St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

FEMORAL NERVE,CONT INFUS

Facility

$2,459.50

Service Code	HCPCS 64448
Hospital Charge Code	30305040
Hospital Revenue Code	510
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$780.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,054.06
Rate for Payer: Aetna Government	$1,054.06
Rate for Payer: Affinity Essential Plan 1&2	$737.84
Rate for Payer: Affinity Essential Plan 3&4	$737.84
Rate for Payer: Affinity Medicaid/CHP/HARP	$737.84
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Cash Price	$1,054.06
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$1,054.06
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	$1,054.06
Rate for Payer: Fidelis Essential Plan Aliesa	$895.95
Rate for Payer: Fidelis Essential Plan QHP	$938.11
Rate for Payer: Fidelis Medicare Advantage	$1,054.06
Rate for Payer: Fidelis Qualified Health Plan	$938.11
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	$1,229.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1,054.06
Rate for Payer: Healthfirst Medicare Advantage	$895.95
Rate for Payer: Healthfirst QHP	$1,054.06
Rate for Payer: Humana Medicare	$1,075.14
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$1,054.06
Rate for Payer: Senior Whole Health Medicare Advantage	$1,054.06
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$1,054.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,054.06
Rate for Payer: Wellcare CHP/FHP/Medicaid	$843.25
Rate for Payer: Wellcare Medicare	$1,001.36

FEMORAL NERVE,CONT INFUS

Facility

$2,459.50

Service Code	HCPCS 64448
Hospital Charge Code	30305040
Hospital Revenue Code	510
Rate for Payer: Cash Price	$1,054.06

FEMORAL NERVE,SINGLE

Facility

$1,893.13

Service Code	HCPCS 64447
Hospital Charge Code	30305041
Hospital Revenue Code	510
Min. Negotiated Rate	$222.00
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,134.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$799.72
Rate for Payer: Aetna Government	$799.72
Rate for Payer: Affinity Essential Plan 1&2	$559.80
Rate for Payer: Affinity Essential Plan 3&4	$559.80
Rate for Payer: Affinity Medicaid/CHP/HARP	$559.80
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$799.72
Rate for Payer: Cash Price	$799.72
Rate for Payer: Cash Price	$799.72
Rate for Payer: Cash Price	$799.72
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$799.72
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	$799.72
Rate for Payer: Fidelis Essential Plan Aliesa	$679.76
Rate for Payer: Fidelis Essential Plan QHP	$711.75
Rate for Payer: Fidelis Medicare Advantage	$799.72
Rate for Payer: Fidelis Qualified Health Plan	$711.75
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	$946.56
Rate for Payer: Hamaspik Choice Inc Medicare	$799.72
Rate for Payer: Healthfirst Medicare Advantage	$679.76
Rate for Payer: Healthfirst QHP	$799.72
Rate for Payer: Humana Medicare	$815.71
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$799.72
Rate for Payer: Senior Whole Health Medicare Advantage	$799.72
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$799.72
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$799.72
Rate for Payer: Wellcare CHP/FHP/Medicaid	$639.78
Rate for Payer: Wellcare Medicare	$759.73

FEMORAL NERVE,SINGLE

Facility

$1,893.13

Service Code	HCPCS 64447
Hospital Charge Code	30305041
Hospital Revenue Code	510
Rate for Payer: Cash Price	$799.72

FEMORAL NEXG LCCK SIZE D-LT

Facility

$24,600.00

Service Code	HCPCS C1776
Hospital Charge Code	64905869
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$25,830.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13,530.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$14,760.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12,300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$14,145.00
Rate for Payer: EmblemHealth Commercial	$12,300.00
Rate for Payer: Fidelis Medicare Advantage	$25,830.00
Rate for Payer: Group Health Inc Commercial	$12,300.00
Rate for Payer: Group Health Inc Medicare	$8,610.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12,300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15,990.00

FEMORAL NEXG LCCK SIZE D-LT

Facility

$24,600.00

Service Code	HCPCS C1776
Hospital Charge Code	64905869
Hospital Revenue Code	278
Min. Negotiated Rate	$12,300.00
Max. Negotiated Rate	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12,300.00

FEMORAL NEXG LCCK SIZE E-LT

Facility

$24,600.00

Service Code	HCPCS C1776
Hospital Charge Code	64905878
Hospital Revenue Code	278
Min. Negotiated Rate	$12,300.00
Max. Negotiated Rate	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12,300.00

FEMORAL NEXG LCCK SIZE E-LT

Facility

$24,600.00

Service Code	HCPCS C1776
Hospital Charge Code	64905878
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$25,830.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$13,530.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$14,760.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12,300.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$14,145.00
Rate for Payer: EmblemHealth Commercial	$12,300.00
Rate for Payer: Fidelis Medicare Advantage	$25,830.00
Rate for Payer: Group Health Inc Commercial	$12,300.00
Rate for Payer: Group Health Inc Medicare	$8,610.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$12,300.00
Rate for Payer: Hamaspik Choice Inc Medicare	$12,300.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$15,990.00

