St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CC RAD CATH 5F JACKY RADIALTERUMO

Facility

$44.00

Service Code	HCPCS C1725
Hospital Charge Code	66520275
Hospital Revenue Code	278
Min. Negotiated Rate	$22.00
Max. Negotiated Rate	$22.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.00
Rate for Payer: Hamaspik Choice Inc Medicare	$22.00

CC RAD CATH 5F JACKY RADIALTERUMO

Facility

$44.00

Service Code	HCPCS C1725
Hospital Charge Code	66520275
Hospital Revenue Code	278
Min. Negotiated Rate	$15.40
Max. Negotiated Rate	$46.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$26.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.30
Rate for Payer: EmblemHealth Commercial	$22.00
Rate for Payer: Fidelis Medicare Advantage	$46.20
Rate for Payer: Group Health Inc Commercial	$22.00
Rate for Payer: Group Health Inc Medicare	$15.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.00
Rate for Payer: Hamaspik Choice Inc Medicare	$22.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.60

CC RAD CATH 6F SARAH RADIALTERUMO

Facility

$44.00

Service Code	HCPCS C1725
Hospital Charge Code	66520276
Hospital Revenue Code	278
Min. Negotiated Rate	$15.40
Max. Negotiated Rate	$46.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$24.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$26.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.30
Rate for Payer: EmblemHealth Commercial	$22.00
Rate for Payer: Fidelis Medicare Advantage	$46.20
Rate for Payer: Group Health Inc Commercial	$22.00
Rate for Payer: Group Health Inc Medicare	$15.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.00
Rate for Payer: Hamaspik Choice Inc Medicare	$22.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$28.60

CC RAD CATH 6F SARAH RADIALTERUMO

Facility

$44.00

Service Code	HCPCS C1725
Hospital Charge Code	66520276
Hospital Revenue Code	278
Min. Negotiated Rate	$22.00
Max. Negotiated Rate	$22.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$22.00
Rate for Payer: Hamaspik Choice Inc Medicare	$22.00

CC RAD-REST DISP ADJ UPR EXT SUPP

Facility

$59.00

Hospital Charge Code	66526862
Hospital Revenue Code	270
Min. Negotiated Rate	$20.65
Max. Negotiated Rate	$47.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.50
Rate for Payer: Aetna Government	$29.50
Rate for Payer: Brighton Health Commercial	$44.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$47.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.12
Rate for Payer: Group Health Inc Commercial	$29.50
Rate for Payer: Group Health Inc Medicare	$20.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.50
Rate for Payer: Hamaspik Choice Inc Medicare	$29.50

CC RA FIX DUAL COILIS-1/DF-1 64CM

Facility

$10,120.00

Service Code	HCPCS C1896
Hospital Charge Code	66528870
Hospital Revenue Code	278
Min. Negotiated Rate	$3,139.11
Max. Negotiated Rate	$10,626.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,566.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,139.11
Rate for Payer: Aetna Government	$3,139.11
Rate for Payer: Brighton Health Commercial	$6,072.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,060.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,819.00
Rate for Payer: EmblemHealth Commercial	$5,060.00
Rate for Payer: Fidelis Medicare Advantage	$10,626.00
Rate for Payer: Group Health Inc Commercial	$5,060.00
Rate for Payer: Group Health Inc Medicare	$3,542.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,060.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,060.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,578.00

CC RA FIX DUAL COILIS-1/DF-1 64CM

Facility

$10,120.00

Service Code	HCPCS C1896
Hospital Charge Code	66528870
Hospital Revenue Code	278
Min. Negotiated Rate	$5,060.00
Max. Negotiated Rate	$5,060.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,060.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,060.00

CC RELIANCE COIL

Facility

$5,060.00

Service Code	HCPCS C1895
Hospital Charge Code	66520059
Hospital Revenue Code	278
Min. Negotiated Rate	$1,297.97
Max. Negotiated Rate	$5,313.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,783.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,297.97
Rate for Payer: Aetna Government	$1,297.97
Rate for Payer: Brighton Health Commercial	$3,036.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,530.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,909.50
Rate for Payer: EmblemHealth Commercial	$2,530.00
Rate for Payer: Fidelis Medicare Advantage	$5,313.00
Rate for Payer: Group Health Inc Commercial	$2,530.00
Rate for Payer: Group Health Inc Medicare	$1,771.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,530.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,530.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,289.00

