278
Min. Negotiated Rate	$265.52
Max. Negotiated Rate	$2,992.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,567.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$265.52
Rate for Payer: Aetna Government	$265.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,425.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,638.75
Rate for Payer: Fidelis Medicare Advantage	$2,992.50
Rate for Payer: Group Health Inc Commercial	$1,425.00
Rate for Payer: Group Health Inc Medicare	$997.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,425.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,425.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,852.50

CDFEPIME 40MG/ML INJ PED

Facility IP

$7.21

Service Code	HCPCS J0692
Hospital Charge Code	41649543
Hospital Revenue Code	636
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.60
Rate for Payer: Hamaspik Choice Inc Medicare	$3.60

CDFEPIME 40MG/ML INJ PED

Facility OP

$7.21

Service Code	HCPCS J0692
Hospital Charge Code	41649543
Hospital Revenue Code	636
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$4.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.85
Rate for Payer: Aetna Government	$1.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1.10
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
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.23
Rate for Payer: SOMOS CHP/HARP/Medicaid	$1.42
Rate for Payer: SOMOS Essential	$1.42
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.69

C. DIFFICILE, DNA

Facility OP

$93.18

Service Code	HCPCS 87493
Hospital Charge Code	40614113
Hospital Revenue Code	300
Min. Negotiated Rate	$29.82
Max. Negotiated Rate	$55.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$51.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.27
Rate for Payer: Aetna Government	$37.27
Rate for Payer: Cash Price	$37.27
Rate for Payer: Cash Price	$37.27
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$37.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.20
Rate for Payer: Elderplan Medicare Advantage	$37.27
Rate for Payer: EmblemHealth Commercial	$37.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$33.54
Rate for Payer: Fidelis Essential Plan Aliesa	$31.68
Rate for Payer: Fidelis Essential Plan QHP	$33.17
Rate for Payer: Fidelis Medicare Advantage	$37.27
Rate for Payer: Fidelis Qualified Health Plan	$33.17
Rate for Payer: Group Health Inc Commercial	$37.27
Rate for Payer: Group Health Inc Medicare	$37.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$46.59
Rate for Payer: Hamaspik Choice Inc Medicare	$37.27
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$37.27
Rate for Payer: Healthfirst Medicare Advantage	$37.27
Rate for Payer: Healthfirst QHP	$37.27
Rate for Payer: Senior Whole Health Medicare Advantage	$37.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$37.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$29.82
Rate for Payer: Wellcare Medicare	$33.54

CEA

Facility OP

$47.40

Service Code	HCPCS 82378
Hospital Charge Code	40609048
Hospital Revenue Code	300
Min. Negotiated Rate	$15.17
Max. Negotiated Rate	$30.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.96
Rate for Payer: Aetna Government	$18.96
Rate for Payer: Cash Price	$18.96
Rate for Payer: Cash Price	$18.96
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$18.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.52
Rate for Payer: Elderplan Medicare Advantage	$18.96
Rate for Payer: EmblemHealth Commercial	$18.96
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17.06
Rate for Payer: Fidelis Essential Plan Aliesa	$16.12
Rate for Payer: Fidelis Essential Plan QHP	$16.87
Rate for Payer: Fidelis Medicare Advantage	$18.96
Rate for Payer: Fidelis Qualified Health Plan	$16.87
Rate for Payer: Group Health Inc Commercial	$18.96
Rate for Payer: Group Health Inc Medicare	$18.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.70
Rate for Payer: Hamaspik Choice Inc Medicare	$18.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18.96
Rate for Payer: Healthfirst Medicare Advantage	$18.96
Rate for Payer: Healthfirst QHP	$18.96
Rate for Payer: Senior Whole Health Medicare Advantage	$18.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.96
Rate for Payer: Wellcare CHP/FHP/Medicaid	$15.17
Rate for Payer: Wellcare Medicare	$17.06

