St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

ACHR BINDING ABS, SERUM

Facility

$46.00

Service Code	HCPCS 83519
Hospital Charge Code	40609089
Hospital Revenue Code	300
Rate for Payer: Cash Price	$18.40

ACID ACETIC CONCENTRATE 45X

Facility

$8.28

Hospital Charge Code	64902070
Hospital Revenue Code	270
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$6.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.14
Rate for Payer: Aetna Government	$4.14
Rate for Payer: Brighton Health Commercial	$6.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.63
Rate for Payer: Group Health Inc Commercial	$4.14
Rate for Payer: Group Health Inc Medicare	$2.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.14
Rate for Payer: Hamaspik Choice Inc Medicare	$4.14

ACIDOPHILUS/CITRUS PECTIN PO TABS [134]

Facility

$0.08

Service Code	NDC 00536142401
Hospital Charge Code	00536142401
Hospital Revenue Code	250
Min. Negotiated Rate	$0.03
Max. Negotiated Rate	$0.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.04
Rate for Payer: Aetna Government	$0.04
Rate for Payer: Brighton Health Commercial	$0.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.05
Rate for Payer: Group Health Inc Commercial	$0.04
Rate for Payer: Group Health Inc Medicare	$0.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.04
Rate for Payer: Hamaspik Choice Inc Medicare	$0.04
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.05

ACL REPAIR KNEE

Facility

$18,117.83

Service Code	HCPCS 27409
Hospital Charge Code	40014305
Hospital Revenue Code	360
Rate for Payer: Cash Price	$8,273.12

ACL REPAIR KNEE

Facility

$18,117.83

Service Code	HCPCS 27409
Hospital Charge Code	40014305
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$13,588.37
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8,273.12
Rate for Payer: Aetna Government	$8,273.12
Rate for Payer: Affinity Essential Plan 1&2	$5,791.18
Rate for Payer: Affinity Essential Plan 3&4	$5,791.18
Rate for Payer: Affinity Medicaid/CHP/HARP	$5,791.18
Rate for Payer: Brighton Health Commercial	$13,588.37
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Cash Price	$8,273.12
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8,273.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$8,273.12
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$7,032.15
Rate for Payer: Fidelis Essential Plan QHP	$7,363.08
Rate for Payer: Fidelis Medicare Advantage	$8,273.12
Rate for Payer: Fidelis Qualified Health Plan	$7,363.08
Rate for Payer: Group Health Inc Commercial	$8,273.12
Rate for Payer: Group Health Inc Medicare	$8,273.12
Rate for Payer: Hamaspik Choice Inc Medicaid	$9,058.92
Rate for Payer: Hamaspik Choice Inc Medicare	$8,273.12
Rate for Payer: Healthfirst Medicare Advantage	$7,032.15
Rate for Payer: Healthfirst QHP	$8,273.12
Rate for Payer: Humana Medicare	$8,438.58
Rate for Payer: Senior Whole Health Medicare Advantage	$8,273.12
Rate for Payer: United Healthcare Commercial	$2,683.00
Rate for Payer: United Healthcare Medicare Advantage	$8,273.12
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,273.12
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6,618.50
Rate for Payer: Wellcare Medicare	$7,859.46

ACL TIGHTROPE RT

Facility

$875.00

Hospital Charge Code	64905350
Hospital Revenue Code	270
Min. Negotiated Rate	$306.25
Max. Negotiated Rate	$700.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$481.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$437.50
Rate for Payer: Aetna Government	$437.50
Rate for Payer: Brighton Health Commercial	$656.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$700.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$595.00
Rate for Payer: Group Health Inc Commercial	$437.50
Rate for Payer: Group Health Inc Medicare	$306.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$437.50
Rate for Payer: Hamaspik Choice Inc Medicare	$437.50

ACMI VACUR 12MM CURVED CURRETTE

Facility

$94.00

Hospital Charge Code	40200465
Hospital Revenue Code	270
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$75.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$51.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$47.00
Rate for Payer: Aetna Government	$47.00
Rate for Payer: Brighton Health Commercial	$70.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$63.92
Rate for Payer: Group Health Inc Commercial	$47.00
Rate for Payer: Group Health Inc Medicare	$32.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.00
Rate for Payer: Hamaspik Choice Inc Medicare	$47.00

