St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

COCK-UP 5TH TOE W PLSTC CLOSE

Facility

$8,291.05

Service Code	HCPCS 28286
Hospital Charge Code	40029698
Hospital Revenue Code	360
Rate for Payer: Cash Price	$3,743.15

COCK-UP 5TH TOE W PLSTC CLOSE

Facility

$8,291.05

Service Code	HCPCS 28286
Hospital Charge Code	40029698
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.00
Max. Negotiated Rate	$6,218.29
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,485.00
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	$1,468.00
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

COCR 12/14 FEM HEAD 36MM )

Facility

$2,314.75

Service Code	HCPCS C1713
Hospital Charge Code	64902656
Hospital Revenue Code	278
Min. Negotiated Rate	$1,157.38
Max. Negotiated Rate	$1,157.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,157.38
Rate for Payer: Hamaspik Choice Inc Medicare	$1,157.38

COCR 12/14 FEM HEAD 36MM )

Facility

$2,314.75

Service Code	HCPCS C1713
Hospital Charge Code	64902656
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,430.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,273.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,388.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,157.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,330.98
Rate for Payer: EmblemHealth Commercial	$1,157.38
Rate for Payer: Fidelis Medicare Advantage	$2,430.49
Rate for Payer: Group Health Inc Commercial	$1,157.38
Rate for Payer: Group Health Inc Medicare	$810.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,157.38
Rate for Payer: Hamaspik Choice Inc Medicare	$1,157.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,504.59

COCR SHELL W/ LINER 28MM 47

Facility

$2,085.63

Service Code	HCPCS C1776
Hospital Charge Code	64903678
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,189.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,147.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,251.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,042.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,199.24
Rate for Payer: EmblemHealth Commercial	$1,042.82
Rate for Payer: Fidelis Medicare Advantage	$2,189.91
Rate for Payer: Group Health Inc Commercial	$1,042.82
Rate for Payer: Group Health Inc Medicare	$729.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,042.82
Rate for Payer: Hamaspik Choice Inc Medicare	$1,042.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,355.66

COCR SHELL W/ LINER 28MM 47

Facility

$2,085.63

Service Code	HCPCS C1776
Hospital Charge Code	64903678
Hospital Revenue Code	278
Min. Negotiated Rate	$1,042.82
Max. Negotiated Rate	$1,042.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,042.82
Rate for Payer: Hamaspik Choice Inc Medicare	$1,042.82

CODEINE 15 MG TAB

Facility

$0.60

Hospital Charge Code	41641377
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Brighton Health Commercial	$0.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.41
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.39

CODEINE 15 MG TAB

Facility

$0.60

Hospital Charge Code	41651377
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$0.48
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.30
Rate for Payer: Aetna Government	$0.30
Rate for Payer: Brighton Health Commercial	$0.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.48
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.41
Rate for Payer: Group Health Inc Commercial	$0.30
Rate for Payer: Group Health Inc Medicare	$0.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.30
Rate for Payer: Hamaspik Choice Inc Medicare	$0.30
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.39

CODEINE SULFATE 15 MG PO TABS [1801]

Facility

$0.86

Service Code	NDC 00054024324
Hospital Charge Code	00054024324
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.43
Rate for Payer: Aetna Government	$0.43
Rate for Payer: Brighton Health Commercial	$0.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.59
Rate for Payer: Group Health Inc Commercial	$0.43
Rate for Payer: Group Health Inc Medicare	$0.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.43
Rate for Payer: Hamaspik Choice Inc Medicare	$0.43
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.56

CO DIFFUSING CAPACITY

Facility

$173.43

Service Code	HCPCS 94729 TC
Hospital Charge Code	30301406
Hospital Revenue Code	460
Min. Negotiated Rate	$40.84
Max. Negotiated Rate	$138.74
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$95.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$40.84
Rate for Payer: Aetna Government	$40.84
Rate for Payer: Brighton Health Commercial	$130.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$138.74
Rate for Payer: Cigna LocalPlus Benefit Plan	$117.93
Rate for Payer: Group Health Inc Commercial	$86.72
Rate for Payer: Group Health Inc Medicare	$60.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$86.72
Rate for Payer: Hamaspik Choice Inc Medicare	$86.72
Rate for Payer: United Healthcare Commercial	$86.72

CODMAN BACTISEALEVD CATH SET

Facility

$1,240.00

Service Code	HCPCS C1725
Hospital Charge Code	40206257
Hospital Revenue Code	278
Min. Negotiated Rate	$620.00
Max. Negotiated Rate	$620.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$620.00
Rate for Payer: Hamaspik Choice Inc Medicare	$620.00

