St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC EYE SERVICE OR PROCEDURE - WAVEFRONT ABERRATION - OU - BOTH EYES

Facility

$69.00

Service Code	CPT 92499
Hospital Charge Code	9209249903
Hospital Revenue Code	920
Min. Negotiated Rate	$20.94
Max. Negotiated Rate	$342.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$29.92
Rate for Payer: Aetna Government	$29.92
Rate for Payer: Affinity Essential Plan 1&2	$20.94
Rate for Payer: Affinity Essential Plan 3&4	$20.94
Rate for Payer: Affinity Medicaid/CHP/HARP	$20.94
Rate for Payer: Brighton Health Commercial	$51.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$29.92
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.92
Rate for Payer: Elderplan Medicare Advantage	$29.92
Rate for Payer: EmblemHealth Commercial	$29.92
Rate for Payer: Fidelis CHP/HARP/Medicaid	$26.93
Rate for Payer: Fidelis Essential Plan Aliesa	$25.43
Rate for Payer: Fidelis Essential Plan QHP	$26.63
Rate for Payer: Fidelis Medicare Advantage	$29.92
Rate for Payer: Fidelis Qualified Health Plan	$26.63
Rate for Payer: Group Health Inc Commercial	$29.92
Rate for Payer: Group Health Inc Medicare	$29.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.92
Rate for Payer: Hamaspik Choice Inc Medicare	$29.92
Rate for Payer: Healthfirst Medicare Advantage	$25.43
Rate for Payer: Healthfirst QHP	$29.92
Rate for Payer: Humana Medicare	$30.52
Rate for Payer: Senior Whole Health Medicare Advantage	$29.92
Rate for Payer: United Healthcare Commercial	$94.00
Rate for Payer: United Healthcare Medicare Advantage	$29.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$29.92
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28.42
Rate for Payer: Wellcare Medicare	$28.42

HC EYE SERVICE OR PROCEDURE - WAVEFRONT ABERRATION - OU - BOTH EYES

Facility

$69.00

Service Code	CPT 92499
Hospital Charge Code	9209249903
Hospital Revenue Code	920
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.50

HC F2 GENE ANALYSIS 20210G >A VARIANT - PROTHROMBIN GENE MUTATION

Facility

$164.00

Service Code	CPT 81240
Hospital Charge Code	3108124001
Hospital Revenue Code	310
Min. Negotiated Rate	$45.98
Max. Negotiated Rate	$147.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$90.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$65.69
Rate for Payer: Aetna Government	$65.69
Rate for Payer: Affinity Essential Plan 1&2	$45.98
Rate for Payer: Affinity Essential Plan 3&4	$45.98
Rate for Payer: Affinity Medicaid/CHP/HARP	$45.98
Rate for Payer: Brighton Health Commercial	$65.69
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$65.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$131.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$111.52
Rate for Payer: Elderplan Medicare Advantage	$65.69
Rate for Payer: EmblemHealth Commercial	$65.69
Rate for Payer: Fidelis CHP/HARP/Medicaid	$59.12
Rate for Payer: Fidelis Essential Plan Aliesa	$55.84
Rate for Payer: Fidelis Essential Plan QHP	$58.46
Rate for Payer: Fidelis Medicare Advantage	$65.69
Rate for Payer: Fidelis Qualified Health Plan	$58.46
Rate for Payer: Group Health Inc Commercial	$65.69
Rate for Payer: Group Health Inc Medicare	$65.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.69
Rate for Payer: Hamaspik Choice Inc Medicare	$65.69
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$65.69
Rate for Payer: Healthfirst Essential Plan	$147.80
Rate for Payer: Healthfirst Medicare Advantage	$65.69
Rate for Payer: Healthfirst QHP	$65.69
Rate for Payer: Humana Medicare	$67.00
Rate for Payer: Senior Whole Health Medicare Advantage	$65.69
Rate for Payer: United Healthcare Medicare Advantage	$65.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$65.69
Rate for Payer: Wellcare CHP/FHP/Medicaid	$65.69
Rate for Payer: Wellcare Medicare	$59.12

HC F2 GENE ANALYSIS 20210G >A VARIANT - PROTHROMBIN GENE MUTATION

Facility

$164.00

Service Code	CPT 81240
Hospital Charge Code	3108124001
Hospital Revenue Code	310
Min. Negotiated Rate	$82.00
Max. Negotiated Rate	$82.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.00

HC F2 GENE ANALYSIS - PROTHROMBIN

Facility

$164.00

Service Code	CPT 81240
Hospital Charge Code	3108124002
Hospital Revenue Code	310
Min. Negotiated Rate	$82.00
Max. Negotiated Rate	$82.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$82.00

