St. Barnabas Hospital

All Charges

Charge

Type

Price

DNA AB (DS) CRITHIDIA W/RFX

Facility OP

$30.13

Service Code	HCPCS 86255
Hospital Charge Code	40728095
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$19.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16.57
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.05
Rate for Payer: Aetna Government	$12.05
Rate for Payer: Cash Price	$12.05
Rate for Payer: Cash Price	$12.05
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.20
Rate for Payer: Elderplan Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$12.05
Rate for Payer: Fidelis CHP/HARP/Medicaid	$10.84
Rate for Payer: Fidelis Essential Plan Aliesa	$10.24
Rate for Payer: Fidelis Essential Plan QHP	$10.72
Rate for Payer: Fidelis Medicare Advantage	$12.05
Rate for Payer: Fidelis Qualified Health Plan	$10.72
Rate for Payer: Group Health Inc Commercial	$12.05
Rate for Payer: Group Health Inc Medicare	$12.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.06
Rate for Payer: Hamaspik Choice Inc Medicare	$12.05
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$12.05
Rate for Payer: Healthfirst Medicare Advantage	$12.05
Rate for Payer: Healthfirst QHP	$12.05
Rate for Payer: Senior Whole Health Medicare Advantage	$12.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.05
Rate for Payer: Wellcare CHP/FHP/Medicaid	$9.64
Rate for Payer: Wellcare Medicare	$10.84

DNA/RNA AMPLIFIED PROB

Facility OP

$87.73

Service Code	HCPCS 87150
Hospital Charge Code	40614325
Hospital Revenue Code	300
Min. Negotiated Rate	$28.07
Max. Negotiated Rate	$55.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$48.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.09
Rate for Payer: Aetna Government	$35.09
Rate for Payer: Cash Price	$35.09
Rate for Payer: Cash Price	$35.09
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$35.09
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.20
Rate for Payer: Elderplan Medicare Advantage	$35.09
Rate for Payer: EmblemHealth Commercial	$35.09
Rate for Payer: Fidelis CHP/HARP/Medicaid	$31.58
Rate for Payer: Fidelis Essential Plan Aliesa	$29.83
Rate for Payer: Fidelis Essential Plan QHP	$31.23
Rate for Payer: Fidelis Medicare Advantage	$35.09
Rate for Payer: Fidelis Qualified Health Plan	$31.23
Rate for Payer: Group Health Inc Commercial	$35.09
Rate for Payer: Group Health Inc Medicare	$35.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$43.86
Rate for Payer: Hamaspik Choice Inc Medicare	$35.09
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35.09
Rate for Payer: Healthfirst Medicare Advantage	$35.09
Rate for Payer: Healthfirst QHP	$35.09
Rate for Payer: Senior Whole Health Medicare Advantage	$35.09
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$35.09
Rate for Payer: Wellcare CHP/FHP/Medicaid	$28.07
Rate for Payer: Wellcare Medicare	$31.58

DOBUTAMINE 1000 MG/D5W INFUSION 250 ML P

Facility IP

$13.80

Service Code	HCPCS J1250
Hospital Charge Code	41642290
Hospital Revenue Code	636
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.90
Rate for Payer: Hamaspik Choice Inc Medicare	$6.90

DOBUTAMINE 1000 MG/D5W INFUSION 250 ML P

Facility OP

$13.80

Service Code	HCPCS J1250
Hospital Charge Code	41642290
Hospital Revenue Code	636
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$9.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.94
Rate for Payer: Group Health Inc Commercial	$6.90
Rate for Payer: Group Health Inc Medicare	$4.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.90
Rate for Payer: Hamaspik Choice Inc Medicare	$6.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9.82
Rate for Payer: SOMOS Essential	$9.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.97

DOBUTAMINE 1000 MG/D5W INFUSION 250 ML P

Facility IP

$13.80

Service Code	HCPCS J1250
Hospital Charge Code	41652290
Hospital Revenue Code	636
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$6.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.90
Rate for Payer: Hamaspik Choice Inc Medicare	$6.90

