St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CEFUROXIME 3MG/0.3ML INJ

Facility

$0.01

Service Code	HCPCS J0697
Hospital Charge Code	41656640
Hospital Revenue Code	636
Max. Negotiated Rate	$2.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.01
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.01
Rate for Payer: Aetna Government	$2.01
Rate for Payer: Brighton Health Commercial	$0.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.01
Rate for Payer: Group Health Inc Commercial	$0.01
Rate for Payer: Group Health Inc Medicare	$0.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.01
Rate for Payer: SOMOS Essential	$2.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.01

CEFUROXIME 3MG/0.3ML INJ

Facility

$0.01

Service Code	HCPCS J0697
Hospital Charge Code	41656640
Hospital Revenue Code	636
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$0.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.01
Rate for Payer: Hamaspik Choice Inc Medicare	$0.01

CEFUROXIME 500 MG TAB

Facility

$1.29

Hospital Charge Code	41655335
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$1.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.65
Rate for Payer: Aetna Government	$0.65
Rate for Payer: Brighton Health Commercial	$0.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.88
Rate for Payer: Group Health Inc Commercial	$0.65
Rate for Payer: Group Health Inc Medicare	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.84

CEFUROXIME 500 MG TAB

Facility

$1.29

Hospital Charge Code	41645335
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$1.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.65
Rate for Payer: Aetna Government	$0.65
Rate for Payer: Brighton Health Commercial	$0.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.03
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.88
Rate for Payer: Group Health Inc Commercial	$0.65
Rate for Payer: Group Health Inc Medicare	$0.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.65
Rate for Payer: Hamaspik Choice Inc Medicare	$0.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.84

CEFUROXIME 750 MG INJ

Facility

$3.34

Service Code	HCPCS J0697
Hospital Charge Code	41653355
Hospital Revenue Code	636
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$1.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.67
Rate for Payer: Hamaspik Choice Inc Medicare	$1.67

CEFUROXIME 750 MG INJ

Facility

$3.34

Service Code	HCPCS J0697
Hospital Charge Code	41653355
Hospital Revenue Code	636
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$2.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.01
Rate for Payer: Aetna Government	$2.01
Rate for Payer: Brighton Health Commercial	$2.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.92
Rate for Payer: Group Health Inc Commercial	$1.67
Rate for Payer: Group Health Inc Medicare	$1.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.67
Rate for Payer: Hamaspik Choice Inc Medicare	$1.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.01
Rate for Payer: SOMOS Essential	$2.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.17

CEFUROXIME 750 MG INJ

Facility

$3.34

Service Code	HCPCS J0697
Hospital Charge Code	41643355
Hospital Revenue Code	636
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$2.17
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.84
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.01
Rate for Payer: Aetna Government	$2.01
Rate for Payer: Brighton Health Commercial	$2.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.67
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.92
Rate for Payer: Group Health Inc Commercial	$1.67
Rate for Payer: Group Health Inc Medicare	$1.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.67
Rate for Payer: Hamaspik Choice Inc Medicare	$1.67
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.01
Rate for Payer: SOMOS Essential	$2.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.17

CEFUROXIME 750 MG INJ

Facility

$3.34

Service Code	HCPCS J0697
Hospital Charge Code	41643355
Hospital Revenue Code	636
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$1.67
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.67
Rate for Payer: Hamaspik Choice Inc Medicare	$1.67

CEFUROXIME 90 MG/ML INJ PEDIATRICS

Facility

$6.00

Hospital Charge Code	41650110
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Brighton Health Commercial	$4.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.08
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.90

CEFUROXIME 90 MG/ML INJ PEDIATRICS

Facility

$6.00

Hospital Charge Code	41640110
Hospital Revenue Code	250
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$4.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.00
Rate for Payer: Aetna Government	$3.00
Rate for Payer: Brighton Health Commercial	$4.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.08
Rate for Payer: Group Health Inc Commercial	$3.00
Rate for Payer: Group Health Inc Medicare	$2.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.90

