St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

COMPRESS LER LEG BIL

Facility

$405.08

Service Code	HCPCS 29581 50
Hospital Charge Code	42500170
Hospital Revenue Code	761
Rate for Payer: Cash Price	$182.22

COMPR MED SERVC/15 MIN

Facility

$250.63

Service Code	HCPCS H2010
Hospital Charge Code	30303120
Hospital Revenue Code	911
Min. Negotiated Rate	$37.85
Max. Negotiated Rate	$8,705.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$137.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.85
Rate for Payer: Aetna Government	$37.85
Rate for Payer: Affinity Essential Plan 1&2	$195.86
Rate for Payer: Affinity Essential Plan 3&4	$195.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$87.05
Rate for Payer: Amida Care Medicaid	$87.05
Rate for Payer: Brighton Health Commercial	$187.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$170.43
Rate for Payer: Fidelis CHP/HARP/Medicaid	$8,705.00
Rate for Payer: Fidelis Essential Plan Aliesa	$87.05
Rate for Payer: Fidelis Essential Plan QHP	$87.05
Rate for Payer: Fidelis Qualified Health Plan	$91.40
Rate for Payer: Group Health Inc Commercial	$125.32
Rate for Payer: Group Health Inc Medicare	$87.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.05
Rate for Payer: Hamaspik Choice Inc Medicare	$125.32
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$87.05
Rate for Payer: Healthfirst Essential Plan	$195.86
Rate for Payer: Healthfirst QHP	$87.05
Rate for Payer: SOMOS CHP/HARP/Medicaid	$87.05
Rate for Payer: SOMOS Essential	$195.86
Rate for Payer: United Healthcare Essential Plan 1&2	$195.86
Rate for Payer: United Healthcare Essential Plan 3&4	$95.76
Rate for Payer: United Healthcare Medicaid	$87.05
Rate for Payer: Wellcare CHP/FHP/Medicaid	$87.05

COMPR MED SERVC/15 MIN

Facility

$250.36

Service Code	HCPCS H2010
Hospital Charge Code	30400079
Hospital Revenue Code	905
Min. Negotiated Rate	$37.85
Max. Negotiated Rate	$8,705.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$137.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.85
Rate for Payer: Aetna Government	$37.85
Rate for Payer: Affinity Essential Plan 1&2	$195.86
Rate for Payer: Affinity Essential Plan 3&4	$195.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$87.05
Rate for Payer: Amida Care Medicaid	$87.05
Rate for Payer: Brighton Health Commercial	$187.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$200.29
Rate for Payer: Cigna LocalPlus Benefit Plan	$170.24
Rate for Payer: Fidelis CHP/HARP/Medicaid	$8,705.00
Rate for Payer: Fidelis Essential Plan Aliesa	$87.05
Rate for Payer: Fidelis Essential Plan QHP	$87.05
Rate for Payer: Fidelis Qualified Health Plan	$91.40
Rate for Payer: Group Health Inc Commercial	$125.18
Rate for Payer: Group Health Inc Medicare	$87.63
Rate for Payer: Hamaspik Choice Inc Medicaid	$87.05
Rate for Payer: Hamaspik Choice Inc Medicare	$125.18
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$87.05
Rate for Payer: Healthfirst Essential Plan	$195.86
Rate for Payer: Healthfirst QHP	$87.05
Rate for Payer: Optum Commercial/Medicare	$143.00
Rate for Payer: SOMOS CHP/HARP/Medicaid	$87.05
Rate for Payer: SOMOS Essential	$195.86
Rate for Payer: United Healthcare Essential Plan 1&2	$195.86
Rate for Payer: United Healthcare Essential Plan 3&4	$95.76
Rate for Payer: United Healthcare Medicaid	$87.05
Rate for Payer: Wellcare CHP/FHP/Medicaid	$87.05

COMP STD PATEL 28X8.0MM

Facility

$1,412.00

Service Code	HCPCS C1776
Hospital Charge Code	40204055
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$1,482.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$776.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$847.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$706.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$811.90
Rate for Payer: EmblemHealth Commercial	$706.00
Rate for Payer: Fidelis Medicare Advantage	$1,482.60
Rate for Payer: Group Health Inc Commercial	$706.00
Rate for Payer: Group Health Inc Medicare	$494.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$706.00
Rate for Payer: Hamaspik Choice Inc Medicare	$706.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$917.80

