St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC SP CONTRAST INJ CK VEN ACCESS

Facility

$556.00

Service Code	CPT 36598 TC
Hospital Charge Code	3613659801
Hospital Revenue Code	361
Min. Negotiated Rate	$86.69
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$118.44
Rate for Payer: Aetna Government	$118.44
Rate for Payer: Brighton Health Commercial	$417.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,092.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,628.64
Rate for Payer: EmblemHealth Commercial	$278.00
Rate for Payer: Group Health Inc Commercial	$278.00
Rate for Payer: Group Health Inc Medicare	$194.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$278.00
Rate for Payer: Hamaspik Choice Inc Medicare	$86.69
Rate for Payer: United Healthcare Commercial	$1,113.00

HC SPECIAL SERVICE/PROC/REPORT

Facility

$348.00

Service Code	CPT 99199
Hospital Charge Code	9819919901
Hospital Revenue Code	981
Min. Negotiated Rate	$121.80
Max. Negotiated Rate	$278.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$191.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$174.00
Rate for Payer: Aetna Government	$174.00
Rate for Payer: Brighton Health Commercial	$261.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$278.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$236.64
Rate for Payer: EmblemHealth Commercial	$174.00
Rate for Payer: Group Health Inc Commercial	$174.00
Rate for Payer: Group Health Inc Medicare	$121.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.00
Rate for Payer: Hamaspik Choice Inc Medicare	$174.00

HC SPECIAL SERVICE/PROC/REPORT

Facility

$348.00

Service Code	CPT 99199
Hospital Charge Code	9819919901
Hospital Revenue Code	981
Min. Negotiated Rate	$174.00
Max. Negotiated Rate	$174.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.00

HC SPECIAL STAINS,GROUP I - BUNDLED CHARGE

Facility

$265.00

Service Code	CPT 88312
Hospital Charge Code	3128831202
Hospital Revenue Code	312
Min. Negotiated Rate	$13.31
Max. Negotiated Rate	$145.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$145.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$65.28
Rate for Payer: Aetna Government	$65.28
Rate for Payer: Affinity Essential Plan 1&2	$45.70
Rate for Payer: Affinity Essential Plan 3&4	$45.70
Rate for Payer: Affinity Medicaid/CHP/HARP	$45.70
Rate for Payer: Brighton Health Commercial	$65.28
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$65.28
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$97.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$81.86
Rate for Payer: Elderplan Medicare Advantage	$65.28
Rate for Payer: EmblemHealth Commercial	$128.36
Rate for Payer: Fidelis CHP/HARP/Medicaid	$58.75
Rate for Payer: Fidelis Essential Plan Aliesa	$55.49
Rate for Payer: Fidelis Essential Plan QHP	$58.10
Rate for Payer: Fidelis Medicare Advantage	$65.28
Rate for Payer: Fidelis Qualified Health Plan	$58.10
Rate for Payer: Group Health Inc Commercial	$65.28
Rate for Payer: Group Health Inc Medicare	$65.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$65.28
Rate for Payer: Hamaspik Choice Inc Medicare	$65.28
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$13.31
Rate for Payer: Healthfirst Essential Plan	$29.95
Rate for Payer: Healthfirst Medicare Advantage	$65.28
Rate for Payer: Healthfirst QHP	$65.28
Rate for Payer: Humana Medicare	$66.59
Rate for Payer: Senior Whole Health Medicare Advantage	$65.28
Rate for Payer: United Healthcare Medicare Advantage	$65.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$65.28
Rate for Payer: Wellcare CHP/FHP/Medicaid	$13.31
Rate for Payer: Wellcare Medicare	$58.75

HC SPECIAL STAINS,GROUP I - BUNDLED CHARGE

Facility

$265.00

Service Code	CPT 88312
Hospital Charge Code	3128831202
Hospital Revenue Code	312
Min. Negotiated Rate	$132.50
Max. Negotiated Rate	$132.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$132.50