CEFUROXIME AXETIL 250 MG PO TABS [9495]

Facility

$4.40

Service Code	NDC 57237005860
Hospital Charge Code	57237005860
Hospital Revenue Code	250
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$3.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.42
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.20
Rate for Payer: Aetna Government	$2.20
Rate for Payer: Brighton Health Commercial	$3.30
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.99
Rate for Payer: Group Health Inc Commercial	$2.20
Rate for Payer: Group Health Inc Medicare	$1.54
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.20
Rate for Payer: Hamaspik Choice Inc Medicare	$2.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.86

CEFUROXIME AXETIL 250 MG PO TABS [9495]

Facility

$4.13

Service Code	NDC 60687027294
Hospital Charge Code	60687027294
Hospital Revenue Code	250
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$3.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.06
Rate for Payer: Aetna Government	$2.06
Rate for Payer: Brighton Health Commercial	$3.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.80
Rate for Payer: Group Health Inc Commercial	$2.06
Rate for Payer: Group Health Inc Medicare	$1.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.06
Rate for Payer: Hamaspik Choice Inc Medicare	$2.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.68

CEFUROXIME AXETIL 500 MG PO TABS [9496]

Facility

$11.10

Service Code	NDC 67877021660
Hospital Charge Code	67877021660
Hospital Revenue Code	250
Min. Negotiated Rate	$3.88
Max. Negotiated Rate	$8.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.55
Rate for Payer: Aetna Government	$5.55
Rate for Payer: Brighton Health Commercial	$8.32
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.55
Rate for Payer: Group Health Inc Commercial	$5.55
Rate for Payer: Group Health Inc Medicare	$3.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.55
Rate for Payer: Hamaspik Choice Inc Medicare	$5.55
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$7.21

CEFUROXIME AXETIL 500 MG PO TABS [9496]

Facility

$8.02

Service Code	NDC 65862070020
Hospital Charge Code	65862070020
Hospital Revenue Code	250
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$6.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.01
Rate for Payer: Aetna Government	$4.01
Rate for Payer: Brighton Health Commercial	$6.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.45
Rate for Payer: Group Health Inc Commercial	$4.01
Rate for Payer: Group Health Inc Medicare	$2.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.01
Rate for Payer: Hamaspik Choice Inc Medicare	$4.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.21

CEFUROXIME AXETIL 500 MG PO TABS [9496]

Facility

$8.02

Service Code	NDC 57237005920
Hospital Charge Code	57237005920
Hospital Revenue Code	250
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$6.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.01
Rate for Payer: Aetna Government	$4.01
Rate for Payer: Brighton Health Commercial	$6.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.41
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.45
Rate for Payer: Group Health Inc Commercial	$4.01
Rate for Payer: Group Health Inc Medicare	$2.81
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.01
Rate for Payer: Hamaspik Choice Inc Medicare	$4.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.21

CEFUROXIME IVP < 1500MG

Facility

$5.05

Service Code	HCPCS J0697
Hospital Charge Code	41657826
Hospital Revenue Code	636
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$3.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.01
Rate for Payer: Aetna Government	$2.01
Rate for Payer: Brighton Health Commercial	$3.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.90
Rate for Payer: Group Health Inc Commercial	$2.52
Rate for Payer: Group Health Inc Medicare	$1.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.52
Rate for Payer: Hamaspik Choice Inc Medicare	$2.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.01
Rate for Payer: SOMOS Essential	$2.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.28

