St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC SUSCEPTIBILITY STUDIES, ANTIMICROBIAL AGENT; MYCOBACTERIA, PROPORTION METHOD, EACH AGENT

Facility

$22.00

Service Code	CPT 87190
Hospital Charge Code	3068719001
Hospital Revenue Code	306
Min. Negotiated Rate	$11.00
Max. Negotiated Rate	$11.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.00

HC SUSEPTIBILITY, ANTIMICROBIAL AGENT, AGAR DILUTION,EACH

Facility

$11.00

Service Code	CPT 87181
Hospital Charge Code	3068718101
Hospital Revenue Code	306
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$5.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.50

HC SUSEPTIBILITY, ANTIMICROBIAL AGENT, AGAR DILUTION,EACH

Facility

$11.00

Service Code	CPT 87181
Hospital Charge Code	3068718101
Hospital Revenue Code	306
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$10.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.75
Rate for Payer: Aetna Government	$4.75
Rate for Payer: Affinity Essential Plan 1&2	$3.33
Rate for Payer: Affinity Essential Plan 3&4	$3.33
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.33
Rate for Payer: Brighton Health Commercial	$8.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.79
Rate for Payer: Elderplan Medicare Advantage	$4.75
Rate for Payer: EmblemHealth Commercial	$4.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$4.28
Rate for Payer: Fidelis Essential Plan Aliesa	$4.04
Rate for Payer: Fidelis Essential Plan QHP	$4.23
Rate for Payer: Fidelis Medicare Advantage	$4.75
Rate for Payer: Fidelis Qualified Health Plan	$4.23
Rate for Payer: Group Health Inc Commercial	$4.75
Rate for Payer: Group Health Inc Medicare	$4.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.55
Rate for Payer: Healthfirst Essential Plan	$10.24
Rate for Payer: Healthfirst Medicare Advantage	$4.75
Rate for Payer: Healthfirst QHP	$4.75
Rate for Payer: Humana Medicare	$4.84
Rate for Payer: Senior Whole Health Medicare Advantage	$4.75
Rate for Payer: United Healthcare Commercial	$6.01
Rate for Payer: United Healthcare Medicare Advantage	$4.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.55
Rate for Payer: Wellcare Medicare	$4.28

HC SUSEPTIBILITY, ANTIMICROBIAL AGENT, ENZYME,EACH

Facility

$11.00

Service Code	CPT 87185
Hospital Charge Code	3068718501
Hospital Revenue Code	306
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$10.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.75
Rate for Payer: Aetna Government	$4.75
Rate for Payer: Affinity Essential Plan 1&2	$3.33
Rate for Payer: Affinity Essential Plan 3&4	$3.33
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.33
Rate for Payer: Brighton Health Commercial	$8.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$4.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.79
Rate for Payer: Elderplan Medicare Advantage	$4.75
Rate for Payer: EmblemHealth Commercial	$4.75
Rate for Payer: Fidelis CHP/HARP/Medicaid	$4.28
Rate for Payer: Fidelis Essential Plan Aliesa	$4.04
Rate for Payer: Fidelis Essential Plan QHP	$4.23
Rate for Payer: Fidelis Medicare Advantage	$4.75
Rate for Payer: Fidelis Qualified Health Plan	$4.23
Rate for Payer: Group Health Inc Commercial	$4.75
Rate for Payer: Group Health Inc Medicare	$4.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.75
Rate for Payer: Hamaspik Choice Inc Medicare	$4.75
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$4.55
Rate for Payer: Healthfirst Essential Plan	$10.24
Rate for Payer: Healthfirst Medicare Advantage	$4.75
Rate for Payer: Healthfirst QHP	$4.75
Rate for Payer: Humana Medicare	$4.84
Rate for Payer: Senior Whole Health Medicare Advantage	$4.75
Rate for Payer: United Healthcare Commercial	$6.01
Rate for Payer: United Healthcare Medicare Advantage	$4.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.55
Rate for Payer: Wellcare Medicare	$4.28

