St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC DEBRIDE SKIN AT FRACTURE SITE, SKIN,SUBCU TISSUE,FASCIA,MUSCLE,BONE

Facility

$2,309.00

Service Code	CPT 11012
Hospital Charge Code	3611101201
Hospital Revenue Code	361
Min. Negotiated Rate	$484.16
Max. Negotiated Rate	$3,566.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,496.91
Rate for Payer: Aetna Government	$3,496.91
Rate for Payer: Affinity Essential Plan 1&2	$2,447.84
Rate for Payer: Affinity Essential Plan 3&4	$2,447.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,447.84
Rate for Payer: Brighton Health Commercial	$1,731.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,496.91
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: Elderplan Medicare Advantage	$3,496.91
Rate for Payer: EmblemHealth Commercial	$3,496.91
Rate for Payer: Fidelis CHP/HARP/Medicaid	$3,147.22
Rate for Payer: Fidelis Essential Plan Aliesa	$2,972.37
Rate for Payer: Fidelis Essential Plan QHP	$3,112.25
Rate for Payer: Fidelis Medicare Advantage	$3,496.91
Rate for Payer: Fidelis Qualified Health Plan	$3,112.25
Rate for Payer: Group Health Inc Commercial	$3,496.91
Rate for Payer: Group Health Inc Medicare	$3,496.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,496.91
Rate for Payer: Hamaspik Choice Inc Medicare	$1,201.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$484.16
Rate for Payer: Healthfirst Medicare Advantage	$2,972.37
Rate for Payer: Healthfirst QHP	$3,496.91
Rate for Payer: Humana Medicare	$3,566.85
Rate for Payer: Senior Whole Health Medicare Advantage	$3,496.91
Rate for Payer: United Healthcare Commercial	$1,188.00
Rate for Payer: United Healthcare Medicare Advantage	$3,496.91
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,496.91
Rate for Payer: Wellcare CHP/FHP/Medicaid	$3,322.06
Rate for Payer: Wellcare Medicare	$3,322.06

HC DEBRIDE SKIN AT FRACTURE SITE, SKIN,SUBCU TISSUE,FASCIA,MUSCLE,BONE

Facility

$2,309.00

Service Code	CPT 11012
Hospital Charge Code	3611101201
Hospital Revenue Code	361
Min. Negotiated Rate	$1,154.50
Max. Negotiated Rate	$1,154.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,154.50

HC DEBRIDE SKIN/TISSUE ADD'L 20SQCM (ADDON)

Facility

$821.00

Service Code	CPT 11045
Hospital Charge Code	3611104501
Hospital Revenue Code	361
Min. Negotiated Rate	$410.50
Max. Negotiated Rate	$410.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$410.50

HC DEBRIDE SKIN/TISSUE ADD'L 20SQCM (ADDON)

Facility

$821.00

Service Code	CPT 11045
Hospital Charge Code	3611104501
Hospital Revenue Code	361
Min. Negotiated Rate	$22.47
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$22.47
Rate for Payer: Aetna Government	$22.47
Rate for Payer: Brighton Health Commercial	$615.75
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	$410.50
Rate for Payer: Group Health Inc Commercial	$410.50
Rate for Payer: Group Health Inc Medicare	$287.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$410.50
Rate for Payer: Hamaspik Choice Inc Medicare	$410.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$28.15
Rate for Payer: United Healthcare Commercial	$1,113.00

HC DEBRIDE SKIN/TISSUE FIRST 20SQCM

Facility

$967.00

Service Code	CPT 11042
Hospital Charge Code	3611104201
Hospital Revenue Code	361
Min. Negotiated Rate	$483.50
Max. Negotiated Rate	$483.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$483.50