HC F2 GENE ANALYSIS - PROTHROMBIN

Facility

$164.00

Service Code	CPT 81240
Hospital Charge Code	3108124002
Hospital Revenue Code	310
Min. Negotiated Rate	$45.98
Max. Negotiated Rate	$147.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$90.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$65.69
Rate for Payer: Aetna Government	$65.69
Rate for Payer: Affinity Essential Plan 1&2	$45.98
Rate for Payer: Affinity Essential Plan 3&4	$45.98
Rate for Payer: Affinity Medicaid/CHP/HARP	$45.98
Rate for Payer: Brighton Health Commercial	$65.69
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$65.69
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$131.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$111.52
Rate for Payer: Elderplan Medicare Advantage	$65.69
Rate for Payer: EmblemHealth Commercial	$65.69
Rate for Payer: Fidelis CHP/HARP/Medicaid	$59.12
Rate for Payer: Fidelis Essential Plan Aliesa	$55.84
Rate for Payer: Fidelis Essential Plan QHP	$58.46
Rate for Payer: Fidelis Medicare Advantage	$65.69
Rate for Payer: Fidelis Qualified Health Plan	$58.46
Rate for Payer: Group Health Inc Commercial	$65.69
Rate for Payer: Group Health Inc Medicare	$65.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.69
Rate for Payer: Hamaspik Choice Inc Medicare	$65.69
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$65.69
Rate for Payer: Healthfirst Essential Plan	$147.80
Rate for Payer: Healthfirst Medicare Advantage	$65.69
Rate for Payer: Healthfirst QHP	$65.69
Rate for Payer: Humana Medicare	$67.00
Rate for Payer: Senior Whole Health Medicare Advantage	$65.69
Rate for Payer: United Healthcare Medicare Advantage	$65.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$65.69
Rate for Payer: Wellcare CHP/FHP/Medicaid	$65.69
Rate for Payer: Wellcare Medicare	$59.12

HC F5 COAGULATION FACTOR V ANAL LEIDEN VARIANT - FACTOR V LEIDEN

Facility

$183.00

Service Code	CPT 81241
Hospital Charge Code	3108124101
Hospital Revenue Code	310
Min. Negotiated Rate	$51.36
Max. Negotiated Rate	$165.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$100.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$73.37
Rate for Payer: Aetna Government	$73.37
Rate for Payer: Affinity Essential Plan 1&2	$51.36
Rate for Payer: Affinity Essential Plan 3&4	$51.36
Rate for Payer: Affinity Medicaid/CHP/HARP	$51.36
Rate for Payer: Brighton Health Commercial	$73.37
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$73.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$146.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$124.44
Rate for Payer: Elderplan Medicare Advantage	$73.37
Rate for Payer: EmblemHealth Commercial	$73.37
Rate for Payer: Fidelis CHP/HARP/Medicaid	$66.03
Rate for Payer: Fidelis Essential Plan Aliesa	$62.36
Rate for Payer: Fidelis Essential Plan QHP	$65.30
Rate for Payer: Fidelis Medicare Advantage	$73.37
Rate for Payer: Fidelis Qualified Health Plan	$65.30
Rate for Payer: Group Health Inc Commercial	$73.37
Rate for Payer: Group Health Inc Medicare	$73.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$73.37
Rate for Payer: Hamaspik Choice Inc Medicare	$73.37
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$73.37
Rate for Payer: Healthfirst Essential Plan	$165.08
Rate for Payer: Healthfirst Medicare Advantage	$73.37
Rate for Payer: Healthfirst QHP	$73.37
Rate for Payer: Humana Medicare	$74.84
Rate for Payer: Senior Whole Health Medicare Advantage	$73.37
Rate for Payer: United Healthcare Medicare Advantage	$73.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$73.37
Rate for Payer: Wellcare CHP/FHP/Medicaid	$73.37
Rate for Payer: Wellcare Medicare	$66.03

HC F5 COAGULATION FACTOR V ANAL LEIDEN VARIANT - FACTOR V LEIDEN

Facility

$183.00

Service Code	CPT 81241
Hospital Charge Code	3108124101
Hospital Revenue Code	310
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$91.50

HC FAC BONES-COMPL REDUCT W/FIX/MU/1

Facility

$10,631.00

Service Code	CPT D7780
Hospital Charge Code	361D778001
Hospital Revenue Code	361
Min. Negotiated Rate	$5,315.50
Max. Negotiated Rate	$5,315.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,315.50