CEFUROXIME IVP < 1500MG

Facility

$5.05

Service Code	HCPCS J0697
Hospital Charge Code	41647826
Hospital Revenue Code	636
Min. Negotiated Rate	$1.77
Max. Negotiated Rate	$3.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.01
Rate for Payer: Aetna Government	$2.01
Rate for Payer: Brighton Health Commercial	$3.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.90
Rate for Payer: Group Health Inc Commercial	$2.52
Rate for Payer: Group Health Inc Medicare	$1.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.52
Rate for Payer: Hamaspik Choice Inc Medicare	$2.52
Rate for Payer: SOMOS CHP/HARP/Medicaid	$2.01
Rate for Payer: SOMOS Essential	$2.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.28

CEFUROXIME IVP < 1500MG

Facility

$5.05

Service Code	HCPCS J0697
Hospital Charge Code	41657826
Hospital Revenue Code	636
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.52
Rate for Payer: Hamaspik Choice Inc Medicare	$2.52

CEFUROXIME IVP < 1500MG

Facility

$5.05

Service Code	HCPCS J0697
Hospital Charge Code	41647826
Hospital Revenue Code	636
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.52
Rate for Payer: Hamaspik Choice Inc Medicare	$2.52

CEFUROXIME SODIUM 1.5 G IV SOLR [27299]

Facility

$6.51

Service Code	HCPCS J0697
Hospital Charge Code	25021011920
Hospital Revenue Code	278
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$3.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.26
Rate for Payer: Hamaspik Choice Inc Medicare	$3.26

CEFUROXIME SODIUM 1.5 G IV SOLR [27299]

Facility

$6.51

Service Code	HCPCS J0697
Hospital Charge Code	25021011920
Hospital Revenue Code	278
Min. Negotiated Rate	$2.01
Max. Negotiated Rate	$6.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.01
Rate for Payer: Aetna Government	$2.01
Rate for Payer: Brighton Health Commercial	$3.91
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.74
Rate for Payer: EmblemHealth Commercial	$3.26
Rate for Payer: Fidelis Medicare Advantage	$6.84
Rate for Payer: Group Health Inc Commercial	$3.26
Rate for Payer: Group Health Inc Medicare	$2.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.26
Rate for Payer: Hamaspik Choice Inc Medicare	$3.26
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.23

CEFUROXIME SODIUM 750 MG IJ SOLR [1465]

Facility

$3.51

Service Code	HCPCS J0697
Hospital Charge Code	00143997922
Hospital Revenue Code	250
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$2.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.01
Rate for Payer: Aetna Government	$2.01
Rate for Payer: Brighton Health Commercial	$2.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.38
Rate for Payer: Group Health Inc Commercial	$1.75
Rate for Payer: Group Health Inc Medicare	$1.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1.75
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$1.89
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$2.01
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$2.01
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$2.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.28

CEFUROXIME SODIUM 750 MG IJ SOLR [1465]

Facility

$3.67

Service Code	HCPCS J0697
Hospital Charge Code	25021011810
Hospital Revenue Code	250
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$2.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.01
Rate for Payer: Aetna Government	$2.01
Rate for Payer: Brighton Health Commercial	$2.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.50
Rate for Payer: Group Health Inc Commercial	$1.84
Rate for Payer: Group Health Inc Medicare	$1.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.84
Rate for Payer: Hamaspik Choice Inc Medicare	$1.84
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$1.89
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$2.01
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$2.01
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$2.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.39

CELECOXIB 100 MG CAP

Facility

$5.00

Hospital Charge Code	41652350
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$4.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.50
Rate for Payer: Aetna Government	$2.50
Rate for Payer: Brighton Health Commercial	$3.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.40
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

CELECOXIB 100 MG CAP

Facility

$5.00

Hospital Charge Code	41642350
Hospital Revenue Code	250
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$4.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.50
Rate for Payer: Aetna Government	$2.50
Rate for Payer: Brighton Health Commercial	$3.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.40
Rate for Payer: Group Health Inc Commercial	$2.50
Rate for Payer: Group Health Inc Medicare	$1.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.50
Rate for Payer: Hamaspik Choice Inc Medicare	$2.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.25

Know your out-of-pocket cost for care.

All Charges