DOBUTAMINE 1000 MG/D5W INFUSION 250 ML P

Facility OP

$13.80

Service Code	HCPCS J1250
Hospital Charge Code	41652290
Hospital Revenue Code	636
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$9.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.59
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6.90
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.94
Rate for Payer: Group Health Inc Commercial	$6.90
Rate for Payer: Group Health Inc Medicare	$4.83
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.90
Rate for Payer: Hamaspik Choice Inc Medicare	$6.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9.82
Rate for Payer: SOMOS Essential	$9.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.97

DOBUTAMINE 12.5 MG/ML INJ

Facility OP

$6.14

Service Code	HCPCS J1250
Hospital Charge Code	41654410
Hospital Revenue Code	636
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$9.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.53
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.94
Rate for Payer: Group Health Inc Commercial	$3.07
Rate for Payer: Group Health Inc Medicare	$2.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.07
Rate for Payer: Hamaspik Choice Inc Medicare	$3.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9.82
Rate for Payer: SOMOS Essential	$9.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.99

DOBUTAMINE 12.5 MG/ML INJ

Facility OP

$6.14

Service Code	HCPCS J1250
Hospital Charge Code	41644410
Hospital Revenue Code	636
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$9.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.53
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.94
Rate for Payer: Group Health Inc Commercial	$3.07
Rate for Payer: Group Health Inc Medicare	$2.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.07
Rate for Payer: Hamaspik Choice Inc Medicare	$3.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9.82
Rate for Payer: SOMOS Essential	$9.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3.99

DOBUTAMINE 12.5 MG/ML INJ

Facility IP

$6.14

Service Code	HCPCS J1250
Hospital Charge Code	41654410
Hospital Revenue Code	636
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$3.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.07
Rate for Payer: Hamaspik Choice Inc Medicare	$3.07

DOBUTAMINE 12.5 MG/ML INJ

Facility IP

$6.14

Service Code	HCPCS J1250
Hospital Charge Code	41644410
Hospital Revenue Code	636
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$3.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.07
Rate for Payer: Hamaspik Choice Inc Medicare	$3.07

DOBUTAMINE 250 MG/D5W 250 ML PREMIX INFU

Facility IP

$8.79

Service Code	HCPCS J1250
Hospital Charge Code	41644675
Hospital Revenue Code	636
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$4.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.40
Rate for Payer: Hamaspik Choice Inc Medicare	$4.40

DOBUTAMINE 250 MG/D5W 250 ML PREMIX INFU

Facility OP

$8.79

Service Code	HCPCS J1250
Hospital Charge Code	41644675
Hospital Revenue Code	636
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$9.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.05
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.94
Rate for Payer: Group Health Inc Commercial	$4.40
Rate for Payer: Group Health Inc Medicare	$3.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.40
Rate for Payer: Hamaspik Choice Inc Medicare	$4.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9.82
Rate for Payer: SOMOS Essential	$9.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.71

DOBUTAMINE 250 MG/D5W 250 ML PREMIX INFU

Facility OP

$8.79

Service Code	HCPCS J1250
Hospital Charge Code	41654675
Hospital Revenue Code	636
Min. Negotiated Rate	$3.08
Max. Negotiated Rate	$9.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.83
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.05
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.94
Rate for Payer: Group Health Inc Commercial	$4.40
Rate for Payer: Group Health Inc Medicare	$3.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.40
Rate for Payer: Hamaspik Choice Inc Medicare	$4.40
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9.82
Rate for Payer: SOMOS Essential	$9.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.71

DOBUTAMINE 250 MG/D5W 250 ML PREMIX INFU

Facility IP

$8.79

Service Code	HCPCS J1250
Hospital Charge Code	41654675
Hospital Revenue Code	636
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$4.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.40
Rate for Payer: Hamaspik Choice Inc Medicare	$4.40

DOBUTAMINE 500MG/40ML VIAL-250MG

Facility IP

$16.14

Service Code	HCPCS J1250
Hospital Charge Code	41658401
Hospital Revenue Code	636
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.07
Rate for Payer: Hamaspik Choice Inc Medicare	$8.07

DOBUTAMINE 500MG/40ML VIAL-250MG

Facility OP

$16.14

Service Code	HCPCS J1250
Hospital Charge Code	41658401
Hospital Revenue Code	636
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$10.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.94
Rate for Payer: Group Health Inc Commercial	$8.07
Rate for Payer: Group Health Inc Medicare	$5.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.07
Rate for Payer: Hamaspik Choice Inc Medicare	$8.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9.82
Rate for Payer: SOMOS Essential	$9.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.49