HC FAC BONES-COMPL REDUCT W/FIX/MU/1

Facility

$10,631.00

Service Code	CPT D7780
Hospital Charge Code	361D778001
Hospital Revenue Code	361
Min. Negotiated Rate	$3,007.33
Max. Negotiated Rate	$8,504.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,847.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,007.33
Rate for Payer: Aetna Government	$3,007.33
Rate for Payer: Brighton Health Commercial	$7,973.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8,504.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,229.08
Rate for Payer: EmblemHealth Commercial	$5,315.50
Rate for Payer: Group Health Inc Commercial	$5,315.50
Rate for Payer: Group Health Inc Medicare	$3,720.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,315.50
Rate for Payer: Hamaspik Choice Inc Medicare	$5,315.50

HC FAC BONES-COMPL REDUCT W/FIX/MULT

Facility

$7,796.00

Service Code	CPT D7680
Hospital Charge Code	361D768001
Hospital Revenue Code	361
Min. Negotiated Rate	$2,255.53
Max. Negotiated Rate	$6,236.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,287.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,255.53
Rate for Payer: Aetna Government	$2,255.53
Rate for Payer: Brighton Health Commercial	$5,847.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,236.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,301.28
Rate for Payer: EmblemHealth Commercial	$3,898.00
Rate for Payer: Group Health Inc Commercial	$3,898.00
Rate for Payer: Group Health Inc Medicare	$2,728.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,898.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,898.00

HC FAC BONES-COMPL REDUCT W/FIX/MULT

Facility

$7,796.00

Service Code	CPT D7680
Hospital Charge Code	361D768001
Hospital Revenue Code	361
Min. Negotiated Rate	$3,898.00
Max. Negotiated Rate	$3,898.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,898.00

HC FAMILY PSYCHOTHERAPY,NO PT

Facility

$397.00

Service Code	CPT 90846
Hospital Charge Code	9169084601
Hospital Revenue Code	916
Min. Negotiated Rate	$198.50
Max. Negotiated Rate	$198.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$198.50

HC FAMILY PSYCHOTHERAPY,NO PT

Facility

$397.00

Service Code	CPT 90846
Hospital Charge Code	9169084602
Hospital Revenue Code	916
Min. Negotiated Rate	$198.50
Max. Negotiated Rate	$198.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$198.50

HC FAMILY PSYCHOTHERAPY,NO PT

Facility

$397.00

Service Code	CPT 90846
Hospital Charge Code	9169084602
Hospital Revenue Code	916
Min. Negotiated Rate	$107.90
Max. Negotiated Rate	$317.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$218.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$196.31
Rate for Payer: Aetna Government	$196.31
Rate for Payer: Affinity Essential Plan 1&2	$137.42
Rate for Payer: Affinity Essential Plan 3&4	$137.42
Rate for Payer: Affinity Medicaid/CHP/HARP	$137.42
Rate for Payer: Brighton Health Commercial	$297.75
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$196.31
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$196.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$317.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$269.96
Rate for Payer: Elderplan Medicare Advantage	$196.31
Rate for Payer: EmblemHealth Commercial	$196.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$176.68
Rate for Payer: Fidelis Essential Plan Aliesa	$166.86
Rate for Payer: Fidelis Essential Plan QHP	$174.72
Rate for Payer: Fidelis Medicare Advantage	$196.31
Rate for Payer: Fidelis Qualified Health Plan	$174.72
Rate for Payer: Group Health Inc Commercial	$196.31
Rate for Payer: Group Health Inc Medicare	$196.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.31
Rate for Payer: Hamaspik Choice Inc Medicare	$196.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$107.90
Rate for Payer: Healthfirst Medicare Advantage	$166.86
Rate for Payer: Healthfirst QHP	$196.31
Rate for Payer: Humana Medicare	$200.24
Rate for Payer: Senior Whole Health Medicare Advantage	$196.31
Rate for Payer: United Healthcare Medicare Advantage	$196.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$196.31
Rate for Payer: Wellcare CHP/FHP/Medicaid	$186.49
Rate for Payer: Wellcare Medicare	$186.49

