St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CYTOMEGALOV AMPLIF NA PROBE

Facility

$87.73

Service Code	HCPCS 87496
Hospital Charge Code	30305720
Hospital Revenue Code	306
Min. Negotiated Rate	$24.56
Max. Negotiated Rate	$65.80
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: Affinity Essential Plan 1&2	$24.56
Rate for Payer: Affinity Essential Plan 3&4	$24.56
Rate for Payer: Affinity Medicaid/CHP/HARP	$24.56
Rate for Payer: Brighton Health Commercial	$65.80
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 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 Medicare Advantage	$35.09
Rate for Payer: Healthfirst QHP	$35.09
Rate for Payer: Humana Medicare	$35.79
Rate for Payer: Senior Whole Health Medicare Advantage	$35.09
Rate for Payer: United Healthcare Commercial	$44.45
Rate for Payer: United Healthcare 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

CYTOMEGALOV AMPLIF NA PROBE

Facility

$87.73

Service Code	HCPCS 87496
Hospital Charge Code	30305720
Hospital Revenue Code	306
Rate for Payer: Cash Price	$35.09

CYTOMEGALOVIRUS (CMV) AB, IGG

Facility

$35.98

Service Code	HCPCS 86644
Hospital Charge Code	40729356
Hospital Revenue Code	300
Min. Negotiated Rate	$10.07
Max. Negotiated Rate	$26.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.39
Rate for Payer: Aetna Government	$14.39
Rate for Payer: Affinity Essential Plan 1&2	$10.07
Rate for Payer: Affinity Essential Plan 3&4	$10.07
Rate for Payer: Affinity Medicaid/CHP/HARP	$10.07
Rate for Payer: Brighton Health Commercial	$26.98
Rate for Payer: Cash Price	$14.39
Rate for Payer: Cash Price	$14.39
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$14.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.35
Rate for Payer: Elderplan Medicare Advantage	$14.39
Rate for Payer: EmblemHealth Commercial	$14.39
Rate for Payer: Fidelis Essential Plan Aliesa	$12.23
Rate for Payer: Fidelis Essential Plan QHP	$12.81
Rate for Payer: Fidelis Medicare Advantage	$14.39
Rate for Payer: Fidelis Qualified Health Plan	$12.81
Rate for Payer: Group Health Inc Commercial	$14.39
Rate for Payer: Group Health Inc Medicare	$14.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.99
Rate for Payer: Hamaspik Choice Inc Medicare	$14.39
Rate for Payer: Healthfirst Medicare Advantage	$14.39
Rate for Payer: Healthfirst QHP	$14.39
Rate for Payer: Humana Medicare	$14.68
Rate for Payer: Senior Whole Health Medicare Advantage	$14.39
Rate for Payer: United Healthcare Commercial	$18.22
Rate for Payer: United Healthcare Medicare Advantage	$14.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.39
Rate for Payer: Wellcare CHP/FHP/Medicaid	$11.51
Rate for Payer: Wellcare Medicare	$12.95

CYTOMEGALOVIRUS (CMV) AB, IGG

Facility

$35.98

Service Code	HCPCS 86644
Hospital Charge Code	40729356
Hospital Revenue Code	300
Rate for Payer: Cash Price	$14.39

