St. Barnabas Hospital

All Charges

Charge

Type

Price

EQ,LYMPHANG,EXTREMITY ONLY, UNI

Facility OP

$1,909.65

Service Code	HCPCS 75801 TC
Hospital Charge Code	41107631
Hospital Revenue Code	320
Min. Negotiated Rate	$668.38
Max. Negotiated Rate	$1,527.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,050.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$954.82
Rate for Payer: Aetna Government	$954.82
Rate for Payer: Cash Price	$726.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,527.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,298.56
Rate for Payer: Group Health Inc Commercial	$954.82
Rate for Payer: Group Health Inc Medicare	$668.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.82
Rate for Payer: Hamaspik Choice Inc Medicare	$954.82

EQ LYMPHANGIO. EXTREM. BIL

Facility OP

$4,940.28

Service Code	HCPCS 75803 TC
Hospital Charge Code	41107488
Hospital Revenue Code	320
Min. Negotiated Rate	$1,729.10
Max. Negotiated Rate	$3,952.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,717.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,470.14
Rate for Payer: Aetna Government	$2,470.14
Rate for Payer: Cash Price	$1,852.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,952.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,359.39
Rate for Payer: Group Health Inc Commercial	$2,470.14
Rate for Payer: Group Health Inc Medicare	$1,729.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,470.14
Rate for Payer: Hamaspik Choice Inc Medicare	$2,470.14

EQ LYMPHANGIO. EXTREM. UNI

Facility OP

$1,909.65

Service Code	HCPCS 75801 TC
Hospital Charge Code	41107487
Hospital Revenue Code	320
Min. Negotiated Rate	$668.38
Max. Negotiated Rate	$1,527.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,050.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$954.82
Rate for Payer: Aetna Government	$954.82
Rate for Payer: Cash Price	$726.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,527.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,298.56
Rate for Payer: Group Health Inc Commercial	$954.82
Rate for Payer: Group Health Inc Medicare	$668.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.82
Rate for Payer: Hamaspik Choice Inc Medicare	$954.82

EQ LYMPHANGIO. PEL-ABD UNI

Facility OP

$4,940.28

Service Code	HCPCS 75805 TC
Hospital Charge Code	41102208
Hospital Revenue Code	320
Min. Negotiated Rate	$1,729.10
Max. Negotiated Rate	$3,952.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,717.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,470.14
Rate for Payer: Aetna Government	$2,470.14
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,952.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,359.39
Rate for Payer: Group Health Inc Commercial	$2,470.14
Rate for Payer: Group Health Inc Medicare	$1,729.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,470.14
Rate for Payer: Hamaspik Choice Inc Medicare	$2,470.14

EQ LYMPHANGIO. PEL/ABD UNI.

Facility OP

$4,940.28

Service Code	HCPCS 75805 TC
Hospital Charge Code	41107489
Hospital Revenue Code	320
Min. Negotiated Rate	$1,729.10
Max. Negotiated Rate	$3,952.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,717.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,470.14
Rate for Payer: Aetna Government	$2,470.14
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,952.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,359.39
Rate for Payer: Group Health Inc Commercial	$2,470.14
Rate for Payer: Group Health Inc Medicare	$1,729.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,470.14
Rate for Payer: Hamaspik Choice Inc Medicare	$2,470.14

EQ LYMPHANG, PELVIC ABD UNI

Facility OP

$4,940.28

Service Code	HCPCS 75805 TC
Hospital Charge Code	41107635
Hospital Revenue Code	320
Min. Negotiated Rate	$1,729.10
Max. Negotiated Rate	$3,952.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,717.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,470.14
Rate for Payer: Aetna Government	$2,470.14
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,952.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,359.39
Rate for Payer: Group Health Inc Commercial	$2,470.14
Rate for Payer: Group Health Inc Medicare	$1,729.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,470.14
Rate for Payer: Hamaspik Choice Inc Medicare	$2,470.14

EQ MECH REMOVAL OBSTRUCTIVE MAT

Facility OP

$705.79

Service Code	HCPCS 75901 TC
Hospital Charge Code	41561838
Hospital Revenue Code	320
Min. Negotiated Rate	$232.43
Max. Negotiated Rate	$564.63
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$388.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$352.90
Rate for Payer: Aetna Government	$352.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$564.63
Rate for Payer: Cigna LocalPlus Benefit Plan	$479.94
Rate for Payer: Fidelis CHP/HARP/Medicaid	$232.43
Rate for Payer: Group Health Inc Commercial	$352.90
Rate for Payer: Group Health Inc Medicare	$247.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.90
Rate for Payer: Hamaspik Choice Inc Medicare	$352.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$258.26

EQ NEPHROSTOMY

Facility OP

$1,685.60

Service Code	HCPCS 50430 TC
Hospital Charge Code	41102528
Hospital Revenue Code	320
Min. Negotiated Rate	$589.96
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$927.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$842.80
Rate for Payer: Aetna Government	$842.80
Rate for Payer: Cash Price	$789.96
Rate for Payer: Cash Price	$789.96
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	$842.80
Rate for Payer: Group Health Inc Medicare	$589.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$842.80
Rate for Payer: Hamaspik Choice Inc Medicare	$842.80

