St. Barnabas Hospital

All Charges

Charge

Type

Price

ACETAMINOPHEN + CODEINE 120 MG-12 MG/5 M

Facility OP

$0.88

Hospital Charge Code	41644033
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$0.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.48
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.44
Rate for Payer: Aetna Government	$0.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.60
Rate for Payer: Group Health Inc Commercial	$0.44
Rate for Payer: Group Health Inc Medicare	$0.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.44
Rate for Payer: Hamaspik Choice Inc Medicare	$0.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.57

ACETAMINOPHEN + CODEINE 300 MG-30 MG TAB

Facility OP

$0.17

Hospital Charge Code	41641910
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.12
Rate for Payer: Group Health Inc Commercial	$0.09
Rate for Payer: Group Health Inc Medicare	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09
Rate for Payer: Hamaspik Choice Inc Medicare	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.11

ACETAMINOPHEN + CODEINE 300 MG-30 MG TAB

Facility OP

$0.17

Hospital Charge Code	41651910
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$0.14
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.09
Rate for Payer: Aetna Government	$0.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.14
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.12
Rate for Payer: Group Health Inc Commercial	$0.09
Rate for Payer: Group Health Inc Medicare	$0.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.09
Rate for Payer: Hamaspik Choice Inc Medicare	$0.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.11

ACETAMINOPHEN + CODEINE 360 MG-36 MG/15

Facility OP

$2.00

Hospital Charge Code	41644036
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

ACETAMINOPHEN + CODEINE 360 MG-36 MG/15

Facility OP

$2.00

Hospital Charge Code	41654036
Hospital Revenue Code	250
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.36
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

ACETAMINOPHEN + OXYCODONE 325 MG-5 MG TA

Facility OP

$0.19

Hospital Charge Code	41652392
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.10
Rate for Payer: Aetna Government	$0.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.13
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.12

ACETAMINOPHEN + OXYCODONE 325 MG-5 MG TA

Facility OP

$0.19

Hospital Charge Code	41642392
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.10
Rate for Payer: Aetna Government	$0.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.13
Rate for Payer: Group Health Inc Commercial	$0.10
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.10
Rate for Payer: Hamaspik Choice Inc Medicare	$0.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.12

ACETAZOLAMIDE 250 MG TAB

Facility OP

$1.05

Hospital Charge Code	41644020
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.53
Rate for Payer: Aetna Government	$0.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.71
Rate for Payer: Group Health Inc Commercial	$0.53
Rate for Payer: Group Health Inc Medicare	$0.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.53
Rate for Payer: Hamaspik Choice Inc Medicare	$0.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.68

ACETAZOLAMIDE 250 MG TAB

Facility OP

$1.05

Hospital Charge Code	41654020
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.84
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.53
Rate for Payer: Aetna Government	$0.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.84
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.71
Rate for Payer: Group Health Inc Commercial	$0.53
Rate for Payer: Group Health Inc Medicare	$0.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.53
Rate for Payer: Hamaspik Choice Inc Medicare	$0.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.68

ACETAZOLAMIDE 500 MG ERC

Facility OP

$7.00

Hospital Charge Code	41643046
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

ACETAZOLAMIDE 500 MG ERC

Facility OP

$7.00

Hospital Charge Code	41653046
Hospital Revenue Code	250
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$5.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.50
Rate for Payer: Aetna Government	$3.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.76
Rate for Payer: Group Health Inc Commercial	$3.50
Rate for Payer: Group Health Inc Medicare	$2.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.50
Rate for Payer: Hamaspik Choice Inc Medicare	$3.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.55

ACETAZOLAMIDE 500 MG INJ

Facility OP

$49.48

Service Code	HCPCS J1120
Hospital Charge Code	41650484
Hospital Revenue Code	636
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$32.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.13
Rate for Payer: Aetna Government	$20.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.45
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26.73
Rate for Payer: Group Health Inc Commercial	$24.74
Rate for Payer: Group Health Inc Medicare	$17.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.74
Rate for Payer: Hamaspik Choice Inc Medicare	$24.74
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27.81
Rate for Payer: SOMOS Essential	$27.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$32.16

ACETAZOLAMIDE 500 MG INJ

Facility IP

$49.48

Service Code	HCPCS J1120
Hospital Charge Code	41650484
Hospital Revenue Code	636
Min. Negotiated Rate	$24.74
Max. Negotiated Rate	$24.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.74
Rate for Payer: Hamaspik Choice Inc Medicare	$24.74