COMP STD PATEL 28X8.0MM

Facility

$1,412.00

Service Code	HCPCS C1776
Hospital Charge Code	40204055
Hospital Revenue Code	278
Min. Negotiated Rate	$706.00
Max. Negotiated Rate	$706.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$706.00
Rate for Payer: Hamaspik Choice Inc Medicare	$706.00

COMP TIB COMPLETE KNEE SZ 6

Facility

$4,550.90

Service Code	HCPCS C1776
Hospital Charge Code	40205065
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,778.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,503.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,730.54
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,275.45
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,616.77
Rate for Payer: EmblemHealth Commercial	$2,275.45
Rate for Payer: Fidelis Medicare Advantage	$4,778.44
Rate for Payer: Group Health Inc Commercial	$2,275.45
Rate for Payer: Group Health Inc Medicare	$1,592.82
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,275.45
Rate for Payer: Hamaspik Choice Inc Medicare	$2,275.45
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,958.08

COMP TIB COMPLETE KNEE SZ 6

Facility

$4,550.90

Service Code	HCPCS C1776
Hospital Charge Code	40205065
Hospital Revenue Code	278
Min. Negotiated Rate	$2,275.45
Max. Negotiated Rate	$2,275.45
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,275.45
Rate for Payer: Hamaspik Choice Inc Medicare	$2,275.45

COMP TIB CRU RET LT/RT 66MM

Facility

$5,391.13

Service Code	HCPCS C1713
Hospital Charge Code	64901473
Hospital Revenue Code	278
Min. Negotiated Rate	$2,695.56
Max. Negotiated Rate	$2,695.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,695.56
Rate for Payer: Hamaspik Choice Inc Medicare	$2,695.56

COMP TIB CRU RET LT/RT 66MM

Facility

$5,391.13

Service Code	HCPCS C1713
Hospital Charge Code	64901473
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$5,660.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,965.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,234.68
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,695.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,099.90
Rate for Payer: EmblemHealth Commercial	$2,695.56
Rate for Payer: Fidelis Medicare Advantage	$5,660.69
Rate for Payer: Group Health Inc Commercial	$2,695.56
Rate for Payer: Group Health Inc Medicare	$1,886.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,695.56
Rate for Payer: Hamaspik Choice Inc Medicare	$2,695.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$3,504.23

COMP TIB CRU RET SZ5 10MM

Facility

$9,710.00

Service Code	HCPCS C1776
Hospital Charge Code	64901476
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$10,195.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,340.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
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 TIB CRU RET SZ5 10MM

Facility

$9,710.00

Service Code	HCPCS C1776
Hospital Charge Code	64901476
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

COMPUTERIZED CORNEAL TOPOGRAPHY

Facility

$171.35

Service Code	HCPCS 92025
Hospital Charge Code	30302053
Hospital Revenue Code	510
Rate for Payer: Cash Price	$70.74

COMPUTERIZED CORNEAL TOPOGRAPHY

Facility

$171.35

Service Code	HCPCS 92025
Hospital Charge Code	30302053
Hospital Revenue Code	510
Min. Negotiated Rate	$49.52
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$94.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$70.74
Rate for Payer: Aetna Government	$70.74
Rate for Payer: Affinity Essential Plan 1&2	$49.52
Rate for Payer: Affinity Essential Plan 3&4	$49.52
Rate for Payer: Affinity Medicaid/CHP/HARP	$49.52
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Cash Price	$70.74
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$70.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Elderplan Medicare Advantage	$70.74
Rate for Payer: Fidelis Essential Plan Aliesa	$60.13
Rate for Payer: Fidelis Essential Plan QHP	$62.96
Rate for Payer: Fidelis Medicare Advantage	$70.74
Rate for Payer: Fidelis Qualified Health Plan	$62.96
Rate for Payer: Group Health Inc Commercial	$250.00
Rate for Payer: Group Health Inc Medicare	$250.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$85.68
Rate for Payer: Hamaspik Choice Inc Medicare	$70.74
Rate for Payer: Healthfirst Medicare Advantage	$60.13
Rate for Payer: Healthfirst QHP	$70.74
Rate for Payer: Humana Medicare	$72.15
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$70.74
Rate for Payer: Senior Whole Health Medicare Advantage	$70.74
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$70.74
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$70.74
Rate for Payer: Wellcare CHP/FHP/Medicaid	$56.59
Rate for Payer: Wellcare Medicare	$67.20

