St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

CARBOPLATIN 450 MG/45ML IV SOLN

Facility

$1.26

Service Code	HCPCS J9045
Hospital Charge Code	6170333950
Hospital Revenue Code	258
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$2.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.64
Rate for Payer: Aetna Government	$2.64
Rate for Payer: Brighton Health Commercial	$0.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.85
Rate for Payer: EmblemHealth Commercial	$0.63
Rate for Payer: Group Health Inc Commercial	$0.63
Rate for Payer: Group Health Inc Medicare	$0.44
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.63
Rate for Payer: Hamaspik Choice Inc Medicare	$0.63
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.82

CARBOPLATIN 450 MG/45ML IV SOLN

Facility

$1.14

Service Code	HCPCS J9045
Hospital Charge Code	5515033501
Hospital Revenue Code	258
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$0.57
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.57

CARBOPLATIN 450 MG/45ML IV SOLN

Facility

$1.14

Service Code	HCPCS J9045
Hospital Charge Code	5515033501
Hospital Revenue Code	258
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$2.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.64
Rate for Payer: Aetna Government	$2.64
Rate for Payer: Brighton Health Commercial	$0.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.91
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.78
Rate for Payer: EmblemHealth Commercial	$0.57
Rate for Payer: Group Health Inc Commercial	$0.57
Rate for Payer: Group Health Inc Medicare	$0.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.57
Rate for Payer: Hamaspik Choice Inc Medicare	$0.57
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.74

CARBOPLATIN 50 MG/5ML IV SOLN

Facility

$3.22

Service Code	HCPCS J9045
Hospital Charge Code	6170333918
Hospital Revenue Code	258
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$2.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.77
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.64
Rate for Payer: Aetna Government	$2.64
Rate for Payer: Brighton Health Commercial	$2.41
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.57
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.19
Rate for Payer: EmblemHealth Commercial	$1.61
Rate for Payer: Group Health Inc Commercial	$1.61
Rate for Payer: Group Health Inc Medicare	$1.13
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.61
Rate for Payer: Hamaspik Choice Inc Medicare	$1.61
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.09

CARBOPLATIN 50 MG/5ML IV SOLN

Facility

$1.98

Service Code	HCPCS J9045
Hospital Charge Code	0703424401
Hospital Revenue Code	258
Min. Negotiated Rate	$0.99
Max. Negotiated Rate	$0.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.99

CARBOPLATIN 50 MG/5ML IV SOLN

Facility

$1.98

Service Code	HCPCS J9045
Hospital Charge Code	0703424401
Hospital Revenue Code	258
Min. Negotiated Rate	$0.69
Max. Negotiated Rate	$2.64
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.64
Rate for Payer: Aetna Government	$2.64
Rate for Payer: Brighton Health Commercial	$1.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.35
Rate for Payer: EmblemHealth Commercial	$0.99
Rate for Payer: Group Health Inc Commercial	$0.99
Rate for Payer: Group Health Inc Medicare	$0.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.99
Rate for Payer: Hamaspik Choice Inc Medicare	$0.99
Rate for Payer: Healthfirst CHP/FHP/Medicaid	$2.47
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.29

CARBOPLATIN 50 MG/5ML IV SOLN

Facility

$3.22

Service Code	HCPCS J9045
Hospital Charge Code	6170333918
Hospital Revenue Code	258
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$1.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.61

CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN

Facility

$177.60

Service Code	HCPCS J0675
Hospital Charge Code	5515045901
Hospital Revenue Code	250
Min. Negotiated Rate	$88.80
Max. Negotiated Rate	$88.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$88.80

CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN

Facility

$382.79

Service Code	HCPCS J0675
Hospital Charge Code	6978424010
Hospital Revenue Code	250
Min. Negotiated Rate	$191.39
Max. Negotiated Rate	$191.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$191.39

CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN

Facility

$382.79

Service Code	HCPCS J0675
Hospital Charge Code	4359891958
Hospital Revenue Code	250
Min. Negotiated Rate	$35.73
Max. Negotiated Rate	$306.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$210.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.05
Rate for Payer: Aetna Government	$51.05
Rate for Payer: Affinity Essential Plan 1&2	$35.73
Rate for Payer: Affinity Essential Plan 3&4	$35.73
Rate for Payer: Affinity Medicaid/CHP/HARP	$35.73
Rate for Payer: Brighton Health Commercial	$287.09
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$51.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$306.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$260.30
Rate for Payer: Elderplan Medicare Advantage	$51.05
Rate for Payer: EmblemHealth Commercial	$51.05
Rate for Payer: Fidelis CHP/HARP/Medicaid	$45.95
Rate for Payer: Fidelis Essential Plan Aliesa	$43.39
Rate for Payer: Fidelis Essential Plan QHP	$45.43
Rate for Payer: Fidelis Medicare Advantage	$51.05
Rate for Payer: Fidelis Qualified Health Plan	$45.43
Rate for Payer: Group Health Inc Commercial	$51.05
Rate for Payer: Group Health Inc Medicare	$51.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.05
Rate for Payer: Hamaspik Choice Inc Medicare	$51.05
Rate for Payer: Healthfirst Medicare Advantage	$43.39
Rate for Payer: Healthfirst QHP	$51.05
Rate for Payer: Humana Medicare	$52.07
Rate for Payer: Senior Whole Health Medicare Advantage	$51.05
Rate for Payer: United Healthcare Medicare Advantage	$51.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$248.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$48.50
Rate for Payer: Wellcare Medicare	$48.50

CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN

Facility

$177.60

Service Code	HCPCS J0675
Hospital Charge Code	8129850101
Hospital Revenue Code	250
Min. Negotiated Rate	$35.73
Max. Negotiated Rate	$142.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$97.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.05
Rate for Payer: Aetna Government	$51.05
Rate for Payer: Affinity Essential Plan 1&2	$35.73
Rate for Payer: Affinity Essential Plan 3&4	$35.73
Rate for Payer: Affinity Medicaid/CHP/HARP	$35.73
Rate for Payer: Brighton Health Commercial	$133.20
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$51.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$120.77
Rate for Payer: Elderplan Medicare Advantage	$51.05
Rate for Payer: EmblemHealth Commercial	$51.05
Rate for Payer: Fidelis CHP/HARP/Medicaid	$45.95
Rate for Payer: Fidelis Essential Plan Aliesa	$43.39
Rate for Payer: Fidelis Essential Plan QHP	$45.43
Rate for Payer: Fidelis Medicare Advantage	$51.05
Rate for Payer: Fidelis Qualified Health Plan	$45.43
Rate for Payer: Group Health Inc Commercial	$51.05
Rate for Payer: Group Health Inc Medicare	$51.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.05
Rate for Payer: Hamaspik Choice Inc Medicare	$51.05
Rate for Payer: Healthfirst Medicare Advantage	$43.39
Rate for Payer: Healthfirst QHP	$51.05
Rate for Payer: Humana Medicare	$52.07
Rate for Payer: Senior Whole Health Medicare Advantage	$51.05
Rate for Payer: United Healthcare Medicare Advantage	$51.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$115.44
Rate for Payer: Wellcare CHP/FHP/Medicaid	$48.50
Rate for Payer: Wellcare Medicare	$48.50

CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN

Facility

$177.60

Service Code	HCPCS J0675
Hospital Charge Code	8129850101
Hospital Revenue Code	250
Min. Negotiated Rate	$88.80
Max. Negotiated Rate	$88.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$88.80

CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN

Facility

$177.60

Service Code	HCPCS J0675
Hospital Charge Code	5515045901
Hospital Revenue Code	250
Min. Negotiated Rate	$35.73
Max. Negotiated Rate	$142.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$97.68
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.05
Rate for Payer: Aetna Government	$51.05
Rate for Payer: Affinity Essential Plan 1&2	$35.73
Rate for Payer: Affinity Essential Plan 3&4	$35.73
Rate for Payer: Affinity Medicaid/CHP/HARP	$35.73
Rate for Payer: Brighton Health Commercial	$133.20
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$51.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$142.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$120.77
Rate for Payer: Elderplan Medicare Advantage	$51.05
Rate for Payer: EmblemHealth Commercial	$51.05
Rate for Payer: Fidelis CHP/HARP/Medicaid	$45.95
Rate for Payer: Fidelis Essential Plan Aliesa	$43.39
Rate for Payer: Fidelis Essential Plan QHP	$45.43
Rate for Payer: Fidelis Medicare Advantage	$51.05
Rate for Payer: Fidelis Qualified Health Plan	$45.43
Rate for Payer: Group Health Inc Commercial	$51.05
Rate for Payer: Group Health Inc Medicare	$51.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.05
Rate for Payer: Hamaspik Choice Inc Medicare	$51.05
Rate for Payer: Healthfirst Medicare Advantage	$43.39
Rate for Payer: Healthfirst QHP	$51.05
Rate for Payer: Humana Medicare	$52.07
Rate for Payer: Senior Whole Health Medicare Advantage	$51.05
Rate for Payer: United Healthcare Medicare Advantage	$51.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$115.44
Rate for Payer: Wellcare CHP/FHP/Medicaid	$48.50
Rate for Payer: Wellcare Medicare	$48.50

CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN

Facility

$382.79

Service Code	HCPCS J0675
Hospital Charge Code	6978424010
Hospital Revenue Code	250
Min. Negotiated Rate	$35.73
Max. Negotiated Rate	$306.23
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$210.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$51.05
Rate for Payer: Aetna Government	$51.05
Rate for Payer: Affinity Essential Plan 1&2	$35.73
Rate for Payer: Affinity Essential Plan 3&4	$35.73
Rate for Payer: Affinity Medicaid/CHP/HARP	$35.73
Rate for Payer: Brighton Health Commercial	$287.09
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$51.05
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$306.23
Rate for Payer: Cigna LocalPlus Benefit Plan	$260.30
Rate for Payer: Elderplan Medicare Advantage	$51.05
Rate for Payer: EmblemHealth Commercial	$51.05
Rate for Payer: Fidelis CHP/HARP/Medicaid	$45.95
Rate for Payer: Fidelis Essential Plan Aliesa	$43.39
Rate for Payer: Fidelis Essential Plan QHP	$45.43
Rate for Payer: Fidelis Medicare Advantage	$51.05
Rate for Payer: Fidelis Qualified Health Plan	$45.43
Rate for Payer: Group Health Inc Commercial	$51.05
Rate for Payer: Group Health Inc Medicare	$51.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$51.05
Rate for Payer: Hamaspik Choice Inc Medicare	$51.05
Rate for Payer: Healthfirst Medicare Advantage	$43.39
Rate for Payer: Healthfirst QHP	$51.05
Rate for Payer: Humana Medicare	$52.07
Rate for Payer: Senior Whole Health Medicare Advantage	$51.05
Rate for Payer: United Healthcare Medicare Advantage	$51.05
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$248.81
Rate for Payer: Wellcare CHP/FHP/Medicaid	$48.50
Rate for Payer: Wellcare Medicare	$48.50

CARBOPROST TROMETHAMINE 250 MCG/ML IM SOLN

Facility

$382.79

Service Code	HCPCS J0675
Hospital Charge Code	4359891958
Hospital Revenue Code	250
Min. Negotiated Rate	$191.39
Max. Negotiated Rate	$191.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$191.39

CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OP SOLN

Facility

$0.67

Service Code	NDC 0023079815
Hospital Charge Code	0023079815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.54
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.37
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.34
Rate for Payer: Aetna Government	$0.34
Rate for Payer: Brighton Health Commercial	$0.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.54
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.46
Rate for Payer: EmblemHealth Commercial	$0.34
Rate for Payer: Group Health Inc Commercial	$0.34
Rate for Payer: Group Health Inc Medicare	$0.23
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34
Rate for Payer: Hamaspik Choice Inc Medicare	$0.34
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.44

CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OP SOLN

Facility

$0.49

Service Code	NDC 0023079801
Hospital Charge Code	0023079801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$0.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25

CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OP SOLN

Facility

$0.67

Service Code	NDC 0023079815
Hospital Charge Code	0023079815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.34
Max. Negotiated Rate	$0.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.34

CARBOXYMETHYLCELLULOSE SODIUM 0.5 % OP SOLN

Facility

$0.49

Service Code	NDC 0023079801
Hospital Charge Code	0023079801
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$0.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.27
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.25
Rate for Payer: Aetna Government	$0.25
Rate for Payer: Brighton Health Commercial	$0.37
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.34
Rate for Payer: EmblemHealth Commercial	$0.25
Rate for Payer: Group Health Inc Commercial	$0.25
Rate for Payer: Group Health Inc Medicare	$0.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.25
Rate for Payer: Hamaspik Choice Inc Medicare	$0.25
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.32

CARBOXYMETHYLCELLULOSE SODIUM 1 % OP GEL

Facility

$0.70

Service Code	NDC 0023920515
Hospital Charge Code	0023920515
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$0.56
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.38
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.35
Rate for Payer: Aetna Government	$0.35
Rate for Payer: Brighton Health Commercial	$0.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.56
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.47
Rate for Payer: EmblemHealth Commercial	$0.35
Rate for Payer: Group Health Inc Commercial	$0.35
Rate for Payer: Group Health Inc Medicare	$0.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.35
Rate for Payer: Hamaspik Choice Inc Medicare	$0.35
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.45

CARBOXYMETHYLCELLULOSE SODIUM 1 % OP GEL

Facility

$0.70

Service Code	NDC 0023920515
Hospital Charge Code	0023920515
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.35

CARBOXYMETHYLCELLULOSE SODIUM 1 % OP SOLN

Facility

$0.21

Service Code	NDC 7040392115
Hospital Charge Code	7040392115
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$0.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11

CARBOXYMETHYLCELLULOSE SODIUM 1 % OP SOLN

Facility

$0.21

Service Code	NDC 7040392115
Hospital Charge Code	7040392115
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$0.17
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	$0.16
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.17
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.14
Rate for Payer: EmblemHealth Commercial	$0.11
Rate for Payer: Group Health Inc Commercial	$0.11
Rate for Payer: Group Health Inc Medicare	$0.07
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.11
Rate for Payer: Hamaspik Choice Inc Medicare	$0.11
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.14

CARBOXYMETHYLCELLULOSE SOD PF 1 % OP GEL

Facility

$0.44

Service Code	NDC 0023455430
Hospital Charge Code	0023455430
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$0.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22

CARBOXYMETHYLCELLULOSE SOD PF 1 % OP GEL

Facility

$0.44

Service Code	NDC 0023455430
Hospital Charge Code	0023455430
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$0.35
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.24
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.22
Rate for Payer: Aetna Government	$0.22
Rate for Payer: Brighton Health Commercial	$0.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.35
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.30
Rate for Payer: EmblemHealth Commercial	$0.22
Rate for Payer: Group Health Inc Commercial	$0.22
Rate for Payer: Group Health Inc Medicare	$0.15
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.22
Rate for Payer: Hamaspik Choice Inc Medicare	$0.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.29

Know your out-of-pocket cost for care.

All Charges