HC SPECIAL STAINS,GROUP II - BUNDLED CHARGE

Facility

$215.00

Service Code	CPT 88313
Hospital Charge Code	3128831302
Hospital Revenue Code	312
Min. Negotiated Rate	$9.98
Max. Negotiated Rate	$160.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$118.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$157.49
Rate for Payer: Aetna Government	$157.49
Rate for Payer: Affinity Essential Plan 1&2	$110.24
Rate for Payer: Affinity Essential Plan 3&4	$110.24
Rate for Payer: Affinity Medicaid/CHP/HARP	$110.24
Rate for Payer: Brighton Health Commercial	$157.49
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$157.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$67.36
Rate for Payer: Elderplan Medicare Advantage	$157.49
Rate for Payer: EmblemHealth Commercial	$94.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$141.74
Rate for Payer: Fidelis Essential Plan Aliesa	$133.87
Rate for Payer: Fidelis Essential Plan QHP	$140.17
Rate for Payer: Fidelis Medicare Advantage	$157.49
Rate for Payer: Fidelis Qualified Health Plan	$140.17
Rate for Payer: Group Health Inc Commercial	$157.49
Rate for Payer: Group Health Inc Medicare	$157.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$157.49
Rate for Payer: Hamaspik Choice Inc Medicare	$157.49
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.98
Rate for Payer: Healthfirst Essential Plan	$22.45
Rate for Payer: Healthfirst Medicare Advantage	$157.49
Rate for Payer: Healthfirst QHP	$157.49
Rate for Payer: Humana Medicare	$160.64
Rate for Payer: Senior Whole Health Medicare Advantage	$157.49
Rate for Payer: United Healthcare Medicare Advantage	$157.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$157.49
Rate for Payer: Wellcare CHP/FHP/Medicaid	$9.98
Rate for Payer: Wellcare Medicare	$141.74

HC SPECIAL STAINS,GROUP II - BUNDLED CHARGE

Facility

$215.00

Service Code	CPT 88313
Hospital Charge Code	3128831302
Hospital Revenue Code	312
Min. Negotiated Rate	$107.50
Max. Negotiated Rate	$107.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$107.50

HC SPECIAL STAINS,GROUP II - LAB SPECIAL STAINS,GROUP II

Facility

$101.00

Service Code	CPT 88313 TC
Hospital Charge Code	3128831301
Hospital Revenue Code	312
Min. Negotiated Rate	$50.50
Max. Negotiated Rate	$50.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.50

HC SPECIAL STAINS,GROUP II - LAB SPECIAL STAINS,GROUP II

Facility

$101.00

Service Code	CPT 88313 TC
Hospital Charge Code	3128831301
Hospital Revenue Code	312
Min. Negotiated Rate	$9.98
Max. Negotiated Rate	$82.13
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$36.13
Rate for Payer: Aetna Government	$36.13
Rate for Payer: Brighton Health Commercial	$75.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.02
Rate for Payer: Cigna LocalPlus Benefit Plan	$67.36
Rate for Payer: EmblemHealth Commercial	$82.13
Rate for Payer: Group Health Inc Commercial	$50.50
Rate for Payer: Group Health Inc Medicare	$35.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.50
Rate for Payer: Hamaspik Choice Inc Medicare	$50.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$9.98
Rate for Payer: Healthfirst Essential Plan	$22.45
Rate for Payer: Wellcare CHP/FHP/Medicaid	$9.98

HC SPECIAL STAINS,GROUP I - LAB SPECIAL STAINS,GROUP I

Facility

$149.00

Service Code	CPT 88312 TC
Hospital Charge Code	3128831201
Hospital Revenue Code	312
Min. Negotiated Rate	$74.50
Max. Negotiated Rate	$74.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.50