CYTOMEGALOVIRUS (CMV) AB, IGM

Facility

$42.13

Service Code	HCPCS 86645
Hospital Charge Code	40729357
Hospital Revenue Code	300
Min. Negotiated Rate	$11.80
Max. Negotiated Rate	$31.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$23.17
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$16.85
Rate for Payer: Aetna Government	$16.85
Rate for Payer: Affinity Essential Plan 1&2	$11.80
Rate for Payer: Affinity Essential Plan 3&4	$11.80
Rate for Payer: Affinity Medicaid/CHP/HARP	$11.80
Rate for Payer: Brighton Health Commercial	$31.60
Rate for Payer: Cash Price	$16.85
Rate for Payer: Cash Price	$16.85
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$16.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$26.78
Rate for Payer: Cigna LocalPlus Benefit Plan	$22.66
Rate for Payer: Elderplan Medicare Advantage	$16.85
Rate for Payer: EmblemHealth Commercial	$16.85
Rate for Payer: Fidelis Essential Plan Aliesa	$14.32
Rate for Payer: Fidelis Essential Plan QHP	$15.00
Rate for Payer: Fidelis Medicare Advantage	$16.85
Rate for Payer: Fidelis Qualified Health Plan	$15.00
Rate for Payer: Group Health Inc Commercial	$16.85
Rate for Payer: Group Health Inc Medicare	$16.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$21.06
Rate for Payer: Hamaspik Choice Inc Medicare	$16.85
Rate for Payer: Healthfirst Medicare Advantage	$16.85
Rate for Payer: Healthfirst QHP	$16.85
Rate for Payer: Humana Medicare	$17.19
Rate for Payer: Senior Whole Health Medicare Advantage	$16.85
Rate for Payer: United Healthcare Commercial	$21.33
Rate for Payer: United Healthcare Medicare Advantage	$16.85
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$16.85
Rate for Payer: Wellcare CHP/FHP/Medicaid	$13.48
Rate for Payer: Wellcare Medicare	$15.16

CYTOMEGALOVIRUS (CMV) AB, IGM

Facility

$42.13

Service Code	HCPCS 86645
Hospital Charge Code	40729357
Hospital Revenue Code	300
Rate for Payer: Cash Price	$16.85

CYTOMEGALOVIRUS (CMV) CULTURE

Facility

$65.18

Service Code	HCPCS 87252
Hospital Charge Code	40619190
Hospital Revenue Code	300
Rate for Payer: Cash Price	$26.07

CYTOMEGALOVIRUS (CMV) CULTURE

Facility

$65.18

Service Code	HCPCS 87252
Hospital Charge Code	40619190
Hospital Revenue Code	300
Min. Negotiated Rate	$18.25
Max. Negotiated Rate	$48.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$35.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.07
Rate for Payer: Aetna Government	$26.07
Rate for Payer: Affinity Essential Plan 1&2	$18.25
Rate for Payer: Affinity Essential Plan 3&4	$18.25
Rate for Payer: Affinity Medicaid/CHP/HARP	$18.25
Rate for Payer: Brighton Health Commercial	$48.88
Rate for Payer: Cash Price	$26.07
Rate for Payer: Cash Price	$26.07
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$26.07
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$41.43
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.06
Rate for Payer: Elderplan Medicare Advantage	$26.07
Rate for Payer: EmblemHealth Commercial	$26.07
Rate for Payer: Fidelis Essential Plan Aliesa	$22.16
Rate for Payer: Fidelis Essential Plan QHP	$23.20
Rate for Payer: Fidelis Medicare Advantage	$26.07
Rate for Payer: Fidelis Qualified Health Plan	$23.20
Rate for Payer: Group Health Inc Commercial	$26.07
Rate for Payer: Group Health Inc Medicare	$26.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$32.59
Rate for Payer: Hamaspik Choice Inc Medicare	$26.07
Rate for Payer: Healthfirst Medicare Advantage	$26.07
Rate for Payer: Healthfirst QHP	$26.07
Rate for Payer: Humana Medicare	$26.59
Rate for Payer: Senior Whole Health Medicare Advantage	$26.07
Rate for Payer: United Healthcare Commercial	$33.01
Rate for Payer: United Healthcare Medicare Advantage	$26.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.07
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20.86
Rate for Payer: Wellcare Medicare	$23.46