ACMI VACUR 14MM CURVED CURRETTE

Facility

$12.00

Hospital Charge Code	40200466
Hospital Revenue Code	270
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$9.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.00
Rate for Payer: Aetna Government	$6.00
Rate for Payer: Brighton Health Commercial	$9.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.16
Rate for Payer: Group Health Inc Commercial	$6.00
Rate for Payer: Group Health Inc Medicare	$4.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.00
Rate for Payer: Hamaspik Choice Inc Medicare	$6.00

ACNE SURGERY

Facility

$529.23

Service Code	HCPCS 10040
Hospital Charge Code	42201300
Hospital Revenue Code	361
Min. Negotiated Rate	$162.06
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$231.52
Rate for Payer: Aetna Government	$231.52
Rate for Payer: Affinity Essential Plan 1&2	$162.06
Rate for Payer: Affinity Essential Plan 3&4	$162.06
Rate for Payer: Affinity Medicaid/CHP/HARP	$162.06
Rate for Payer: Brighton Health Commercial	$396.92
Rate for Payer: Cash Price	$231.52
Rate for Payer: Cash Price	$231.52
Rate for Payer: Cash Price	$231.52
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$231.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$231.52
Rate for Payer: EmblemHealth Commercial	$231.52
Rate for Payer: Fidelis Essential Plan Aliesa	$196.79
Rate for Payer: Fidelis Essential Plan QHP	$206.05
Rate for Payer: Fidelis Medicare Advantage	$231.52
Rate for Payer: Fidelis Qualified Health Plan	$206.05
Rate for Payer: Group Health Inc Commercial	$231.52
Rate for Payer: Group Health Inc Medicare	$231.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$264.62
Rate for Payer: Hamaspik Choice Inc Medicare	$231.52
Rate for Payer: Healthfirst Medicare Advantage	$196.79
Rate for Payer: Healthfirst QHP	$231.52
Rate for Payer: Humana Medicare	$236.15
Rate for Payer: Senior Whole Health Medicare Advantage	$231.52
Rate for Payer: United Healthcare Commercial	$1,113.00
Rate for Payer: United Healthcare Medicare Advantage	$231.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$231.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$185.22
Rate for Payer: Wellcare Medicare	$219.94

ACNE SURGERY

Facility

$529.23

Service Code	HCPCS 10040
Hospital Charge Code	42201300
Hospital Revenue Code	361
Rate for Payer: Cash Price	$231.52

Acne surgery (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)

Facility

$2,915.00

Service Code	CPT 10040
Hospital Revenue Code	361
Min. Negotiated Rate	$162.06
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$231.52
Rate for Payer: Aetna Government	$231.52
Rate for Payer: Affinity Essential Plan 1&2	$162.06
Rate for Payer: Affinity Essential Plan 3&4	$162.06
Rate for Payer: Affinity Medicaid/CHP/HARP	$162.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$231.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$231.52
Rate for Payer: EmblemHealth Commercial	$231.52
Rate for Payer: Fidelis Essential Plan Aliesa	$196.79
Rate for Payer: Fidelis Essential Plan QHP	$206.05
Rate for Payer: Fidelis Medicare Advantage	$231.52
Rate for Payer: Fidelis Qualified Health Plan	$206.05
Rate for Payer: Group Health Inc Commercial	$231.52
Rate for Payer: Group Health Inc Medicare	$231.52
Rate for Payer: Hamaspik Choice Inc Medicare	$231.52
Rate for Payer: Healthfirst Medicare Advantage	$196.79
Rate for Payer: Healthfirst QHP	$231.52
Rate for Payer: Humana Medicare	$236.15
Rate for Payer: Senior Whole Health Medicare Advantage	$231.52
Rate for Payer: United Healthcare Commercial	$1,113.00
Rate for Payer: United Healthcare Medicare Advantage	$231.52
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$231.52
Rate for Payer: Wellcare CHP/FHP/Medicaid	$185.22
Rate for Payer: Wellcare Medicare	$219.94

