St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

COMPLX RPR-S/A/L 2.6-7.5 CM

Facility

$1,505.35

Service Code	HCPCS 13121
Hospital Charge Code	30305946
Hospital Revenue Code	450
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$726.29
Rate for Payer: Aetna Government	$726.29
Rate for Payer: Affinity Essential Plan 1&2	$508.40
Rate for Payer: Affinity Essential Plan 3&4	$508.40
Rate for Payer: Affinity Medicaid/CHP/HARP	$508.40
Rate for Payer: Brighton Health Commercial	$874.00
Rate for Payer: Carelon Behavioral Health CHP/Medicaid	$726.29
Rate for Payer: Carelon Behavioral Health Medicare Advantage	$726.29
Rate for Payer: Cash Price	$726.29
Rate for Payer: Cash Price	$726.29
Rate for Payer: Cash Price	$726.29
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$726.29
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	$726.29
Rate for Payer: EmblemHealth Commercial	$525.00
Rate for Payer: Fidelis Essential Plan Aliesa	$617.35
Rate for Payer: Fidelis Essential Plan QHP	$646.40
Rate for Payer: Fidelis Medicare Advantage	$726.29
Rate for Payer: Fidelis Qualified Health Plan	$646.40
Rate for Payer: Group Health Inc Commercial	$525.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$752.68
Rate for Payer: Hamaspik Choice Inc Medicare	$726.29
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: Healthfirst QHP	$726.29
Rate for Payer: Humana Medicare	$740.82
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$726.29
Rate for Payer: Senior Whole Health Medicare Advantage	$726.29
Rate for Payer: United Healthcare Commercial	$569.00
Rate for Payer: United Healthcare Medicare Advantage	$726.29
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$726.29
Rate for Payer: Wellcare CHP/FHP/Medicaid	$581.03
Rate for Payer: Wellcare Medicare	$689.98

COMPLX RPR-S/A/L 2.6-7.5 CM

Facility

$1,505.35

Service Code	HCPCS 13121
Hospital Charge Code	30105946
Hospital Revenue Code	450
Rate for Payer: Cash Price	$726.29

COMPLX RPR S/A/L ADDL 5CM/>

Facility

$752.68

Service Code	HCPCS 13122
Hospital Charge Code	30105947
Hospital Revenue Code	450
Min. Negotiated Rate	$114.77
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.77
Rate for Payer: Aetna Government	$114.77
Rate for Payer: Brighton Health Commercial	$874.00
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: EmblemHealth Commercial	$525.00
Rate for Payer: Group Health Inc Commercial	$525.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$376.34
Rate for Payer: Hamaspik Choice Inc Medicare	$376.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: United Healthcare Commercial	$569.00

COMPLX RPR S/A/L ADDL 5CM/>

Facility

$752.68

Service Code	HCPCS 13122
Hospital Charge Code	30305947
Hospital Revenue Code	450
Min. Negotiated Rate	$114.77
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,412.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$114.77
Rate for Payer: Aetna Government	$114.77
Rate for Payer: Brighton Health Commercial	$874.00
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: EmblemHealth Commercial	$525.00
Rate for Payer: Group Health Inc Commercial	$525.00
Rate for Payer: Group Health Inc Medicare	$525.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$376.34
Rate for Payer: Hamaspik Choice Inc Medicare	$376.34
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$165.00
Rate for Payer: Healthfirst Medicare Advantage	$225.00
Rate for Payer: United Healthcare Commercial	$569.00

COMP. METABOLIC PANEL (14)