FEMORAL PERONEAL BYPASS

Facility

$5,171.19

Service Code	HCPCS 35566
Hospital Charge Code	40031900
Hospital Revenue Code	360
Min. Negotiated Rate	$1,496.00
Max. Negotiated Rate	$3,878.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,844.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,909.58
Rate for Payer: Aetna Government	$1,909.58
Rate for Payer: Brighton Health Commercial	$3,878.39
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: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$2,585.60
Rate for Payer: Group Health Inc Medicare	$1,809.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,585.60
Rate for Payer: Hamaspik Choice Inc Medicare	$2,585.60
Rate for Payer: United Healthcare Commercial	$1,496.00

FEMORAL POPLITEAL BYPASS

Facility

$4,177.74

Service Code	HCPCS 35556
Hospital Charge Code	40031905
Hospital Revenue Code	360
Min. Negotiated Rate	$1,462.21
Max. Negotiated Rate	$3,133.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,297.76
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,599.34
Rate for Payer: Aetna Government	$1,599.34
Rate for Payer: Brighton Health Commercial	$3,133.30
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: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$2,088.87
Rate for Payer: Group Health Inc Medicare	$1,462.21
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,088.87
Rate for Payer: Hamaspik Choice Inc Medicare	$2,088.87
Rate for Payer: United Healthcare Commercial	$1,496.00

FEMORAL POST BLK SZ E 5MM

Facility

$7,020.00

Service Code	HCPCS L1690
Hospital Charge Code	64905886
Hospital Revenue Code	278
Min. Negotiated Rate	$3,510.00
Max. Negotiated Rate	$3,510.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,510.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,510.00

FEMORAL POST BLK SZ E 5MM

Facility

$7,020.00

Service Code	HCPCS L1690
Hospital Charge Code	64905886
Hospital Revenue Code	278
Min. Negotiated Rate	$989.62
Max. Negotiated Rate	$7,371.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,861.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$989.62
Rate for Payer: Aetna Government	$989.62
Rate for Payer: Brighton Health Commercial	$4,212.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,510.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$4,036.50
Rate for Payer: EmblemHealth Commercial	$3,510.00
Rate for Payer: Fidelis Medicare Advantage	$7,371.00
Rate for Payer: Group Health Inc Commercial	$3,510.00
Rate for Payer: Group Health Inc Medicare	$2,457.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,510.00
Rate for Payer: Hamaspik Choice Inc Medicare	$3,510.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,563.00

FEMORAL PSN

Facility

$2,805.00

Service Code	HCPCS C1776
Hospital Charge Code	64907170
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$2,945.25
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,542.75
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$1,683.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,402.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$1,612.88
Rate for Payer: EmblemHealth Commercial	$1,402.50
Rate for Payer: Fidelis Medicare Advantage	$2,945.25
Rate for Payer: Group Health Inc Commercial	$1,402.50
Rate for Payer: Group Health Inc Medicare	$981.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,402.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,402.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,823.25

FEMORAL PSN

Facility

$2,805.00

Service Code	HCPCS C1776
Hospital Charge Code	64907170
Hospital Revenue Code	278
Min. Negotiated Rate	$1,402.50
Max. Negotiated Rate	$1,402.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,402.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1,402.50

FEMORAL STEM

Facility

$1,403.68

Hospital Charge Code	40202170
Hospital Revenue Code	270
Min. Negotiated Rate	$491.29
Max. Negotiated Rate	$1,122.94
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$772.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$701.84
Rate for Payer: Aetna Government	$701.84
Rate for Payer: Brighton Health Commercial	$1,052.76
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1,122.94
Rate for Payer: Cigna LocalPlus Benefit Plan	$954.50
Rate for Payer: Group Health Inc Commercial	$701.84
Rate for Payer: Group Health Inc Medicare	$491.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$701.84
Rate for Payer: Hamaspik Choice Inc Medicare	$701.84

FEMORAL TIBIAL BYPASS

Facility

$5,171.19

Service Code	HCPCS 35566
Hospital Charge Code	40031910
Hospital Revenue Code	360
Min. Negotiated Rate	$1,496.00
Max. Negotiated Rate	$3,878.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,844.15
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,909.58
Rate for Payer: Aetna Government	$1,909.58
Rate for Payer: Brighton Health Commercial	$3,878.39
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: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$2,585.60
Rate for Payer: Group Health Inc Medicare	$1,809.92
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,585.60
Rate for Payer: Hamaspik Choice Inc Medicare	$2,585.60
Rate for Payer: United Healthcare Commercial	$1,496.00