ACOUSTIC IMMITTANCE TESTING

Facility

$419.03

Service Code	HCPCS 92570
Hospital Charge Code	42003105
Hospital Revenue Code	471
Rate for Payer: Cash Price	$180.64

ACOUSTIC IMMITTANCE TESTING

Facility

$419.03

Service Code	HCPCS 92570
Hospital Charge Code	42003105
Hospital Revenue Code	471
Min. Negotiated Rate	$126.45
Max. Negotiated Rate	$335.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.64
Rate for Payer: Aetna Government	$180.64
Rate for Payer: Affinity Essential Plan 1&2	$126.45
Rate for Payer: Affinity Essential Plan 3&4	$126.45
Rate for Payer: Affinity Medicaid/CHP/HARP	$126.45
Rate for Payer: Brighton Health Commercial	$314.27
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cash Price	$180.64
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$180.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$335.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.94
Rate for Payer: Elderplan Medicare Advantage	$180.64
Rate for Payer: EmblemHealth Commercial	$180.64
Rate for Payer: Fidelis Essential Plan Aliesa	$153.54
Rate for Payer: Fidelis Essential Plan QHP	$160.77
Rate for Payer: Fidelis Medicare Advantage	$180.64
Rate for Payer: Fidelis Qualified Health Plan	$160.77
Rate for Payer: Group Health Inc Commercial	$180.64
Rate for Payer: Group Health Inc Medicare	$180.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.52
Rate for Payer: Hamaspik Choice Inc Medicare	$180.64
Rate for Payer: Healthfirst Medicare Advantage	$153.54
Rate for Payer: Healthfirst QHP	$180.64
Rate for Payer: Humana Medicare	$184.25
Rate for Payer: Senior Whole Health Medicare Advantage	$180.64
Rate for Payer: United Healthcare Commercial	$158.00
Rate for Payer: United Healthcare Medicare Advantage	$180.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$180.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$144.51
Rate for Payer: Wellcare Medicare	$171.61

ACOUSTIC REFLEX TESTING

Facility

$101.25

Service Code	HCPCS 92568
Hospital Charge Code	42003000
Hospital Revenue Code	471
Rate for Payer: Cash Price	$46.38

ACOUSTIC REFLEX TESTING

Facility

$101.25

Service Code	HCPCS 92568
Hospital Charge Code	42003000
Hospital Revenue Code	471
Min. Negotiated Rate	$32.47
Max. Negotiated Rate	$158.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$46.38
Rate for Payer: Aetna Government	$46.38
Rate for Payer: Affinity Essential Plan 1&2	$32.47
Rate for Payer: Affinity Essential Plan 3&4	$32.47
Rate for Payer: Affinity Medicaid/CHP/HARP	$32.47
Rate for Payer: Brighton Health Commercial	$75.94
Rate for Payer: Cash Price	$46.38
Rate for Payer: Cash Price	$46.38
Rate for Payer: Cash Price	$46.38
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$46.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$81.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.85
Rate for Payer: Elderplan Medicare Advantage	$46.38
Rate for Payer: EmblemHealth Commercial	$46.38
Rate for Payer: Fidelis Essential Plan Aliesa	$39.42
Rate for Payer: Fidelis Essential Plan QHP	$41.28
Rate for Payer: Fidelis Medicare Advantage	$46.38
Rate for Payer: Fidelis Qualified Health Plan	$41.28
Rate for Payer: Group Health Inc Commercial	$46.38
Rate for Payer: Group Health Inc Medicare	$46.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.62
Rate for Payer: Hamaspik Choice Inc Medicare	$46.38
Rate for Payer: Healthfirst Medicare Advantage	$39.42
Rate for Payer: Healthfirst QHP	$46.38
Rate for Payer: Humana Medicare	$47.31
Rate for Payer: Senior Whole Health Medicare Advantage	$46.38
Rate for Payer: United Healthcare Commercial	$158.00
Rate for Payer: United Healthcare Medicare Advantage	$46.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46.38
Rate for Payer: Wellcare CHP/FHP/Medicaid	$37.10
Rate for Payer: Wellcare Medicare	$44.06