HC FAMILY PSYCHOTHERAPY,NO PT

Facility

$397.00

Service Code	CPT 90846
Hospital Charge Code	9169084601
Hospital Revenue Code	916
Min. Negotiated Rate	$107.90
Max. Negotiated Rate	$317.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$218.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$196.31
Rate for Payer: Aetna Government	$196.31
Rate for Payer: Affinity Essential Plan 1&2	$137.42
Rate for Payer: Affinity Essential Plan 3&4	$137.42
Rate for Payer: Affinity Medicaid/CHP/HARP	$137.42
Rate for Payer: Brighton Health Commercial	$297.75
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$196.31
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$196.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$317.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$269.96
Rate for Payer: Elderplan Medicare Advantage	$196.31
Rate for Payer: EmblemHealth Commercial	$196.31
Rate for Payer: Fidelis CHP/HARP/Medicaid	$176.68
Rate for Payer: Fidelis Essential Plan Aliesa	$166.86
Rate for Payer: Fidelis Essential Plan QHP	$174.72
Rate for Payer: Fidelis Medicare Advantage	$196.31
Rate for Payer: Fidelis Qualified Health Plan	$174.72
Rate for Payer: Group Health Inc Commercial	$196.31
Rate for Payer: Group Health Inc Medicare	$196.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$196.31
Rate for Payer: Hamaspik Choice Inc Medicare	$196.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$107.90
Rate for Payer: Healthfirst Medicare Advantage	$166.86
Rate for Payer: Healthfirst QHP	$196.31
Rate for Payer: Humana Medicare	$200.24
Rate for Payer: Senior Whole Health Medicare Advantage	$196.31
Rate for Payer: United Healthcare Medicare Advantage	$196.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$196.31
Rate for Payer: Wellcare CHP/FHP/Medicaid	$186.49
Rate for Payer: Wellcare Medicare	$186.49

HC FAMILY PSYCHOTHERAPY W PHYS

Facility

$397.00

Service Code	CPT 90847
Hospital Charge Code	9169084701
Hospital Revenue Code	916
Min. Negotiated Rate	$1.24
Max. Negotiated Rate	$646.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$188.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$196.31
Rate for Payer: Aetna Government	$196.31
Rate for Payer: Affinity Essential Plan 1&2	$646.37
Rate for Payer: Affinity Essential Plan 3&4	$646.37
Rate for Payer: Affinity Medicaid/CHP/HARP	$287.27
Rate for Payer: Amida Care Medicaid	$287.27
Rate for Payer: Brighton Health Commercial	$297.75
Rate for Payer: Carelon Behavioral Health HARP/QHP	$287.27
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$196.31
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$196.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$317.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$269.96
Rate for Payer: Elderplan Medicare Advantage	$196.31
Rate for Payer: EmblemHealth Commercial	$196.31
Rate for Payer: EmblemHealth Essential Plan 1&2	$646.37
Rate for Payer: EmblemHealth Essential Plan 3&4	$287.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$287.27
Rate for Payer: Fidelis Essential Plan Aliesa	$646.37
Rate for Payer: Fidelis Essential Plan QHP	$646.37
Rate for Payer: Fidelis Medicare Advantage	$196.31
Rate for Payer: Fidelis Qualified Health Plan	$301.64
Rate for Payer: Group Health Inc Commercial	$196.31
Rate for Payer: Group Health Inc Medicare	$196.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$287.27
Rate for Payer: Hamaspik Choice Inc Medicare	$196.31
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$287.27
Rate for Payer: Healthfirst Essential Plan	$646.37
Rate for Payer: Healthfirst Medicare Advantage	$166.86
Rate for Payer: Healthfirst QHP	$468.26
Rate for Payer: Humana Medicare	$200.24
Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid	$287.27
Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa)	$646.37
Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa)	$646.37
Rate for Payer: Optum Medicaid	$1.24
Rate for Payer: Senior Whole Health Medicare Advantage	$196.31
Rate for Payer: SOMOS CHP/HARP/Medicaid	$287.27
Rate for Payer: SOMOS Essential	$646.37
Rate for Payer: United Healthcare Essential Plan 1&2	$646.37
Rate for Payer: United Healthcare Essential Plan 3&4	$316.00
Rate for Payer: United Healthcare Medicaid	$287.27
Rate for Payer: United Healthcare Medicare Advantage	$196.31
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$196.31
Rate for Payer: Wellcare CHP/FHP/Medicaid	$287.27
Rate for Payer: Wellcare Medicare	$186.49

HC FAMILY PSYCHOTHERAPY W PHYS

Facility

$397.00

Service Code	CPT 90847
Hospital Charge Code	9169084701
Hospital Revenue Code	916
Min. Negotiated Rate	$198.50
Max. Negotiated Rate	$198.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$198.50

