St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC AVULSION OF NAIL PLATE, SINGLE

Facility

$529.00

Service Code	CPT 11730
Hospital Charge Code	3611173001
Hospital Revenue Code	361
Min. Negotiated Rate	$59.75
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$242.78
Rate for Payer: Aetna Government	$242.78
Rate for Payer: Affinity Essential Plan 1&2	$169.95
Rate for Payer: Affinity Essential Plan 3&4	$169.95
Rate for Payer: Affinity Medicaid/CHP/HARP	$169.95
Rate for Payer: Brighton Health Commercial	$396.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$242.78
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: Elderplan Medicare Advantage	$242.78
Rate for Payer: EmblemHealth Commercial	$242.78
Rate for Payer: Fidelis CHP/HARP/Medicaid	$218.50
Rate for Payer: Fidelis Essential Plan Aliesa	$206.36
Rate for Payer: Fidelis Essential Plan QHP	$216.07
Rate for Payer: Fidelis Medicare Advantage	$242.78
Rate for Payer: Fidelis Qualified Health Plan	$216.07
Rate for Payer: Group Health Inc Commercial	$242.78
Rate for Payer: Group Health Inc Medicare	$242.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$242.78
Rate for Payer: Hamaspik Choice Inc Medicare	$242.78
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$59.75
Rate for Payer: Healthfirst Medicare Advantage	$206.36
Rate for Payer: Healthfirst QHP	$242.78
Rate for Payer: Humana Medicare	$247.64
Rate for Payer: Senior Whole Health Medicare Advantage	$242.78
Rate for Payer: United Healthcare Commercial	$1,113.00
Rate for Payer: United Healthcare Medicare Advantage	$242.78
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$242.78
Rate for Payer: Wellcare CHP/FHP/Medicaid	$230.64
Rate for Payer: Wellcare Medicare	$230.64

HC AVULSION OF NAIL PLATE, SINGLE

Facility

$529.00

Service Code	CPT 11730
Hospital Charge Code	3611173001
Hospital Revenue Code	361
Min. Negotiated Rate	$264.50
Max. Negotiated Rate	$264.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$264.50

HC BACTERIA CULTURE SCREEN - GENERIC

Facility

$16.00

Service Code	CPT 87081
Hospital Charge Code	3068708103
Hospital Revenue Code	306
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$8.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.00

HC BACTERIA CULTURE SCREEN - GENERIC

Facility

$16.00

Service Code	CPT 87081
Hospital Charge Code	3068708103
Hospital Revenue Code	306
Min. Negotiated Rate	$4.64
Max. Negotiated Rate	$12.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.63
Rate for Payer: Aetna Government	$6.63
Rate for Payer: Affinity Essential Plan 1&2	$4.64
Rate for Payer: Affinity Essential Plan 3&4	$4.64
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.64
Rate for Payer: Brighton Health Commercial	$12.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.48
Rate for Payer: Elderplan Medicare Advantage	$6.63
Rate for Payer: EmblemHealth Commercial	$6.63
Rate for Payer: Fidelis CHP/HARP/Medicaid	$5.97
Rate for Payer: Fidelis Essential Plan Aliesa	$5.64
Rate for Payer: Fidelis Essential Plan QHP	$5.90
Rate for Payer: Fidelis Medicare Advantage	$6.63
Rate for Payer: Fidelis Qualified Health Plan	$5.90
Rate for Payer: Group Health Inc Commercial	$6.63
Rate for Payer: Group Health Inc Medicare	$6.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.63
Rate for Payer: Hamaspik Choice Inc Medicare	$6.63
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.25
Rate for Payer: Healthfirst Essential Plan	$11.81
Rate for Payer: Healthfirst Medicare Advantage	$6.63
Rate for Payer: Healthfirst QHP	$6.63
Rate for Payer: Humana Medicare	$6.76
Rate for Payer: Senior Whole Health Medicare Advantage	$6.63
Rate for Payer: United Healthcare Commercial	$8.40
Rate for Payer: United Healthcare Medicare Advantage	$6.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.25
Rate for Payer: Wellcare Medicare	$5.97