HC DEBRIDE SKIN/TISSUE FIRST 20SQCM

Facility

$967.00

Service Code	CPT 11042
Hospital Charge Code	3611104201
Hospital Revenue Code	361
Min. Negotiated Rate	$69.22
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$488.15
Rate for Payer: Aetna Government	$488.15
Rate for Payer: Affinity Essential Plan 1&2	$341.70
Rate for Payer: Affinity Essential Plan 3&4	$341.70
Rate for Payer: Affinity Medicaid/CHP/HARP	$341.70
Rate for Payer: Brighton Health Commercial	$725.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$488.15
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: Elderplan Medicare Advantage	$488.15
Rate for Payer: EmblemHealth Commercial	$488.15
Rate for Payer: Fidelis CHP/HARP/Medicaid	$439.33
Rate for Payer: Fidelis Essential Plan Aliesa	$414.93
Rate for Payer: Fidelis Essential Plan QHP	$434.45
Rate for Payer: Fidelis Medicare Advantage	$488.15
Rate for Payer: Fidelis Qualified Health Plan	$434.45
Rate for Payer: Group Health Inc Commercial	$488.15
Rate for Payer: Group Health Inc Medicare	$488.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$488.15
Rate for Payer: Hamaspik Choice Inc Medicare	$214.39
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$69.22
Rate for Payer: Healthfirst Medicare Advantage	$414.93
Rate for Payer: Healthfirst QHP	$488.15
Rate for Payer: Humana Medicare	$497.91
Rate for Payer: Senior Whole Health Medicare Advantage	$488.15
Rate for Payer: United Healthcare Commercial	$1,113.00
Rate for Payer: United Healthcare Medicare Advantage	$488.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$488.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$463.74
Rate for Payer: Wellcare Medicare	$463.74

HC DEBRIDE TISSUE/MUSCLE ADD'L 20SQCM (ADDON)

Facility

$821.00

Service Code	CPT 11046
Hospital Charge Code	3611104601
Hospital Revenue Code	361
Min. Negotiated Rate	$410.50
Max. Negotiated Rate	$410.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$410.50

HC DEBRIDE TISSUE/MUSCLE ADD'L 20SQCM (ADDON)

Facility

$821.00

Service Code	CPT 11046
Hospital Charge Code	3611104601
Hospital Revenue Code	361
Min. Negotiated Rate	$62.52
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.49
Rate for Payer: Aetna Government	$63.49
Rate for Payer: Brighton Health Commercial	$615.75
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	$410.50
Rate for Payer: Group Health Inc Commercial	$410.50
Rate for Payer: Group Health Inc Medicare	$287.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$410.50
Rate for Payer: Hamaspik Choice Inc Medicare	$410.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$62.52
Rate for Payer: United Healthcare Commercial	$1,113.00

HC DEBRIDE TISSUE/MUSCLE FIRST 20SQCM

Facility

$1,505.00

Service Code	CPT 11043
Hospital Charge Code	3611104301
Hospital Revenue Code	361
Min. Negotiated Rate	$752.50
Max. Negotiated Rate	$752.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$752.50

HC DEBRIDE TISSUE/MUSCLE FIRST 20SQCM

Facility

$1,505.00

Service Code	CPT 11043
Hospital Charge Code	3611104301
Hospital Revenue Code	361
Min. Negotiated Rate	$177.20
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$747.91
Rate for Payer: Aetna Government	$747.91
Rate for Payer: Affinity Essential Plan 1&2	$523.54
Rate for Payer: Affinity Essential Plan 3&4	$523.54
Rate for Payer: Affinity Medicaid/CHP/HARP	$523.54
Rate for Payer: Brighton Health Commercial	$1,128.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$747.91
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: Elderplan Medicare Advantage	$747.91
Rate for Payer: EmblemHealth Commercial	$747.91
Rate for Payer: Fidelis CHP/HARP/Medicaid	$673.12
Rate for Payer: Fidelis Essential Plan Aliesa	$635.72
Rate for Payer: Fidelis Essential Plan QHP	$665.64
Rate for Payer: Fidelis Medicare Advantage	$747.91
Rate for Payer: Fidelis Qualified Health Plan	$665.64
Rate for Payer: Group Health Inc Commercial	$747.91
Rate for Payer: Group Health Inc Medicare	$747.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$747.91
Rate for Payer: Hamaspik Choice Inc Medicare	$328.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$177.20
Rate for Payer: Healthfirst Medicare Advantage	$635.72
Rate for Payer: Healthfirst QHP	$747.91
Rate for Payer: Humana Medicare	$762.87
Rate for Payer: Senior Whole Health Medicare Advantage	$747.91
Rate for Payer: United Healthcare Commercial	$1,113.00
Rate for Payer: United Healthcare Medicare Advantage	$747.91
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$747.91
Rate for Payer: Wellcare CHP/FHP/Medicaid	$710.51
Rate for Payer: Wellcare Medicare	$710.51