CC RELIANCE COIL

Facility

$5,060.00

Service Code	HCPCS C1895
Hospital Charge Code	66520059
Hospital Revenue Code	278
Min. Negotiated Rate	$2,530.00
Max. Negotiated Rate	$2,530.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,530.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,530.00

CC RELIANCE COIL IS-1/DF 1-64CM

Facility

$5,060.00

Service Code	HCPCS C1895
Hospital Charge Code	66526883
Hospital Revenue Code	278
Min. Negotiated Rate	$2,530.00
Max. Negotiated Rate	$2,530.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,530.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,530.00

CC RELIANCE COIL IS-1/DF 1-64CM

Facility

$5,060.00

Service Code	HCPCS C1895
Hospital Charge Code	66526883
Hospital Revenue Code	278
Min. Negotiated Rate	$1,297.97
Max. Negotiated Rate	$5,313.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,783.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,297.97
Rate for Payer: Aetna Government	$1,297.97
Rate for Payer: Brighton Health Commercial	$3,036.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,530.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,909.50
Rate for Payer: EmblemHealth Commercial	$2,530.00
Rate for Payer: Fidelis Medicare Advantage	$5,313.00
Rate for Payer: Group Health Inc Commercial	$2,530.00
Rate for Payer: Group Health Inc Medicare	$1,771.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,530.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,530.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,289.00

CC RELIANCE DUAL IS-1/DF-1-59 CM

Facility

$5,060.00

Service Code	HCPCS C1895
Hospital Charge Code	66526877
Hospital Revenue Code	278
Min. Negotiated Rate	$2,530.00
Max. Negotiated Rate	$2,530.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,530.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,530.00

CC RELIANCE DUAL IS-1/DF-1-59 CM

Facility

$5,060.00

Service Code	HCPCS C1895
Hospital Charge Code	66526877
Hospital Revenue Code	278
Min. Negotiated Rate	$1,297.97
Max. Negotiated Rate	$5,313.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,783.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,297.97
Rate for Payer: Aetna Government	$1,297.97
Rate for Payer: Brighton Health Commercial	$3,036.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,530.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,909.50
Rate for Payer: EmblemHealth Commercial	$2,530.00
Rate for Payer: Fidelis Medicare Advantage	$5,313.00
Rate for Payer: Group Health Inc Commercial	$2,530.00
Rate for Payer: Group Health Inc Medicare	$1,771.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,530.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,530.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,289.00

CC RELIANCE FIX COIL IS-1/DF-1 64

Facility

$5,060.00

Service Code	HCPCS C1777
Hospital Charge Code	66526881
Hospital Revenue Code	275
Min. Negotiated Rate	$988.18
Max. Negotiated Rate	$5,313.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,783.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$988.18
Rate for Payer: Aetna Government	$988.18
Rate for Payer: Brighton Health Commercial	$3,036.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,530.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,909.50
Rate for Payer: EmblemHealth Commercial	$2,530.00
Rate for Payer: Fidelis Medicare Advantage	$5,313.00
Rate for Payer: Group Health Inc Commercial	$2,530.00
Rate for Payer: Group Health Inc Medicare	$1,771.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,530.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,530.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,289.00

CC REMOVE 1-PACER LEAD ONLY

Facility

$9,037.83

Service Code	HCPCS 33234
Hospital Charge Code	66528641
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$6,778.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,541.28
Rate for Payer: Aetna Government	$4,541.28
Rate for Payer: Affinity Essential Plan 1&2	$3,178.90
Rate for Payer: Affinity Essential Plan 3&4	$3,178.90
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,178.90
Rate for Payer: Brighton Health Commercial	$6,778.37
Rate for Payer: Cash Price	$4,541.28
Rate for Payer: Cash Price	$4,541.28
Rate for Payer: Cash Price	$4,541.28
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4,541.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$4,541.28
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,860.09
Rate for Payer: Fidelis Essential Plan QHP	$4,041.74
Rate for Payer: Fidelis Medicare Advantage	$4,541.28
Rate for Payer: Fidelis Qualified Health Plan	$4,041.74
Rate for Payer: Group Health Inc Commercial	$4,541.28
Rate for Payer: Group Health Inc Medicare	$4,541.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,518.92
Rate for Payer: Hamaspik Choice Inc Medicare	$4,541.28
Rate for Payer: Healthfirst Medicare Advantage	$3,860.09
Rate for Payer: Healthfirst QHP	$4,541.28
Rate for Payer: Humana Medicare	$4,632.11
Rate for Payer: Senior Whole Health Medicare Advantage	$4,541.28
Rate for Payer: United Healthcare Commercial	$1,835.00
Rate for Payer: United Healthcare Medicare Advantage	$4,541.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,541.28
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,633.02
Rate for Payer: Wellcare Medicare	$4,314.22

