St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

EGD US FIND NEEDLE BX/ASPIR

Facility

$4,716.98

Service Code	HCPCS 43242
Hospital Charge Code	41112831
Hospital Revenue Code	750
Min. Negotiated Rate	$955.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,200.46
Rate for Payer: Aetna Government	$2,200.46
Rate for Payer: Affinity Essential Plan 1&2	$1,540.32
Rate for Payer: Affinity Essential Plan 3&4	$1,540.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,540.32
Rate for Payer: Brighton Health Commercial	$955.00
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,200.46
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	$2,200.46
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$1,870.39
Rate for Payer: Fidelis Essential Plan QHP	$1,958.41
Rate for Payer: Fidelis Medicare Advantage	$2,200.46
Rate for Payer: Fidelis Qualified Health Plan	$1,958.41
Rate for Payer: Group Health Inc Commercial	$2,200.46
Rate for Payer: Group Health Inc Medicare	$2,200.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,358.49
Rate for Payer: Hamaspik Choice Inc Medicare	$2,200.46
Rate for Payer: Healthfirst Medicare Advantage	$1,870.39
Rate for Payer: Healthfirst QHP	$2,200.46
Rate for Payer: Humana Medicare	$2,244.47
Rate for Payer: Senior Whole Health Medicare Advantage	$2,200.46
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$2,200.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,200.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,760.37
Rate for Payer: Wellcare Medicare	$2,090.44

EGD US FIND NEEDLE BX/ASPIR

Facility

$4,716.98

Service Code	HCPCS 43242
Hospital Charge Code	41112831
Hospital Revenue Code	750
Rate for Payer: Cash Price	$2,200.46

EGD US FINE NEEDLE BX/ASPIR

Facility

$4,716.98

Service Code	HCPCS 43238
Hospital Charge Code	41112830
Hospital Revenue Code	750
Rate for Payer: Cash Price	$2,200.46

EGD US FINE NEEDLE BX/ASPIR

Facility

$4,716.98

Service Code	HCPCS 43238
Hospital Charge Code	41112830
Hospital Revenue Code	750
Min. Negotiated Rate	$955.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,888.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2,200.46
Rate for Payer: Aetna Government	$2,200.46
Rate for Payer: Affinity Essential Plan 1&2	$1,540.32
Rate for Payer: Affinity Essential Plan 3&4	$1,540.32
Rate for Payer: Affinity Medicaid/CHP/HARP	$1,540.32
Rate for Payer: Brighton Health Commercial	$955.00
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Cash Price	$2,200.46
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$2,200.46
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	$2,200.46
Rate for Payer: EmblemHealth Commercial	$1,505.00
Rate for Payer: Fidelis Essential Plan Aliesa	$1,870.39
Rate for Payer: Fidelis Essential Plan QHP	$1,958.41
Rate for Payer: Fidelis Medicare Advantage	$2,200.46
Rate for Payer: Fidelis Qualified Health Plan	$1,958.41
Rate for Payer: Group Health Inc Commercial	$2,200.46
Rate for Payer: Group Health Inc Medicare	$2,200.46
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,358.49
Rate for Payer: Hamaspik Choice Inc Medicare	$2,200.46
Rate for Payer: Healthfirst Medicare Advantage	$1,870.39
Rate for Payer: Healthfirst QHP	$2,200.46
Rate for Payer: Humana Medicare	$2,244.47
Rate for Payer: Senior Whole Health Medicare Advantage	$2,200.46
Rate for Payer: United Healthcare Commercial	$1,409.00
Rate for Payer: United Healthcare Medicare Advantage	$2,200.46
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,200.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$1,760.37
Rate for Payer: Wellcare Medicare	$2,090.44

Egg Crate Mattress

Facility

$111.63

Hospital Charge Code	40201430
Hospital Revenue Code	270
Min. Negotiated Rate	$39.07
Max. Negotiated Rate	$89.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$61.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$55.82
Rate for Payer: Aetna Government	$55.82
Rate for Payer: Brighton Health Commercial	$83.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$89.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$75.91
Rate for Payer: Group Health Inc Commercial	$55.82
Rate for Payer: Group Health Inc Medicare	$39.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$55.82
Rate for Payer: Hamaspik Choice Inc Medicare	$55.82

