St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

HC THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING

Facility

$1,909.00

Service Code	CPT 32554 TC
Hospital Charge Code	7613255401
Hospital Revenue Code	761
Min. Negotiated Rate	$954.50
Max. Negotiated Rate	$954.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.50

HC THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING

Facility

$1,909.00

Service Code	CPT 32554 TC
Hospital Charge Code	3613255401
Hospital Revenue Code	361
Min. Negotiated Rate	$208.84
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$208.84
Rate for Payer: Aetna Government	$208.84
Rate for Payer: Brighton Health Commercial	$1,431.75
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	$954.50
Rate for Payer: Group Health Inc Commercial	$954.50
Rate for Payer: Group Health Inc Medicare	$668.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.50
Rate for Payer: Hamaspik Choice Inc Medicare	$332.31
Rate for Payer: United Healthcare Commercial	$1,188.00

HC THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING

Facility

$1,909.00

Service Code	CPT 32554 TC
Hospital Charge Code	3613255401
Hospital Revenue Code	361
Min. Negotiated Rate	$954.50
Max. Negotiated Rate	$954.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$954.50

HC THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING

Facility

$1,909.00

Service Code	CPT 32554 TC
Hospital Charge Code	7613255401
Hospital Revenue Code	761
Min. Negotiated Rate	$208.84
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$208.84
Rate for Payer: Aetna Government	$208.84
Rate for Payer: Brighton Health Commercial	$1,431.75
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	$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	$954.50
Rate for Payer: Hamaspik Choice Inc Medicare	$332.31

HC THORACOSCOPY, SURGICAL, W/PLEURODESIS

Facility

$1,377.00

Service Code	CPT 32650 TC
Hospital Charge Code	3613265001
Hospital Revenue Code	361
Min. Negotiated Rate	$688.50
Max. Negotiated Rate	$688.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.50

HC THORACOSCOPY, SURGICAL, W/PLEURODESIS

Facility

$1,377.00

Service Code	CPT 32650 TC
Hospital Charge Code	3613265001
Hospital Revenue Code	361
Min. Negotiated Rate	$481.95
Max. Negotiated Rate	$3,190.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$757.35
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$725.76
Rate for Payer: Aetna Government	$725.76
Rate for Payer: Brighton Health Commercial	$1,032.75
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	$688.50
Rate for Payer: Group Health Inc Commercial	$688.50
Rate for Payer: Group Health Inc Medicare	$481.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$688.50
Rate for Payer: Hamaspik Choice Inc Medicare	$688.50
Rate for Payer: United Healthcare Commercial	$3,190.00

HC THORACOSTOMY W/OPEN FLAP DRAINAGE

Facility

$2,085.00

Service Code	CPT 32036
Hospital Charge Code	3613203601
Hospital Revenue Code	361
Min. Negotiated Rate	$1,042.50
Max. Negotiated Rate	$1,042.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,042.50

HC THORACOSTOMY W/OPEN FLAP DRAINAGE

Facility

$2,085.00

Service Code	CPT 32036
Hospital Charge Code	3613203601
Hospital Revenue Code	361
Min. Negotiated Rate	$729.75
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,146.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$845.34
Rate for Payer: Aetna Government	$845.34
Rate for Payer: Brighton Health Commercial	$1,563.75
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	$1,042.50
Rate for Payer: Group Health Inc Commercial	$1,042.50
Rate for Payer: Group Health Inc Medicare	$729.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,042.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,042.50
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$928.23
Rate for Payer: United Healthcare Commercial	$1,496.00

HC THORACOTOMY WITH EXPLORATION & CARDIAC MASSAGE

Facility

$5,240.00

Service Code	CPT 32160
Hospital Charge Code	3613216001
Hospital Revenue Code	361
Min. Negotiated Rate	$2,620.00
Max. Negotiated Rate	$2,620.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,620.00

HC THORACOTOMY WITH EXPLORATION & CARDIAC MASSAGE

Facility

$5,240.00

Service Code	CPT 32160
Hospital Charge Code	3613216001
Hospital Revenue Code	361
Min. Negotiated Rate	$858.42
Max. Negotiated Rate	$3,930.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,882.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$858.42
Rate for Payer: Aetna Government	$858.42
Rate for Payer: Brighton Health Commercial	$3,930.00
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	$2,620.00
Rate for Payer: Group Health Inc Commercial	$2,620.00
Rate for Payer: Group Health Inc Medicare	$1,834.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,620.00
Rate for Payer: Hamaspik Choice Inc Medicare	$2,620.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$942.59
Rate for Payer: United Healthcare Commercial	$1,496.00