CYTOMEGALOVIRUS IGG AB/CSF

Facility

$35.98

Service Code	HCPCS 86644
Hospital Charge Code	40717064
Hospital Revenue Code	300
Min. Negotiated Rate	$10.07
Max. Negotiated Rate	$26.98
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$19.79
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$14.39
Rate for Payer: Aetna Government	$14.39
Rate for Payer: Affinity Essential Plan 1&2	$10.07
Rate for Payer: Affinity Essential Plan 3&4	$10.07
Rate for Payer: Affinity Medicaid/CHP/HARP	$10.07
Rate for Payer: Brighton Health Commercial	$26.98
Rate for Payer: Cash Price	$14.39
Rate for Payer: Cash Price	$14.39
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$14.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$22.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$19.35
Rate for Payer: Elderplan Medicare Advantage	$14.39
Rate for Payer: EmblemHealth Commercial	$14.39
Rate for Payer: Fidelis Essential Plan Aliesa	$12.23
Rate for Payer: Fidelis Essential Plan QHP	$12.81
Rate for Payer: Fidelis Medicare Advantage	$14.39
Rate for Payer: Fidelis Qualified Health Plan	$12.81
Rate for Payer: Group Health Inc Commercial	$14.39
Rate for Payer: Group Health Inc Medicare	$14.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$17.99
Rate for Payer: Hamaspik Choice Inc Medicare	$14.39
Rate for Payer: Healthfirst Medicare Advantage	$14.39
Rate for Payer: Healthfirst QHP	$14.39
Rate for Payer: Humana Medicare	$14.68
Rate for Payer: Senior Whole Health Medicare Advantage	$14.39
Rate for Payer: United Healthcare Commercial	$18.22
Rate for Payer: United Healthcare Medicare Advantage	$14.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$14.39
Rate for Payer: Wellcare CHP/FHP/Medicaid	$11.51
Rate for Payer: Wellcare Medicare	$12.95

CYTOMEGALOVIRUS IGG AB/CSF

Facility

$35.98

Service Code	HCPCS 86644
Hospital Charge Code	40717064
Hospital Revenue Code	300
Rate for Payer: Cash Price	$14.39

CYTO/MOLECULAR REPORT

Facility

$58.54

Service Code	HCPCS 88291
Hospital Charge Code	30305613
Hospital Revenue Code	311
Min. Negotiated Rate	$19.57
Max. Negotiated Rate	$43.90
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$32.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$19.57
Rate for Payer: Aetna Government	$19.57
Rate for Payer: Brighton Health Commercial	$43.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$33.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.93
Rate for Payer: Group Health Inc Commercial	$29.27
Rate for Payer: Group Health Inc Medicare	$20.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$29.27
Rate for Payer: Hamaspik Choice Inc Medicare	$29.27

CYTOPATH CELL ENHANCE TECH

Facility

$149.83

Service Code	HCPCS 88112
Hospital Charge Code	40635498
Hospital Revenue Code	310
Min. Negotiated Rate	$43.86
Max. Negotiated Rate	$82.41
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$82.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.66
Rate for Payer: Aetna Government	$62.66
Rate for Payer: Affinity Essential Plan 1&2	$43.86
Rate for Payer: Affinity Essential Plan 3&4	$43.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$43.86
Rate for Payer: Brighton Health Commercial	$62.66
Rate for Payer: Cash Price	$62.66
Rate for Payer: Cash Price	$62.66
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$62.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$52.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$44.18
Rate for Payer: Elderplan Medicare Advantage	$62.66
Rate for Payer: EmblemHealth Commercial	$62.66
Rate for Payer: Fidelis Essential Plan Aliesa	$53.26
Rate for Payer: Fidelis Essential Plan QHP	$55.77
Rate for Payer: Fidelis Medicare Advantage	$62.66
Rate for Payer: Fidelis Qualified Health Plan	$55.77
Rate for Payer: Group Health Inc Commercial	$62.66
Rate for Payer: Group Health Inc Medicare	$62.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.92
Rate for Payer: Hamaspik Choice Inc Medicare	$62.66
Rate for Payer: Healthfirst Medicare Advantage	$62.66
Rate for Payer: Healthfirst QHP	$62.66
Rate for Payer: Humana Medicare	$63.91
Rate for Payer: Senior Whole Health Medicare Advantage	$62.66
Rate for Payer: United Healthcare Medicare Advantage	$62.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$62.66
Rate for Payer: Wellcare CHP/FHP/Medicaid	$50.13
Rate for Payer: Wellcare Medicare	$56.39

CYTOPATH CELL ENHANCE TECH

Facility

$149.83

Service Code	HCPCS 88112
Hospital Charge Code	40635498
Hospital Revenue Code	310
Rate for Payer: Cash Price	$62.66