CEA FLUID

Facility OP

$47.40

Service Code	HCPCS 82378
Hospital Charge Code	40609749
Hospital Revenue Code	301
Min. Negotiated Rate	$15.17
Max. Negotiated Rate	$30.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.07
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.96
Rate for Payer: Aetna Government	$18.96
Rate for Payer: Cash Price	$18.96
Rate for Payer: Cash Price	$18.96
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$18.96
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.52
Rate for Payer: Elderplan Medicare Advantage	$18.96
Rate for Payer: EmblemHealth Commercial	$18.96
Rate for Payer: Fidelis CHP/HARP/Medicaid	$17.06
Rate for Payer: Fidelis Essential Plan Aliesa	$16.12
Rate for Payer: Fidelis Essential Plan QHP	$16.87
Rate for Payer: Fidelis Medicare Advantage	$18.96
Rate for Payer: Fidelis Qualified Health Plan	$16.87
Rate for Payer: Group Health Inc Commercial	$18.96
Rate for Payer: Group Health Inc Medicare	$18.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.70
Rate for Payer: Hamaspik Choice Inc Medicare	$18.96
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18.96
Rate for Payer: Healthfirst Medicare Advantage	$18.96
Rate for Payer: Healthfirst QHP	$18.96
Rate for Payer: Senior Whole Health Medicare Advantage	$18.96
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$18.96
Rate for Payer: Wellcare CHP/FHP/Medicaid	$15.17
Rate for Payer: Wellcare Medicare	$17.06

CEEPHALEXIN 250MG/5ML UD

Facility OP

$1.52

Hospital Charge Code	41646556
Hospital Revenue Code	250
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$1.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.76
Rate for Payer: Aetna Government	$0.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.03
Rate for Payer: Group Health Inc Commercial	$0.76
Rate for Payer: Group Health Inc Medicare	$0.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.76
Rate for Payer: Hamaspik Choice Inc Medicare	$0.76
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.99

CEFAZOLIN 1000 MG INJ

Facility OP

$7.00

Service Code	HCPCS J0690
Hospital Charge Code	41644843
Hospital Revenue Code	636
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$4.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.02
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.78
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.86
Rate for Payer: SOMOS Essential	$0.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

CEFAZOLIN 1000 MG INJ

Facility IP

$7.00

Service Code	HCPCS J0690
Hospital Charge Code	41654843
Hospital Revenue Code	636
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50

CEFAZOLIN 1000 MG INJ

Facility IP

$7.00

Service Code	HCPCS J0690
Hospital Charge Code	41644843
Hospital Revenue Code	636
Min. Negotiated Rate	$3.50
Max. Negotiated Rate	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50

CEFAZOLIN 1000 MG INJ

Facility OP

$7.00

Service Code	HCPCS J0690
Hospital Charge Code	41654843
Hospital Revenue Code	636
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$4.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.02
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.78
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.86
Rate for Payer: SOMOS Essential	$0.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

CEFAZOLIN 1G/D5W 50ML-500MG

Facility OP

$3.00

Service Code	HCPCS J0690
Hospital Charge Code	41648856
Hospital Revenue Code	636
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$1.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.72
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.78
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.86
Rate for Payer: SOMOS Essential	$0.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

CEFAZOLIN 1G/D5W 50ML-500MG

Facility IP

$3.00

Service Code	HCPCS J0690
Hospital Charge Code	41648856
Hospital Revenue Code	636
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50

CEFAZOLIN 20 MG/ML INJ NEONATAL

Facility IP

$2.00

Service Code	HCPCS J0690
Hospital Charge Code	41642846
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

CEFAZOLIN 20 MG/ML INJ NEONATAL

Facility OP

$2.00

Hospital Charge Code	41652846
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

CEFAZOLIN 20 MG/ML INJ NEONATAL

Facility OP

$2.00

Service Code	HCPCS J0690
Hospital Charge Code	41642846
Hospital Revenue Code	636
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.78
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.86
Rate for Payer: SOMOS Essential	$0.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

CEFAZOLIN 225 MG/ML INJ PEDIATRIC

Facility IP

$2.00

Service Code	HCPCS J0690
Hospital Charge Code	41650684
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

CEFAZOLIN 225 MG/ML INJ PEDIATRIC

Facility OP

$2.00

Service Code	HCPCS J0690
Hospital Charge Code	41640684
Hospital Revenue Code	636
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.75
Rate for Payer: Aetna Government	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.78
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.87
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.86
Rate for Payer: SOMOS Essential	$0.86
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

Price Transparency.

All Charges