St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC CHG US, EYE B-SCAN - B-SCAN ULTRASOUND - OS - LEFT EYE

Facility

$339.00

Service Code	CPT 76512 TC
Hospital Charge Code	4027651203
Hospital Revenue Code	402
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$254.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.38
Rate for Payer: Aetna Government	$31.38
Rate for Payer: Brighton Health Commercial	$254.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.43
Rate for Payer: EmblemHealth Commercial	$18.72
Rate for Payer: Group Health Inc Commercial	$169.50
Rate for Payer: Group Health Inc Medicare	$118.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50
Rate for Payer: Hamaspik Choice Inc Medicare	$169.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18.72
Rate for Payer: Healthfirst Essential Plan	$132.37
Rate for Payer: United Healthcare Commercial	$77.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$58.83

HC CHG US, EYE B-SCAN - B-SCAN ULTRASOUND - OS - LEFT EYE

Facility

$339.00

Service Code	CPT 76512 TC
Hospital Charge Code	4027651203
Hospital Revenue Code	402
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$169.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50

HC CHG US, EYE B-SCAN - B-SCAN ULTRASOUND - OU - BOTH EYES

Facility

$339.00

Service Code	CPT 76512 TC
Hospital Charge Code	4027651204
Hospital Revenue Code	402
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$169.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50

HC CHG US, EYE B-SCAN - B-SCAN ULTRASOUND - OU - BOTH EYES

Facility

$339.00

Service Code	CPT 76512 TC
Hospital Charge Code	4027651204
Hospital Revenue Code	402
Min. Negotiated Rate	$18.72
Max. Negotiated Rate	$254.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$31.38
Rate for Payer: Aetna Government	$31.38
Rate for Payer: Brighton Health Commercial	$254.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.43
Rate for Payer: EmblemHealth Commercial	$18.72
Rate for Payer: Group Health Inc Commercial	$169.50
Rate for Payer: Group Health Inc Medicare	$118.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50
Rate for Payer: Hamaspik Choice Inc Medicare	$169.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$18.72
Rate for Payer: Healthfirst Essential Plan	$132.37
Rate for Payer: United Healthcare Commercial	$77.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$58.83

HC CHG US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - CV US RENAL

Facility

$339.00

Service Code	CPT 76770 TC
Hospital Charge Code	4027677003
Hospital Revenue Code	402
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$169.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50

HC CHG US,RETROPERIT, B-SCAN/REAL TIME,COMPLETE - CV US RENAL

Facility

$339.00

Service Code	CPT 76770 TC
Hospital Charge Code	4027677003
Hospital Revenue Code	402
Min. Negotiated Rate	$60.39
Max. Negotiated Rate	$254.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$60.39
Rate for Payer: Aetna Government	$60.39
Rate for Payer: Brighton Health Commercial	$254.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.43
Rate for Payer: EmblemHealth Commercial	$76.92
Rate for Payer: Group Health Inc Commercial	$169.50
Rate for Payer: Group Health Inc Medicare	$118.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50
Rate for Payer: Hamaspik Choice Inc Medicare	$169.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$76.92
Rate for Payer: Healthfirst Essential Plan	$231.41
Rate for Payer: United Healthcare Commercial	$77.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$102.85

HC CHG US, RETROPERITNL ABD, LTD - CV US ABDOMINAL AORTA LIMITED

Facility

$339.00

Service Code	CPT 76775 TC
Hospital Charge Code	4027677503
Hospital Revenue Code	402
Min. Negotiated Rate	$23.02
Max. Negotiated Rate	$254.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.02
Rate for Payer: Aetna Government	$23.02
Rate for Payer: Brighton Health Commercial	$254.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.43
Rate for Payer: EmblemHealth Commercial	$35.15
Rate for Payer: Group Health Inc Commercial	$169.50
Rate for Payer: Group Health Inc Medicare	$118.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50
Rate for Payer: Hamaspik Choice Inc Medicare	$169.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35.15
Rate for Payer: Healthfirst Essential Plan	$162.31
Rate for Payer: United Healthcare Commercial	$77.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$72.14

HC CHG US, RETROPERITNL ABD, LTD - CV US ABDOMINAL AORTA LIMITED

Facility

$339.00

Service Code	CPT 76775 TC
Hospital Charge Code	4027677503
Hospital Revenue Code	402
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$169.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50

HC CHG US, RETROPERITNL ABD, LTD - CV US RENAL LIMITED

Facility

$339.00

Service Code	CPT 76775 TC
Hospital Charge Code	4027677504
Hospital Revenue Code	402
Min. Negotiated Rate	$169.50
Max. Negotiated Rate	$169.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50

