St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

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	$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 3.0

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520119
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 3.0

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520119
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 24MM 4.0

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520121
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 4.0

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520121
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 MONO 20MM 2.75

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520114
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 MONO 20MM 2.75

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520114
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 MONO 20MM 3.0

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520115
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 MONO 20MM 3.0

Facility

$1,800.00

Service Code	HCPCS C1876
Hospital Charge Code	66520115
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 STERILE TOWELS DE ROYAL

Facility

$1.00

Hospital Charge Code	66528233
Hospital Revenue Code	270
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.50
Rate for Payer: Aetna Government	$0.50
Rate for Payer: Brighton Health Commercial	$0.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.68
Rate for Payer: Group Health Inc Commercial	$0.50
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.50
Rate for Payer: Hamaspik Choice Inc Medicare	$0.50

CC ST JUDE MEDICAL 5FR PAC WIRES

Facility

$190.00

Hospital Charge Code	66528377
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 TELEGEN IS-1/DF-1-DR

Facility

$38,864.00

Service Code	HCPCS C1721
Hospital Charge Code	66528868
Hospital Revenue Code	275
Min. Negotiated Rate	$5,000.00
Max. Negotiated Rate	$40,807.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$21,375.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,000.00
Rate for Payer: Aetna Government	$5,000.00
Rate for Payer: Brighton Health Commercial	$23,318.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19,432.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$22,346.80
Rate for Payer: EmblemHealth Commercial	$19,432.00
Rate for Payer: Fidelis Medicare Advantage	$40,807.20
Rate for Payer: Group Health Inc Commercial	$19,432.00
Rate for Payer: Group Health Inc Medicare	$13,602.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$19,432.00
Rate for Payer: Hamaspik Choice Inc Medicare	$19,432.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$25,261.60

CC TELEGEN IS-1/DF-1-VR E102

Facility

$32,988.00

Service Code	HCPCS C1722
Hospital Charge Code	66528871
Hospital Revenue Code	275
Min. Negotiated Rate	$3,988.80
Max. Negotiated Rate	$34,637.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$18,143.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,988.80
Rate for Payer: Aetna Government	$3,988.80
Rate for Payer: Brighton Health Commercial	$19,792.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16,494.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$18,968.10
Rate for Payer: EmblemHealth Commercial	$16,494.00
Rate for Payer: Fidelis Medicare Advantage	$34,637.40
Rate for Payer: Group Health Inc Commercial	$16,494.00
Rate for Payer: Group Health Inc Medicare	$11,545.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$16,494.00
Rate for Payer: Hamaspik Choice Inc Medicare	$16,494.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$21,442.20

CC TELIGEN IS-1/DF-1-DR

Facility

$19,432.00

Service Code	HCPCS C1721
Hospital Charge Code	66526880
Hospital Revenue Code	275
Min. Negotiated Rate	$5,000.00
Max. Negotiated Rate	$20,403.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10,687.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5,000.00
Rate for Payer: Aetna Government	$5,000.00
Rate for Payer: Brighton Health Commercial	$11,659.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9,716.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$11,173.40
Rate for Payer: EmblemHealth Commercial	$9,716.00
Rate for Payer: Fidelis Medicare Advantage	$20,403.60
Rate for Payer: Group Health Inc Commercial	$9,716.00
Rate for Payer: Group Health Inc Medicare	$6,801.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,716.00
Rate for Payer: Hamaspik Choice Inc Medicare	$9,716.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12,630.80

CC TELIGEN IS-1/DF 1-VR

Facility

$16,994.00

Service Code	HCPCS C1722
Hospital Charge Code	66526876
Hospital Revenue Code	275
Min. Negotiated Rate	$3,988.80
Max. Negotiated Rate	$17,843.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9,346.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,988.80
Rate for Payer: Aetna Government	$3,988.80
Rate for Payer: Brighton Health Commercial	$10,196.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8,497.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,771.55
Rate for Payer: EmblemHealth Commercial	$8,497.00
Rate for Payer: Fidelis Medicare Advantage	$17,843.70
Rate for Payer: Group Health Inc Commercial	$8,497.00
Rate for Payer: Group Health Inc Medicare	$5,947.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$8,497.00
Rate for Payer: Hamaspik Choice Inc Medicare	$8,497.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11,046.10