HC SPECIAL STAINS,GROUP I - LAB SPECIAL STAINS,GROUP I

Facility

$149.00

Service Code	CPT 88312 TC
Hospital Charge Code	3128831201
Hospital Revenue Code	312
Min. Negotiated Rate	$13.31
Max. Negotiated Rate	$111.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$81.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$45.02
Rate for Payer: Aetna Government	$45.02
Rate for Payer: Brighton Health Commercial	$111.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$97.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$81.86
Rate for Payer: EmblemHealth Commercial	$100.60
Rate for Payer: Group Health Inc Commercial	$74.50
Rate for Payer: Group Health Inc Medicare	$52.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$74.50
Rate for Payer: Hamaspik Choice Inc Medicare	$74.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$13.31
Rate for Payer: Healthfirst Essential Plan	$29.95
Rate for Payer: Wellcare CHP/FHP/Medicaid	$13.31

HC SPECIAL TREATMENT PROCEDURE - TOTAL BODY IRRADIATION

Facility

$1,631.00

Service Code	CPT 77470 TC
Hospital Charge Code	3337747004
Hospital Revenue Code	333
Min. Negotiated Rate	$41.28
Max. Negotiated Rate	$1,304.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$897.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$63.26
Rate for Payer: Aetna Government	$63.26
Rate for Payer: Brighton Health Commercial	$1,223.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,304.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,109.08
Rate for Payer: EmblemHealth Commercial	$815.50
Rate for Payer: Fidelis CHP/HARP/Medicaid	$279.92
Rate for Payer: Fidelis Essential Plan Aliesa	$279.92
Rate for Payer: Fidelis Essential Plan QHP	$294.00
Rate for Payer: Fidelis Qualified Health Plan	$294.00
Rate for Payer: Group Health Inc Commercial	$815.50
Rate for Payer: Group Health Inc Medicare	$570.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$815.50
Rate for Payer: Hamaspik Choice Inc Medicare	$815.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$41.28
Rate for Payer: Healthfirst Essential Plan	$289.49
Rate for Payer: Wellcare CHP/FHP/Medicaid	$128.66

HC SPECIAL TREATMENT PROCEDURE - TOTAL BODY IRRADIATION

Facility

$1,631.00

Service Code	CPT 77470 TC
Hospital Charge Code	3337747004
Hospital Revenue Code	333
Min. Negotiated Rate	$815.50
Max. Negotiated Rate	$815.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$815.50

HC SPECIMAN HANDLING

Facility

$75.00

Service Code	CPT 99001
Hospital Charge Code	3009900101
Hospital Revenue Code	300
Min. Negotiated Rate	$7.03
Max. Negotiated Rate	$60.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$13.00
Rate for Payer: Aetna Government	$13.00
Rate for Payer: Brighton Health Commercial	$56.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.00
Rate for Payer: EmblemHealth Commercial	$37.50
Rate for Payer: Group Health Inc Commercial	$37.50
Rate for Payer: Group Health Inc Medicare	$26.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.50
Rate for Payer: Hamaspik Choice Inc Medicare	$37.50
Rate for Payer: United Healthcare Commercial	$7.03

HC SPECIMAN HANDLING

Facility

$75.00

Service Code	CPT 99001
Hospital Charge Code	3009900101
Hospital Revenue Code	300
Min. Negotiated Rate	$37.50
Max. Negotiated Rate	$37.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.50

HC SPECIM-TRANSFER - PHYSICIAN TO LAB

Facility

$49.00

Service Code	CPT 99000
Hospital Charge Code	3009900001
Hospital Revenue Code	300
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$24.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.50

HC SPECIM-TRANSFER - PHYSICIAN TO LAB

Facility

$49.00

Service Code	CPT 99000
Hospital Charge Code	3009900001
Hospital Revenue Code	300
Min. Negotiated Rate	$6.12
Max. Negotiated Rate	$39.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$26.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.00
Rate for Payer: Aetna Government	$7.00
Rate for Payer: Brighton Health Commercial	$36.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$39.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$33.32
Rate for Payer: EmblemHealth Commercial	$24.50
Rate for Payer: Group Health Inc Commercial	$24.50
Rate for Payer: Group Health Inc Medicare	$17.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$24.50
Rate for Payer: Hamaspik Choice Inc Medicare	$24.50
Rate for Payer: United Healthcare Commercial	$6.12