EQ NEPHROS. TUBE CHANGE

Facility OP

$650.40

Service Code	HCPCS 75984 TC
Hospital Charge Code	41102735
Hospital Revenue Code	320
Min. Negotiated Rate	$65.76
Max. Negotiated Rate	$520.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$357.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$325.20
Rate for Payer: Aetna Government	$325.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$520.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$442.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$65.76
Rate for Payer: Group Health Inc Commercial	$325.20
Rate for Payer: Group Health Inc Medicare	$227.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$325.20
Rate for Payer: Hamaspik Choice Inc Medicare	$325.20
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$73.07

EQ ORBITAL

Facility OP

$1,909.65

Service Code	HCPCS 75880 TC
Hospital Charge Code	41102698
Hospital Revenue Code	320
Min. Negotiated Rate	$83.84
Max. Negotiated Rate	$1,527.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,050.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$954.82
Rate for Payer: Aetna Government	$954.82
Rate for Payer: Cash Price	$726.47
Rate for Payer: Cash Price	$726.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,527.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,298.56
Rate for Payer: Fidelis CHP/HARP/Medicaid	$83.84
Rate for Payer: Group Health Inc Commercial	$954.82
Rate for Payer: Group Health Inc Medicare	$668.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.82
Rate for Payer: Hamaspik Choice Inc Medicare	$954.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$93.15

EQ OUTPT CONS. LEAST COMPLX-15MIN

Facility OP

$358.63

Service Code	HCPCS 99241 TC
Hospital Charge Code	41108609
Hospital Revenue Code	510
Min. Negotiated Rate	$173.89
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$197.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$179.32
Rate for Payer: Aetna Government	$179.32
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
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	$179.32
Rate for Payer: Hamaspik Choice Inc Medicare	$179.32

EQ OUTPT CONS. MOD COMPLX - 30MIN

Facility OP

$395.39

Service Code	HCPCS 99242 TC
Hospital Charge Code	41108610
Hospital Revenue Code	510
Min. Negotiated Rate	$173.89
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$217.46
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$197.70
Rate for Payer: Aetna Government	$197.70
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
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	$197.70
Rate for Payer: Hamaspik Choice Inc Medicare	$197.70

EQ OUTPT CONS. MOST COMPLEX-60MIN

Facility OP

$528.33

Service Code	HCPCS 99244 TC
Hospital Charge Code	41108611
Hospital Revenue Code	510
Min. Negotiated Rate	$173.89
Max. Negotiated Rate	$290.58
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$290.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$264.16
Rate for Payer: Aetna Government	$264.16
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
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	$264.16
Rate for Payer: Hamaspik Choice Inc Medicare	$264.16

EQ PELVIC

Facility OP

$13,920.70

Service Code	HCPCS 75736 TC
Hospital Charge Code	41102584
Hospital Revenue Code	320
Min. Negotiated Rate	$102.25
Max. Negotiated Rate	$11,136.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,656.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,960.35
Rate for Payer: Aetna Government	$6,960.35
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11,136.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$9,466.08
Rate for Payer: Fidelis CHP/HARP/Medicaid	$102.25
Rate for Payer: Group Health Inc Commercial	$6,960.35
Rate for Payer: Group Health Inc Medicare	$4,872.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.35
Rate for Payer: Hamaspik Choice Inc Medicare	$6,960.35
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$113.61

EQ PERC DIAL BIL STRICT W/O STENT

Facility OP

$1,116.80

Service Code	HCPCS 74363 TC
Hospital Charge Code	41107670
Hospital Revenue Code	320
Min. Negotiated Rate	$390.88
Max. Negotiated Rate	$893.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$614.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$558.40
Rate for Payer: Aetna Government	$558.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$893.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$759.42
Rate for Payer: Group Health Inc Commercial	$558.40
Rate for Payer: Group Health Inc Medicare	$390.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$558.40
Rate for Payer: Hamaspik Choice Inc Medicare	$558.40

EQ PERC DILA BIL STRICT W STENT

Facility OP

$1,116.80

Service Code	HCPCS 74363 TC
Hospital Charge Code	41107672
Hospital Revenue Code	320
Min. Negotiated Rate	$390.88
Max. Negotiated Rate	$893.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$614.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$558.40
Rate for Payer: Aetna Government	$558.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$893.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$759.42
Rate for Payer: Group Health Inc Commercial	$558.40
Rate for Payer: Group Health Inc Medicare	$390.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$558.40
Rate for Payer: Hamaspik Choice Inc Medicare	$558.40

EQ PERC. DIL. BIL W/STENT

Facility OP

$1,116.80

Service Code	HCPCS 74363 TC
Hospital Charge Code	41102719
Hospital Revenue Code	320
Min. Negotiated Rate	$390.88
Max. Negotiated Rate	$893.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$614.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$558.40
Rate for Payer: Aetna Government	$558.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$893.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$759.42
Rate for Payer: Group Health Inc Commercial	$558.40
Rate for Payer: Group Health Inc Medicare	$390.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$558.40
Rate for Payer: Hamaspik Choice Inc Medicare	$558.40