CYTOPATH CONCENTRATE TECH

Facility

$101.25

Service Code	HCPCS 88108
Hospital Charge Code	40635407
Hospital Revenue Code	311
Min. Negotiated Rate	$32.47
Max. Negotiated Rate	$55.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$46.38
Rate for Payer: Aetna Government	$46.38
Rate for Payer: Affinity Essential Plan 1&2	$32.47
Rate for Payer: Affinity Essential Plan 3&4	$32.47
Rate for Payer: Affinity Medicaid/CHP/HARP	$32.47
Rate for Payer: Brighton Health Commercial	$46.38
Rate for Payer: Cash Price	$46.38
Rate for Payer: Cash Price	$46.38
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$46.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$54.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$46.11
Rate for Payer: Elderplan Medicare Advantage	$46.38
Rate for Payer: EmblemHealth Commercial	$46.38
Rate for Payer: Fidelis Essential Plan Aliesa	$39.42
Rate for Payer: Fidelis Essential Plan QHP	$41.28
Rate for Payer: Fidelis Medicare Advantage	$46.38
Rate for Payer: Fidelis Qualified Health Plan	$41.28
Rate for Payer: Group Health Inc Commercial	$46.38
Rate for Payer: Group Health Inc Medicare	$46.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.62
Rate for Payer: Hamaspik Choice Inc Medicare	$46.38
Rate for Payer: Healthfirst Medicare Advantage	$46.38
Rate for Payer: Healthfirst QHP	$46.38
Rate for Payer: Humana Medicare	$47.31
Rate for Payer: Senior Whole Health Medicare Advantage	$46.38
Rate for Payer: United Healthcare Medicare Advantage	$46.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46.38
Rate for Payer: Wellcare CHP/FHP/Medicaid	$37.10
Rate for Payer: Wellcare Medicare	$41.74

CYTOPATH CONCENTRATE TECH

Facility

$101.25

Service Code	HCPCS 88108
Hospital Charge Code	40635407
Hospital Revenue Code	311
Rate for Payer: Cash Price	$46.38

CYTOPATH C/V AUTO FLUID REDO

Facility

$104.92

Service Code	HCPCS 88175
Hospital Charge Code	40618029
Hospital Revenue Code	310
Rate for Payer: Cash Price	$26.61

CYTOPATH C/V AUTO FLUID REDO

Facility

$104.92

Service Code	HCPCS 88175
Hospital Charge Code	40618029
Hospital Revenue Code	310
Min. Negotiated Rate	$18.63
Max. Negotiated Rate	$57.71
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$26.61
Rate for Payer: Aetna Government	$26.61
Rate for Payer: Affinity Essential Plan 1&2	$18.63
Rate for Payer: Affinity Essential Plan 3&4	$18.63
Rate for Payer: Affinity Medicaid/CHP/HARP	$18.63
Rate for Payer: Brighton Health Commercial	$26.61
Rate for Payer: Cash Price	$26.61
Rate for Payer: Cash Price	$26.61
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$26.61
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$35.63
Rate for Payer: Elderplan Medicare Advantage	$26.61
Rate for Payer: EmblemHealth Commercial	$26.61
Rate for Payer: Fidelis Essential Plan Aliesa	$22.62
Rate for Payer: Fidelis Essential Plan QHP	$23.68
Rate for Payer: Fidelis Medicare Advantage	$26.61
Rate for Payer: Fidelis Qualified Health Plan	$23.68
Rate for Payer: Group Health Inc Commercial	$26.61
Rate for Payer: Group Health Inc Medicare	$26.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.46
Rate for Payer: Hamaspik Choice Inc Medicare	$26.61
Rate for Payer: Healthfirst Medicare Advantage	$26.61
Rate for Payer: Healthfirst QHP	$26.61
Rate for Payer: Humana Medicare	$27.14
Rate for Payer: Senior Whole Health Medicare Advantage	$26.61
Rate for Payer: United Healthcare Medicare Advantage	$26.61
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$26.61
Rate for Payer: Wellcare CHP/FHP/Medicaid	$21.29
Rate for Payer: Wellcare Medicare	$23.95