HC CHG US, RETROPERITNL ABD, LTD - CV US RENAL LIMITED

Facility

$339.00

Service Code	CPT 76775 TC
Hospital Charge Code	4027677504
Hospital Revenue Code	402
Min. Negotiated Rate	$23.02
Max. Negotiated Rate	$254.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$186.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23.02
Rate for Payer: Aetna Government	$23.02
Rate for Payer: Brighton Health Commercial	$254.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$206.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.43
Rate for Payer: EmblemHealth Commercial	$35.15
Rate for Payer: Group Health Inc Commercial	$169.50
Rate for Payer: Group Health Inc Medicare	$118.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$169.50
Rate for Payer: Hamaspik Choice Inc Medicare	$169.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35.15
Rate for Payer: Healthfirst Essential Plan	$162.31
Rate for Payer: United Healthcare Commercial	$77.02
Rate for Payer: Wellcare CHP/FHP/Medicaid	$72.14

HC CHLAMYDIA, ANTIBODY - CHLAMYDIA ANTIBODIES

Facility

$29.00

Service Code	CPT 86631
Hospital Charge Code	3028663101
Hospital Revenue Code	302
Min. Negotiated Rate	$8.11
Max. Negotiated Rate	$21.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.82
Rate for Payer: Aetna Government	$11.82
Rate for Payer: Affinity Essential Plan 1&2	$8.27
Rate for Payer: Affinity Essential Plan 3&4	$8.27
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.27
Rate for Payer: Brighton Health Commercial	$21.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$11.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$20.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.92
Rate for Payer: Elderplan Medicare Advantage	$11.82
Rate for Payer: EmblemHealth Commercial	$11.82
Rate for Payer: Fidelis CHP/HARP/Medicaid	$10.64
Rate for Payer: Fidelis Essential Plan Aliesa	$10.05
Rate for Payer: Fidelis Essential Plan QHP	$10.52
Rate for Payer: Fidelis Medicare Advantage	$11.82
Rate for Payer: Fidelis Qualified Health Plan	$10.52
Rate for Payer: Group Health Inc Commercial	$11.82
Rate for Payer: Group Health Inc Medicare	$11.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.82
Rate for Payer: Hamaspik Choice Inc Medicare	$11.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.11
Rate for Payer: Healthfirst Essential Plan	$18.25
Rate for Payer: Healthfirst Medicare Advantage	$11.82
Rate for Payer: Healthfirst QHP	$11.82
Rate for Payer: Humana Medicare	$12.06
Rate for Payer: Senior Whole Health Medicare Advantage	$11.82
Rate for Payer: United Healthcare Commercial	$14.98
Rate for Payer: United Healthcare Medicare Advantage	$11.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.82
Rate for Payer: Wellcare CHP/FHP/Medicaid	$8.11
Rate for Payer: Wellcare Medicare	$10.64

HC CHLAMYDIA, ANTIBODY - CHLAMYDIA ANTIBODIES

Facility

$29.00

Service Code	CPT 86631
Hospital Charge Code	3028663101
Hospital Revenue Code	302
Min. Negotiated Rate	$14.50
Max. Negotiated Rate	$14.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.50

HC CHLAMYDIA, IGM, ANTIBODY - CHLAMYDIA ANTIBODY, IGM

Facility

$31.00

Service Code	CPT 86632
Hospital Charge Code	3028663201
Hospital Revenue Code	302
Min. Negotiated Rate	$8.11
Max. Negotiated Rate	$23.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.68
Rate for Payer: Aetna Government	$12.68
Rate for Payer: Affinity Essential Plan 1&2	$8.88
Rate for Payer: Affinity Essential Plan 3&4	$8.88
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.88
Rate for Payer: Brighton Health Commercial	$23.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$21.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$18.16
Rate for Payer: Elderplan Medicare Advantage	$12.68
Rate for Payer: EmblemHealth Commercial	$12.68
Rate for Payer: Fidelis CHP/HARP/Medicaid	$11.41
Rate for Payer: Fidelis Essential Plan Aliesa	$10.78
Rate for Payer: Fidelis Essential Plan QHP	$11.29
Rate for Payer: Fidelis Medicare Advantage	$12.68
Rate for Payer: Fidelis Qualified Health Plan	$11.29
Rate for Payer: Group Health Inc Commercial	$12.68
Rate for Payer: Group Health Inc Medicare	$12.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$12.68
Rate for Payer: Hamaspik Choice Inc Medicare	$12.68
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.11
Rate for Payer: Healthfirst Essential Plan	$18.25
Rate for Payer: Healthfirst Medicare Advantage	$12.68
Rate for Payer: Healthfirst QHP	$12.68
Rate for Payer: Humana Medicare	$12.93
Rate for Payer: Senior Whole Health Medicare Advantage	$12.68
Rate for Payer: United Healthcare Commercial	$16.07
Rate for Payer: United Healthcare Medicare Advantage	$12.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.68
Rate for Payer: Wellcare CHP/FHP/Medicaid	$8.11
Rate for Payer: Wellcare Medicare	$11.41