ACP DISCUS/DSCN MKR DOCD

Facility

$10.00

Service Code	HCPCS 1123F
Hospital Charge Code	30306661
Hospital Revenue Code	969
Min. Negotiated Rate	$0.01
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.01
Rate for Payer: Aetna Government	$0.01
Rate for Payer: Brighton Health Commercial	$7.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Group Health Inc Commercial	$5.00
Rate for Payer: Group Health Inc Medicare	$3.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5.00

ACROMIOPLASTY SHOULDER

Facility

$8,291.05

Service Code	HCPCS 23130
Hospital Charge Code	40029801
Hospital Revenue Code	360
Min. Negotiated Rate	$1,505.00
Max. Negotiated Rate	$6,218.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,880.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3,743.15
Rate for Payer: Aetna Government	$3,743.15
Rate for Payer: Affinity Essential Plan 1&2	$2,620.20
Rate for Payer: Affinity Essential Plan 3&4	$2,620.20
Rate for Payer: Affinity Medicaid/CHP/HARP	$2,620.20
Rate for Payer: Brighton Health Commercial	$6,218.29
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Cash Price	$3,743.15
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$3,743.15
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,915.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,477.75
Rate for Payer: Elderplan Medicare Advantage	$3,743.15
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$3,181.68
Rate for Payer: Fidelis Essential Plan QHP	$3,331.40
Rate for Payer: Fidelis Medicare Advantage	$3,743.15
Rate for Payer: Fidelis Qualified Health Plan	$3,331.40
Rate for Payer: Group Health Inc Commercial	$3,743.15
Rate for Payer: Group Health Inc Medicare	$3,743.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,145.52
Rate for Payer: Hamaspik Choice Inc Medicare	$3,743.15
Rate for Payer: Healthfirst Medicare Advantage	$3,181.68
Rate for Payer: Healthfirst QHP	$3,743.15
Rate for Payer: Humana Medicare	$3,818.01
Rate for Payer: Senior Whole Health Medicare Advantage	$3,743.15
Rate for Payer: United Healthcare Commercial	$2,683.00
Rate for Payer: United Healthcare Medicare Advantage	$3,743.15
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,743.15
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,994.52
Rate for Payer: Wellcare Medicare	$3,555.99

ACROMIOPLASTY SHOULDER

Facility

$8,291.05

Service Code	HCPCS 23130
Hospital Charge Code	40029801
Hospital Revenue Code	360
Rate for Payer: Cash Price	$3,743.15

ACTBLR SHELL 52MM/POR COATED,LTDH

Facility

$3,360.00

Hospital Charge Code	40202079
Hospital Revenue Code	270
Min. Negotiated Rate	$1,176.00
Max. Negotiated Rate	$2,688.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,848.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,680.00
Rate for Payer: Aetna Government	$1,680.00
Rate for Payer: Brighton Health Commercial	$2,520.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,688.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,284.80
Rate for Payer: Group Health Inc Commercial	$1,680.00
Rate for Payer: Group Health Inc Medicare	$1,176.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,680.00

ACTBLR SHELL 54MM/POR COATED,LTDH

Facility

$3,360.00

Hospital Charge Code	40202085
Hospital Revenue Code	270
Min. Negotiated Rate	$1,176.00
Max. Negotiated Rate	$2,688.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,848.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,680.00
Rate for Payer: Aetna Government	$1,680.00
Rate for Payer: Brighton Health Commercial	$2,520.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,688.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,284.80
Rate for Payer: Group Health Inc Commercial	$1,680.00
Rate for Payer: Group Health Inc Medicare	$1,176.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,680.00

ACTBLR SHELL 58MM/PORO CTD,LTD HL

Facility

$3,360.00

Hospital Charge Code	40209409
Hospital Revenue Code	270
Min. Negotiated Rate	$1,176.00
Max. Negotiated Rate	$2,688.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,848.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,680.00
Rate for Payer: Aetna Government	$1,680.00
Rate for Payer: Brighton Health Commercial	$2,520.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,688.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,284.80
Rate for Payer: Group Health Inc Commercial	$1,680.00
Rate for Payer: Group Health Inc Medicare	$1,176.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,680.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,680.00