CC REMOVE 1-PACER LEAD ONLY

Facility

$9,037.83

Service Code	HCPCS 33234
Hospital Charge Code	66528641
Hospital Revenue Code	360
Rate for Payer: Cash Price	$4,541.28

CC REMOVE 2-PACER LEAD ONLY

Facility

$9,037.83

Service Code	HCPCS 33235
Hospital Charge Code	66528642
Hospital Revenue Code	360
Rate for Payer: Cash Price	$4,541.28

CC REMOVE 2-PACER LEAD ONLY

Facility

$9,037.83

Service Code	HCPCS 33235
Hospital Charge Code	66528642
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$6,778.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,541.28
Rate for Payer: Aetna Government	$4,541.28
Rate for Payer: Affinity Essential Plan 1&2	$3,178.90
Rate for Payer: Affinity Essential Plan 3&4	$3,178.90
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,178.90
Rate for Payer: Brighton Health Commercial	$6,778.37
Rate for Payer: Cash Price	$4,541.28
Rate for Payer: Cash Price	$4,541.28
Rate for Payer: Cash Price	$4,541.28
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4,541.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$4,541.28
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,860.09
Rate for Payer: Fidelis Essential Plan QHP	$4,041.74
Rate for Payer: Fidelis Medicare Advantage	$4,541.28
Rate for Payer: Fidelis Qualified Health Plan	$4,041.74
Rate for Payer: Group Health Inc Commercial	$4,541.28
Rate for Payer: Group Health Inc Medicare	$4,541.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,518.92
Rate for Payer: Hamaspik Choice Inc Medicare	$4,541.28
Rate for Payer: Healthfirst Medicare Advantage	$3,860.09
Rate for Payer: Healthfirst QHP	$4,541.28
Rate for Payer: Humana Medicare	$4,632.11
Rate for Payer: Senior Whole Health Medicare Advantage	$4,541.28
Rate for Payer: United Healthcare Commercial	$1,835.00
Rate for Payer: United Healthcare Medicare Advantage	$4,541.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,541.28
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,633.02
Rate for Payer: Wellcare Medicare	$4,314.22

CC REMOVE PPM OR PG

Facility

$23,145.25

Service Code	HCPCS 33233
Hospital Charge Code	66528640
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$17,358.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9,824.59
Rate for Payer: Aetna Government	$9,824.59
Rate for Payer: Affinity Essential Plan 1&2	$6,877.21
Rate for Payer: Affinity Essential Plan 3&4	$6,877.21
Rate for Payer: Affinity Medicaid/CHP/HARP	$6,877.21
Rate for Payer: Brighton Health Commercial	$17,358.94
Rate for Payer: Cash Price	$9,824.59
Rate for Payer: Cash Price	$9,824.59
Rate for Payer: Cash Price	$9,824.59
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$9,824.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$9,824.59
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$8,350.90
Rate for Payer: Fidelis Essential Plan QHP	$8,743.89
Rate for Payer: Fidelis Medicare Advantage	$9,824.59
Rate for Payer: Fidelis Qualified Health Plan	$8,743.89
Rate for Payer: Group Health Inc Commercial	$9,824.59
Rate for Payer: Group Health Inc Medicare	$9,824.59
Rate for Payer: Hamaspik Choice Inc Medicaid	$11,572.62
Rate for Payer: Hamaspik Choice Inc Medicare	$9,824.59
Rate for Payer: Healthfirst Medicare Advantage	$8,350.90
Rate for Payer: Healthfirst QHP	$9,824.59
Rate for Payer: Humana Medicare	$10,021.08
Rate for Payer: Senior Whole Health Medicare Advantage	$9,824.59
Rate for Payer: United Healthcare Commercial	$1,835.00
Rate for Payer: United Healthcare Medicare Advantage	$9,824.59
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9,824.59
Rate for Payer: Wellcare CHP/FHP/Medicaid	$7,859.67
Rate for Payer: Wellcare Medicare	$9,333.36

CC REMOVE PPM OR PG

Facility

$23,145.25

Service Code	HCPCS 33233
Hospital Charge Code	66528640
Hospital Revenue Code	360
Rate for Payer: Cash Price	$9,824.59