EKG

Facility

$145.50

Service Code	HCPCS 93000
Hospital Charge Code	30301306
Hospital Revenue Code	730
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$116.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.04
Rate for Payer: Aetna Government	$15.04
Rate for Payer: Brighton Health Commercial	$109.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$116.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$98.94
Rate for Payer: Group Health Inc Commercial	$72.75
Rate for Payer: Group Health Inc Medicare	$50.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.75
Rate for Payer: Hamaspik Choice Inc Medicare	$72.75
Rate for Payer: United Healthcare Commercial	$101.00

EKG, 12 LEAD &REPORT

Facility

$145.50

Service Code	HCPCS 93000
Hospital Charge Code	30301320
Hospital Revenue Code	730
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$116.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$80.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$15.04
Rate for Payer: Aetna Government	$15.04
Rate for Payer: Brighton Health Commercial	$109.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$116.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$98.94
Rate for Payer: Group Health Inc Commercial	$72.75
Rate for Payer: Group Health Inc Medicare	$50.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$72.75
Rate for Payer: Hamaspik Choice Inc Medicare	$72.75
Rate for Payer: United Healthcare Commercial	$101.00

EKG LEADS

Facility

$69.46

Hospital Charge Code	40201450
Hospital Revenue Code	270
Min. Negotiated Rate	$24.31
Max. Negotiated Rate	$55.57
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$38.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$34.73
Rate for Payer: Aetna Government	$34.73
Rate for Payer: Brighton Health Commercial	$52.10
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$55.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$47.23
Rate for Payer: Group Health Inc Commercial	$34.73
Rate for Payer: Group Health Inc Medicare	$24.31
Rate for Payer: Hamaspik Choice Inc Medicaid	$34.73
Rate for Payer: Hamaspik Choice Inc Medicare	$34.73

ELASTIC STOCKINGS

Facility

$19.85

Hospital Charge Code	40191410
Hospital Revenue Code	710
Min. Negotiated Rate	$6.95
Max. Negotiated Rate	$15.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$10.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$9.92
Rate for Payer: Aetna Government	$9.92
Rate for Payer: Brighton Health Commercial	$14.89
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$15.88
Rate for Payer: Cigna LocalPlus Benefit Plan	$13.50
Rate for Payer: Group Health Inc Commercial	$9.92
Rate for Payer: Group Health Inc Medicare	$6.95
Rate for Payer: Hamaspik Choice Inc Medicaid	$9.92
Rate for Payer: Hamaspik Choice Inc Medicare	$9.92

ELASTIC STOCKINGS

Facility

$61.67

Hospital Charge Code	40201410
Hospital Revenue Code	270
Min. Negotiated Rate	$21.58
Max. Negotiated Rate	$49.34
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.84
Rate for Payer: Aetna Government	$30.84
Rate for Payer: Brighton Health Commercial	$46.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$49.34
Rate for Payer: Cigna LocalPlus Benefit Plan	$41.94
Rate for Payer: Group Health Inc Commercial	$30.84
Rate for Payer: Group Health Inc Medicare	$21.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.84
Rate for Payer: Hamaspik Choice Inc Medicare	$30.84

ELASTOSIL HANDLE W/AO COUPLING

Facility

$420.00

Hospital Charge Code	40200644
Hospital Revenue Code	270
Min. Negotiated Rate	$147.00
Max. Negotiated Rate	$336.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$231.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$210.00
Rate for Payer: Aetna Government	$210.00
Rate for Payer: Brighton Health Commercial	$315.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$336.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$285.60
Rate for Payer: Group Health Inc Commercial	$210.00
Rate for Payer: Group Health Inc Medicare	$147.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$210.00
Rate for Payer: Hamaspik Choice Inc Medicare	$210.00

ELECTROACOUSTIC EVAL-HAE BINAURAL

Facility

$212.63

Service Code	HCPCS 92595
Hospital Charge Code	42004525
Hospital Revenue Code	470
Min. Negotiated Rate	$38.99
Max. Negotiated Rate	$170.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$116.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$38.99
Rate for Payer: Aetna Government	$38.99
Rate for Payer: Brighton Health Commercial	$159.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$170.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$144.59
Rate for Payer: Group Health Inc Commercial	$106.32
Rate for Payer: Group Health Inc Medicare	$74.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$106.32
Rate for Payer: Hamaspik Choice Inc Medicare	$106.32
Rate for Payer: United Healthcare Commercial	$158.00