CYTOPATH FLUID, WASHINGS, ETC

Facility

$101.25

Service Code	HCPCS 88104 TC
Hospital Charge Code	40635466
Hospital Revenue Code	312
Rate for Payer: Cash Price	$46.38

CYTOPATH FLUID, WASHINGS, ETC

Facility

$101.25

Service Code	HCPCS 88104 TC
Hospital Charge Code	40635466
Hospital Revenue Code	312
Min. Negotiated Rate	$32.47
Max. Negotiated Rate	$55.69
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$46.38
Rate for Payer: Aetna Government	$46.38
Rate for Payer: Affinity Essential Plan 1&2	$32.47
Rate for Payer: Affinity Essential Plan 3&4	$32.47
Rate for Payer: Affinity Medicaid/CHP/HARP	$32.47
Rate for Payer: Brighton Health Commercial	$46.38
Rate for Payer: Cash Price	$46.38
Rate for Payer: Cash Price	$46.38
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$46.38
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$42.59
Rate for Payer: Cigna LocalPlus Benefit Plan	$36.04
Rate for Payer: Elderplan Medicare Advantage	$46.38
Rate for Payer: EmblemHealth Commercial	$46.38
Rate for Payer: Fidelis Essential Plan Aliesa	$39.42
Rate for Payer: Fidelis Essential Plan QHP	$41.28
Rate for Payer: Fidelis Medicare Advantage	$46.38
Rate for Payer: Fidelis Qualified Health Plan	$41.28
Rate for Payer: Group Health Inc Commercial	$46.38
Rate for Payer: Group Health Inc Medicare	$46.38
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.62
Rate for Payer: Hamaspik Choice Inc Medicare	$46.38
Rate for Payer: Healthfirst Medicare Advantage	$46.38
Rate for Payer: Healthfirst QHP	$46.38
Rate for Payer: Humana Medicare	$47.31
Rate for Payer: Senior Whole Health Medicare Advantage	$46.38
Rate for Payer: United Healthcare Medicare Advantage	$46.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46.38
Rate for Payer: Wellcare CHP/FHP/Medicaid	$37.10
Rate for Payer: Wellcare Medicare	$41.74

Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision

Facility

$2,915.00

Service Code	CPT 88174
Hospital Revenue Code	360
Min. Negotiated Rate	$17.76
Max. Negotiated Rate	$2,915.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.37
Rate for Payer: Aetna Government	$25.37
Rate for Payer: Affinity Essential Plan 1&2	$17.76
Rate for Payer: Affinity Essential Plan 3&4	$17.76
Rate for Payer: Affinity Medicaid/CHP/HARP	$17.76
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$25.37
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	$25.37
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$21.56
Rate for Payer: Fidelis Essential Plan QHP	$22.58
Rate for Payer: Fidelis Medicare Advantage	$25.37
Rate for Payer: Fidelis Qualified Health Plan	$22.58
Rate for Payer: Group Health Inc Commercial	$25.37
Rate for Payer: Group Health Inc Medicare	$25.37
Rate for Payer: Hamaspik Choice Inc Medicare	$25.37
Rate for Payer: Healthfirst Medicare Advantage	$21.56
Rate for Payer: Healthfirst QHP	$25.37
Rate for Payer: Humana Medicare	$25.88
Rate for Payer: Senior Whole Health Medicare Advantage	$25.37
Rate for Payer: United Healthcare Medicare Advantage	$25.37
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$25.37
Rate for Payer: Wellcare CHP/FHP/Medicaid	$20.30
Rate for Payer: Wellcare Medicare	$24.10

CYTOPATH SMEAR OTHER SOURCE

Facility

$69.63

Service Code	HCPCS 88161
Hospital Charge Code	40635408
Hospital Revenue Code	311
Rate for Payer: Cash Price	$34.43