HC CHLAMYDIA, IGM, ANTIBODY - CHLAMYDIA ANTIBODY, IGM

Facility

$31.00

Service Code	CPT 86632
Hospital Charge Code	3028663201
Hospital Revenue Code	302
Min. Negotiated Rate	$15.50
Max. Negotiated Rate	$15.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.50

HC CHOLECYSTOGRAM, ORAL CONTRAST

Facility

$551.00

Service Code	CPT 74290 TC
Hospital Charge Code	3207429001
Hospital Revenue Code	320
Min. Negotiated Rate	$275.50
Max. Negotiated Rate	$275.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.50

HC CHOLECYSTOGRAM, ORAL CONTRAST

Facility

$551.00

Service Code	CPT 74290 TC
Hospital Charge Code	3207429001
Hospital Revenue Code	320
Min. Negotiated Rate	$42.26
Max. Negotiated Rate	$413.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$303.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$42.26
Rate for Payer: Aetna Government	$42.26
Rate for Payer: Brighton Health Commercial	$413.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$185.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$156.21
Rate for Payer: EmblemHealth Commercial	$71.47
Rate for Payer: Group Health Inc Commercial	$275.50
Rate for Payer: Group Health Inc Medicare	$192.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$275.50
Rate for Payer: Hamaspik Choice Inc Medicare	$275.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$71.47
Rate for Payer: Healthfirst Essential Plan	$106.85
Rate for Payer: Wellcare CHP/FHP/Medicaid	$47.49

HC CHOLECYSTOSTOMY,PERCUTANEOUS, COMPLETE

Facility

$9,417.00

Service Code	CPT 47490 TC
Hospital Charge Code	3614749001
Hospital Revenue Code	361
Min. Negotiated Rate	$378.16
Max. Negotiated Rate	$7,062.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$378.16
Rate for Payer: Aetna Government	$378.16
Rate for Payer: Brighton Health Commercial	$7,062.75
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	$4,708.50
Rate for Payer: Group Health Inc Commercial	$4,708.50
Rate for Payer: Group Health Inc Medicare	$3,295.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,708.50
Rate for Payer: Hamaspik Choice Inc Medicare	$4,708.50
Rate for Payer: United Healthcare Commercial	$1,835.00

HC CHOLECYSTOSTOMY,PERCUTANEOUS, COMPLETE

Facility

$9,417.00

Service Code	CPT 47490 TC
Hospital Charge Code	3614749001
Hospital Revenue Code	361
Min. Negotiated Rate	$4,708.50
Max. Negotiated Rate	$4,708.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,708.50

HC CHOLINESTERASE CHALLENGE - TENSILON TEST

Facility

$766.00

Service Code	CPT 95857
Hospital Charge Code	9209585701
Hospital Revenue Code	920
Min. Negotiated Rate	$383.00
Max. Negotiated Rate	$383.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$383.00

HC CHOLINESTERASE CHALLENGE - TENSILON TEST

Facility

$766.00

Service Code	CPT 95857
Hospital Charge Code	9209585701
Hospital Revenue Code	920
Min. Negotiated Rate	$31.21
Max. Negotiated Rate	$612.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$421.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$380.47
Rate for Payer: Aetna Government	$380.47
Rate for Payer: Affinity Essential Plan 1&2	$266.33
Rate for Payer: Affinity Essential Plan 3&4	$266.33
Rate for Payer: Affinity Medicaid/CHP/HARP	$266.33
Rate for Payer: Brighton Health Commercial	$574.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$380.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$612.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$520.88
Rate for Payer: Elderplan Medicare Advantage	$380.47
Rate for Payer: EmblemHealth Commercial	$380.47
Rate for Payer: Fidelis CHP/HARP/Medicaid	$342.42
Rate for Payer: Fidelis Essential Plan Aliesa	$323.40
Rate for Payer: Fidelis Essential Plan QHP	$338.62
Rate for Payer: Fidelis Medicare Advantage	$380.47
Rate for Payer: Fidelis Qualified Health Plan	$338.62
Rate for Payer: Group Health Inc Commercial	$380.47
Rate for Payer: Group Health Inc Medicare	$380.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$380.47
Rate for Payer: Hamaspik Choice Inc Medicare	$380.47
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$31.21
Rate for Payer: Healthfirst Medicare Advantage	$323.40
Rate for Payer: Healthfirst QHP	$380.47
Rate for Payer: Humana Medicare	$388.08
Rate for Payer: Senior Whole Health Medicare Advantage	$380.47
Rate for Payer: United Healthcare Commercial	$94.00
Rate for Payer: United Healthcare Medicare Advantage	$380.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$380.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$361.45
Rate for Payer: Wellcare Medicare	$361.45

HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE

Facility

$18.00

Service Code	CPT 84703
Hospital Charge Code	3018470301
Hospital Revenue Code	301
Min. Negotiated Rate	$2.02
Max. Negotiated Rate	$13.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$9.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.52
Rate for Payer: Aetna Government	$7.52
Rate for Payer: Affinity Essential Plan 1&2	$5.26
Rate for Payer: Affinity Essential Plan 3&4	$5.26
Rate for Payer: Affinity Medicaid/CHP/HARP	$5.26
Rate for Payer: Brighton Health Commercial	$13.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$7.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.76
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.74
Rate for Payer: Elderplan Medicare Advantage	$7.52
Rate for Payer: EmblemHealth Commercial	$7.52
Rate for Payer: Fidelis CHP/HARP/Medicaid	$6.77
Rate for Payer: Fidelis Essential Plan Aliesa	$6.39
Rate for Payer: Fidelis Essential Plan QHP	$6.69
Rate for Payer: Fidelis Medicare Advantage	$7.52
Rate for Payer: Fidelis Qualified Health Plan	$6.69
Rate for Payer: Group Health Inc Commercial	$7.52
Rate for Payer: Group Health Inc Medicare	$7.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.52
Rate for Payer: Hamaspik Choice Inc Medicare	$7.52
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.02
Rate for Payer: Healthfirst Essential Plan	$4.54
Rate for Payer: Healthfirst Medicare Advantage	$7.52
Rate for Payer: Healthfirst QHP	$7.52
Rate for Payer: Humana Medicare	$7.67
Rate for Payer: Senior Whole Health Medicare Advantage	$7.52
Rate for Payer: United Healthcare Commercial	$9.51
Rate for Payer: United Healthcare Medicare Advantage	$7.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2.02
Rate for Payer: Wellcare Medicare	$6.77

HC CHORIONIC GONADOTROPIN, QUAL - HCG QUALITATIVE URINE

Facility

$18.00

Service Code	CPT 84703
Hospital Charge Code	3018470301
Hospital Revenue Code	301
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.00

HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD

Facility

$37.00

Service Code	CPT 84702
Hospital Charge Code	3018470201
Hospital Revenue Code	301
Min. Negotiated Rate	$18.50
Max. Negotiated Rate	$18.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$18.50

HC CHORIONIC GONADOTROPIN, QUANT - HCG QUANTITATIVE BLOOD

Facility

$37.00

Service Code	CPT 84702
Hospital Charge Code	3018470201
Hospital Revenue Code	301
Min. Negotiated Rate	$10.54
Max. Negotiated Rate	$28.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$20.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.05
Rate for Payer: Aetna Government	$15.05
Rate for Payer: Affinity Essential Plan 1&2	$10.54
Rate for Payer: Affinity Essential Plan 3&4	$10.54
Rate for Payer: Affinity Medicaid/CHP/HARP	$10.54
Rate for Payer: Brighton Health Commercial	$27.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$15.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.53
Rate for Payer: Elderplan Medicare Advantage	$15.05
Rate for Payer: EmblemHealth Commercial	$15.05
Rate for Payer: Fidelis CHP/HARP/Medicaid	$13.54
Rate for Payer: Fidelis Essential Plan Aliesa	$12.79
Rate for Payer: Fidelis Essential Plan QHP	$13.39
Rate for Payer: Fidelis Medicare Advantage	$15.05
Rate for Payer: Fidelis Qualified Health Plan	$13.39
Rate for Payer: Group Health Inc Commercial	$15.05
Rate for Payer: Group Health Inc Medicare	$15.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.05
Rate for Payer: Hamaspik Choice Inc Medicare	$15.05
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$12.49
Rate for Payer: Healthfirst Essential Plan	$28.10
Rate for Payer: Healthfirst Medicare Advantage	$15.05
Rate for Payer: Healthfirst QHP	$15.05
Rate for Payer: Humana Medicare	$15.35
Rate for Payer: Senior Whole Health Medicare Advantage	$15.05
Rate for Payer: United Healthcare Commercial	$19.07
Rate for Payer: United Healthcare Medicare Advantage	$15.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15.05
Rate for Payer: Wellcare CHP/FHP/Medicaid	$12.49
Rate for Payer: Wellcare Medicare	$13.54

HC CHORION VILLUS BIOPSY

Facility

$1,914.00

Service Code	CPT 59015
Hospital Charge Code	3615901501
Hospital Revenue Code	361
Min. Negotiated Rate	$957.00
Max. Negotiated Rate	$957.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$957.00

Know your out-of-pocket cost for care.

All Charges