HC SUSEPTIBILITY, ANTIMICROBIAL AGENT, ENZYME,EACH

Facility

$11.00

Service Code	CPT 87185
Hospital Charge Code	3068718501
Hospital Revenue Code	306
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$5.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.50

HC SUSEPTIBILITY, ANTIMICROBIAL AGENT, MICRODILUTION/AGAR DILUTION,EACH

Facility

$21.00

Service Code	CPT 87186
Hospital Charge Code	3068718601
Hospital Revenue Code	306
Min. Negotiated Rate	$10.50
Max. Negotiated Rate	$10.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$10.50

HC SUSEPTIBILITY, ANTIMICROBIAL AGENT, MICRODILUTION/AGAR DILUTION,EACH

Facility

$21.00

Service Code	CPT 87186
Hospital Charge Code	3068718601
Hospital Revenue Code	306
Min. Negotiated Rate	$6.05
Max. Negotiated Rate	$15.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$11.55
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.65
Rate for Payer: Aetna Government	$8.65
Rate for Payer: Affinity Essential Plan 1&2	$6.05
Rate for Payer: Affinity Essential Plan 3&4	$6.05
Rate for Payer: Affinity Medicaid/CHP/HARP	$6.05
Rate for Payer: Brighton Health Commercial	$15.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$8.65
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$14.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$12.37
Rate for Payer: Elderplan Medicare Advantage	$8.65
Rate for Payer: EmblemHealth Commercial	$8.65
Rate for Payer: Fidelis CHP/HARP/Medicaid	$7.79
Rate for Payer: Fidelis Essential Plan Aliesa	$7.35
Rate for Payer: Fidelis Essential Plan QHP	$7.70
Rate for Payer: Fidelis Medicare Advantage	$8.65
Rate for Payer: Fidelis Qualified Health Plan	$7.70
Rate for Payer: Group Health Inc Commercial	$8.65
Rate for Payer: Group Health Inc Medicare	$8.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.65
Rate for Payer: Hamaspik Choice Inc Medicare	$8.65
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$6.66
Rate for Payer: Healthfirst Essential Plan	$14.98
Rate for Payer: Healthfirst Medicare Advantage	$8.65
Rate for Payer: Healthfirst QHP	$8.65
Rate for Payer: Humana Medicare	$8.82
Rate for Payer: Senior Whole Health Medicare Advantage	$8.65
Rate for Payer: United Healthcare Commercial	$10.95
Rate for Payer: United Healthcare Medicare Advantage	$8.65
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8.65
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6.66
Rate for Payer: Wellcare Medicare	$7.79

HC SUTURE EYELID WOUND,FULL THICK

Facility

$6,341.00

Service Code	CPT 67935
Hospital Charge Code	3616793501
Hospital Revenue Code	361
Min. Negotiated Rate	$491.18
Max. Negotiated Rate	$4,755.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,850.46
Rate for Payer: Aetna Government	$2,850.46
Rate for Payer: Affinity Essential Plan 1&2	$1,995.32
Rate for Payer: Affinity Essential Plan 3&4	$1,995.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,995.32
Rate for Payer: Brighton Health Commercial	$4,755.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,850.46
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: Elderplan Medicare Advantage	$2,850.46
Rate for Payer: EmblemHealth Commercial	$2,850.46
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2,565.41
Rate for Payer: Fidelis Essential Plan Aliesa	$2,422.89
Rate for Payer: Fidelis Essential Plan QHP	$2,536.91
Rate for Payer: Fidelis Medicare Advantage	$2,850.46
Rate for Payer: Fidelis Qualified Health Plan	$2,536.91
Rate for Payer: Group Health Inc Commercial	$2,850.46
Rate for Payer: Group Health Inc Medicare	$2,850.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,850.46
Rate for Payer: Hamaspik Choice Inc Medicare	$1,026.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$491.18
Rate for Payer: Healthfirst Medicare Advantage	$2,422.89
Rate for Payer: Healthfirst QHP	$2,850.46
Rate for Payer: Humana Medicare	$2,907.47
Rate for Payer: Senior Whole Health Medicare Advantage	$2,850.46
Rate for Payer: United Healthcare Commercial	$1,468.00
Rate for Payer: United Healthcare Medicare Advantage	$2,850.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,850.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,707.94
Rate for Payer: Wellcare Medicare	$2,707.94