DOBUTAMINE 500MG/40ML VIAL-250MG

Facility OP

$16.14

Service Code	HCPCS J1250
Hospital Charge Code	41648401
Hospital Revenue Code	636
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$10.49
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.21
Rate for Payer: Aetna Government	$8.21
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.07
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.28
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.94
Rate for Payer: Group Health Inc Commercial	$8.07
Rate for Payer: Group Health Inc Medicare	$5.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.07
Rate for Payer: Hamaspik Choice Inc Medicare	$8.07
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.82
Rate for Payer: SOMOS CHP/HARP/Medicaid	$9.82
Rate for Payer: SOMOS Essential	$9.82
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.49

DOBUTAMINE 500MG/40ML VIAL-250MG

Facility IP

$16.14

Service Code	HCPCS J1250
Hospital Charge Code	41648401
Hospital Revenue Code	636
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$8.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.07
Rate for Payer: Hamaspik Choice Inc Medicare	$8.07

DOCETAXEL 20 MG/0.5 ML INJ

Facility IP

$9.33

Service Code	HCPCS J9171
Hospital Charge Code	41641739
Hospital Revenue Code	636
Min. Negotiated Rate	$4.66
Max. Negotiated Rate	$4.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.66
Rate for Payer: Hamaspik Choice Inc Medicare	$4.66

DOCETAXEL 20 MG/0.5 ML INJ

Facility OP

$9.33

Service Code	HCPCS J9171
Hospital Charge Code	41651739
Hospital Revenue Code	636
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$6.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.36
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.84
Rate for Payer: Group Health Inc Commercial	$4.66
Rate for Payer: Group Health Inc Medicare	$3.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.66
Rate for Payer: Hamaspik Choice Inc Medicare	$4.66
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.92
Rate for Payer: SOMOS Essential	$0.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.06

DOCETAXEL 20 MG/0.5 ML INJ

Facility IP

$9.33

Service Code	HCPCS J9171
Hospital Charge Code	41651739
Hospital Revenue Code	636
Min. Negotiated Rate	$4.66
Max. Negotiated Rate	$4.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.66
Rate for Payer: Hamaspik Choice Inc Medicare	$4.66

DOCETAXEL 20 MG/0.5 ML INJ

Facility OP

$9.33

Service Code	HCPCS J9171
Hospital Charge Code	41641739
Hospital Revenue Code	636
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$6.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.13
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.66
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.36
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.84
Rate for Payer: Group Health Inc Commercial	$4.66
Rate for Payer: Group Health Inc Medicare	$3.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.66
Rate for Payer: Hamaspik Choice Inc Medicare	$4.66
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.92
Rate for Payer: SOMOS Essential	$0.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.06

DOCETAXEL 80 MG/2 ML INJ

Facility IP

$9.35

Service Code	HCPCS J9171
Hospital Charge Code	41641740
Hospital Revenue Code	636
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$4.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.68
Rate for Payer: Hamaspik Choice Inc Medicare	$4.68

DOCETAXEL 80 MG/2 ML INJ

Facility OP

$9.35

Service Code	HCPCS J9171
Hospital Charge Code	41641740
Hospital Revenue Code	636
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$6.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.38
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.84
Rate for Payer: Group Health Inc Commercial	$4.68
Rate for Payer: Group Health Inc Medicare	$3.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.68
Rate for Payer: Hamaspik Choice Inc Medicare	$4.68
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.92
Rate for Payer: SOMOS Essential	$0.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.08

DOCETAXEL 80 MG/2 ML INJ

Facility OP

$9.35

Service Code	HCPCS J9171
Hospital Charge Code	41651740
Hospital Revenue Code	636
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$6.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.14
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.48
Rate for Payer: Aetna Government	$0.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.38
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.84
Rate for Payer: Group Health Inc Commercial	$4.68
Rate for Payer: Group Health Inc Medicare	$3.27
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.68
Rate for Payer: Hamaspik Choice Inc Medicare	$4.68
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$0.94
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.92
Rate for Payer: SOMOS Essential	$0.92
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.08

Price Transparency.

All Charges