CODMAN BACTISEALEVD CATH SET

Facility

$1,240.00

Service Code	HCPCS C1725
Hospital Charge Code	40206257
Hospital Revenue Code	278
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$1,302.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$682.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$44.85
Rate for Payer: Aetna Government	$44.85
Rate for Payer: Brighton Health Commercial	$744.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$620.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$713.00
Rate for Payer: EmblemHealth Commercial	$620.00
Rate for Payer: Fidelis Medicare Advantage	$1,302.00
Rate for Payer: Group Health Inc Commercial	$620.00
Rate for Payer: Group Health Inc Medicare	$434.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$620.00
Rate for Payer: Hamaspik Choice Inc Medicare	$620.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$806.00

CODMAN BIPOLAR CON

Facility

$31.25

Hospital Charge Code	64905979
Hospital Revenue Code	270
Min. Negotiated Rate	$10.94
Max. Negotiated Rate	$25.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.62
Rate for Payer: Aetna Government	$15.62
Rate for Payer: Brighton Health Commercial	$23.44
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$21.25
Rate for Payer: Group Health Inc Commercial	$15.62
Rate for Payer: Group Health Inc Medicare	$10.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.62
Rate for Payer: Hamaspik Choice Inc Medicare	$15.62

COIL PUSHER 76-177 CM

Facility

$462.50

Hospital Charge Code	64903560
Hospital Revenue Code	270
Min. Negotiated Rate	$161.88
Max. Negotiated Rate	$370.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$254.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$231.25
Rate for Payer: Aetna Government	$231.25
Rate for Payer: Brighton Health Commercial	$346.88
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$370.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$314.50
Rate for Payer: Group Health Inc Commercial	$231.25
Rate for Payer: Group Health Inc Medicare	$161.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$231.25
Rate for Payer: Hamaspik Choice Inc Medicare	$231.25

COLCHICINE 0.6 MG PO TABS [1821]

Facility

$6.74

Service Code	NDC 00254200811
Hospital Charge Code	00254200811
Hospital Revenue Code	250
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$5.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.37
Rate for Payer: Aetna Government	$3.37
Rate for Payer: Brighton Health Commercial	$5.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.58
Rate for Payer: Group Health Inc Commercial	$3.37
Rate for Payer: Group Health Inc Medicare	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.37
Rate for Payer: Hamaspik Choice Inc Medicare	$3.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.38

COLCHICINE 0.6 MG PO TABS [1821]

Facility

$6.74

Service Code	NDC 00254200801
Hospital Charge Code	00254200801
Hospital Revenue Code	250
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$5.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.37
Rate for Payer: Aetna Government	$3.37
Rate for Payer: Brighton Health Commercial	$5.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.58
Rate for Payer: Group Health Inc Commercial	$3.37
Rate for Payer: Group Health Inc Medicare	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.37
Rate for Payer: Hamaspik Choice Inc Medicare	$3.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.38

COLCHICINE 0.6 MG PO TABS [1821]

Facility

$6.74

Service Code	NDC 70710135103
Hospital Charge Code	70710135103
Hospital Revenue Code	250
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$5.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.37
Rate for Payer: Aetna Government	$3.37
Rate for Payer: Brighton Health Commercial	$5.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.58
Rate for Payer: Group Health Inc Commercial	$3.37
Rate for Payer: Group Health Inc Medicare	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.37
Rate for Payer: Hamaspik Choice Inc Medicare	$3.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.38

COLCHICINE 0.6 MG PO TABS [1821]

Facility

$6.74

Service Code	NDC 43598037201
Hospital Charge Code	43598037201
Hospital Revenue Code	250
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$5.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.37
Rate for Payer: Aetna Government	$3.37
Rate for Payer: Brighton Health Commercial	$5.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.58
Rate for Payer: Group Health Inc Commercial	$3.37
Rate for Payer: Group Health Inc Medicare	$2.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.37
Rate for Payer: Hamaspik Choice Inc Medicare	$3.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.38

COLCHICINE 0.6 MG PO TABS [1821]

Facility

$7.90

Service Code	NDC 70010000201
Hospital Charge Code	70010000201
Hospital Revenue Code	250
Min. Negotiated Rate	$2.77
Max. Negotiated Rate	$6.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.95
Rate for Payer: Aetna Government	$3.95
Rate for Payer: Brighton Health Commercial	$5.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.37
Rate for Payer: Group Health Inc Commercial	$3.95
Rate for Payer: Group Health Inc Medicare	$2.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.95
Rate for Payer: Hamaspik Choice Inc Medicare	$3.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.14

COLCHICINE 0.6 MG TAB

Facility

$9.60

Hospital Charge Code	41653530
Hospital Revenue Code	250
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$7.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.80
Rate for Payer: Aetna Government	$4.80
Rate for Payer: Brighton Health Commercial	$7.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.53
Rate for Payer: Group Health Inc Commercial	$4.80
Rate for Payer: Group Health Inc Medicare	$3.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.80
Rate for Payer: Hamaspik Choice Inc Medicare	$4.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.24