HC THROMBECTOMY A-V GRAFT, EXC HEMODIALYSIS

Facility

$13,920.00

Service Code	CPT 35875 TC
Hospital Charge Code	3613587501
Hospital Revenue Code	361
Min. Negotiated Rate	$678.77
Max. Negotiated Rate	$10,440.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,593.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$678.77
Rate for Payer: Aetna Government	$678.77
Rate for Payer: Brighton Health Commercial	$10,440.00
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	$6,960.00
Rate for Payer: Group Health Inc Commercial	$6,960.00
Rate for Payer: Group Health Inc Medicare	$4,872.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,009.55
Rate for Payer: United Healthcare Commercial	$2,546.00

HC THROMBECTOMY A-V GRAFT, EXC HEMODIALYSIS

Facility

$13,920.00

Service Code	CPT 35875 TC
Hospital Charge Code	3613587501
Hospital Revenue Code	361
Min. Negotiated Rate	$6,960.00
Max. Negotiated Rate	$6,960.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.00

HC THROMBECTOMY A-V GRAFT, EXC HEMODIALYSIS, W REVISION

Facility

$13,920.00

Service Code	CPT 35876 TC
Hospital Charge Code	3613587601
Hospital Revenue Code	361
Min. Negotiated Rate	$6,960.00
Max. Negotiated Rate	$6,960.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.00

HC THROMBECTOMY A-V GRAFT, EXC HEMODIALYSIS, W REVISION

Facility

$13,920.00

Service Code	CPT 35876 TC
Hospital Charge Code	3613587601
Hospital Revenue Code	361
Min. Negotiated Rate	$1,078.01
Max. Negotiated Rate	$10,440.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,593.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,078.01
Rate for Payer: Aetna Government	$1,078.01
Rate for Payer: Brighton Health Commercial	$10,440.00
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	$6,960.00
Rate for Payer: Group Health Inc Commercial	$6,960.00
Rate for Payer: Group Health Inc Medicare	$4,872.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,960.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,009.55
Rate for Payer: United Healthcare Commercial	$2,546.00

HC THROMBIN TIME, PLASMA - THROMBIN TIME

Facility

$14.00

Service Code	CPT 85670
Hospital Charge Code	3058567001
Hospital Revenue Code	305
Min. Negotiated Rate	$7.00
Max. Negotiated Rate	$7.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.00

HC THROMBIN TIME, PLASMA - THROMBIN TIME

Facility

$14.00

Service Code	CPT 85670
Hospital Charge Code	3058567001
Hospital Revenue Code	305
Min. Negotiated Rate	$4.04
Max. Negotiated Rate	$12.04
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.77
Rate for Payer: Aetna Government	$5.77
Rate for Payer: Affinity Essential Plan 1&2	$4.04
Rate for Payer: Affinity Essential Plan 3&4	$4.04
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.04
Rate for Payer: Brighton Health Commercial	$10.50
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.81
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.26
Rate for Payer: Elderplan Medicare Advantage	$5.77
Rate for Payer: EmblemHealth Commercial	$5.77
Rate for Payer: Fidelis CHP/HARP/Medicaid	$5.19
Rate for Payer: Fidelis Essential Plan Aliesa	$4.90
Rate for Payer: Fidelis Essential Plan QHP	$5.14
Rate for Payer: Fidelis Medicare Advantage	$5.77
Rate for Payer: Fidelis Qualified Health Plan	$5.14
Rate for Payer: Group Health Inc Commercial	$5.77
Rate for Payer: Group Health Inc Medicare	$5.77
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.77
Rate for Payer: Hamaspik Choice Inc Medicare	$5.77
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$5.35
Rate for Payer: Healthfirst Essential Plan	$12.04
Rate for Payer: Healthfirst Medicare Advantage	$5.77
Rate for Payer: Healthfirst QHP	$5.77
Rate for Payer: Humana Medicare	$5.89
Rate for Payer: Senior Whole Health Medicare Advantage	$5.77
Rate for Payer: United Healthcare Commercial	$7.32
Rate for Payer: United Healthcare Medicare Advantage	$5.77
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.77
Rate for Payer: Wellcare CHP/FHP/Medicaid	$5.35
Rate for Payer: Wellcare Medicare	$5.19

