St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

GLYCOLIC ACID 35% 120ML

Facility

$60.00

Hospital Charge Code	41658009
Hospital Revenue Code	250
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Brighton Health Commercial	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$39.00

GLYCOLIC ACID 35% 120ML

Facility

$60.00

Hospital Charge Code	41648009
Hospital Revenue Code	250
Min. Negotiated Rate	$21.00
Max. Negotiated Rate	$48.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$33.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$30.00
Rate for Payer: Aetna Government	$30.00
Rate for Payer: Brighton Health Commercial	$45.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$48.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$40.80
Rate for Payer: Group Health Inc Commercial	$30.00
Rate for Payer: Group Health Inc Medicare	$21.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$30.00
Rate for Payer: Hamaspik Choice Inc Medicare	$30.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$39.00

GLYCOLIC ACID 50% 120ML

Facility

$79.00

Hospital Charge Code	41658010
Hospital Revenue Code	250
Min. Negotiated Rate	$27.65
Max. Negotiated Rate	$63.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$43.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$39.50
Rate for Payer: Aetna Government	$39.50
Rate for Payer: Brighton Health Commercial	$59.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$53.72
Rate for Payer: Group Health Inc Commercial	$39.50
Rate for Payer: Group Health Inc Medicare	$27.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$39.50
Rate for Payer: Hamaspik Choice Inc Medicare	$39.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$51.35

GLYCOLIC ACID 50% 120ML

Facility

$79.00

Hospital Charge Code	41648010
Hospital Revenue Code	250
Min. Negotiated Rate	$27.65
Max. Negotiated Rate	$63.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$43.45
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$39.50
Rate for Payer: Aetna Government	$39.50
Rate for Payer: Brighton Health Commercial	$59.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$63.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$53.72
Rate for Payer: Group Health Inc Commercial	$39.50
Rate for Payer: Group Health Inc Medicare	$27.65
Rate for Payer: Hamaspik Choice Inc Medicaid	$39.50
Rate for Payer: Hamaspik Choice Inc Medicare	$39.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$51.35

GLYCOLIC ACID 70% 120ML

Facility

$104.00

Hospital Charge Code	41648011
Hospital Revenue Code	250
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$83.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$52.00
Rate for Payer: Aetna Government	$52.00
Rate for Payer: Brighton Health Commercial	$78.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$83.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$70.72
Rate for Payer: Group Health Inc Commercial	$52.00
Rate for Payer: Group Health Inc Medicare	$36.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$67.60

GLYCOLIC ACID 70% 120ML

Facility

$104.00

Hospital Charge Code	41658011
Hospital Revenue Code	250
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$83.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$57.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$52.00
Rate for Payer: Aetna Government	$52.00
Rate for Payer: Brighton Health Commercial	$78.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$83.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$70.72
Rate for Payer: Group Health Inc Commercial	$52.00
Rate for Payer: Group Health Inc Medicare	$36.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$52.00
Rate for Payer: Hamaspik Choice Inc Medicare	$52.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$67.60

GLYCOPYRROLATE 0.2 MG/ML IJ SOLN (WRAPPED) [401302]

Facility

$14.38

Service Code	NDC 00517460225
Hospital Charge Code	00517460225
Hospital Revenue Code	250
Min. Negotiated Rate	$5.03
Max. Negotiated Rate	$11.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.91
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.19
Rate for Payer: Aetna Government	$7.19
Rate for Payer: Brighton Health Commercial	$10.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.78
Rate for Payer: Group Health Inc Commercial	$7.19
Rate for Payer: Group Health Inc Medicare	$5.03
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.19
Rate for Payer: Hamaspik Choice Inc Medicare	$7.19
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.34

GLYCOPYRROLATE 0.2 MG/ML IJ SOLN (WRAPPED) [401302]

Facility

$4.56

Service Code	NDC 51754600004
Hospital Charge Code	51754600004
Hospital Revenue Code	250
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$3.65
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$2.51
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$2.28
Rate for Payer: Aetna Government	$2.28
Rate for Payer: Brighton Health Commercial	$3.42
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3.65
Rate for Payer: Cigna LocalPlus Benefit Plan	$3.10
Rate for Payer: Group Health Inc Commercial	$2.28
Rate for Payer: Group Health Inc Medicare	$1.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$2.28
Rate for Payer: Hamaspik Choice Inc Medicare	$2.28
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.96

GLYCOPYRROLATE 0.2 MG/ML IJ SOLN (WRAPPED) [401302]

Facility

$3.12

Service Code	NDC 00143968125
Hospital Charge Code	00143968125
Hospital Revenue Code	250
Min. Negotiated Rate	$1.09
Max. Negotiated Rate	$2.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.72
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.56
Rate for Payer: Aetna Government	$1.56
Rate for Payer: Brighton Health Commercial	$2.34
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.12
Rate for Payer: Group Health Inc Commercial	$1.56
Rate for Payer: Group Health Inc Medicare	$1.09
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.56
Rate for Payer: Hamaspik Choice Inc Medicare	$1.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.03

GLYCOPYRROLATE 0.2 MG/ML IJ SOLN (WRAPPED) [401302]

Facility

$3.00

Service Code	NDC 71288041401
Hospital Charge Code	71288041401
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

GLYCOPYRROLATE 0.2 MG/ML IJ SOLN (WRAPPED) [401302]