CC TEMPORARY PACEMAKER

Facility

$23,145.25

Service Code	HCPCS 33210
Hospital Charge Code	66528908
Hospital Revenue Code	481
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$11,572.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,593.00
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	$6,937.00
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	$9,824.59
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	$2,546.00
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 TEMPORARY PACEMAKER

Facility

$23,145.25

Service Code	HCPCS 33210
Hospital Charge Code	66528908
Hospital Revenue Code	481
Rate for Payer: Cash Price	$9,824.59

CC TERUMO GILDESHEATH 10CM

Facility

$19.00

Service Code	HCPCS C1769
Hospital Charge Code	66525011
Hospital Revenue Code	278
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$19.95
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.08
Rate for Payer: Aetna Government	$4.08
Rate for Payer: Brighton Health Commercial	$11.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.92
Rate for Payer: EmblemHealth Commercial	$9.50
Rate for Payer: Fidelis Medicare Advantage	$19.95
Rate for Payer: Group Health Inc Commercial	$9.50
Rate for Payer: Group Health Inc Medicare	$6.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.50
Rate for Payer: Hamaspik Choice Inc Medicare	$9.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.35

CC TERUMO GILDESHEATH 10CM

Facility

$19.00

Service Code	HCPCS C1769
Hospital Charge Code	66525011
Hospital Revenue Code	278
Min. Negotiated Rate	$9.50
Max. Negotiated Rate	$9.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.50
Rate for Payer: Hamaspik Choice Inc Medicare	$9.50

CC THER/PROPH/DIAG IV INF, INIT

Facility

$556.50

Service Code	HCPCS 96365
Hospital Charge Code	66528677
Hospital Revenue Code	260
Min. Negotiated Rate	$76.00
Max. Negotiated Rate	$445.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$306.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$247.87
Rate for Payer: Aetna Government	$247.87
Rate for Payer: Affinity Essential Plan 1&2	$173.51
Rate for Payer: Affinity Essential Plan 3&4	$173.51
Rate for Payer: Affinity Medicaid/CHP/HARP	$173.51
Rate for Payer: Brighton Health Commercial	$417.38
Rate for Payer: Cash Price	$247.87
Rate for Payer: Cash Price	$247.87
Rate for Payer: Cash Price	$247.87
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$247.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$445.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$378.42
Rate for Payer: Elderplan Medicare Advantage	$247.87
Rate for Payer: EmblemHealth Commercial	$247.87
Rate for Payer: Fidelis Essential Plan Aliesa	$210.69
Rate for Payer: Fidelis Essential Plan QHP	$220.60
Rate for Payer: Fidelis Medicare Advantage	$247.87
Rate for Payer: Fidelis Qualified Health Plan	$220.60
Rate for Payer: Group Health Inc Commercial	$247.87
Rate for Payer: Group Health Inc Medicare	$247.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$278.25
Rate for Payer: Hamaspik Choice Inc Medicare	$247.87
Rate for Payer: Healthfirst Medicare Advantage	$210.69
Rate for Payer: Healthfirst QHP	$247.87
Rate for Payer: Humana Medicare	$252.83
Rate for Payer: Senior Whole Health Medicare Advantage	$247.87
Rate for Payer: United Healthcare Commercial	$76.00
Rate for Payer: United Healthcare Medicare Advantage	$247.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$247.87
Rate for Payer: Wellcare CHP/FHP/Medicaid	$198.30
Rate for Payer: Wellcare Medicare	$235.48

CC THER/PROPH/DIAG IV INF, INIT

Facility

$556.50

Service Code	HCPCS 96365
Hospital Charge Code	66528677
Hospital Revenue Code	260
Rate for Payer: Cash Price	$247.87

CC THRESHOLD PACING CABLES

Facility

$11.20

Hospital Charge Code	66528277
Hospital Revenue Code	480
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$316.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.60
Rate for Payer: Aetna Government	$5.60
Rate for Payer: Brighton Health Commercial	$8.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.96
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.62
Rate for Payer: Group Health Inc Commercial	$5.60
Rate for Payer: Group Health Inc Medicare	$3.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.60
Rate for Payer: Hamaspik Choice Inc Medicare	$5.60
Rate for Payer: United Healthcare Commercial	$316.00