CYTOPATH SMEAR OTHER SOURCE

Facility

$69.63

Service Code	HCPCS 88161
Hospital Charge Code	40635408
Hospital Revenue Code	311
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$38.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.30
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.43
Rate for Payer: Aetna Government	$34.43
Rate for Payer: Affinity Essential Plan 1&2	$24.10
Rate for Payer: Affinity Essential Plan 3&4	$24.10
Rate for Payer: Affinity Medicaid/CHP/HARP	$24.10
Rate for Payer: Brighton Health Commercial	$34.43
Rate for Payer: Cash Price	$34.43
Rate for Payer: Cash Price	$34.43
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$34.43
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$34.55
Rate for Payer: Cigna LocalPlus Benefit Plan	$29.24
Rate for Payer: Elderplan Medicare Advantage	$34.43
Rate for Payer: EmblemHealth Commercial	$34.43
Rate for Payer: Fidelis Essential Plan Aliesa	$29.27
Rate for Payer: Fidelis Essential Plan QHP	$30.64
Rate for Payer: Fidelis Medicare Advantage	$34.43
Rate for Payer: Fidelis Qualified Health Plan	$30.64
Rate for Payer: Group Health Inc Commercial	$34.43
Rate for Payer: Group Health Inc Medicare	$34.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.82
Rate for Payer: Hamaspik Choice Inc Medicare	$34.43
Rate for Payer: Healthfirst Medicare Advantage	$34.43
Rate for Payer: Healthfirst QHP	$34.43
Rate for Payer: Humana Medicare	$35.12
Rate for Payer: Senior Whole Health Medicare Advantage	$34.43
Rate for Payer: United Healthcare Medicare Advantage	$34.43
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$34.43
Rate for Payer: Wellcare CHP/FHP/Medicaid	$27.54
Rate for Payer: Wellcare Medicare	$30.99

CYTOPATH SMEARS OVER 5 SLIDES

Facility

$152.95

Service Code	HCPCS 88162
Hospital Charge Code	40635472
Hospital Revenue Code	311
Rate for Payer: Cash Price	$62.66

CYTOPATH SMEARS OVER 5 SLIDES

Facility

$152.95

Service Code	HCPCS 88162
Hospital Charge Code	40635472
Hospital Revenue Code	311
Min. Negotiated Rate	$39.28
Max. Negotiated Rate	$84.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$84.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$62.66
Rate for Payer: Aetna Government	$62.66
Rate for Payer: Affinity Essential Plan 1&2	$43.86
Rate for Payer: Affinity Essential Plan 3&4	$43.86
Rate for Payer: Affinity Medicaid/CHP/HARP	$43.86
Rate for Payer: Brighton Health Commercial	$62.66
Rate for Payer: Cash Price	$62.66
Rate for Payer: Cash Price	$62.66
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$62.66
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$46.42
Rate for Payer: Cigna LocalPlus Benefit Plan	$39.28
Rate for Payer: Elderplan Medicare Advantage	$62.66
Rate for Payer: EmblemHealth Commercial	$62.66
Rate for Payer: Fidelis Essential Plan Aliesa	$53.26
Rate for Payer: Fidelis Essential Plan QHP	$55.77
Rate for Payer: Fidelis Medicare Advantage	$62.66
Rate for Payer: Fidelis Qualified Health Plan	$55.77
Rate for Payer: Group Health Inc Commercial	$62.66
Rate for Payer: Group Health Inc Medicare	$62.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$76.48
Rate for Payer: Hamaspik Choice Inc Medicare	$62.66
Rate for Payer: Healthfirst Medicare Advantage	$62.66
Rate for Payer: Healthfirst QHP	$62.66
Rate for Payer: Humana Medicare	$63.91
Rate for Payer: Senior Whole Health Medicare Advantage	$62.66
Rate for Payer: United Healthcare Medicare Advantage	$62.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$62.66
Rate for Payer: Wellcare CHP/FHP/Medicaid	$50.13
Rate for Payer: Wellcare Medicare	$56.39

CYTOPATH SPUTUM, ETC

Facility

$69.63

Service Code	HCPCS 88160
Hospital Charge Code	40635471
Hospital Revenue Code	311
Rate for Payer: Cash Price	$34.43

Know your out-of-pocket cost for care.

All Charges