Facility

$3.50

Service Code	NDC 00781382596
Hospital Charge Code	00781382596
Hospital Revenue Code	250
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$2.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.75
Rate for Payer: Aetna Government	$1.75
Rate for Payer: Brighton Health Commercial	$2.62
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.38
Rate for Payer: Group Health Inc Commercial	$1.75
Rate for Payer: Group Health Inc Medicare	$1.22
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.75
Rate for Payer: Hamaspik Choice Inc Medicare	$1.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$2.28

GLYCOPYRROLATE 0.2 MG/ML IJ SOLN (WRAPPED) [401302]

Facility

$7.31

Service Code	NDC 16729047108
Hospital Charge Code	16729047108
Hospital Revenue Code	250
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$5.85
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.02
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$3.66
Rate for Payer: Aetna Government	$3.66
Rate for Payer: Brighton Health Commercial	$5.49
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5.85
Rate for Payer: Cigna LocalPlus Benefit Plan	$4.97
Rate for Payer: Group Health Inc Commercial	$3.66
Rate for Payer: Group Health Inc Medicare	$2.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$3.66
Rate for Payer: Hamaspik Choice Inc Medicare	$3.66
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4.75

GLYCOPYRROLATE 0.2 MG/ML IJ SOLN (WRAPPED) [401302]

Facility

$3.00

Service Code	NDC 71288041403
Hospital Charge Code	71288041403
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$2.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.65
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.50
Rate for Payer: Aetna Government	$1.50
Rate for Payer: Brighton Health Commercial	$2.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$2.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$2.04
Rate for Payer: Group Health Inc Commercial	$1.50
Rate for Payer: Group Health Inc Medicare	$1.05
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.50
Rate for Payer: Hamaspik Choice Inc Medicare	$1.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.95

GLYCOPYRROLATE 0.2 MG/ML IJ SOLN (WRAPPED) [401302]

Facility

$0.75

Service Code	NDC 71288041494
Hospital Charge Code	71288041494
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$0.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.41
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.38
Rate for Payer: Aetna Government	$0.38
Rate for Payer: Brighton Health Commercial	$0.56
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.51
Rate for Payer: Group Health Inc Commercial	$0.38
Rate for Payer: Group Health Inc Medicare	$0.26
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.38
Rate for Payer: Hamaspik Choice Inc Medicare	$0.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.49

GLYCOPYRROLATE 0.2 MG/ML IJ SOLN (WRAPPED) [401302]

Facility

$8.89

Service Code	NDC 71839012525
Hospital Charge Code	71839012525
Hospital Revenue Code	250
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$7.11
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.89
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.44
Rate for Payer: Aetna Government	$4.44
Rate for Payer: Brighton Health Commercial	$6.67
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.11
Rate for Payer: Cigna LocalPlus Benefit Plan	$6.04
Rate for Payer: Group Health Inc Commercial	$4.44
Rate for Payer: Group Health Inc Medicare	$3.11
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.44
Rate for Payer: Hamaspik Choice Inc Medicare	$4.44
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.78

GLYCOPYRROLATE 0.4 MG INJ

Facility

$2.00

Service Code	HCPCS J3490
Hospital Charge Code	41650788
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

GLYCOPYRROLATE 0.4 MG INJ

Facility

$2.00

Service Code	HCPCS J3490
Hospital Charge Code	41650788
Hospital Revenue Code	636
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

GLYCOPYRROLATE 0.4 MG INJ

Facility

$2.00

Service Code	HCPCS J3490
Hospital Charge Code	41640788
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

GLYCOPYRROLATE 0.4 MG INJ

Facility

$2.00

Service Code	HCPCS J3490
Hospital Charge Code	41640788
Hospital Revenue Code	636
Min. Negotiated Rate	$0.70
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$1.00
Rate for Payer: Aetna Government	$1.00
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

GLYCOPYRROLATE 1 MG/5ML INJ

Facility

$2.00

Service Code	HCPCS J7643
Hospital Charge Code	41647035
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.61
Rate for Payer: Aetna Government	$0.61
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

GLYCOPYRROLATE 1 MG/5ML INJ

Facility

$2.00

Service Code	HCPCS J7643
Hospital Charge Code	41647035
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

GLYCOPYRROLATE 1MG/5ML INJ

Facility

$2.00

Service Code	HCPCS J7643
Hospital Charge Code	41657035
Hospital Revenue Code	636
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00

GLYCOPYRROLATE 1MG/5ML INJ

Facility

$2.00

Service Code	HCPCS J7643
Hospital Charge Code	41657035
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$1.30
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1.10
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.61
Rate for Payer: Aetna Government	$0.61
Rate for Payer: Brighton Health Commercial	$1.20
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.15
Rate for Payer: Group Health Inc Commercial	$1.00
Rate for Payer: Group Health Inc Medicare	$0.70
Rate for Payer: Hamaspik Choice Inc Medicaid	$1.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.30

GLYCOPYRROLATE 1 MG/5ML PO SOLN [107829]

Facility

$1.27

Service Code	NDC 00259050116
Hospital Charge Code	00259050116
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$1.01
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.63
Rate for Payer: Aetna Government	$0.63
Rate for Payer: Brighton Health Commercial	$0.95
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.01
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.86
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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.82

GLYCOPYRROLATE 1 MG/5ML PO SOLN [107829]

Facility

$1.14

Service Code	NDC 49884004233
Hospital Charge Code	49884004233
Hospital Revenue Code	250
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$0.91
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.63
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.57
Rate for Payer: Aetna Government	$0.57
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: 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.74

Know your out-of-pocket cost for care.

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