COLCHICINE 0.6 MG TAB

Facility

$9.60

Hospital Charge Code	41643530
Hospital Revenue Code	250
Min. Negotiated Rate	$3.36
Max. Negotiated Rate	$7.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.80
Rate for Payer: Aetna Government	$4.80
Rate for Payer: Brighton Health Commercial	$7.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.53
Rate for Payer: Group Health Inc Commercial	$4.80
Rate for Payer: Group Health Inc Medicare	$3.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.80
Rate for Payer: Hamaspik Choice Inc Medicare	$4.80
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.24

COLD AGGLUTININS ( SEROLOGY)

Facility

$20.15

Service Code	HCPCS 86157
Hospital Charge Code	40721340
Hospital Revenue Code	300
Min. Negotiated Rate	$5.64
Max. Negotiated Rate	$15.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.06
Rate for Payer: Aetna Government	$8.06
Rate for Payer: Affinity Essential Plan 1&2	$5.64
Rate for Payer: Affinity Essential Plan 3&4	$5.64
Rate for Payer: Affinity Medicaid/CHP/HARP	$5.64
Rate for Payer: Brighton Health Commercial	$15.11
Rate for Payer: Cash Price	$8.06
Rate for Payer: Cash Price	$8.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.83
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.86
Rate for Payer: Elderplan Medicare Advantage	$8.06
Rate for Payer: EmblemHealth Commercial	$8.06
Rate for Payer: Fidelis Essential Plan Aliesa	$6.85
Rate for Payer: Fidelis Essential Plan QHP	$7.17
Rate for Payer: Fidelis Medicare Advantage	$8.06
Rate for Payer: Fidelis Qualified Health Plan	$7.17
Rate for Payer: Group Health Inc Commercial	$8.06
Rate for Payer: Group Health Inc Medicare	$8.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.08
Rate for Payer: Hamaspik Choice Inc Medicare	$8.06
Rate for Payer: Healthfirst Medicare Advantage	$8.06
Rate for Payer: Healthfirst QHP	$8.06
Rate for Payer: Humana Medicare	$8.22
Rate for Payer: Senior Whole Health Medicare Advantage	$8.06
Rate for Payer: United Healthcare Commercial	$10.22
Rate for Payer: United Healthcare Medicare Advantage	$8.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6.45
Rate for Payer: Wellcare Medicare	$7.25

COLD AGGLUTININS ( SEROLOGY)

Facility

$20.15

Service Code	HCPCS 86157
Hospital Charge Code	40721340
Hospital Revenue Code	300
Rate for Payer: Cash Price	$8.06

COLD AGGLUTININ TITER, QUANT

Facility

$20.15

Service Code	HCPCS 86157
Hospital Charge Code	40729327
Hospital Revenue Code	300
Min. Negotiated Rate	$5.64
Max. Negotiated Rate	$15.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.06
Rate for Payer: Aetna Government	$8.06
Rate for Payer: Affinity Essential Plan 1&2	$5.64
Rate for Payer: Affinity Essential Plan 3&4	$5.64
Rate for Payer: Affinity Medicaid/CHP/HARP	$5.64
Rate for Payer: Brighton Health Commercial	$15.11
Rate for Payer: Cash Price	$8.06
Rate for Payer: Cash Price	$8.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.83
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.86
Rate for Payer: Elderplan Medicare Advantage	$8.06
Rate for Payer: EmblemHealth Commercial	$8.06
Rate for Payer: Fidelis Essential Plan Aliesa	$6.85
Rate for Payer: Fidelis Essential Plan QHP	$7.17
Rate for Payer: Fidelis Medicare Advantage	$8.06
Rate for Payer: Fidelis Qualified Health Plan	$7.17
Rate for Payer: Group Health Inc Commercial	$8.06
Rate for Payer: Group Health Inc Medicare	$8.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.08
Rate for Payer: Hamaspik Choice Inc Medicare	$8.06
Rate for Payer: Healthfirst Medicare Advantage	$8.06
Rate for Payer: Healthfirst QHP	$8.06
Rate for Payer: Humana Medicare	$8.22
Rate for Payer: Senior Whole Health Medicare Advantage	$8.06
Rate for Payer: United Healthcare Commercial	$10.22
Rate for Payer: United Healthcare Medicare Advantage	$8.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6.45
Rate for Payer: Wellcare Medicare	$7.25

COLD AGGLUTININ TITER, QUANT

Facility

$20.15

Service Code	HCPCS 86157
Hospital Charge Code	40729327
Hospital Revenue Code	300
Rate for Payer: Cash Price	$8.06

Know your out-of-pocket cost for care.

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