HC THROMBOLYTIC THERAPY, STROKE

Facility

$997.00

Service Code	CPT 37195
Hospital Charge Code	7613719501
Hospital Revenue Code	761
Min. Negotiated Rate	$250.00
Max. Negotiated Rate	$3,092.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$342.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$405.27
Rate for Payer: Aetna Government	$405.27
Rate for Payer: Affinity Essential Plan 1&2	$283.69
Rate for Payer: Affinity Essential Plan 3&4	$283.69
Rate for Payer: Affinity Medicaid/CHP/HARP	$283.69
Rate for Payer: Brighton Health Commercial	$747.75
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$405.27
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	$405.27
Rate for Payer: EmblemHealth Commercial	$250.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$364.74
Rate for Payer: Fidelis Essential Plan Aliesa	$344.48
Rate for Payer: Fidelis Essential Plan QHP	$360.69
Rate for Payer: Fidelis Medicare Advantage	$405.27
Rate for Payer: Fidelis Qualified Health Plan	$360.69
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	$405.27
Rate for Payer: Hamaspik Choice Inc Medicare	$405.27
Rate for Payer: Healthfirst Medicare Advantage	$344.48
Rate for Payer: Healthfirst QHP	$405.27
Rate for Payer: Humana Medicare	$413.38
Rate for Payer: Senior Whole Health Medicare Advantage	$405.27
Rate for Payer: United Healthcare Medicare Advantage	$405.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$405.27
Rate for Payer: Wellcare CHP/FHP/Medicaid	$385.01
Rate for Payer: Wellcare Medicare	$385.01

HC THROMBOLYTIC THERAPY, STROKE

Facility

$997.00

Service Code	CPT 37195
Hospital Charge Code	7613719501
Hospital Revenue Code	761
Min. Negotiated Rate	$498.50
Max. Negotiated Rate	$498.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$498.50

HC THROMBOPLAS TIME PARTIAL - APTT

Facility

$15.00

Service Code	CPT 85730
Hospital Charge Code	3058573001
Hospital Revenue Code	305
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$13.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.01
Rate for Payer: Aetna Government	$6.01
Rate for Payer: Affinity Essential Plan 1&2	$4.21
Rate for Payer: Affinity Essential Plan 3&4	$4.21
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.21
Rate for Payer: Brighton Health Commercial	$11.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.59
Rate for Payer: Elderplan Medicare Advantage	$6.01
Rate for Payer: EmblemHealth Commercial	$6.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$5.41
Rate for Payer: Fidelis Essential Plan Aliesa	$5.11
Rate for Payer: Fidelis Essential Plan QHP	$5.35
Rate for Payer: Fidelis Medicare Advantage	$6.01
Rate for Payer: Fidelis Qualified Health Plan	$5.35
Rate for Payer: Group Health Inc Commercial	$6.01
Rate for Payer: Group Health Inc Medicare	$6.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.01
Rate for Payer: Hamaspik Choice Inc Medicare	$6.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$6.01
Rate for Payer: Healthfirst Essential Plan	$13.52
Rate for Payer: Healthfirst Medicare Advantage	$6.01
Rate for Payer: Healthfirst QHP	$6.01
Rate for Payer: Humana Medicare	$6.13
Rate for Payer: Senior Whole Health Medicare Advantage	$6.01
Rate for Payer: United Healthcare Commercial	$7.61
Rate for Payer: United Healthcare Medicare Advantage	$6.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6.01
Rate for Payer: Wellcare Medicare	$5.41

HC THROMBOPLAS TIME PARTIAL - APTT

Facility

$15.00

Service Code	CPT 85730
Hospital Charge Code	3058573001
Hospital Revenue Code	305
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.50

HC THROMBOPLAS TIME PARTIAL - PTT CRRT SYSTEM

Facility

$15.00

Service Code	CPT 85730
Hospital Charge Code	3058573002
Hospital Revenue Code	305
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.50