HC FANCC GENE ANALYSIS - FANCONI ANEMIA C

Facility

$91.00

Service Code	CPT 81242
Hospital Charge Code	3108124201
Hospital Revenue Code	310
Min. Negotiated Rate	$25.63
Max. Negotiated Rate	$72.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$50.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$36.62
Rate for Payer: Aetna Government	$36.62
Rate for Payer: Affinity Essential Plan 1&2	$25.63
Rate for Payer: Affinity Essential Plan 3&4	$25.63
Rate for Payer: Affinity Medicaid/CHP/HARP	$25.63
Rate for Payer: Brighton Health Commercial	$36.62
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$36.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$72.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$61.88
Rate for Payer: Elderplan Medicare Advantage	$36.62
Rate for Payer: EmblemHealth Commercial	$36.62
Rate for Payer: Fidelis CHP/HARP/Medicaid	$32.96
Rate for Payer: Fidelis Essential Plan Aliesa	$31.13
Rate for Payer: Fidelis Essential Plan QHP	$32.59
Rate for Payer: Fidelis Medicare Advantage	$36.62
Rate for Payer: Fidelis Qualified Health Plan	$32.59
Rate for Payer: Group Health Inc Commercial	$36.62
Rate for Payer: Group Health Inc Medicare	$36.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$36.62
Rate for Payer: Hamaspik Choice Inc Medicare	$36.62
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$36.62
Rate for Payer: Healthfirst Medicare Advantage	$36.62
Rate for Payer: Healthfirst QHP	$36.62
Rate for Payer: Humana Medicare	$37.35
Rate for Payer: Senior Whole Health Medicare Advantage	$36.62
Rate for Payer: United Healthcare Medicare Advantage	$36.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$36.62
Rate for Payer: Wellcare CHP/FHP/Medicaid	$34.79
Rate for Payer: Wellcare Medicare	$32.96

HC FANCC GENE ANALYSIS - FANCONI ANEMIA C

Facility

$91.00

Service Code	CPT 81242
Hospital Charge Code	3108124201
Hospital Revenue Code	310
Min. Negotiated Rate	$45.50
Max. Negotiated Rate	$45.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$45.50

HC FASCIOTOMY, PALMAR, PERCUTANEOUS

Facility

$4,220.00

Service Code	CPT 26040
Hospital Charge Code	3612604001
Hospital Revenue Code	361
Min. Negotiated Rate	$382.49
Max. Negotiated Rate	$3,165.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
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	$3,165.00
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	$382.49
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	$1,409.00
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

HC FASCIOTOMY, PALMAR, PERCUTANEOUS

Facility

$4,220.00

Service Code	CPT 26040
Hospital Charge Code	3612604001
Hospital Revenue Code	361
Min. Negotiated Rate	$2,110.00
Max. Negotiated Rate	$2,110.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,110.00

HC FATS/LIPIDS, FECES, QUALITATIVE - FECAL FAT QUALITATIVE

Facility

$12.00

Service Code	CPT 82705
Hospital Charge Code	3018270501
Hospital Revenue Code	301
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$11.47
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.10
Rate for Payer: Aetna Government	$5.10
Rate for Payer: Affinity Essential Plan 1&2	$3.57
Rate for Payer: Affinity Essential Plan 3&4	$3.57
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.57
Rate for Payer: Brighton Health Commercial	$9.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.28
Rate for Payer: Elderplan Medicare Advantage	$5.10
Rate for Payer: EmblemHealth Commercial	$5.10
Rate for Payer: Fidelis CHP/HARP/Medicaid	$4.59
Rate for Payer: Fidelis Essential Plan Aliesa	$4.33
Rate for Payer: Fidelis Essential Plan QHP	$4.54
Rate for Payer: Fidelis Medicare Advantage	$5.10
Rate for Payer: Fidelis Qualified Health Plan	$4.54
Rate for Payer: Group Health Inc Commercial	$5.10
Rate for Payer: Group Health Inc Medicare	$5.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.10
Rate for Payer: Hamaspik Choice Inc Medicare	$5.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.10
Rate for Payer: Healthfirst Essential Plan	$11.47
Rate for Payer: Healthfirst Medicare Advantage	$5.10
Rate for Payer: Healthfirst QHP	$5.10
Rate for Payer: Humana Medicare	$5.20
Rate for Payer: Senior Whole Health Medicare Advantage	$5.10
Rate for Payer: United Healthcare Commercial	$6.44
Rate for Payer: United Healthcare Medicare Advantage	$5.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.10
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.10
Rate for Payer: Wellcare Medicare	$4.59

HC FATS/LIPIDS, FECES, QUALITATIVE - FECAL FAT QUALITATIVE

Facility

$12.00

Service Code	CPT 82705
Hospital Charge Code	3018270501
Hospital Revenue Code	301
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.00

HC FATS/LIPIDS, FECES, QUANTITATIVE - FECAL FAT QUANTITATIVE

Facility

$42.00

Service Code	CPT 82710
Hospital Charge Code	3018271001
Hospital Revenue Code	301
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.00

Know your out-of-pocket cost for care.

All Charges