HC SUTURE EYELID WOUND,FULL THICK

Facility

$6,341.00

Service Code	CPT 67935
Hospital Charge Code	3616793501
Hospital Revenue Code	361
Min. Negotiated Rate	$3,170.50
Max. Negotiated Rate	$3,170.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,170.50

HC SUTURE EYELID WOUND,PARTIAL THICK

Facility

$5,861.00

Service Code	CPT 67930
Hospital Charge Code	3616793001
Hospital Revenue Code	361
Min. Negotiated Rate	$2,930.50
Max. Negotiated Rate	$2,930.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,930.50

HC SUTURE EYELID WOUND,PARTIAL THICK

Facility

$5,861.00

Service Code	CPT 67930
Hospital Charge Code	3616793001
Hospital Revenue Code	361
Min. Negotiated Rate	$226.10
Max. Negotiated Rate	$4,395.75
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,850.46
Rate for Payer: Aetna Government	$2,850.46
Rate for Payer: Affinity Essential Plan 1&2	$1,995.32
Rate for Payer: Affinity Essential Plan 3&4	$1,995.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,995.32
Rate for Payer: Brighton Health Commercial	$4,395.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,850.46
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: Elderplan Medicare Advantage	$2,850.46
Rate for Payer: EmblemHealth Commercial	$2,850.46
Rate for Payer: Fidelis CHP/HARP/Medicaid	$2,565.41
Rate for Payer: Fidelis Essential Plan Aliesa	$2,422.89
Rate for Payer: Fidelis Essential Plan QHP	$2,536.91
Rate for Payer: Fidelis Medicare Advantage	$2,850.46
Rate for Payer: Fidelis Qualified Health Plan	$2,536.91
Rate for Payer: Group Health Inc Commercial	$2,850.46
Rate for Payer: Group Health Inc Medicare	$2,850.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,850.46
Rate for Payer: Hamaspik Choice Inc Medicare	$226.10
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$263.36
Rate for Payer: Healthfirst Medicare Advantage	$2,422.89
Rate for Payer: Healthfirst QHP	$2,850.46
Rate for Payer: Humana Medicare	$2,907.47
Rate for Payer: Senior Whole Health Medicare Advantage	$2,850.46
Rate for Payer: United Healthcare Commercial	$1,468.00
Rate for Payer: United Healthcare Medicare Advantage	$2,850.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,850.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$2,707.94
Rate for Payer: Wellcare Medicare	$2,707.94

HC SUTURE REMOVAL, BY PHYS OTHER THAN ORIG CLOSED WOUND

Facility

$154.00

Service Code	CPT S0630
Hospital Charge Code	510S063001
Hospital Revenue Code	510
Min. Negotiated Rate	$77.00
Max. Negotiated Rate	$77.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$77.00

HC SUTURE REMOVAL, BY PHYS OTHER THAN ORIG CLOSED WOUND

Facility

$154.00

Service Code	CPT S0630
Hospital Charge Code	510S063001
Hospital Revenue Code	510
Min. Negotiated Rate	$57.08
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$84.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$57.08
Rate for Payer: Aetna Government	$57.08
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$217.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.48
Rate for Payer: EmblemHealth Commercial	$250.00
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	$77.00
Rate for Payer: Hamaspik Choice Inc Medicare	$77.00
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-ONLY EST HIGH 40

Facility

$327.00

Service Code	CPT 98015
Hospital Charge Code	5109801501
Hospital Revenue Code	510
Min. Negotiated Rate	$163.50
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$179.85
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$163.50
Rate for Payer: Aetna Government	$163.50
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$217.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.48
Rate for Payer: EmblemHealth Commercial	$250.00
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	$163.50
Rate for Payer: Hamaspik Choice Inc Medicare	$163.50
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-ONLY EST HIGH 40