ACTH, PLASMA

Facility

$96.55

Service Code	HCPCS 82024
Hospital Charge Code	40609032
Hospital Revenue Code	300
Min. Negotiated Rate	$27.03
Max. Negotiated Rate	$72.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$53.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$38.62
Rate for Payer: Aetna Government	$38.62
Rate for Payer: Affinity Essential Plan 1&2	$27.03
Rate for Payer: Affinity Essential Plan 3&4	$27.03
Rate for Payer: Affinity Medicaid/CHP/HARP	$27.03
Rate for Payer: Brighton Health Commercial	$72.41
Rate for Payer: Cash Price	$38.62
Rate for Payer: Cash Price	$38.62
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$38.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$61.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.95
Rate for Payer: Elderplan Medicare Advantage	$38.62
Rate for Payer: EmblemHealth Commercial	$38.62
Rate for Payer: Fidelis Essential Plan Aliesa	$32.83
Rate for Payer: Fidelis Essential Plan QHP	$34.37
Rate for Payer: Fidelis Medicare Advantage	$38.62
Rate for Payer: Fidelis Qualified Health Plan	$34.37
Rate for Payer: Group Health Inc Commercial	$38.62
Rate for Payer: Group Health Inc Medicare	$38.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$48.28
Rate for Payer: Hamaspik Choice Inc Medicare	$38.62
Rate for Payer: Healthfirst Medicare Advantage	$38.62
Rate for Payer: Healthfirst QHP	$38.62
Rate for Payer: Humana Medicare	$39.39
Rate for Payer: Senior Whole Health Medicare Advantage	$38.62
Rate for Payer: United Healthcare Commercial	$48.92
Rate for Payer: United Healthcare Medicare Advantage	$38.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$38.62
Rate for Payer: Wellcare CHP/FHP/Medicaid	$30.90
Rate for Payer: Wellcare Medicare	$34.76

ACTH, PLASMA

Facility

$96.55

Service Code	HCPCS 82024
Hospital Charge Code	40609032
Hospital Revenue Code	300
Rate for Payer: Cash Price	$38.62

ACTIN (SMOOTH MUSCLE) ANTIBODY

Facility

$28.83

Service Code	HCPCS 83516
Hospital Charge Code	40729238
Hospital Revenue Code	300
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$21.62
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$15.86
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.53
Rate for Payer: Aetna Government	$11.53
Rate for Payer: Affinity Essential Plan 1&2	$8.07
Rate for Payer: Affinity Essential Plan 3&4	$8.07
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.07
Rate for Payer: Brighton Health Commercial	$21.62
Rate for Payer: Cash Price	$11.53
Rate for Payer: Cash Price	$11.53
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$11.53
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.52
Rate for Payer: Elderplan Medicare Advantage	$11.53
Rate for Payer: EmblemHealth Commercial	$11.53
Rate for Payer: Fidelis Essential Plan Aliesa	$9.80
Rate for Payer: Fidelis Essential Plan QHP	$10.26
Rate for Payer: Fidelis Medicare Advantage	$11.53
Rate for Payer: Fidelis Qualified Health Plan	$10.26
Rate for Payer: Group Health Inc Commercial	$11.53
Rate for Payer: Group Health Inc Medicare	$11.53
Rate for Payer: Hamaspik Choice Inc Medicaid	$14.42
Rate for Payer: Hamaspik Choice Inc Medicare	$11.53
Rate for Payer: Healthfirst Medicare Advantage	$11.53
Rate for Payer: Healthfirst QHP	$11.53
Rate for Payer: Humana Medicare	$11.76
Rate for Payer: Senior Whole Health Medicare Advantage	$11.53
Rate for Payer: United Healthcare Commercial	$14.62
Rate for Payer: United Healthcare Medicare Advantage	$11.53
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$11.53
Rate for Payer: Wellcare CHP/FHP/Medicaid	$9.22
Rate for Payer: Wellcare Medicare	$10.38

ACTIN (SMOOTH MUSCLE) ANTIBODY

Facility

$28.83

Service Code	HCPCS 83516
Hospital Charge Code	40729238
Hospital Revenue Code	300
Rate for Payer: Cash Price	$11.53

Know your out-of-pocket cost for care.

All Charges