HC DECALCIFY TISSUE - LAB DECALCIFY TISSUE

Facility

$32.00

Service Code	CPT 88311 TC
Hospital Charge Code	3128831105
Hospital Revenue Code	312
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$16.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00

HC DECALCIFY TISSUE - LAB DECALCIFY TISSUE

Facility

$32.00

Service Code	CPT 88311 TC
Hospital Charge Code	3128831105
Hospital Revenue Code	312
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$24.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Brighton Health Commercial	$24.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.90
Rate for Payer: EmblemHealth Commercial	$9.93
Rate for Payer: Group Health Inc Commercial	$16.00
Rate for Payer: Group Health Inc Medicare	$11.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00
Rate for Payer: Hamaspik Choice Inc Medicare	$16.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.93

HC DECALCIFY TISSUE - LAB SURG PATH,LEVEL III

Facility

$32.00

Service Code	CPT 88311 TC
Hospital Charge Code	3128831101
Hospital Revenue Code	312
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$24.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Brighton Health Commercial	$24.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.90
Rate for Payer: EmblemHealth Commercial	$9.93
Rate for Payer: Group Health Inc Commercial	$16.00
Rate for Payer: Group Health Inc Medicare	$11.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00
Rate for Payer: Hamaspik Choice Inc Medicare	$16.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.93

HC DECALCIFY TISSUE - LAB SURG PATH,LEVEL III

Facility

$32.00

Service Code	CPT 88311 TC
Hospital Charge Code	3128831101
Hospital Revenue Code	312
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$16.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00

HC DECALCIFY TISSUE - LAB SURG PATH,LEVEL IV

Facility

$32.00

Service Code	CPT 88311 TC
Hospital Charge Code	3128831102
Hospital Revenue Code	312
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$16.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00

HC DECALCIFY TISSUE - LAB SURG PATH,LEVEL IV

Facility

$32.00

Service Code	CPT 88311 TC
Hospital Charge Code	3128831102
Hospital Revenue Code	312
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$24.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Brighton Health Commercial	$24.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.90
Rate for Payer: EmblemHealth Commercial	$9.93
Rate for Payer: Group Health Inc Commercial	$16.00
Rate for Payer: Group Health Inc Medicare	$11.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00
Rate for Payer: Hamaspik Choice Inc Medicare	$16.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.93

HC DECALCIFY TISSUE - LAB SURG PATH,LEVEL V

Facility

$32.00

Service Code	CPT 88311 TC
Hospital Charge Code	3128831103
Hospital Revenue Code	312
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$16.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00

HC DECALCIFY TISSUE - LAB SURG PATH,LEVEL V

Facility

$32.00

Service Code	CPT 88311 TC
Hospital Charge Code	3128831103
Hospital Revenue Code	312
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$24.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Brighton Health Commercial	$24.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.90
Rate for Payer: EmblemHealth Commercial	$9.93
Rate for Payer: Group Health Inc Commercial	$16.00
Rate for Payer: Group Health Inc Medicare	$11.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00
Rate for Payer: Hamaspik Choice Inc Medicare	$16.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.93

HC DECALCIFY TISSUE - LAB SURG PATH,LEVEL VI

Facility

$32.00

Service Code	CPT 88311 TC
Hospital Charge Code	3128831104
Hospital Revenue Code	312
Min. Negotiated Rate	$16.00
Max. Negotiated Rate	$16.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00

HC DECALCIFY TISSUE - LAB SURG PATH,LEVEL VI

Facility

$32.00

Service Code	CPT 88311 TC
Hospital Charge Code	3128831104
Hospital Revenue Code	312
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$24.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.59
Rate for Payer: Aetna Government	$5.59
Rate for Payer: Brighton Health Commercial	$24.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.90
Rate for Payer: EmblemHealth Commercial	$9.93
Rate for Payer: Group Health Inc Commercial	$16.00
Rate for Payer: Group Health Inc Medicare	$11.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$16.00
Rate for Payer: Hamaspik Choice Inc Medicare	$16.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.93

HC DECANNULATION OF TRACHEOSTOMY

Facility

$7,933.00

Service Code	CPT 69424 TC
Hospital Charge Code	3616942401
Hospital Revenue Code	361
Min. Negotiated Rate	$3,966.50
Max. Negotiated Rate	$3,966.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,966.50