ELECTROACOUSTIC EVAL -HAE MONAURA

Facility

$141.75

Service Code	HCPCS 92594
Hospital Charge Code	42004524
Hospital Revenue Code	470
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$158.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$77.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$18.19
Rate for Payer: Aetna Government	$18.19
Rate for Payer: Brighton Health Commercial	$106.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$113.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$96.39
Rate for Payer: Group Health Inc Commercial	$70.88
Rate for Payer: Group Health Inc Medicare	$49.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$70.88
Rate for Payer: Hamaspik Choice Inc Medicare	$70.88
Rate for Payer: United Healthcare Commercial	$158.00

ELECTROCHLEOGRAPHY

Facility

$419.03

Service Code	HCPCS 92584
Hospital Charge Code	42004515
Hospital Revenue Code	471
Rate for Payer: Cash Price	$180.64

ELECTROCHLEOGRAPHY

Facility

$419.03

Service Code	HCPCS 92584
Hospital Charge Code	42004515
Hospital Revenue Code	471
Min. Negotiated Rate	$126.45
Max. Negotiated Rate	$335.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$230.47
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$180.64
Rate for Payer: Aetna Government	$180.64
Rate for Payer: Affinity Essential Plan 1&2	$126.45
Rate for Payer: Affinity Essential Plan 3&4	$126.45
Rate for Payer: Affinity Medicaid/CHP/HARP	$126.45
Rate for Payer: Brighton Health Commercial	$314.27
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cash Price	$180.64
Rate for Payer: Cash Price	$180.64
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$180.64
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$335.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$284.94
Rate for Payer: Elderplan Medicare Advantage	$180.64
Rate for Payer: EmblemHealth Commercial	$180.64
Rate for Payer: Fidelis Essential Plan Aliesa	$153.54
Rate for Payer: Fidelis Essential Plan QHP	$160.77
Rate for Payer: Fidelis Medicare Advantage	$180.64
Rate for Payer: Fidelis Qualified Health Plan	$160.77
Rate for Payer: Group Health Inc Commercial	$180.64
Rate for Payer: Group Health Inc Medicare	$180.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$209.52
Rate for Payer: Hamaspik Choice Inc Medicare	$180.64
Rate for Payer: Healthfirst Medicare Advantage	$153.54
Rate for Payer: Healthfirst QHP	$180.64
Rate for Payer: Humana Medicare	$184.25
Rate for Payer: Senior Whole Health Medicare Advantage	$180.64
Rate for Payer: United Healthcare Commercial	$158.00
Rate for Payer: United Healthcare Medicare Advantage	$180.64
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$180.64
Rate for Payer: Wellcare CHP/FHP/Medicaid	$144.51
Rate for Payer: Wellcare Medicare	$171.61

ELECTRODE 33CM SPATULA CORBITT

Facility

$118.71

Hospital Charge Code	64904338
Hospital Revenue Code	270
Min. Negotiated Rate	$41.55
Max. Negotiated Rate	$94.97
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$65.29
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$59.36
Rate for Payer: Aetna Government	$59.36
Rate for Payer: Brighton Health Commercial	$89.03
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$94.97
Rate for Payer: Cigna LocalPlus Benefit Plan	$80.72
Rate for Payer: Group Health Inc Commercial	$59.36
Rate for Payer: Group Health Inc Medicare	$41.55
Rate for Payer: Hamaspik Choice Inc Medicaid	$59.36
Rate for Payer: Hamaspik Choice Inc Medicare	$59.36

ELECTRODE ACCESSARY ULT CLR 1

Facility

$11.62

Hospital Charge Code	64903991
Hospital Revenue Code	270
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$9.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.39
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.81
Rate for Payer: Aetna Government	$5.81
Rate for Payer: Brighton Health Commercial	$8.72
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.30
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.90
Rate for Payer: Group Health Inc Commercial	$5.81
Rate for Payer: Group Health Inc Medicare	$4.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.81
Rate for Payer: Hamaspik Choice Inc Medicare	$5.81

ELECTRODE ACCESSORY ULT CLEAN1

Facility

$10.40

Hospital Charge Code	40200402
Hospital Revenue Code	270
Min. Negotiated Rate	$3.64
Max. Negotiated Rate	$8.32
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.20
Rate for Payer: Aetna Government	$5.20
Rate for Payer: Brighton Health Commercial	$7.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.32
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.07
Rate for Payer: Group Health Inc Commercial	$5.20
Rate for Payer: Group Health Inc Medicare	$3.64
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.20
Rate for Payer: Hamaspik Choice Inc Medicare	$5.20