EQ PERC. DRAIN. STENT. URETE

Facility OP

$9,142.40

Service Code	HCPCS 50433 TC
Hospital Charge Code	41102530
Hospital Revenue Code	320
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$5,028.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,028.32
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,571.20
Rate for Payer: Aetna Government	$4,571.20
Rate for Payer: Cash Price	$4,031.47
Rate for Payer: Cash Price	$4,031.47
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	$4,571.20
Rate for Payer: Group Health Inc Medicare	$3,199.84
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,571.20
Rate for Payer: Hamaspik Choice Inc Medicare	$4,571.20

EQ PERC. PLACE ENTERCLYSIS

Facility OP

$697.79

Service Code	HCPCS 74355 TC
Hospital Charge Code	41102520
Hospital Revenue Code	320
Min. Negotiated Rate	$244.23
Max. Negotiated Rate	$558.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$383.78
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$348.90
Rate for Payer: Aetna Government	$348.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$558.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$474.50
Rate for Payer: Group Health Inc Commercial	$348.90
Rate for Payer: Group Health Inc Medicare	$244.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$348.90
Rate for Payer: Hamaspik Choice Inc Medicare	$348.90

EQ PERC. PLACE IVC FILTER

Facility OP

$13,920.70

Service Code	HCPCS 37191 TC
Hospital Charge Code	41102779
Hospital Revenue Code	320
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$7,656.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,656.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6,960.35
Rate for Payer: Aetna Government	$6,960.35
Rate for Payer: Cash Price	$6,354.94
Rate for Payer: Cash Price	$6,354.94
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	$6,960.35
Rate for Payer: Group Health Inc Medicare	$4,872.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.35
Rate for Payer: Hamaspik Choice Inc Medicare	$6,960.35

EQ PERC. TRANS. RETR. F.B.

Facility OP

$8,393.53

Service Code	HCPCS 37197 TC
Hospital Charge Code	41102610
Hospital Revenue Code	361
Min. Negotiated Rate	$2,477.75
Max. Negotiated Rate	$4,616.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,616.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,196.76
Rate for Payer: Aetna Government	$4,196.76
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
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	$4,196.76
Rate for Payer: Group Health Inc Medicare	$2,937.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.76
Rate for Payer: Hamaspik Choice Inc Medicare	$4,196.76

EQ PERCUTANEOUS CHOLECYSTOSTOMY

Facility OP

$453.64

Service Code	HCPCS 75989 TC
Hospital Charge Code	41547674
Hospital Revenue Code	320
Min. Negotiated Rate	$64.66
Max. Negotiated Rate	$362.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$249.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$226.82
Rate for Payer: Aetna Government	$226.82
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$362.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$308.48
Rate for Payer: Fidelis CHP/HARP/Medicaid	$64.66
Rate for Payer: Group Health Inc Commercial	$226.82
Rate for Payer: Group Health Inc Medicare	$158.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$226.82
Rate for Payer: Hamaspik Choice Inc Medicare	$226.82
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$71.84

EQ PER. DIL. BIL W/O STENT

Facility OP

$1,116.80

Service Code	HCPCS 74363 TC
Hospital Charge Code	41102717
Hospital Revenue Code	320
Min. Negotiated Rate	$390.88
Max. Negotiated Rate	$893.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$614.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$558.40
Rate for Payer: Aetna Government	$558.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$893.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$759.42
Rate for Payer: Group Health Inc Commercial	$558.40
Rate for Payer: Group Health Inc Medicare	$390.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$558.40
Rate for Payer: Hamaspik Choice Inc Medicare	$558.40

EQ PERITO, ABD PARACENTESIS

Facility OP

$1,458.58

Service Code	HCPCS 74190 TC
Hospital Charge Code	41107618
Hospital Revenue Code	320
Min. Negotiated Rate	$510.50
Max. Negotiated Rate	$1,166.86
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$802.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$729.29
Rate for Payer: Aetna Government	$729.29
Rate for Payer: Cash Price	$637.97
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,166.86
Rate for Payer: Cigna LocalPlus Benefit Plan	$991.83
Rate for Payer: Group Health Inc Commercial	$729.29
Rate for Payer: Group Health Inc Medicare	$510.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$729.29
Rate for Payer: Hamaspik Choice Inc Medicare	$729.29

EQ PORTAL VENOGRAM, W/PRESSURES

Facility OP

$8,393.53

Service Code	HCPCS 75885 TC
Hospital Charge Code	41107727
Hospital Revenue Code	320
Min. Negotiated Rate	$80.88
Max. Negotiated Rate	$6,714.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4,616.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,196.76
Rate for Payer: Aetna Government	$4,196.76
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cash Price	$3,686.08
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,714.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,707.60
Rate for Payer: Fidelis CHP/HARP/Medicaid	$80.88
Rate for Payer: Group Health Inc Commercial	$4,196.76
Rate for Payer: Group Health Inc Medicare	$2,937.74
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,196.76
Rate for Payer: Hamaspik Choice Inc Medicare	$4,196.76
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$89.87

Price Transparency.

All Charges