St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

IRINOTECAN HCL 100 MG/5ML IV SOLN

Facility

$7.21

Service Code	HCPCS J9206
Hospital Charge Code	4596361455
Hospital Revenue Code	258
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$5.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.35
Rate for Payer: Aetna Government	$2.35
Rate for Payer: Brighton Health Commercial	$5.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.91
Rate for Payer: EmblemHealth Commercial	$3.61
Rate for Payer: Group Health Inc Commercial	$3.61
Rate for Payer: Group Health Inc Medicare	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.61
Rate for Payer: Hamaspik Choice Inc Medicare	$3.61
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.69

IRINOTECAN HCL 100 MG/5ML IV SOLN

Facility

$7.21

Service Code	HCPCS J9206
Hospital Charge Code	6050561281
Hospital Revenue Code	258
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$5.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.35
Rate for Payer: Aetna Government	$2.35
Rate for Payer: Brighton Health Commercial	$5.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.91
Rate for Payer: EmblemHealth Commercial	$3.61
Rate for Payer: Group Health Inc Commercial	$3.61
Rate for Payer: Group Health Inc Medicare	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.61
Rate for Payer: Hamaspik Choice Inc Medicare	$3.61
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.69

IRINOTECAN HCL 100 MG/5ML IV SOLN

Facility

$15.00

Service Code	HCPCS J9206
Hospital Charge Code	0143970101
Hospital Revenue Code	258
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$7.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.50

IRINOTECAN HCL 100 MG/5ML IV SOLN

Facility

$7.21

Service Code	HCPCS J9206
Hospital Charge Code	7070017022
Hospital Revenue Code	258
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$5.77
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.35
Rate for Payer: Aetna Government	$2.35
Rate for Payer: Brighton Health Commercial	$5.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.77
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.91
Rate for Payer: EmblemHealth Commercial	$3.61
Rate for Payer: Group Health Inc Commercial	$3.61
Rate for Payer: Group Health Inc Medicare	$2.52
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.61
Rate for Payer: Hamaspik Choice Inc Medicare	$3.61
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$1.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.69

IRINOTECAN HCL 100 MG/5ML IV SOLN

Facility

$7.21

Service Code	HCPCS J9206
Hospital Charge Code	4596361455
Hospital Revenue Code	258
Min. Negotiated Rate	$3.61
Max. Negotiated Rate	$3.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.61

IRINOTECAN HCL 100 MG/5ML IV SOLN

Facility

$7.21

Service Code	HCPCS J9206
Hospital Charge Code	6050561281
Hospital Revenue Code	258
Min. Negotiated Rate	$3.61
Max. Negotiated Rate	$3.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.61

IRINOTECAN HCL 100 MG/5ML IV SOLN

Facility

$7.21

Service Code	HCPCS J9206
Hospital Charge Code	7070017022
Hospital Revenue Code	258
Min. Negotiated Rate	$3.61
Max. Negotiated Rate	$3.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.61

IRINOTECAN HCL LIPOSOME 43 MG/10ML IV INJ

Facility

$331.92

Service Code	HCPCS J9205
Hospital Charge Code	1505400431
Hospital Revenue Code	258
Min. Negotiated Rate	$165.96
Max. Negotiated Rate	$165.96
Rate for Payer: Hamaspik Choice Inc Medicaid	$165.96