ELECTRODE,ADULT,QUIKCMBO2

Facility

$22.75

Hospital Charge Code	64903172
Hospital Revenue Code	270
Min. Negotiated Rate	$7.96
Max. Negotiated Rate	$18.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$12.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$11.38
Rate for Payer: Aetna Government	$11.38
Rate for Payer: Brighton Health Commercial	$17.06
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$18.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$15.47
Rate for Payer: Group Health Inc Commercial	$11.38
Rate for Payer: Group Health Inc Medicare	$7.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$11.38
Rate for Payer: Hamaspik Choice Inc Medicare	$11.38

ELECTRODE,BALL,5MM

Facility

$40.48

Hospital Charge Code	64903034
Hospital Revenue Code	270
Min. Negotiated Rate	$14.17
Max. Negotiated Rate	$32.38
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$22.26
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$20.24
Rate for Payer: Aetna Government	$20.24
Rate for Payer: Brighton Health Commercial	$30.36
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$32.38
Rate for Payer: Cigna LocalPlus Benefit Plan	$27.53
Rate for Payer: Group Health Inc Commercial	$20.24
Rate for Payer: Group Health Inc Medicare	$14.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$20.24
Rate for Payer: Hamaspik Choice Inc Medicare	$20.24

ELECTRODE,BLADE,ULTRACLEAN,6

Facility

$12.77

Hospital Charge Code	64903986
Hospital Revenue Code	270
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$10.22
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.38
Rate for Payer: Aetna Government	$6.38
Rate for Payer: Brighton Health Commercial	$9.58
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$10.22
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.68
Rate for Payer: Group Health Inc Commercial	$6.38
Rate for Payer: Group Health Inc Medicare	$4.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.38
Rate for Payer: Hamaspik Choice Inc Medicare	$6.38

ELECTRODE,ECG,SNAP,TEARDROP F

Facility

$0.22

Hospital Charge Code	64901642
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$0.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.11
Rate for Payer: Aetna Government	$0.11
Rate for Payer: Brighton Health Commercial	$0.17
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.15
Rate for Payer: Group Health Inc Commercial	$0.11
Rate for Payer: Group Health Inc Medicare	$0.08
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11
Rate for Payer: Hamaspik Choice Inc Medicare	$0.11

ELECTRODE EKG PATIENT RETURN DISP

Facility

$11.80

Hospital Charge Code	64903229
Hospital Revenue Code	270
Min. Negotiated Rate	$4.13
Max. Negotiated Rate	$9.44
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$6.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.90
Rate for Payer: Aetna Government	$5.90
Rate for Payer: Brighton Health Commercial	$8.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$9.44
Rate for Payer: Cigna LocalPlus Benefit Plan	$8.02
Rate for Payer: Group Health Inc Commercial	$5.90
Rate for Payer: Group Health Inc Medicare	$4.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$5.90
Rate for Payer: Hamaspik Choice Inc Medicare	$5.90

ELECTRODE EKG PATIENT RETURN DISP

Facility

$307.36

Hospital Charge Code	40200426
Hospital Revenue Code	270
Min. Negotiated Rate	$107.58
Max. Negotiated Rate	$245.89
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$169.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$153.68
Rate for Payer: Aetna Government	$153.68
Rate for Payer: Brighton Health Commercial	$230.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$245.89
Rate for Payer: Cigna LocalPlus Benefit Plan	$209.00
Rate for Payer: Group Health Inc Commercial	$153.68
Rate for Payer: Group Health Inc Medicare	$107.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$153.68
Rate for Payer: Hamaspik Choice Inc Medicare	$153.68

ELECTRODE ENDO 22FR 30 DEG

Facility

$1,966.90

Hospital Charge Code	64905091
Hospital Revenue Code	270
Min. Negotiated Rate	$688.42
Max. Negotiated Rate	$1,573.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,081.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$983.45
Rate for Payer: Aetna Government	$983.45
Rate for Payer: Brighton Health Commercial	$1,475.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,573.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,337.49
Rate for Payer: Group Health Inc Commercial	$983.45
Rate for Payer: Group Health Inc Medicare	$688.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$983.45
Rate for Payer: Hamaspik Choice Inc Medicare	$983.45

Know your out-of-pocket cost for care.

All Charges