ACETAZOLAMIDE 500 MG INJ

Facility OP

$49.48

Service Code	HCPCS J1120
Hospital Charge Code	41640484
Hospital Revenue Code	636
Min. Negotiated Rate	$17.32
Max. Negotiated Rate	$32.16
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$27.21
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.13
Rate for Payer: Aetna Government	$20.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$24.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.45
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26.73
Rate for Payer: Group Health Inc Commercial	$24.74
Rate for Payer: Group Health Inc Medicare	$17.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.74
Rate for Payer: Hamaspik Choice Inc Medicare	$24.74
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$29.70
Rate for Payer: SOMOS CHP/HARP/Medicaid	$27.81
Rate for Payer: SOMOS Essential	$27.81
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$32.16

ACETAZOLAMIDE 500 MG INJ

Facility IP

$49.48

Service Code	HCPCS J1120
Hospital Charge Code	41640484
Hospital Revenue Code	636
Min. Negotiated Rate	$24.74
Max. Negotiated Rate	$24.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.74
Rate for Payer: Hamaspik Choice Inc Medicare	$24.74

ACETAZOLAMIDE 5 MG/ML INJ PEDIATRIC

Facility OP

$1.88

Hospital Charge Code	41643060
Hospital Revenue Code	250
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$1.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.94
Rate for Payer: Aetna Government	$0.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.28
Rate for Payer: Group Health Inc Commercial	$0.94
Rate for Payer: Group Health Inc Medicare	$0.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.94
Rate for Payer: Hamaspik Choice Inc Medicare	$0.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.22

ACETAZOLAMIDE 5 MG/ML INJ PEDIATRIC

Facility OP

$1.88

Hospital Charge Code	41653060
Hospital Revenue Code	250
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$1.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.03
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.94
Rate for Payer: Aetna Government	$0.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.28
Rate for Payer: Group Health Inc Commercial	$0.94
Rate for Payer: Group Health Inc Medicare	$0.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.94
Rate for Payer: Hamaspik Choice Inc Medicare	$0.94
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.22

ACETIC ACID 3% TOPICAL SOLN

Facility OP

$1.00

Hospital Charge Code	41654618
Hospital Revenue Code	250
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: 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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

ACETIC ACID 3% TOPICAL SOLN

Facility OP

$1.00

Hospital Charge Code	41644618
Hospital Revenue Code	250
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: 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
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.65

ACETIC ACID IRRIGATION 0.25% SOLN

Facility OP

$4.00

Hospital Charge Code	41651274
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

ACETIC ACID IRRIGATION 0.25% SOLN

Facility OP

$4.00

Hospital Charge Code	41641274
Hospital Revenue Code	250
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$3.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.00
Rate for Payer: Aetna Government	$2.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.72
Rate for Payer: Group Health Inc Commercial	$2.00
Rate for Payer: Group Health Inc Medicare	$1.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.60

ACETIC ACID OTIC 2% SOLN

Facility OP

$42.34

Hospital Charge Code	41643461
Hospital Revenue Code	250
Min. Negotiated Rate	$14.82
Max. Negotiated Rate	$33.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.17
Rate for Payer: Aetna Government	$21.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.79
Rate for Payer: Group Health Inc Commercial	$21.17
Rate for Payer: Group Health Inc Medicare	$14.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.17
Rate for Payer: Hamaspik Choice Inc Medicare	$21.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$27.52

ACETIC ACID OTIC 2% SOLN

Facility OP

$42.34

Hospital Charge Code	41653461
Hospital Revenue Code	250
Min. Negotiated Rate	$14.82
Max. Negotiated Rate	$33.87
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$21.17
Rate for Payer: Aetna Government	$21.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$28.79
Rate for Payer: Group Health Inc Commercial	$21.17
Rate for Payer: Group Health Inc Medicare	$14.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.17
Rate for Payer: Hamaspik Choice Inc Medicare	$21.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$27.52

ACET OSTEOTOME

Facility OP

$2,285.50

Hospital Charge Code	64907316
Hospital Revenue Code	279
Min. Negotiated Rate	$799.92
Max. Negotiated Rate	$1,828.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,257.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,142.75
Rate for Payer: Aetna Government	$1,142.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,828.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,554.14
Rate for Payer: Group Health Inc Commercial	$1,142.75
Rate for Payer: Group Health Inc Medicare	$799.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,142.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,142.75

ACETYLCHOLINE 1% OPHTHALMIC INTRAOCULAR

Facility OP

$68.74

Hospital Charge Code	41654578
Hospital Revenue Code	250
Min. Negotiated Rate	$24.06
Max. Negotiated Rate	$54.99
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$37.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.37
Rate for Payer: Aetna Government	$34.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$54.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.74
Rate for Payer: Group Health Inc Commercial	$34.37
Rate for Payer: Group Health Inc Medicare	$24.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.37
Rate for Payer: Hamaspik Choice Inc Medicare	$34.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$44.68

Price Transparency.

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