HC DECANNULATION OF TRACHEOSTOMY

Facility

$7,933.00

Service Code	CPT 69424 TC
Hospital Charge Code	3616942401
Hospital Revenue Code	361
Min. Negotiated Rate	$92.19
Max. Negotiated Rate	$5,949.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.63
Rate for Payer: Aetna Government	$118.63
Rate for Payer: Brighton Health Commercial	$5,949.75
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	$3,966.50
Rate for Payer: Group Health Inc Commercial	$3,966.50
Rate for Payer: Group Health Inc Medicare	$2,776.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,966.50
Rate for Payer: Hamaspik Choice Inc Medicare	$92.19
Rate for Payer: United Healthcare Commercial	$1,835.00

HC DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH

Facility

$937.00

Service Code	CPT 36593
Hospital Charge Code	3613659301
Hospital Revenue Code	361
Min. Negotiated Rate	$468.50
Max. Negotiated Rate	$468.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$468.50

HC DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH

Facility

$937.00

Service Code	CPT 36593
Hospital Charge Code	3613659301
Hospital Revenue Code	361
Min. Negotiated Rate	$32.99
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$405.27
Rate for Payer: Aetna Government	$405.27
Rate for Payer: Affinity Essential Plan 1&2	$283.69
Rate for Payer: Affinity Essential Plan 3&4	$283.69
Rate for Payer: Affinity Medicaid/CHP/HARP	$283.69
Rate for Payer: Brighton Health Commercial	$702.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$405.27
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: Elderplan Medicare Advantage	$405.27
Rate for Payer: EmblemHealth Commercial	$405.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$364.74
Rate for Payer: Fidelis Essential Plan Aliesa	$344.48
Rate for Payer: Fidelis Essential Plan QHP	$360.69
Rate for Payer: Fidelis Medicare Advantage	$405.27
Rate for Payer: Fidelis Qualified Health Plan	$360.69
Rate for Payer: Group Health Inc Commercial	$405.27
Rate for Payer: Group Health Inc Medicare	$405.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$405.27
Rate for Payer: Hamaspik Choice Inc Medicare	$32.99
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$40.83
Rate for Payer: Healthfirst Medicare Advantage	$344.48
Rate for Payer: Healthfirst QHP	$405.27
Rate for Payer: Humana Medicare	$413.38
Rate for Payer: Senior Whole Health Medicare Advantage	$405.27
Rate for Payer: United Healthcare Commercial	$1,113.00
Rate for Payer: United Healthcare Medicare Advantage	$405.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$405.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$385.01
Rate for Payer: Wellcare Medicare	$385.01

HC DECOMP FASCIOTOMY, FOREARM/WRIST, W/ DEBRIDEMENT

Facility

$4,105.00

Service Code	CPT 25025
Hospital Charge Code	3612502501
Hospital Revenue Code	361
Min. Negotiated Rate	$838.29
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,955.41
Rate for Payer: Aetna Government	$1,955.41
Rate for Payer: Affinity Essential Plan 1&2	$1,368.79
Rate for Payer: Affinity Essential Plan 3&4	$1,368.79
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,368.79
Rate for Payer: Brighton Health Commercial	$3,078.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,955.41
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: Elderplan Medicare Advantage	$1,955.41
Rate for Payer: EmblemHealth Commercial	$1,955.41
Rate for Payer: Fidelis CHP/HARP/Medicaid	$1,759.87
Rate for Payer: Fidelis Essential Plan Aliesa	$1,662.10
Rate for Payer: Fidelis Essential Plan QHP	$1,740.31
Rate for Payer: Fidelis Medicare Advantage	$1,955.41
Rate for Payer: Fidelis Qualified Health Plan	$1,740.31
Rate for Payer: Group Health Inc Commercial	$1,955.41
Rate for Payer: Group Health Inc Medicare	$1,955.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,955.41
Rate for Payer: Hamaspik Choice Inc Medicare	$838.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1,455.22
Rate for Payer: Healthfirst Medicare Advantage	$1,662.10
Rate for Payer: Healthfirst QHP	$1,955.41
Rate for Payer: Humana Medicare	$1,994.52
Rate for Payer: Senior Whole Health Medicare Advantage	$1,955.41
Rate for Payer: United Healthcare Commercial	$1,468.00
Rate for Payer: United Healthcare Medicare Advantage	$1,955.41
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,955.41
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,857.64
Rate for Payer: Wellcare Medicare	$1,857.64

Know your out-of-pocket cost for care.

All Charges