HC BACTERIA CULTURE SCREEN - LEGIONELLA CULTURE

Facility

$16.00

Service Code	CPT 87081
Hospital Charge Code	3068708101
Hospital Revenue Code	306
Min. Negotiated Rate	$4.64
Max. Negotiated Rate	$12.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.63
Rate for Payer: Aetna Government	$6.63
Rate for Payer: Affinity Essential Plan 1&2	$4.64
Rate for Payer: Affinity Essential Plan 3&4	$4.64
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.64
Rate for Payer: Brighton Health Commercial	$12.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.48
Rate for Payer: Elderplan Medicare Advantage	$6.63
Rate for Payer: EmblemHealth Commercial	$6.63
Rate for Payer: Fidelis CHP/HARP/Medicaid	$5.97
Rate for Payer: Fidelis Essential Plan Aliesa	$5.64
Rate for Payer: Fidelis Essential Plan QHP	$5.90
Rate for Payer: Fidelis Medicare Advantage	$6.63
Rate for Payer: Fidelis Qualified Health Plan	$5.90
Rate for Payer: Group Health Inc Commercial	$6.63
Rate for Payer: Group Health Inc Medicare	$6.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.63
Rate for Payer: Hamaspik Choice Inc Medicare	$6.63
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.25
Rate for Payer: Healthfirst Essential Plan	$11.81
Rate for Payer: Healthfirst Medicare Advantage	$6.63
Rate for Payer: Healthfirst QHP	$6.63
Rate for Payer: Humana Medicare	$6.76
Rate for Payer: Senior Whole Health Medicare Advantage	$6.63
Rate for Payer: United Healthcare Commercial	$8.40
Rate for Payer: United Healthcare Medicare Advantage	$6.63
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.63
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.25
Rate for Payer: Wellcare Medicare	$5.97

HC BACTERIA CULTURE SCREEN - LEGIONELLA CULTURE

Facility

$16.00

Service Code	CPT 87081
Hospital Charge Code	3068708101
Hospital Revenue Code	306
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$8.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.00

HC BACTERIA IDENTIFICATION, AEROBIC ISOLATE

Facility

$20.00

Service Code	CPT 87077
Hospital Charge Code	3068707701
Hospital Revenue Code	306
Min. Negotiated Rate	$5.66
Max. Negotiated Rate	$18.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.08
Rate for Payer: Aetna Government	$8.08
Rate for Payer: Affinity Essential Plan 1&2	$5.66
Rate for Payer: Affinity Essential Plan 3&4	$5.66
Rate for Payer: Affinity Medicaid/CHP/HARP	$5.66
Rate for Payer: Brighton Health Commercial	$15.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.73
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.56
Rate for Payer: Elderplan Medicare Advantage	$8.08
Rate for Payer: EmblemHealth Commercial	$8.08
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.27
Rate for Payer: Fidelis Essential Plan Aliesa	$6.87
Rate for Payer: Fidelis Essential Plan QHP	$7.19
Rate for Payer: Fidelis Medicare Advantage	$8.08
Rate for Payer: Fidelis Qualified Health Plan	$7.19
Rate for Payer: Group Health Inc Commercial	$8.08
Rate for Payer: Group Health Inc Medicare	$8.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.08
Rate for Payer: Hamaspik Choice Inc Medicare	$8.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.08
Rate for Payer: Healthfirst Essential Plan	$18.18
Rate for Payer: Healthfirst Medicare Advantage	$8.08
Rate for Payer: Healthfirst QHP	$8.08
Rate for Payer: Humana Medicare	$8.24
Rate for Payer: Senior Whole Health Medicare Advantage	$8.08
Rate for Payer: United Healthcare Commercial	$10.23
Rate for Payer: United Healthcare Medicare Advantage	$8.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$8.08
Rate for Payer: Wellcare Medicare	$7.27