IRINOTECAN HCL LIPOSOME 43 MG/10ML IV INJ

Facility

$331.92

Service Code	HCPCS J9205
Hospital Charge Code	1505400431
Hospital Revenue Code	258
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$265.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$182.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$66.00
Rate for Payer: Aetna Government	$66.00
Rate for Payer: Affinity Essential Plan 1&2	$46.20
Rate for Payer: Affinity Essential Plan 3&4	$46.20
Rate for Payer: Affinity Medicaid/CHP/HARP	$46.20
Rate for Payer: Brighton Health Commercial	$248.94
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$66.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$265.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$225.71
Rate for Payer: Elderplan Medicare Advantage	$66.00
Rate for Payer: EmblemHealth Commercial	$66.00
Rate for Payer: Fidelis CHP/HARP/Medicaid	$59.40
Rate for Payer: Fidelis Essential Plan Aliesa	$56.10
Rate for Payer: Fidelis Essential Plan QHP	$58.74
Rate for Payer: Fidelis Medicare Advantage	$66.00
Rate for Payer: Fidelis Qualified Health Plan	$58.74
Rate for Payer: Group Health Inc Commercial	$66.00
Rate for Payer: Group Health Inc Medicare	$66.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$66.00
Rate for Payer: Hamaspik Choice Inc Medicare	$66.00
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$66.00
Rate for Payer: Healthfirst Medicare Advantage	$56.10
Rate for Payer: Healthfirst QHP	$66.00
Rate for Payer: Humana Medicare	$67.32
Rate for Payer: Senior Whole Health Medicare Advantage	$66.00
Rate for Payer: United Healthcare Medicare Advantage	$66.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$215.75
Rate for Payer: Wellcare CHP/FHP/Medicaid	$62.70
Rate for Payer: Wellcare Medicare	$62.70

IRON SUCROSE 20 MG/ML IV SOLN

Facility

$14.69

Service Code	HCPCS J1756
Hospital Charge Code	0517234010
Hospital Revenue Code	258
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.35

IRON SUCROSE 20 MG/ML IV SOLN

Facility

$14.69

Service Code	HCPCS J1756
Hospital Charge Code	0517234010
Hospital Revenue Code	258
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$27.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Affinity Essential Plan 1&2	$0.61
Rate for Payer: Affinity Essential Plan 3&4	$0.61
Rate for Payer: Affinity Medicaid/CHP/HARP	$0.27
Rate for Payer: Amida Care Medicaid	$0.27
Rate for Payer: Brighton Health Commercial	$11.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.99
Rate for Payer: EmblemHealth Commercial	$7.35
Rate for Payer: EmblemHealth Essential Plan 1&2	$0.61
Rate for Payer: EmblemHealth Essential Plan 3&4	$0.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.27
Rate for Payer: Fidelis Essential Plan Aliesa	$0.61
Rate for Payer: Fidelis Essential Plan QHP	$0.61
Rate for Payer: Fidelis Qualified Health Plan	$0.28
Rate for Payer: Group Health Inc Commercial	$7.35
Rate for Payer: Group Health Inc Medicare	$5.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$7.35
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27.00
Rate for Payer: Healthfirst Essential Plan	$0.61
Rate for Payer: Healthfirst QHP	$0.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.27
Rate for Payer: SOMOS Essential	$0.61
Rate for Payer: United Healthcare Essential Plan 1&2	$0.61
Rate for Payer: United Healthcare Essential Plan 3&4	$0.30
Rate for Payer: United Healthcare Medicaid	$0.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.55
Rate for Payer: Wellcare CHP/FHP/Medicaid	$0.27

IRON SUCROSE 20 MG/ML IV SOLN

Facility

$14.69

Service Code	HCPCS J1756
Hospital Charge Code	0517231005
Hospital Revenue Code	258
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.35

IRON SUCROSE 20 MG/ML IV SOLN

Facility

$14.69

Service Code	HCPCS J1756
Hospital Charge Code	0517231005
Hospital Revenue Code	258
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$27.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.23
Rate for Payer: Aetna Government	$0.23
Rate for Payer: Affinity Essential Plan 1&2	$0.61
Rate for Payer: Affinity Essential Plan 3&4	$0.61
Rate for Payer: Affinity Medicaid/CHP/HARP	$0.27
Rate for Payer: Amida Care Medicaid	$0.27
Rate for Payer: Brighton Health Commercial	$11.02
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.99
Rate for Payer: EmblemHealth Commercial	$7.35
Rate for Payer: EmblemHealth Essential Plan 1&2	$0.61
Rate for Payer: EmblemHealth Essential Plan 3&4	$0.27
Rate for Payer: Fidelis CHP/HARP/Medicaid	$0.27
Rate for Payer: Fidelis Essential Plan Aliesa	$0.61
Rate for Payer: Fidelis Essential Plan QHP	$0.61
Rate for Payer: Fidelis Qualified Health Plan	$0.28
Rate for Payer: Group Health Inc Commercial	$7.35
Rate for Payer: Group Health Inc Medicare	$5.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.27
Rate for Payer: Hamaspik Choice Inc Medicare	$7.35
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$27.00
Rate for Payer: Healthfirst Essential Plan	$0.61
Rate for Payer: Healthfirst QHP	$0.44
Rate for Payer: SOMOS CHP/HARP/Medicaid	$0.27
Rate for Payer: SOMOS Essential	$0.61
Rate for Payer: United Healthcare Essential Plan 1&2	$0.61
Rate for Payer: United Healthcare Essential Plan 3&4	$0.30
Rate for Payer: United Healthcare Medicaid	$0.27
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.55
Rate for Payer: Wellcare CHP/FHP/Medicaid	$0.27