Facility

$26.40

Service Code	HCPCS 80053
Hospital Charge Code	40609816
Hospital Revenue Code	301
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$19.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$14.52
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.56
Rate for Payer: Aetna Government	$10.56
Rate for Payer: Affinity Essential Plan 1&2	$7.39
Rate for Payer: Affinity Essential Plan 3&4	$7.39
Rate for Payer: Affinity Medicaid/CHP/HARP	$7.39
Rate for Payer: Brighton Health Commercial	$19.80
Rate for Payer: Cash Price	$10.56
Rate for Payer: Cash Price	$10.56
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$10.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.21
Rate for Payer: Elderplan Medicare Advantage	$10.56
Rate for Payer: EmblemHealth Commercial	$10.56
Rate for Payer: Fidelis Essential Plan Aliesa	$8.98
Rate for Payer: Fidelis Essential Plan QHP	$9.40
Rate for Payer: Fidelis Medicare Advantage	$10.56
Rate for Payer: Fidelis Qualified Health Plan	$9.40
Rate for Payer: Group Health Inc Commercial	$10.56
Rate for Payer: Group Health Inc Medicare	$10.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$13.20
Rate for Payer: Hamaspik Choice Inc Medicare	$10.56
Rate for Payer: Healthfirst Medicare Advantage	$10.56
Rate for Payer: Healthfirst QHP	$10.56
Rate for Payer: Humana Medicare	$10.77
Rate for Payer: Senior Whole Health Medicare Advantage	$10.56
Rate for Payer: United Healthcare Commercial	$13.38
Rate for Payer: United Healthcare Medicare Advantage	$10.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.56
Rate for Payer: Wellcare CHP/FHP/Medicaid	$8.45
Rate for Payer: Wellcare Medicare	$9.50

COMP. METABOLIC PANEL (14)

Facility

$26.40

Service Code	HCPCS 80053
Hospital Charge Code	40609816
Hospital Revenue Code	301
Rate for Payer: Cash Price	$10.56

COMP MONO TIB SZ 7 FEM SZ C-H

Facility

$9,710.00

Service Code	HCPCS C1713
Hospital Charge Code	64901992
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$10,195.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,340.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$5,826.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,855.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,583.25
Rate for Payer: EmblemHealth Commercial	$4,855.00
Rate for Payer: Fidelis Medicare Advantage	$10,195.50
Rate for Payer: Group Health Inc Commercial	$4,855.00
Rate for Payer: Group Health Inc Medicare	$3,398.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,855.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,855.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,311.50

COMP MONO TIB SZ 7 FEM SZ C-H

Facility

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	40205072
Hospital Revenue Code	278
Min. Negotiated Rate	$3,884.00
Max. Negotiated Rate	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00

COMP MONO TIB SZ 7 FEM SZ C-H

Facility

$9,710.00

Service Code	HCPCS C1713
Hospital Charge Code	64901992
Hospital Revenue Code	278
Min. Negotiated Rate	$4,855.00
Max. Negotiated Rate	$4,855.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,855.00
Rate for Payer: Hamaspik Choice Inc Medicare	$4,855.00

COMP MONO TIB SZ 7 FEM SZ C-H

Facility

$7,768.00

Service Code	HCPCS C1776
Hospital Charge Code	40205072
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$8,156.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,272.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$4,660.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,884.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,466.60
Rate for Payer: EmblemHealth Commercial	$3,884.00
Rate for Payer: Fidelis Medicare Advantage	$8,156.40
Rate for Payer: Group Health Inc Commercial	$3,884.00
Rate for Payer: Group Health Inc Medicare	$2,718.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,884.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,884.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5,049.20

COMP NEXGEN PATELLA 29MM

Facility

$2,940.00

Service Code	HCPCS C1776
Hospital Charge Code	40205053
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,087.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,617.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,764.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,470.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,690.50
Rate for Payer: EmblemHealth Commercial	$1,470.00
Rate for Payer: Fidelis Medicare Advantage	$3,087.00
Rate for Payer: Group Health Inc Commercial	$1,470.00
Rate for Payer: Group Health Inc Medicare	$1,029.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,470.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,470.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,911.00

COMP NEXGEN PATELLA 29MM

Facility

$2,940.00

Service Code	HCPCS C1776
Hospital Charge Code	40205053
Hospital Revenue Code	278
Min. Negotiated Rate	$1,470.00
Max. Negotiated Rate	$1,470.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,470.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,470.00

COMP NEXGEN PATELLA 32MM

Facility

$2,269.50

Service Code	HCPCS C1776
Hospital Charge Code	40204057
Hospital Revenue Code	278
Min. Negotiated Rate	$1,134.75
Max. Negotiated Rate	$1,134.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,134.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,134.75