HC BACTERIA IDENTIFICATION, AEROBIC ISOLATE

Facility

$20.00

Service Code	CPT 87077
Hospital Charge Code	3068707701
Hospital Revenue Code	306
Min. Negotiated Rate	$10.00
Max. Negotiated Rate	$10.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.00

HC BACTERIUM, ANTIBODY - PNEUMOCOCCAL IM

Facility

$32.00

Service Code	CPT 86609
Hospital Charge Code	3028660901
Hospital Revenue Code	302
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$16.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00

HC BACTERIUM, ANTIBODY - PNEUMOCOCCAL IM

Facility

$32.00

Service Code	CPT 86609
Hospital Charge Code	3028660901
Hospital Revenue Code	302
Min. Negotiated Rate	$9.02
Max. Negotiated Rate	$24.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.88
Rate for Payer: Aetna Government	$12.88
Rate for Payer: Affinity Essential Plan 1&2	$9.02
Rate for Payer: Affinity Essential Plan 3&4	$9.02
Rate for Payer: Affinity Medicaid/CHP/HARP	$9.02
Rate for Payer: Brighton Health Commercial	$24.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.43
Rate for Payer: Elderplan Medicare Advantage	$12.88
Rate for Payer: EmblemHealth Commercial	$12.88
Rate for Payer: Fidelis CHP/HARP/Medicaid	$11.59
Rate for Payer: Fidelis Essential Plan Aliesa	$10.95
Rate for Payer: Fidelis Essential Plan QHP	$11.46
Rate for Payer: Fidelis Medicare Advantage	$12.88
Rate for Payer: Fidelis Qualified Health Plan	$11.46
Rate for Payer: Group Health Inc Commercial	$12.88
Rate for Payer: Group Health Inc Medicare	$12.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.88
Rate for Payer: Hamaspik Choice Inc Medicare	$12.88
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$12.88
Rate for Payer: Healthfirst Medicare Advantage	$12.88
Rate for Payer: Healthfirst QHP	$12.88
Rate for Payer: Humana Medicare	$13.14
Rate for Payer: Senior Whole Health Medicare Advantage	$12.88
Rate for Payer: United Healthcare Commercial	$16.32
Rate for Payer: United Healthcare Medicare Advantage	$12.88
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.88
Rate for Payer: Wellcare CHP/FHP/Medicaid	$12.24
Rate for Payer: Wellcare Medicare	$11.59

HC BALLOON ANGIOPLASTY ARTERY - XR PERIPHERAL ARTERY ANGIOPLASTY

Facility

$322.00

Service Code	CPT 75962 TC
Hospital Charge Code	3237596201
Hospital Revenue Code	323
Min. Negotiated Rate	$112.70
Max. Negotiated Rate	$8,089.59
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$177.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$161.00
Rate for Payer: Aetna Government	$161.00
Rate for Payer: Brighton Health Commercial	$241.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8,089.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,809.22
Rate for Payer: EmblemHealth Commercial	$161.00
Rate for Payer: Group Health Inc Commercial	$161.00
Rate for Payer: Group Health Inc Medicare	$112.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$161.00
Rate for Payer: Hamaspik Choice Inc Medicare	$161.00

HC BALLOON ANGIOPLASTY ARTERY - XR PERIPHERAL ARTERY ANGIOPLASTY

Facility

$322.00

Service Code	CPT 75962 TC
Hospital Charge Code	3237596201
Hospital Revenue Code	323
Min. Negotiated Rate	$161.00
Max. Negotiated Rate	$161.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$161.00

HC BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I

Facility

$2,804.00

Service Code	CPT 50706
Hospital Charge Code	3615070601
Hospital Revenue Code	361
Min. Negotiated Rate	$1,402.00
Max. Negotiated Rate	$1,402.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,402.00