CC THROMBOLYSIS, INTRACORONARY

Facility

$30,010.30

Service Code	HCPCS 92997
Hospital Charge Code	66528379
Hospital Revenue Code	480
Rate for Payer: Cash Price	$12,721.98

CC THROMBOLYSIS, INTRACORONARY

Facility

$30,010.30

Service Code	HCPCS 92997
Hospital Charge Code	66528379
Hospital Revenue Code	480
Min. Negotiated Rate	$316.00
Max. Negotiated Rate	$24,008.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16,505.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12,721.98
Rate for Payer: Aetna Government	$12,721.98
Rate for Payer: Affinity Essential Plan 1&2	$8,905.39
Rate for Payer: Affinity Essential Plan 3&4	$8,905.39
Rate for Payer: Affinity Medicaid/CHP/HARP	$8,905.39
Rate for Payer: Brighton Health Commercial	$22,507.72
Rate for Payer: Cash Price	$12,721.98
Rate for Payer: Cash Price	$12,721.98
Rate for Payer: Cash Price	$12,721.98
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12,721.98
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24,008.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$20,407.00
Rate for Payer: Elderplan Medicare Advantage	$12,721.98
Rate for Payer: EmblemHealth Commercial	$12,721.98
Rate for Payer: Fidelis Essential Plan Aliesa	$10,813.68
Rate for Payer: Fidelis Essential Plan QHP	$11,322.56
Rate for Payer: Fidelis Medicare Advantage	$12,721.98
Rate for Payer: Fidelis Qualified Health Plan	$11,322.56
Rate for Payer: Group Health Inc Commercial	$12,721.98
Rate for Payer: Group Health Inc Medicare	$12,721.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$15,005.15
Rate for Payer: Hamaspik Choice Inc Medicare	$12,721.98
Rate for Payer: Healthfirst Medicare Advantage	$10,813.68
Rate for Payer: Healthfirst QHP	$12,721.98
Rate for Payer: Humana Medicare	$12,976.42
Rate for Payer: Senior Whole Health Medicare Advantage	$12,721.98
Rate for Payer: United Healthcare Commercial	$316.00
Rate for Payer: United Healthcare Medicare Advantage	$12,721.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12,721.98
Rate for Payer: Wellcare CHP/FHP/Medicaid	$10,177.58
Rate for Payer: Wellcare Medicare	$12,085.88

CC TOTAL HEMOGLOBIN (THB) MEASURE

Facility

$5.93

Service Code	HCPCS 85018
Hospital Charge Code	66526895
Hospital Revenue Code	300
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$4.45
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.37
Rate for Payer: Aetna Government	$2.37
Rate for Payer: Affinity Essential Plan 1&2	$1.66
Rate for Payer: Affinity Essential Plan 3&4	$1.66
Rate for Payer: Affinity Medicaid/CHP/HARP	$1.66
Rate for Payer: Brighton Health Commercial	$4.45
Rate for Payer: Cash Price	$2.37
Rate for Payer: Cash Price	$2.37
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.18
Rate for Payer: Elderplan Medicare Advantage	$2.37
Rate for Payer: EmblemHealth Commercial	$2.37
Rate for Payer: Fidelis Essential Plan Aliesa	$2.01
Rate for Payer: Fidelis Essential Plan QHP	$2.11
Rate for Payer: Fidelis Medicare Advantage	$2.37
Rate for Payer: Fidelis Qualified Health Plan	$2.11
Rate for Payer: Group Health Inc Commercial	$2.37
Rate for Payer: Group Health Inc Medicare	$2.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.96
Rate for Payer: Hamaspik Choice Inc Medicare	$2.37
Rate for Payer: Healthfirst Medicare Advantage	$2.37
Rate for Payer: Healthfirst QHP	$2.37
Rate for Payer: Humana Medicare	$2.42
Rate for Payer: Senior Whole Health Medicare Advantage	$2.37
Rate for Payer: United Healthcare Commercial	$3.00
Rate for Payer: United Healthcare Medicare Advantage	$2.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.37
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1.90
Rate for Payer: Wellcare Medicare	$2.13

Know your out-of-pocket cost for care.

All Charges