St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

F024-IGE SHRIMP

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729269
Hospital Revenue Code	300
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F024-IGE SHRIMP

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729269
Hospital Revenue Code	300
Rate for Payer: Cash Price	$5.22

F025-IGE TOMATO

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729290
Hospital Revenue Code	300
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F025-IGE TOMATO

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729290
Hospital Revenue Code	300
Rate for Payer: Cash Price	$5.22

F026-IGE PORK

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729765
Hospital Revenue Code	305
Rate for Payer: Cash Price	$5.22

F026-IGE PORK

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729765
Hospital Revenue Code	305
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F027-IGE BEEF

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729299
Hospital Revenue Code	300
Rate for Payer: Cash Price	$5.22

F027-IGE BEEF

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729299
Hospital Revenue Code	300
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F031-IGE CARROT

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729308
Hospital Revenue Code	300
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F031-IGE CARROT

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729308
Hospital Revenue Code	300
Rate for Payer: Cash Price	$5.22

F033-IGE ORANGE

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729762
Hospital Revenue Code	305
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F033-IGE ORANGE

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729762
Hospital Revenue Code	305
Rate for Payer: Cash Price	$5.22

F035-IGE POTATO, WHITE

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729766
Hospital Revenue Code	305
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F035-IGE POTATO, WHITE

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729766
Hospital Revenue Code	305
Rate for Payer: Cash Price	$5.22

F036-IGE COCONUT

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729313
Hospital Revenue Code	300
Rate for Payer: Cash Price	$5.22

F036-IGE COCONUT

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729313
Hospital Revenue Code	300
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F037-IGE MUSSEL

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729780
Hospital Revenue Code	305
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F037-IGE MUSSEL

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729780
Hospital Revenue Code	305
Rate for Payer: Cash Price	$5.22

F040-IGE TUNA

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729285
Hospital Revenue Code	300
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F040-IGE TUNA

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729285
Hospital Revenue Code	300
Rate for Payer: Cash Price	$5.22

F041-IGE SALMON

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729287
Hospital Revenue Code	300
Rate for Payer: Cash Price	$5.22

F041-IGE SALMON

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729287
Hospital Revenue Code	300
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F044-IGE STRAWBERRY

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729300
Hospital Revenue Code	300
Rate for Payer: Cash Price	$5.22

F044-IGE STRAWBERRY

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729300
Hospital Revenue Code	300
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$9.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.18
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$5.22
Rate for Payer: Aetna Government	$5.22
Rate for Payer: Affinity Essential Plan 1&2	$3.65
Rate for Payer: Affinity Essential Plan 3&4	$3.65
Rate for Payer: Affinity Medicaid/CHP/HARP	$3.65
Rate for Payer: Brighton Health Commercial	$9.79
Rate for Payer: Cash Price	$5.22
Rate for Payer: Cash Price	$5.22
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$5.22
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$8.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$7.01
Rate for Payer: Elderplan Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$5.22
Rate for Payer: Fidelis Essential Plan Aliesa	$4.44
Rate for Payer: Fidelis Essential Plan QHP	$4.65
Rate for Payer: Fidelis Medicare Advantage	$5.22
Rate for Payer: Fidelis Qualified Health Plan	$4.65
Rate for Payer: Group Health Inc Commercial	$5.22
Rate for Payer: Group Health Inc Medicare	$5.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.52
Rate for Payer: Hamaspik Choice Inc Medicare	$5.22
Rate for Payer: Healthfirst Medicare Advantage	$5.22
Rate for Payer: Healthfirst QHP	$5.22
Rate for Payer: Humana Medicare	$5.32
Rate for Payer: Senior Whole Health Medicare Advantage	$5.22
Rate for Payer: United Healthcare Commercial	$6.61
Rate for Payer: United Healthcare Medicare Advantage	$5.22
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.22
Rate for Payer: Wellcare CHP/FHP/Medicaid	$4.18
Rate for Payer: Wellcare Medicare	$4.70

F049-IGE APPLE

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729781
Hospital Revenue Code	305
Rate for Payer: Cash Price	$5.22

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