HC BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I

Facility

$2,804.00

Service Code	CPT 50706
Hospital Charge Code	3615070601
Hospital Revenue Code	361
Min. Negotiated Rate	$197.71
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$227.74
Rate for Payer: Aetna Government	$227.74
Rate for Payer: Brighton Health Commercial	$2,103.00
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	$1,402.00
Rate for Payer: Group Health Inc Commercial	$1,402.00
Rate for Payer: Group Health Inc Medicare	$981.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,402.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,402.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$197.71
Rate for Payer: United Healthcare Commercial	$1,113.00

HC BARTONELLA, ANTIBODY - BARTONELLA AB PANEL

Facility

$25.00

Service Code	CPT 86611
Hospital Charge Code	3028661101
Hospital Revenue Code	302
Min. Negotiated Rate	$12.50
Max. Negotiated Rate	$12.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.50

HC BARTONELLA, ANTIBODY - BARTONELLA AB PANEL

Facility

$25.00

Service Code	CPT 86611
Hospital Charge Code	3028661101
Hospital Revenue Code	302
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$18.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.18
Rate for Payer: Aetna Government	$10.18
Rate for Payer: Affinity Essential Plan 1&2	$7.13
Rate for Payer: Affinity Essential Plan 3&4	$7.13
Rate for Payer: Affinity Medicaid/CHP/HARP	$7.13
Rate for Payer: Brighton Health Commercial	$18.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$10.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.55
Rate for Payer: Elderplan Medicare Advantage	$10.18
Rate for Payer: EmblemHealth Commercial	$10.18
Rate for Payer: Fidelis CHP/HARP/Medicaid	$9.16
Rate for Payer: Fidelis Essential Plan Aliesa	$8.65
Rate for Payer: Fidelis Essential Plan QHP	$9.06
Rate for Payer: Fidelis Medicare Advantage	$10.18
Rate for Payer: Fidelis Qualified Health Plan	$9.06
Rate for Payer: Group Health Inc Commercial	$10.18
Rate for Payer: Group Health Inc Medicare	$10.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.18
Rate for Payer: Hamaspik Choice Inc Medicare	$10.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.11
Rate for Payer: Healthfirst Essential Plan	$18.25
Rate for Payer: Healthfirst Medicare Advantage	$10.18
Rate for Payer: Healthfirst QHP	$10.18
Rate for Payer: Humana Medicare	$10.38
Rate for Payer: Senior Whole Health Medicare Advantage	$10.18
Rate for Payer: United Healthcare Commercial	$12.89
Rate for Payer: United Healthcare Medicare Advantage	$10.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$8.11
Rate for Payer: Wellcare Medicare	$9.16

HC BARTONELLA, ANTIBODY BARTONELLA HENSELAE IGG/IGM

Facility

$25.00

Service Code	CPT 86611
Hospital Charge Code	3028661102
Hospital Revenue Code	302
Min. Negotiated Rate	$7.13
Max. Negotiated Rate	$18.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.18
Rate for Payer: Aetna Government	$10.18
Rate for Payer: Affinity Essential Plan 1&2	$7.13
Rate for Payer: Affinity Essential Plan 3&4	$7.13
Rate for Payer: Affinity Medicaid/CHP/HARP	$7.13
Rate for Payer: Brighton Health Commercial	$18.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$10.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$17.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.55
Rate for Payer: Elderplan Medicare Advantage	$10.18
Rate for Payer: EmblemHealth Commercial	$10.18
Rate for Payer: Fidelis CHP/HARP/Medicaid	$9.16
Rate for Payer: Fidelis Essential Plan Aliesa	$8.65
Rate for Payer: Fidelis Essential Plan QHP	$9.06
Rate for Payer: Fidelis Medicare Advantage	$10.18
Rate for Payer: Fidelis Qualified Health Plan	$9.06
Rate for Payer: Group Health Inc Commercial	$10.18
Rate for Payer: Group Health Inc Medicare	$10.18
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.18
Rate for Payer: Hamaspik Choice Inc Medicare	$10.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.11
Rate for Payer: Healthfirst Essential Plan	$18.25
Rate for Payer: Healthfirst Medicare Advantage	$10.18
Rate for Payer: Healthfirst QHP	$10.18
Rate for Payer: Humana Medicare	$10.38
Rate for Payer: Senior Whole Health Medicare Advantage	$10.18
Rate for Payer: United Healthcare Commercial	$12.89
Rate for Payer: United Healthcare Medicare Advantage	$10.18
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.18
Rate for Payer: Wellcare CHP/FHP/Medicaid	$8.11
Rate for Payer: Wellcare Medicare	$9.16