COMP VANGUARD FEMORAL CR

Facility

$6,570.00

Service Code	HCPCS C1713
Hospital Charge Code	40204050
Hospital Revenue Code	278
Min. Negotiated Rate	$3,285.00
Max. Negotiated Rate	$3,285.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,285.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,285.00

COMP VANGUARD FEMORAL CR

Facility

$6,570.00

Service Code	HCPCS C1713
Hospital Charge Code	40204050
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$6,898.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,613.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$3,942.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,285.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,777.75
Rate for Payer: EmblemHealth Commercial	$3,285.00
Rate for Payer: Fidelis Medicare Advantage	$6,898.50
Rate for Payer: Group Health Inc Commercial	$3,285.00
Rate for Payer: Group Health Inc Medicare	$2,299.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,285.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,285.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,270.50

COMP VANGUARD TIB BEAR 12X7MM

Facility

$2,298.00

Service Code	HCPCS C1776
Hospital Charge Code	40204052
Hospital Revenue Code	278
Min. Negotiated Rate	$1,149.00
Max. Negotiated Rate	$1,149.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,149.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,149.00

COMP VANGUARD TIB BEAR 12X7MM

Facility

$2,298.00

Service Code	HCPCS C1776
Hospital Charge Code	40204052
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,412.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,263.90
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,378.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,149.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,321.35
Rate for Payer: EmblemHealth Commercial	$1,149.00
Rate for Payer: Fidelis Medicare Advantage	$2,412.90
Rate for Payer: Group Health Inc Commercial	$1,149.00
Rate for Payer: Group Health Inc Medicare	$804.30
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,149.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,149.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,493.70

CONCAVE REAMER -018

Facility

$1,852.00

Hospital Charge Code	40005916
Hospital Revenue Code	272
Min. Negotiated Rate	$648.20
Max. Negotiated Rate	$1,481.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,018.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$926.00
Rate for Payer: Aetna Government	$926.00
Rate for Payer: Brighton Health Commercial	$1,389.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,481.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,259.36
Rate for Payer: Group Health Inc Commercial	$926.00
Rate for Payer: Group Health Inc Medicare	$648.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$926.00
Rate for Payer: Hamaspik Choice Inc Medicare	$926.00

CONCAVE REAMER -020

Facility

$1,852.00

Hospital Charge Code	40005917
Hospital Revenue Code	272
Min. Negotiated Rate	$648.20
Max. Negotiated Rate	$1,481.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,018.60
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$926.00
Rate for Payer: Aetna Government	$926.00
Rate for Payer: Brighton Health Commercial	$1,389.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,481.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,259.36
Rate for Payer: Group Health Inc Commercial	$926.00
Rate for Payer: Group Health Inc Medicare	$648.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$926.00
Rate for Payer: Hamaspik Choice Inc Medicare	$926.00

CONCENTRATE ACID 1020

Facility

$0.30

Hospital Charge Code	40209469
Hospital Revenue Code	270
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.15
Rate for Payer: Aetna Government	$0.15
Rate for Payer: Brighton Health Commercial	$0.23
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.24
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
Rate for Payer: Group Health Inc Commercial	$0.15
Rate for Payer: Group Health Inc Medicare	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.15
Rate for Payer: Hamaspik Choice Inc Medicare	$0.15