HC THROMBOPLAS TIME PARTIAL - PTT CRRT SYSTEM

Facility

$15.00

Service Code	CPT 85730
Hospital Charge Code	3058573002
Hospital Revenue Code	305
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$13.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.01
Rate for Payer: Aetna Government	$6.01
Rate for Payer: Affinity Essential Plan 1&2	$4.21
Rate for Payer: Affinity Essential Plan 3&4	$4.21
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.21
Rate for Payer: Brighton Health Commercial	$11.25
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.01
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.59
Rate for Payer: Elderplan Medicare Advantage	$6.01
Rate for Payer: EmblemHealth Commercial	$6.01
Rate for Payer: Fidelis CHP/HARP/Medicaid	$5.41
Rate for Payer: Fidelis Essential Plan Aliesa	$5.11
Rate for Payer: Fidelis Essential Plan QHP	$5.35
Rate for Payer: Fidelis Medicare Advantage	$6.01
Rate for Payer: Fidelis Qualified Health Plan	$5.35
Rate for Payer: Group Health Inc Commercial	$6.01
Rate for Payer: Group Health Inc Medicare	$6.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.01
Rate for Payer: Hamaspik Choice Inc Medicare	$6.01
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$6.01
Rate for Payer: Healthfirst Essential Plan	$13.52
Rate for Payer: Healthfirst Medicare Advantage	$6.01
Rate for Payer: Healthfirst QHP	$6.01
Rate for Payer: Humana Medicare	$6.13
Rate for Payer: Senior Whole Health Medicare Advantage	$6.01
Rate for Payer: United Healthcare Commercial	$7.61
Rate for Payer: United Healthcare Medicare Advantage	$6.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.01
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6.01
Rate for Payer: Wellcare Medicare	$5.41

HC THROMBOPLAS TIME PART PLASMA FRAC - EQUAL MIX,APTT

Facility

$16.00

Service Code	CPT 85732
Hospital Charge Code	3058573201
Hospital Revenue Code	305
Min. Negotiated Rate	$4.53
Max. Negotiated Rate	$14.06
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.47
Rate for Payer: Aetna Government	$6.47
Rate for Payer: Affinity Essential Plan 1&2	$4.53
Rate for Payer: Affinity Essential Plan 3&4	$4.53
Rate for Payer: Affinity Medicaid/CHP/HARP	$4.53
Rate for Payer: Brighton Health Commercial	$12.00
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$6.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.99
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.25
Rate for Payer: Elderplan Medicare Advantage	$6.47
Rate for Payer: EmblemHealth Commercial	$6.47
Rate for Payer: Fidelis CHP/HARP/Medicaid	$5.82
Rate for Payer: Fidelis Essential Plan Aliesa	$5.50
Rate for Payer: Fidelis Essential Plan QHP	$5.76
Rate for Payer: Fidelis Medicare Advantage	$6.47
Rate for Payer: Fidelis Qualified Health Plan	$5.76
Rate for Payer: Group Health Inc Commercial	$6.47
Rate for Payer: Group Health Inc Medicare	$6.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.47
Rate for Payer: Hamaspik Choice Inc Medicare	$6.47
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$6.25
Rate for Payer: Healthfirst Essential Plan	$14.06
Rate for Payer: Healthfirst Medicare Advantage	$6.47
Rate for Payer: Healthfirst QHP	$6.47
Rate for Payer: Humana Medicare	$6.60
Rate for Payer: Senior Whole Health Medicare Advantage	$6.47
Rate for Payer: United Healthcare Commercial	$8.20
Rate for Payer: United Healthcare Medicare Advantage	$6.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6.47
Rate for Payer: Wellcare CHP/FHP/Medicaid	$6.25
Rate for Payer: Wellcare Medicare	$5.82

HC THROMBOPLAS TIME PART PLASMA FRAC - EQUAL MIX,APTT

Facility

$16.00

Service Code	CPT 85732
Hospital Charge Code	3058573201
Hospital Revenue Code	305
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$8.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.00

HC THROMBOPLAS TIME PART PLASMA FRAC - PTT MIXING STUDY

Facility

$16.00

Service Code	CPT 85732
Hospital Charge Code	3058573202
Hospital Revenue Code	305
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$8.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.00

Know your out-of-pocket cost for care.

All Charges