HC BARTONELLA, ANTIBODY BARTONELLA HENSELAE IGG/IGM

Facility

$25.00

Service Code	CPT 86611
Hospital Charge Code	3028661102
Hospital Revenue Code	302
Min. Negotiated Rate	$12.50
Max. Negotiated Rate	$12.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.50

HC BARTONELLA, DNA, AMP PROBE - BARTONELLA, DNA, AMP PROBE

Facility

$46.00

Service Code	CPT 87471
Hospital Charge Code	3068747101
Hospital Revenue Code	306
Min. Negotiated Rate	$24.56
Max. Negotiated Rate	$59.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$25.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.09
Rate for Payer: Aetna Government	$35.09
Rate for Payer: Affinity Essential Plan 1&2	$24.56
Rate for Payer: Affinity Essential Plan 3&4	$24.56
Rate for Payer: Affinity Medicaid/CHP/HARP	$24.56
Rate for Payer: Brighton Health Commercial	$34.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$35.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$59.64
Rate for Payer: Cigna LocalPlus Benefit Plan	$50.20
Rate for Payer: Elderplan Medicare Advantage	$35.09
Rate for Payer: EmblemHealth Commercial	$35.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31.58
Rate for Payer: Fidelis Essential Plan Aliesa	$29.83
Rate for Payer: Fidelis Essential Plan QHP	$31.23
Rate for Payer: Fidelis Medicare Advantage	$35.09
Rate for Payer: Fidelis Qualified Health Plan	$31.23
Rate for Payer: Group Health Inc Commercial	$35.09
Rate for Payer: Group Health Inc Medicare	$35.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.09
Rate for Payer: Hamaspik Choice Inc Medicare	$35.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35.09
Rate for Payer: Healthfirst Medicare Advantage	$35.09
Rate for Payer: Healthfirst QHP	$35.09
Rate for Payer: Humana Medicare	$35.79
Rate for Payer: Senior Whole Health Medicare Advantage	$35.09
Rate for Payer: United Healthcare Commercial	$44.45
Rate for Payer: United Healthcare Medicare Advantage	$35.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$33.34
Rate for Payer: Wellcare Medicare	$31.58

HC BARTONELLA, DNA, AMP PROBE - BARTONELLA, DNA, AMP PROBE

Facility

$46.00

Service Code	CPT 87471
Hospital Charge Code	3068747101
Hospital Revenue Code	306
Min. Negotiated Rate	$23.00
Max. Negotiated Rate	$23.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$23.00