CONCENTRATE ACID R-145-4 2.5CA

Facility

$9.29

Hospital Charge Code	64902303
Hospital Revenue Code	270
Min. Negotiated Rate	$3.25
Max. Negotiated Rate	$7.43
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.64
Rate for Payer: Aetna Government	$4.64
Rate for Payer: Brighton Health Commercial	$6.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.32
Rate for Payer: Group Health Inc Commercial	$4.64
Rate for Payer: Group Health Inc Medicare	$3.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.64
Rate for Payer: Hamaspik Choice Inc Medicare	$4.64

CONCHA COLUMN SHELFPAK, PED

Facility

$20.64

Hospital Charge Code	64901753
Hospital Revenue Code	270
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$16.51
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.32
Rate for Payer: Aetna Government	$10.32
Rate for Payer: Brighton Health Commercial	$15.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$16.51
Rate for Payer: Cigna LocalPlus Benefit Plan	$14.04
Rate for Payer: Group Health Inc Commercial	$10.32
Rate for Payer: Group Health Inc Medicare	$7.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.32
Rate for Payer: Hamaspik Choice Inc Medicare	$10.32

CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES

Facility

$215,447.76

Service Code	MSDRG 212
Min. Negotiated Rate	$72,860.52
Max. Negotiated Rate	$215,447.76
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$158,813.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$156,689.28
Rate for Payer: Aetna Government	$156,689.28
Rate for Payer: Brighton Health Commercial	$156,175.15
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$159,823.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$185,999.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$153,494.54
Rate for Payer: Elderplan Medicare Advantage	$148,854.82
Rate for Payer: EmblemHealth Commercial	$92,358.80
Rate for Payer: Fidelis Medicare Advantage	$156,689.28
Rate for Payer: Group Health Inc Commercial	$156,689.28
Rate for Payer: Group Health Inc Medicare	$156,689.28
Rate for Payer: Hamaspik Choice Inc Medicare	$156,689.28
Rate for Payer: Healthfirst Medicare Advantage	$72,860.52
Rate for Payer: Humana Medicare	$215,447.76
Rate for Payer: Senior Whole Health Medicare Advantage	$156,689.28
Rate for Payer: United Healthcare Commercial	$214,196.91
Rate for Payer: United Healthcare Medicare Advantage	$156,689.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$156,689.28
Rate for Payer: Wellcare Medicare	$148,854.82

CONCURRENT IV INFUSION

Facility

$71.45

Service Code	HCPCS 96368
Hospital Charge Code	40509895
Hospital Revenue Code	260
Min. Negotiated Rate	$18.06
Max. Negotiated Rate	$76.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.06
Rate for Payer: Aetna Government	$18.06
Rate for Payer: Brighton Health Commercial	$53.59
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$57.16
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.59
Rate for Payer: Group Health Inc Commercial	$35.72
Rate for Payer: Group Health Inc Medicare	$25.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.72
Rate for Payer: Hamaspik Choice Inc Medicare	$35.72
Rate for Payer: United Healthcare Commercial	$76.00

CONCUSSION WITH CC

Facility

$32,001.68

Service Code	MSDRG 089
Min. Negotiated Rate	$9,860.39
Max. Negotiated Rate	$32,001.68
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$16,955.28
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$23,273.95
Rate for Payer: Aetna Government	$23,273.95
Rate for Payer: Brighton Health Commercial	$16,673.55
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$23,739.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19,857.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$16,387.36
Rate for Payer: Elderplan Medicare Advantage	$22,110.25
Rate for Payer: EmblemHealth Commercial	$9,860.39
Rate for Payer: Fidelis Medicare Advantage	$23,273.95
Rate for Payer: Group Health Inc Commercial	$23,273.95
Rate for Payer: Group Health Inc Medicare	$23,273.95
Rate for Payer: Hamaspik Choice Inc Medicare	$23,273.95
Rate for Payer: Healthfirst Medicare Advantage	$10,822.39
Rate for Payer: Humana Medicare	$32,001.68
Rate for Payer: Senior Whole Health Medicare Advantage	$23,273.95
Rate for Payer: United Healthcare Commercial	$22,868.06
Rate for Payer: United Healthcare Medicare Advantage	$23,273.95
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$23,273.95
Rate for Payer: Wellcare Medicare	$22,110.25

Know your out-of-pocket cost for care.

All Charges