FEMORO FEMORAL BYPASS

Facility

$3,913.69

Service Code	HCPCS 35558
Hospital Charge Code	40031915
Hospital Revenue Code	360
Min. Negotiated Rate	$1,369.79
Max. Negotiated Rate	$2,935.27
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,152.53
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1,405.28
Rate for Payer: Aetna Government	$1,405.28
Rate for Payer: Brighton Health Commercial	$2,935.27
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: EmblemHealth Commercial	$1,505.00
Rate for Payer: Group Health Inc Commercial	$1,956.84
Rate for Payer: Group Health Inc Medicare	$1,369.79
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,956.84
Rate for Payer: Hamaspik Choice Inc Medicare	$1,956.84
Rate for Payer: United Healthcare Commercial	$1,496.00

FEM POST TRI AUG

Facility

$4,271.25

Service Code	HCPCS C1776
Hospital Charge Code	64907217
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$4,484.81
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2,349.19
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$2,562.75
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2,135.62
Rate for Payer: Cigna LocalPlus Benefit Plan	$2,455.97
Rate for Payer: EmblemHealth Commercial	$2,135.62
Rate for Payer: Fidelis Medicare Advantage	$4,484.81
Rate for Payer: Group Health Inc Commercial	$2,135.62
Rate for Payer: Group Health Inc Medicare	$1,494.94
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,135.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,135.62
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2,776.31

FEM POST TRI AUG

Facility

$4,271.25

Service Code	HCPCS C1776
Hospital Charge Code	64907217
Hospital Revenue Code	278
Min. Negotiated Rate	$2,135.62
Max. Negotiated Rate	$2,135.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$2,135.62
Rate for Payer: Hamaspik Choice Inc Medicare	$2,135.62

FEMRL COMPONENT 3 R CEMENTED

Facility

$688.00

Service Code	HCPCS C1776
Hospital Charge Code	40209704
Hospital Revenue Code	278
Min. Negotiated Rate	$240.80
Max. Negotiated Rate	$722.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$378.40
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$412.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$344.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$395.60
Rate for Payer: EmblemHealth Commercial	$344.00
Rate for Payer: Fidelis Medicare Advantage	$722.40
Rate for Payer: Group Health Inc Commercial	$344.00
Rate for Payer: Group Health Inc Medicare	$240.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$344.00
Rate for Payer: Hamaspik Choice Inc Medicare	$344.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$447.20

FEMRL COMPONENT 3 R CEMENTED

Facility

$688.00

Service Code	HCPCS C1776
Hospital Charge Code	40209704
Hospital Revenue Code	278
Min. Negotiated Rate	$344.00
Max. Negotiated Rate	$344.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$344.00
Rate for Payer: Hamaspik Choice Inc Medicare	$344.00

FEM STEM MRS

Facility

$13,018.12

Service Code	HCPCS C1776
Hospital Charge Code	64907280
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$13,669.03
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7,159.97
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$7,810.87
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$6,509.06
Rate for Payer: Cigna LocalPlus Benefit Plan	$7,485.42
Rate for Payer: EmblemHealth Commercial	$6,509.06
Rate for Payer: Fidelis Medicare Advantage	$13,669.03
Rate for Payer: Group Health Inc Commercial	$6,509.06
Rate for Payer: Group Health Inc Medicare	$4,556.34
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,509.06
Rate for Payer: Hamaspik Choice Inc Medicare	$6,509.06
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$8,461.78

FEM STEM MRS

Facility

$13,018.12

Service Code	HCPCS C1776
Hospital Charge Code	64907280
Hospital Revenue Code	278
Min. Negotiated Rate	$6,509.06
Max. Negotiated Rate	$6,509.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$6,509.06
Rate for Payer: Hamaspik Choice Inc Medicare	$6,509.06

FEM STM MRS W/O BD

Facility

$9,429.38

Service Code	HCPCS C1776
Hospital Charge Code	64907281
Hospital Revenue Code	278
Min. Negotiated Rate	$4,714.69
Max. Negotiated Rate	$4,714.69
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,714.69
Rate for Payer: Hamaspik Choice Inc Medicare	$4,714.69

FEM STM MRS W/O BD

Facility

$9,429.38

Service Code	HCPCS C1776
Hospital Charge Code	64907281
Hospital Revenue Code	278
Min. Negotiated Rate	$339.17
Max. Negotiated Rate	$9,900.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,186.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$339.17
Rate for Payer: Aetna Government	$339.17
Rate for Payer: Brighton Health Commercial	$5,657.63
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$4,714.69
Rate for Payer: Cigna LocalPlus Benefit Plan	$5,421.89
Rate for Payer: EmblemHealth Commercial	$4,714.69
Rate for Payer: Fidelis Medicare Advantage	$9,900.85
Rate for Payer: Group Health Inc Commercial	$4,714.69
Rate for Payer: Group Health Inc Medicare	$3,300.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$4,714.69
Rate for Payer: Hamaspik Choice Inc Medicare	$4,714.69
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,129.10

Know your out-of-pocket cost for care.

All Charges