IRRITABLE BOWEL SYNDROME

Facility

$181.92

Service Code	EAPG 00632
Min. Negotiated Rate	$131.92
Max. Negotiated Rate	$181.92
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$131.92
Rate for Payer: Healthfirst Commercial	$181.92

ISATUXIMAB-IRFC 100 MG/5ML IV SOLN

Facility

$185.33

Service Code	HCPCS J9227
Hospital Charge Code	0024065401
Hospital Revenue Code	258
Min. Negotiated Rate	$92.66
Max. Negotiated Rate	$92.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$92.66

ISATUXIMAB-IRFC 100 MG/5ML IV SOLN

Facility

$185.33

Service Code	HCPCS J9227
Hospital Charge Code	0024065401
Hospital Revenue Code	258
Min. Negotiated Rate	$57.33
Max. Negotiated Rate	$148.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$101.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$81.90
Rate for Payer: Aetna Government	$81.90
Rate for Payer: Affinity Essential Plan 1&2	$57.33
Rate for Payer: Affinity Essential Plan 3&4	$57.33
Rate for Payer: Affinity Medicaid/CHP/HARP	$57.33
Rate for Payer: Brighton Health Commercial	$138.99
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$81.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$148.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$126.02
Rate for Payer: Elderplan Medicare Advantage	$81.90
Rate for Payer: EmblemHealth Commercial	$81.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$73.71
Rate for Payer: Fidelis Essential Plan Aliesa	$69.61
Rate for Payer: Fidelis Essential Plan QHP	$72.89
Rate for Payer: Fidelis Medicare Advantage	$81.90
Rate for Payer: Fidelis Qualified Health Plan	$72.89
Rate for Payer: Group Health Inc Commercial	$81.90
Rate for Payer: Group Health Inc Medicare	$81.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.90
Rate for Payer: Hamaspik Choice Inc Medicare	$81.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$81.90
Rate for Payer: Healthfirst Medicare Advantage	$69.61
Rate for Payer: Healthfirst QHP	$81.90
Rate for Payer: Humana Medicare	$83.54
Rate for Payer: Senior Whole Health Medicare Advantage	$81.90
Rate for Payer: United Healthcare Medicare Advantage	$81.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$120.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$77.81
Rate for Payer: Wellcare Medicare	$77.81

ISATUXIMAB-IRFC 500 MG/25ML IV SOLN

Facility

$185.33

Service Code	HCPCS J9227
Hospital Charge Code	0024065601
Hospital Revenue Code	258
Min. Negotiated Rate	$92.66
Max. Negotiated Rate	$92.66
Rate for Payer: Hamaspik Choice Inc Medicaid	$92.66

