St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CC SHEATH TERUMO 4FR PINNACLE10CM

Facility

$19.40

Service Code	HCPCS C1766
Hospital Charge Code	66520256
Hospital Revenue Code	278
Min. Negotiated Rate	$6.79
Max. Negotiated Rate	$20.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.67
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.80
Rate for Payer: Aetna Government	$6.80
Rate for Payer: Brighton Health Commercial	$11.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.16
Rate for Payer: EmblemHealth Commercial	$9.70
Rate for Payer: Fidelis Medicare Advantage	$20.37
Rate for Payer: Group Health Inc Commercial	$9.70
Rate for Payer: Group Health Inc Medicare	$6.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.70
Rate for Payer: Hamaspik Choice Inc Medicare	$9.70
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.61

CC SHEATH TERUMO 5FRPINNACLE 10CM

Facility

$190.00

Hospital Charge Code	66520257
Hospital Revenue Code	480
Min. Negotiated Rate	$66.50
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$104.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$95.00
Rate for Payer: Aetna Government	$95.00
Rate for Payer: Brighton Health Commercial	$142.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$152.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$129.20
Rate for Payer: Group Health Inc Commercial	$95.00
Rate for Payer: Group Health Inc Medicare	$66.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$95.00
Rate for Payer: Hamaspik Choice Inc Medicare	$95.00
Rate for Payer: United Healthcare Commercial	$316.00

CC SHEATH TERUMO 5FR PINNACLE25CM

Facility

$37.90

Hospital Charge Code	66520258
Hospital Revenue Code	480
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.95
Rate for Payer: Aetna Government	$18.95
Rate for Payer: Brighton Health Commercial	$28.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$30.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$25.77
Rate for Payer: Group Health Inc Commercial	$18.95
Rate for Payer: Group Health Inc Medicare	$13.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.95
Rate for Payer: Hamaspik Choice Inc Medicare	$18.95
Rate for Payer: United Healthcare Commercial	$316.00

CC SHIELD CONTAMINATION CATH-GAR

Facility

$614.00

Hospital Charge Code	66520238
Hospital Revenue Code	481
Min. Negotiated Rate	$214.90
Max. Negotiated Rate	$6,937.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$337.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$307.00
Rate for Payer: Aetna Government	$307.00
Rate for Payer: Brighton Health Commercial	$6,937.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,959.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,215.78
Rate for Payer: Group Health Inc Commercial	$307.00
Rate for Payer: Group Health Inc Medicare	$214.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$307.00
Rate for Payer: Hamaspik Choice Inc Medicare	$307.00

CC SINGLE PATIENT DISPOSABLE SET

Facility

$55.50

Hospital Charge Code	66520253
Hospital Revenue Code	270
Min. Negotiated Rate	$19.42
Max. Negotiated Rate	$44.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$30.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$27.75
Rate for Payer: Aetna Government	$27.75
Rate for Payer: Brighton Health Commercial	$41.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$44.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$37.74
Rate for Payer: Group Health Inc Commercial	$27.75
Rate for Payer: Group Health Inc Medicare	$19.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$27.75
Rate for Payer: Hamaspik Choice Inc Medicare	$27.75

CC SINGLE PT DISPOSABLE SET LONG

Facility

$65.16

Hospital Charge Code	66529920
Hospital Revenue Code	270
Min. Negotiated Rate	$22.81
Max. Negotiated Rate	$52.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$32.58
Rate for Payer: Aetna Government	$32.58
Rate for Payer: Brighton Health Commercial	$48.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.13
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.31
Rate for Payer: Group Health Inc Commercial	$32.58
Rate for Payer: Group Health Inc Medicare	$22.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.58
Rate for Payer: Hamaspik Choice Inc Medicare	$32.58

CC SINUS OR JUGL CATH VENOGRAM

Facility

$8,393.53

Service Code	HCPCS 75860 26
Hospital Charge Code	66528654
Hospital Revenue Code	320
Min. Negotiated Rate	$1,217.14
Max. Negotiated Rate	$4,616.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,616.44
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	$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	$1,438.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,217.14
Rate for Payer: Elderplan Medicare Advantage	$3,686.08
Rate for Payer: EmblemHealth Commercial	$2,580.26
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3,133.17
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	$3,317.47
Rate for Payer: Group Health Inc Medicare	$3,317.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.76
Rate for Payer: Hamaspik Choice Inc Medicare	$3,686.08
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$3,317.47
Rate for Payer: Healthfirst Medicare Advantage	$3,686.08
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 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

CC SINUS OR JUGL CATH VENOGRAM

Facility

$8,393.53

Service Code	HCPCS 75860 26
Hospital Charge Code	66528654
Hospital Revenue Code	320
Rate for Payer: Cash Price	$3,686.08