HC BASIC METABOLIC PANEL CALCIUM IONIZED - BUNDLED CHARGE

Facility

$34.00

Service Code	CPT 80047
Hospital Charge Code	3018004701
Hospital Revenue Code	301
Min. Negotiated Rate	$7.32
Max. Negotiated Rate	$25.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.73
Rate for Payer: Aetna Government	$13.73
Rate for Payer: Affinity Essential Plan 1&2	$9.61
Rate for Payer: Affinity Essential Plan 3&4	$9.61
Rate for Payer: Affinity Medicaid/CHP/HARP	$9.61
Rate for Payer: Brighton Health Commercial	$25.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$13.73
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.11
Rate for Payer: Elderplan Medicare Advantage	$13.73
Rate for Payer: EmblemHealth Commercial	$13.73
Rate for Payer: Fidelis CHP/HARP/Medicaid	$12.36
Rate for Payer: Fidelis Essential Plan Aliesa	$11.67
Rate for Payer: Fidelis Essential Plan QHP	$12.22
Rate for Payer: Fidelis Medicare Advantage	$13.73
Rate for Payer: Fidelis Qualified Health Plan	$12.22
Rate for Payer: Group Health Inc Commercial	$13.73
Rate for Payer: Group Health Inc Medicare	$13.73
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.73
Rate for Payer: Hamaspik Choice Inc Medicare	$13.73
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$7.32
Rate for Payer: Healthfirst Essential Plan	$16.47
Rate for Payer: Healthfirst Medicare Advantage	$13.73
Rate for Payer: Healthfirst QHP	$13.73
Rate for Payer: Humana Medicare	$14.00
Rate for Payer: Senior Whole Health Medicare Advantage	$13.73
Rate for Payer: United Healthcare Commercial	$10.72
Rate for Payer: United Healthcare Medicare Advantage	$13.73
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$13.73
Rate for Payer: Wellcare CHP/FHP/Medicaid	$7.32
Rate for Payer: Wellcare Medicare	$12.36

HC BASIC METABOLIC PANEL CALCIUM IONIZED - BUNDLED CHARGE

Facility

$34.00

Service Code	CPT 80047
Hospital Charge Code	3018004701
Hospital Revenue Code	301
Min. Negotiated Rate	$17.00
Max. Negotiated Rate	$17.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.00

HC BASIC METABOLIC PANEL CALCIUM TOTAL - BUNDLED CHARGE

Facility

$21.00

Service Code	CPT 80048
Hospital Charge Code	3018004801
Hospital Revenue Code	301
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.50

HC BASIC METABOLIC PANEL CALCIUM TOTAL - BUNDLED CHARGE

Facility

$21.00

Service Code	CPT 80048
Hospital Charge Code	3018004801
Hospital Revenue Code	301
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$16.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.46
Rate for Payer: Aetna Government	$8.46
Rate for Payer: Affinity Essential Plan 1&2	$5.92
Rate for Payer: Affinity Essential Plan 3&4	$5.92
Rate for Payer: Affinity Medicaid/CHP/HARP	$5.92
Rate for Payer: Brighton Health Commercial	$15.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8.46
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.11
Rate for Payer: Elderplan Medicare Advantage	$8.46
Rate for Payer: EmblemHealth Commercial	$8.46
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.61
Rate for Payer: Fidelis Essential Plan Aliesa	$7.19
Rate for Payer: Fidelis Essential Plan QHP	$7.53
Rate for Payer: Fidelis Medicare Advantage	$8.46
Rate for Payer: Fidelis Qualified Health Plan	$7.53
Rate for Payer: Group Health Inc Commercial	$8.46
Rate for Payer: Group Health Inc Medicare	$8.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.46
Rate for Payer: Hamaspik Choice Inc Medicare	$8.46
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$7.32
Rate for Payer: Healthfirst Essential Plan	$16.47
Rate for Payer: Healthfirst Medicare Advantage	$8.46
Rate for Payer: Healthfirst QHP	$8.46
Rate for Payer: Humana Medicare	$8.63
Rate for Payer: Senior Whole Health Medicare Advantage	$8.46
Rate for Payer: United Healthcare Commercial	$10.72
Rate for Payer: United Healthcare Medicare Advantage	$8.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$7.32
Rate for Payer: Wellcare Medicare	$7.61

HC B CELLS, TOTAL COUNT - B CELLS, TOTAL COUNT

Facility

$66.00

Service Code	CPT 86355
Hospital Charge Code	3028635501
Hospital Revenue Code	302
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$33.00

Know your out-of-pocket cost for care.

All Charges