ISATUXIMAB-IRFC 500 MG/25ML IV SOLN

Facility

$185.33

Service Code	HCPCS J9227
Hospital Charge Code	0024065601
Hospital Revenue Code	258
Min. Negotiated Rate	$57.33
Max. Negotiated Rate	$148.26
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$101.93
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$81.90
Rate for Payer: Aetna Government	$81.90
Rate for Payer: Affinity Essential Plan 1&2	$57.33
Rate for Payer: Affinity Essential Plan 3&4	$57.33
Rate for Payer: Affinity Medicaid/CHP/HARP	$57.33
Rate for Payer: Brighton Health Commercial	$138.99
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$81.90
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$148.26
Rate for Payer: Cigna LocalPlus Benefit Plan	$126.02
Rate for Payer: Elderplan Medicare Advantage	$81.90
Rate for Payer: EmblemHealth Commercial	$81.90
Rate for Payer: Fidelis CHP/HARP/Medicaid	$73.71
Rate for Payer: Fidelis Essential Plan Aliesa	$69.61
Rate for Payer: Fidelis Essential Plan QHP	$72.89
Rate for Payer: Fidelis Medicare Advantage	$81.90
Rate for Payer: Fidelis Qualified Health Plan	$72.89
Rate for Payer: Group Health Inc Commercial	$81.90
Rate for Payer: Group Health Inc Medicare	$81.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$81.90
Rate for Payer: Hamaspik Choice Inc Medicare	$81.90
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$81.90
Rate for Payer: Healthfirst Medicare Advantage	$69.61
Rate for Payer: Healthfirst QHP	$81.90
Rate for Payer: Humana Medicare	$83.54
Rate for Payer: Senior Whole Health Medicare Advantage	$81.90
Rate for Payer: United Healthcare Medicare Advantage	$81.90
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$120.46
Rate for Payer: Wellcare CHP/FHP/Medicaid	$77.81
Rate for Payer: Wellcare Medicare	$77.81

ISAVUCONAZONIUM SULFATE 186 MG PO CAPS

Facility

$121.16

Service Code	NDC 0469052014
Hospital Charge Code	0469052014
Hospital Revenue Code	250
Min. Negotiated Rate	$42.41
Max. Negotiated Rate	$96.93
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$66.64
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$60.58
Rate for Payer: Aetna Government	$60.58
Rate for Payer: Brighton Health Commercial	$90.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$96.93
Rate for Payer: Cigna LocalPlus Benefit Plan	$82.39
Rate for Payer: EmblemHealth Commercial	$60.58
Rate for Payer: Group Health Inc Commercial	$60.58
Rate for Payer: Group Health Inc Medicare	$42.41
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.58
Rate for Payer: Hamaspik Choice Inc Medicare	$60.58
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$78.75

ISAVUCONAZONIUM SULFATE 186 MG PO CAPS

Facility

$121.16

Service Code	NDC 0469052014
Hospital Charge Code	0469052014
Hospital Revenue Code	250
Min. Negotiated Rate	$60.58
Max. Negotiated Rate	$60.58
Rate for Payer: Hamaspik Choice Inc Medicaid	$60.58

ISOFLURANE IN SOLN

Facility

$0.29

Service Code	NDC 1001936040
Hospital Charge Code	1001936040
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$0.14
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14

ISOFLURANE IN SOLN

Facility

$0.29

Service Code	NDC 1001936040
Hospital Charge Code	1001936040
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$0.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.14
Rate for Payer: Aetna Government	$0.14
Rate for Payer: Brighton Health Commercial	$0.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.20
Rate for Payer: EmblemHealth Commercial	$0.14
Rate for Payer: Group Health Inc Commercial	$0.14
Rate for Payer: Group Health Inc Medicare	$0.10
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.14
Rate for Payer: Hamaspik Choice Inc Medicare	$0.14
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.19

ISONIAZID 100 MG PO TABS

Facility

$0.15

Service Code	NDC 0555006602
Hospital Charge Code	0555006602
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$0.12
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.08
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.07
Rate for Payer: Aetna Government	$0.07
Rate for Payer: Brighton Health Commercial	$0.11
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.12
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.10
Rate for Payer: EmblemHealth Commercial	$0.07
Rate for Payer: Group Health Inc Commercial	$0.07
Rate for Payer: Group Health Inc Medicare	$0.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07
Rate for Payer: Hamaspik Choice Inc Medicare	$0.07
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.10

ISONIAZID 100 MG PO TABS

Facility

$0.15

Service Code	NDC 0555006602
Hospital Charge Code	0555006602
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.07

ISONIAZID 100 MG PO TABS

Facility

$2.42

Service Code	NDC 8166510710
Hospital Charge Code	8166510710
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$1.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.33
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.21
Rate for Payer: Aetna Government	$1.21
Rate for Payer: Brighton Health Commercial	$1.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.65
Rate for Payer: EmblemHealth Commercial	$1.21
Rate for Payer: Group Health Inc Commercial	$1.21
Rate for Payer: Group Health Inc Medicare	$0.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.21
Rate for Payer: Hamaspik Choice Inc Medicare	$1.21
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.57

Know your out-of-pocket cost for care.

All Charges