CC SKIN PREP TRAY

Facility

$5.69

Hospital Charge Code	66528232
Hospital Revenue Code	270
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$4.55
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.84
Rate for Payer: Aetna Government	$2.84
Rate for Payer: Brighton Health Commercial	$4.27
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.87
Rate for Payer: Group Health Inc Commercial	$2.84
Rate for Payer: Group Health Inc Medicare	$1.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.84
Rate for Payer: Hamaspik Choice Inc Medicare	$2.84

CC SQ REM SC/DC ICD GENERATOR

Facility

$9,037.83

Service Code	HCPCS 33241
Hospital Charge Code	66528646
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 SQ REM SC/DC ICD GENERATOR

Facility

$9,037.83

Service Code	HCPCS 33241
Hospital Charge Code	66528646
Hospital Revenue Code	360
Rate for Payer: Cash Price	$4,541.28

CC STAT LOCK

Facility

$36.50

Hospital Charge Code	66528374
Hospital Revenue Code	480
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.25
Rate for Payer: Aetna Government	$18.25
Rate for Payer: Brighton Health Commercial	$27.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$29.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$24.82
Rate for Payer: Group Health Inc Commercial	$18.25
Rate for Payer: Group Health Inc Medicare	$12.78
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.25
Rate for Payer: Hamaspik Choice Inc Medicare	$18.25
Rate for Payer: United Healthcare Commercial	$316.00

CC STENT LIB MONO 12MM 2.75

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520111
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,890.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$990.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,080.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,035.00
Rate for Payer: EmblemHealth Commercial	$900.00
Rate for Payer: Fidelis Medicare Advantage	$1,890.00
Rate for Payer: Group Health Inc Commercial	$900.00
Rate for Payer: Group Health Inc Medicare	$630.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,170.00

CC STENT LIB MONO 12MM 2.75

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520111
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00

CC STENT LIB MONO 12MM 3.0

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520110
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,890.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$990.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,080.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,035.00
Rate for Payer: EmblemHealth Commercial	$900.00
Rate for Payer: Fidelis Medicare Advantage	$1,890.00
Rate for Payer: Group Health Inc Commercial	$900.00
Rate for Payer: Group Health Inc Medicare	$630.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,170.00

CC STENT LIB MONO 12MM 3.0

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520110
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00

CC STENT LIB MONO 12MM 3.5

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520112
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00

CC STENT LIB MONO 12MM 3.5

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520112
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,890.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$990.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,080.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,035.00
Rate for Payer: EmblemHealth Commercial	$900.00
Rate for Payer: Fidelis Medicare Advantage	$1,890.00
Rate for Payer: Group Health Inc Commercial	$900.00
Rate for Payer: Group Health Inc Medicare	$630.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,170.00

CC STENT LIB MONO 20MM 3.5

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520116
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00

CC STENT LIB MONO 20MM 3.5

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520116
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,890.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$990.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,080.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,035.00
Rate for Payer: EmblemHealth Commercial	$900.00
Rate for Payer: Fidelis Medicare Advantage	$1,890.00
Rate for Payer: Group Health Inc Commercial	$900.00
Rate for Payer: Group Health Inc Medicare	$630.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,170.00

CC STENT LIB MONO 20MM 4.0

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520117
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00

CC STENT LIB MONO 20MM 4.0

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520117
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,890.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$990.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,080.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,035.00
Rate for Payer: EmblemHealth Commercial	$900.00
Rate for Payer: Fidelis Medicare Advantage	$1,890.00
Rate for Payer: Group Health Inc Commercial	$900.00
Rate for Payer: Group Health Inc Medicare	$630.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,170.00

CC STENT LIB MONO 24CM 3.5

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520120
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,890.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$990.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,080.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,035.00
Rate for Payer: EmblemHealth Commercial	$900.00
Rate for Payer: Fidelis Medicare Advantage	$1,890.00
Rate for Payer: Group Health Inc Commercial	$900.00
Rate for Payer: Group Health Inc Medicare	$630.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,170.00

CC STENT LIB MONO 24CM 3.5

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520120
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$900.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00

CC STENT LIB MONO 24MM 2.75

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520118
Hospital Revenue Code	278
Min. Negotiated Rate	$398.18
Max. Negotiated Rate	$1,890.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$990.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$398.18
Rate for Payer: Aetna Government	$398.18
Rate for Payer: Brighton Health Commercial	$1,080.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$900.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,035.00
Rate for Payer: EmblemHealth Commercial	$900.00
Rate for Payer: Fidelis Medicare Advantage	$1,890.00
Rate for Payer: Group Health Inc Commercial	$900.00
Rate for Payer: Group Health Inc Medicare	$630.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$900.00
Rate for Payer: Hamaspik Choice Inc Medicare	$900.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,170.00

Know your out-of-pocket cost for care.

All Charges