HC SPECTROPHOTOMETRY - PORPHYRIN TOTAL

Facility

$20.00

Service Code	CPT 84311
Hospital Charge Code	3018431101
Hospital Revenue Code	301
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$15.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.10
Rate for Payer: Aetna Government	$8.10
Rate for Payer: Affinity Essential Plan 1&2	$5.67
Rate for Payer: Affinity Essential Plan 3&4	$5.67
Rate for Payer: Affinity Medicaid/CHP/HARP	$5.67
Rate for Payer: Brighton Health Commercial	$15.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.87
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.99
Rate for Payer: Elderplan Medicare Advantage	$8.10
Rate for Payer: EmblemHealth Commercial	$8.10
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.29
Rate for Payer: Fidelis Essential Plan Aliesa	$6.88
Rate for Payer: Fidelis Essential Plan QHP	$7.21
Rate for Payer: Fidelis Medicare Advantage	$8.10
Rate for Payer: Fidelis Qualified Health Plan	$7.21
Rate for Payer: Group Health Inc Commercial	$8.10
Rate for Payer: Group Health Inc Medicare	$8.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.10
Rate for Payer: Hamaspik Choice Inc Medicare	$8.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$8.10
Rate for Payer: Healthfirst Medicare Advantage	$8.10
Rate for Payer: Healthfirst QHP	$8.10
Rate for Payer: Humana Medicare	$8.26
Rate for Payer: Senior Whole Health Medicare Advantage	$8.10
Rate for Payer: United Healthcare Commercial	$8.85
Rate for Payer: United Healthcare Medicare Advantage	$8.10
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.10
Rate for Payer: Wellcare CHP/FHP/Medicaid	$7.70
Rate for Payer: Wellcare Medicare	$7.29

HC SPECTROPHOTOMETRY - PORPHYRIN TOTAL

Facility

$20.00

Service Code	CPT 84311
Hospital Charge Code	3018431101
Hospital Revenue Code	301
Min. Negotiated Rate	$10.00
Max. Negotiated Rate	$10.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.00

HC SPEECH AUDIOMETRY, COMPLETE

Facility

$101.00

Service Code	CPT 92556
Hospital Charge Code	4719255601
Hospital Revenue Code	471
Min. Negotiated Rate	$50.50
Max. Negotiated Rate	$50.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.50

HC SPEECH AUDIOMETRY, COMPLETE

Facility

$101.00

Service Code	CPT 92556
Hospital Charge Code	4719255601
Hospital Revenue Code	471
Min. Negotiated Rate	$50.81
Max. Negotiated Rate	$158.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$72.58
Rate for Payer: Aetna Government	$72.58
Rate for Payer: Affinity Essential Plan 1&2	$50.81
Rate for Payer: Affinity Essential Plan 3&4	$50.81
Rate for Payer: Affinity Medicaid/CHP/HARP	$50.81
Rate for Payer: Brighton Health Commercial	$75.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$72.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.68
Rate for Payer: Elderplan Medicare Advantage	$72.58
Rate for Payer: EmblemHealth Commercial	$72.58
Rate for Payer: Fidelis CHP/HARP/Medicaid	$65.32
Rate for Payer: Fidelis Essential Plan Aliesa	$61.69
Rate for Payer: Fidelis Essential Plan QHP	$64.60
Rate for Payer: Fidelis Medicare Advantage	$72.58
Rate for Payer: Fidelis Qualified Health Plan	$64.60
Rate for Payer: Group Health Inc Commercial	$72.58
Rate for Payer: Group Health Inc Medicare	$72.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.58
Rate for Payer: Hamaspik Choice Inc Medicare	$72.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$54.96
Rate for Payer: Healthfirst Medicare Advantage	$61.69
Rate for Payer: Healthfirst QHP	$72.58
Rate for Payer: Humana Medicare	$74.03
Rate for Payer: Senior Whole Health Medicare Advantage	$72.58
Rate for Payer: United Healthcare Commercial	$158.00
Rate for Payer: United Healthcare Medicare Advantage	$72.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$72.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$68.95
Rate for Payer: Wellcare Medicare	$68.95