Facility

$327.00

Service Code	CPT 98015
Hospital Charge Code	5109801501
Hospital Revenue Code	510
Min. Negotiated Rate	$163.50
Max. Negotiated Rate	$163.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$163.50

HC SYNCH AUDIO-ONLY EST LOW 20

Facility

$283.00

Service Code	CPT 98013
Hospital Charge Code	5109801301
Hospital Revenue Code	510
Min. Negotiated Rate	$141.50
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$155.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$141.50
Rate for Payer: Aetna Government	$141.50
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$217.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.48
Rate for Payer: EmblemHealth Commercial	$250.00
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	$141.50
Rate for Payer: Hamaspik Choice Inc Medicare	$141.50
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-ONLY EST LOW 20

Facility

$283.00

Service Code	CPT 98013
Hospital Charge Code	5109801301
Hospital Revenue Code	510
Min. Negotiated Rate	$141.50
Max. Negotiated Rate	$141.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$141.50

HC SYNCH AUDIO-ONLY EST MOD 30

Facility

$304.00

Service Code	CPT 98014
Hospital Charge Code	5109801401
Hospital Revenue Code	510
Min. Negotiated Rate	$152.00
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$167.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$152.00
Rate for Payer: Aetna Government	$152.00
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$217.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.48
Rate for Payer: EmblemHealth Commercial	$250.00
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	$152.00
Rate for Payer: Hamaspik Choice Inc Medicare	$152.00
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-ONLY EST MOD 30

Facility

$304.00

Service Code	CPT 98014
Hospital Charge Code	5109801401
Hospital Revenue Code	510
Min. Negotiated Rate	$152.00
Max. Negotiated Rate	$152.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$152.00

HC SYNCH AUDIO-ONLY EST SF 10

Facility

$263.00

Service Code	CPT 98012
Hospital Charge Code	5109801201
Hospital Revenue Code	510
Min. Negotiated Rate	$131.50
Max. Negotiated Rate	$131.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$131.50

HC SYNCH AUDIO-ONLY EST SF 10

Facility

$263.00

Service Code	CPT 98012
Hospital Charge Code	5109801201
Hospital Revenue Code	510
Min. Negotiated Rate	$131.50
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$144.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$131.50
Rate for Payer: Aetna Government	$131.50
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$217.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.48
Rate for Payer: EmblemHealth Commercial	$250.00
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	$131.50
Rate for Payer: Hamaspik Choice Inc Medicare	$131.50
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-ONLY NEW HIGH 60

Facility

$360.00

Service Code	CPT 98011
Hospital Charge Code	5109801101
Hospital Revenue Code	510
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$198.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.00
Rate for Payer: Aetna Government	$180.00
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$217.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.48
Rate for Payer: EmblemHealth Commercial	$250.00
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	$180.00
Rate for Payer: Hamaspik Choice Inc Medicare	$180.00
Rate for Payer: United Healthcare Commercial	$222.00

HC SYNCH AUDIO-ONLY NEW HIGH 60

Facility

$360.00

Service Code	CPT 98011
Hospital Charge Code	5109801101
Hospital Revenue Code	510
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$180.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$180.00

HC SYNCH AUDIO-ONLY NEW LOW 30

Facility

$311.00

Service Code	CPT 98009
Hospital Charge Code	5109800901
Hospital Revenue Code	510
Min. Negotiated Rate	$155.50
Max. Negotiated Rate	$155.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$155.50

HC SYNCH AUDIO-ONLY NEW LOW 30

Facility

$311.00

Service Code	CPT 98009
Hospital Charge Code	5109800901
Hospital Revenue Code	510
Min. Negotiated Rate	$155.50
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$171.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$155.50
Rate for Payer: Aetna Government	$155.50
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$217.04
Rate for Payer: Cigna LocalPlus Benefit Plan	$184.48
Rate for Payer: EmblemHealth Commercial	$250.00
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	$155.50
Rate for Payer: Hamaspik Choice Inc Medicare	$155.50
Rate for Payer: United Healthcare Commercial	$222.00

Know your out-of-pocket cost for care.

All Charges