CC REM SC/DC ICD LEAD, TV EXTRACT

Facility

$9,037.83

Service Code	HCPCS 33244
Hospital Charge Code	66528647
Hospital Revenue Code	360
Rate for Payer: Cash Price	$4,541.28

CC REM SC/DC ICD LEAD, TV EXTRACT

Facility

$9,037.83

Service Code	HCPCS 33244
Hospital Charge Code	66528647
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$6,778.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,541.28
Rate for Payer: Aetna Government	$4,541.28
Rate for Payer: Affinity Essential Plan 1&2	$3,178.90
Rate for Payer: Affinity Essential Plan 3&4	$3,178.90
Rate for Payer: Affinity Medicaid/CHP/HARP	$3,178.90
Rate for Payer: Brighton Health Commercial	$6,778.37
Rate for Payer: Cash Price	$4,541.28
Rate for Payer: Cash Price	$4,541.28
Rate for Payer: Cash Price	$4,541.28
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4,541.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$4,541.28
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,860.09
Rate for Payer: Fidelis Essential Plan QHP	$4,041.74
Rate for Payer: Fidelis Medicare Advantage	$4,541.28
Rate for Payer: Fidelis Qualified Health Plan	$4,041.74
Rate for Payer: Group Health Inc Commercial	$4,541.28
Rate for Payer: Group Health Inc Medicare	$4,541.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,518.92
Rate for Payer: Hamaspik Choice Inc Medicare	$4,541.28
Rate for Payer: Healthfirst Medicare Advantage	$3,860.09
Rate for Payer: Healthfirst QHP	$4,541.28
Rate for Payer: Humana Medicare	$4,632.11
Rate for Payer: Senior Whole Health Medicare Advantage	$4,541.28
Rate for Payer: United Healthcare Commercial	$1,835.00
Rate for Payer: United Healthcare Medicare Advantage	$4,541.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,541.28
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,633.02
Rate for Payer: Wellcare Medicare	$4,314.22

CC RENAL, BILATERAL & SELECT. INJ

Facility

$3,839.45

Service Code	HCPCS 36245
Hospital Charge Code	66528385
Hospital Revenue Code	360
Min. Negotiated Rate	$278.84
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$278.84
Rate for Payer: Aetna Government	$278.84
Rate for Payer: Brighton Health Commercial	$2,879.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$1,919.72
Rate for Payer: Group Health Inc Medicare	$1,343.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,919.72
Rate for Payer: Hamaspik Choice Inc Medicare	$1,919.72
Rate for Payer: United Healthcare Commercial	$1,113.00

CC RENAL, BILATERAL & SELECTIVE

Facility

$8,393.53

Service Code	HCPCS 36252
Hospital Charge Code	66528384
Hospital Revenue Code	360
Rate for Payer: Cash Price	$3,686.08

CC RENAL, BILATERAL & SELECTIVE

Facility

$8,393.53

Service Code	HCPCS 36252
Hospital Charge Code	66528384
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$6,295.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,686.08
Rate for Payer: Aetna Government	$3,686.08
Rate for Payer: Affinity Essential Plan 1&2	$2,580.26
Rate for Payer: Affinity Essential Plan 3&4	$2,580.26
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,580.26
Rate for Payer: Brighton Health Commercial	$6,295.15
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,686.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$3,686.08
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,133.17
Rate for Payer: Fidelis Essential Plan QHP	$3,280.61
Rate for Payer: Fidelis Medicare Advantage	$3,686.08
Rate for Payer: Fidelis Qualified Health Plan	$3,280.61
Rate for Payer: Group Health Inc Commercial	$3,686.08
Rate for Payer: Group Health Inc Medicare	$3,686.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.76
Rate for Payer: Hamaspik Choice Inc Medicare	$3,686.08
Rate for Payer: Healthfirst Medicare Advantage	$3,133.17
Rate for Payer: Healthfirst QHP	$3,686.08
Rate for Payer: Humana Medicare	$3,759.80
Rate for Payer: Senior Whole Health Medicare Advantage	$3,686.08
Rate for Payer: United Healthcare Commercial	$1,835.00
Rate for Payer: United Healthcare Medicare Advantage	$3,686.08
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,686.08
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,948.86
Rate for Payer: Wellcare Medicare	$3,501.78

Know your out-of-pocket cost for care.

All Charges