HC SPEECH EVALUATION, COMPLEX - FL SPEECH EVALUATION

Facility

$705.00

Service Code	CPT 70371 TC
Hospital Charge Code	3207037101
Hospital Revenue Code	320
Min. Negotiated Rate	$352.50
Max. Negotiated Rate	$352.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.50

HC SPEECH EVALUATION, COMPLEX - FL SPEECH EVALUATION

Facility

$705.00

Service Code	CPT 70371 TC
Hospital Charge Code	3207037101
Hospital Revenue Code	320
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$528.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$387.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.80
Rate for Payer: Aetna Government	$37.80
Rate for Payer: Brighton Health Commercial	$528.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$178.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$150.40
Rate for Payer: EmblemHealth Commercial	$73.57
Rate for Payer: Group Health Inc Commercial	$352.50
Rate for Payer: Group Health Inc Medicare	$246.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$352.50
Rate for Payer: Hamaspik Choice Inc Medicare	$352.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$73.57
Rate for Payer: Healthfirst Essential Plan	$136.19
Rate for Payer: Wellcare CHP/FHP/Medicaid	$60.53

HC SPEECH THRESHOLD AUDIOMETRY

Facility

$101.00

Service Code	CPT 92555
Hospital Charge Code	4719255501
Hospital Revenue Code	471
Min. Negotiated Rate	$50.50
Max. Negotiated Rate	$50.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$50.50

HC SPEECH THRESHOLD AUDIOMETRY

Facility

$101.00

Service Code	CPT 92555
Hospital Charge Code	4719255501
Hospital Revenue Code	471
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$158.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$55.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$72.58
Rate for Payer: Aetna Government	$72.58
Rate for Payer: Affinity Essential Plan 1&2	$50.81
Rate for Payer: Affinity Essential Plan 3&4	$50.81
Rate for Payer: Affinity Medicaid/CHP/HARP	$50.81
Rate for Payer: Brighton Health Commercial	$75.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$72.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$80.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$68.68
Rate for Payer: Elderplan Medicare Advantage	$72.58
Rate for Payer: EmblemHealth Commercial	$72.58
Rate for Payer: Fidelis CHP/HARP/Medicaid	$65.32
Rate for Payer: Fidelis Essential Plan Aliesa	$61.69
Rate for Payer: Fidelis Essential Plan QHP	$64.60
Rate for Payer: Fidelis Medicare Advantage	$72.58
Rate for Payer: Fidelis Qualified Health Plan	$64.60
Rate for Payer: Group Health Inc Commercial	$72.58
Rate for Payer: Group Health Inc Medicare	$72.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.58
Rate for Payer: Hamaspik Choice Inc Medicare	$72.58
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$35.55
Rate for Payer: Healthfirst Medicare Advantage	$61.69
Rate for Payer: Healthfirst QHP	$72.58
Rate for Payer: Humana Medicare	$74.03
Rate for Payer: Senior Whole Health Medicare Advantage	$72.58
Rate for Payer: United Healthcare Commercial	$158.00
Rate for Payer: United Healthcare Medicare Advantage	$72.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$72.58
Rate for Payer: Wellcare CHP/FHP/Medicaid	$68.95
Rate for Payer: Wellcare Medicare	$68.95

Know your out-of-pocket cost for care.

All Charges