COMP NEXGEN PATELLA 32MM

Facility

$2,836.88

Service Code	HCPCS C1776
Hospital Charge Code	64901884
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,978.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,560.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,702.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,418.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,631.21
Rate for Payer: EmblemHealth Commercial	$1,418.44
Rate for Payer: Fidelis Medicare Advantage	$2,978.72
Rate for Payer: Group Health Inc Commercial	$1,418.44
Rate for Payer: Group Health Inc Medicare	$992.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,418.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,418.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,843.97

COMP NEXGEN PATELLA 32MM

Facility

$2,836.88

Service Code	HCPCS C1776
Hospital Charge Code	64901884
Hospital Revenue Code	278
Min. Negotiated Rate	$1,418.44
Max. Negotiated Rate	$1,418.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,418.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,418.44

COMP NEXGEN PATELLA 32MM

Facility

$2,269.50

Service Code	HCPCS C1776
Hospital Charge Code	40204057
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,382.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,248.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,361.70
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,134.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,304.96
Rate for Payer: EmblemHealth Commercial	$1,134.75
Rate for Payer: Fidelis Medicare Advantage	$2,382.98
Rate for Payer: Group Health Inc Commercial	$1,134.75
Rate for Payer: Group Health Inc Medicare	$794.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,134.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,134.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,475.18

COMP NEXGEN PATTELLA 35MM

Facility

$2,836.88

Service Code	HCPCS C1776
Hospital Charge Code	64902135
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,978.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,560.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,702.13
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,418.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,631.21
Rate for Payer: EmblemHealth Commercial	$1,418.44
Rate for Payer: Fidelis Medicare Advantage	$2,978.72
Rate for Payer: Group Health Inc Commercial	$1,418.44
Rate for Payer: Group Health Inc Medicare	$992.91
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,418.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,418.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,843.97

COMP NEXGEN PATTELLA 35MM

Facility

$2,836.88

Service Code	HCPCS C1776
Hospital Charge Code	64902135
Hospital Revenue Code	278
Min. Negotiated Rate	$1,418.44
Max. Negotiated Rate	$1,418.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,418.44
Rate for Payer: Hamaspik Choice Inc Medicare	$1,418.44

COMPONENT 29MM 8.0 MM CEMNT

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64905820
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$2,100.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$1,200.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,000.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,150.00
Rate for Payer: EmblemHealth Commercial	$1,000.00
Rate for Payer: Fidelis Medicare Advantage	$2,100.00
Rate for Payer: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,300.00

COMPONENT 29MM 8.0 MM CEMNT

Facility

$2,000.00

Service Code	HCPCS C1713
Hospital Charge Code	64905820
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.00
Max. Negotiated Rate	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

COMPONENT ARTC 15MM,2.5X4.5

Facility

$3,470.00

Service Code	HCPCS C1776
Hospital Charge Code	64906477
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$3,643.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,908.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,082.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,735.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,995.25
Rate for Payer: EmblemHealth Commercial	$1,735.00
Rate for Payer: Fidelis Medicare Advantage	$3,643.50
Rate for Payer: Group Health Inc Commercial	$1,735.00
Rate for Payer: Group Health Inc Medicare	$1,214.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,735.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,735.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,255.50

COMPONENT ARTC 15MM,2.5X4.5

Facility

$3,470.00

Service Code	HCPCS C1776
Hospital Charge Code	64906477
Hospital Revenue Code	278
Min. Negotiated Rate	$1,735.00
Max. Negotiated Rate	$1,735.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,735.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,735.00

COMPONENT BIPOLAR 28MM ID 44MM

Facility

$2,085.63

Service Code	HCPCS C1776
Hospital Charge Code	64903538
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

COMPONENT BIPOLAR 28MM ID 44MM

Facility

$2,085.63

Service Code	HCPCS C1776
Hospital Charge Code	64903538
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

COMPONENT BIPOLAR 28MM ID 45MM

Facility

$2,085.63

Service Code	HCPCS C1776
Hospital Charge Code	64903544
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

Know your out-of-pocket cost for care.

All Charges