St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

GYRUS ACMI VACUR 7MM CURVED RIGID

Facility

$94.00

Hospital Charge Code	40200469
Hospital Revenue Code	270
Min. Negotiated Rate	$32.90
Max. Negotiated Rate	$75.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$51.70
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$47.00
Rate for Payer: Aetna Government	$47.00
Rate for Payer: Brighton Health Commercial	$70.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$75.20
Rate for Payer: Cigna LocalPlus Benefit Plan	$63.92
Rate for Payer: Group Health Inc Commercial	$47.00
Rate for Payer: Group Health Inc Medicare	$32.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$47.00
Rate for Payer: Hamaspik Choice Inc Medicare	$47.00

H001-IGE HOUSE DUST(GREER)

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729249
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

H001-IGE HOUSE DUST(GREER)

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729249
Hospital Revenue Code	300
Rate for Payer: Cash Price	$5.22

H002-IGE HOUSE DUST HOLLISTER

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729248
Hospital Revenue Code	300
Rate for Payer: Cash Price	$5.22

H002-IGE HOUSE DUST HOLLISTER

Facility

$13.05

Service Code	HCPCS 86003
Hospital Charge Code	40729248
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

HA AB, TOTAL W/REFLEX TO IGM

Facility

$30.98

Service Code	HCPCS 86708
Hospital Charge Code	40718080
Hospital Revenue Code	302
Min. Negotiated Rate	$8.67
Max. Negotiated Rate	$23.24
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$17.04
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$12.39
Rate for Payer: Aetna Government	$12.39
Rate for Payer: Affinity Essential Plan 1&2	$8.67
Rate for Payer: Affinity Essential Plan 3&4	$8.67
Rate for Payer: Affinity Medicaid/CHP/HARP	$8.67
Rate for Payer: Brighton Health Commercial	$23.24
Rate for Payer: Cash Price	$12.39
Rate for Payer: Cash Price	$12.39
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$12.39
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$19.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$16.66
Rate for Payer: Elderplan Medicare Advantage	$12.39
Rate for Payer: EmblemHealth Commercial	$12.39
Rate for Payer: Fidelis Essential Plan Aliesa	$10.53
Rate for Payer: Fidelis Essential Plan QHP	$11.03
Rate for Payer: Fidelis Medicare Advantage	$12.39
Rate for Payer: Fidelis Qualified Health Plan	$11.03
Rate for Payer: Group Health Inc Commercial	$12.39
Rate for Payer: Group Health Inc Medicare	$12.39
Rate for Payer: Hamaspik Choice Inc Medicaid	$15.49
Rate for Payer: Hamaspik Choice Inc Medicare	$12.39
Rate for Payer: Healthfirst Medicare Advantage	$12.39
Rate for Payer: Healthfirst QHP	$12.39
Rate for Payer: Humana Medicare	$12.64
Rate for Payer: Senior Whole Health Medicare Advantage	$12.39
Rate for Payer: United Healthcare Commercial	$15.69
Rate for Payer: United Healthcare Medicare Advantage	$12.39
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$12.39
Rate for Payer: Wellcare CHP/FHP/Medicaid	$9.91
Rate for Payer: Wellcare Medicare	$11.15

HA AB, TOTAL W/REFLEX TO IGM

Facility

$30.98

Service Code	HCPCS 86708
Hospital Charge Code	40718080
Hospital Revenue Code	302
Rate for Payer: Cash Price	$12.39

HAEMOPHILUS B CONJUGATE (PRP-T) VACCINE

Facility

$51.97

Service Code	HCPCS J3490
Hospital Charge Code	41643032
Hospital Revenue Code	636
Min. Negotiated Rate	$25.98
Max. Negotiated Rate	$25.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.98
Rate for Payer: Hamaspik Choice Inc Medicare	$25.98

HAEMOPHILUS B CONJUGATE (PRP-T) VACCINE

Facility

$51.97

Service Code	HCPCS J3490
Hospital Charge Code	41643032
Hospital Revenue Code	636
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$33.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.98
Rate for Payer: Aetna Government	$25.98
Rate for Payer: Brighton Health Commercial	$31.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$29.88
Rate for Payer: Group Health Inc Commercial	$25.98
Rate for Payer: Group Health Inc Medicare	$18.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.98
Rate for Payer: Hamaspik Choice Inc Medicare	$25.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.78

HAEMOPHILUS B CONJUGATE (PRP-T) VACCINE

Facility

$51.97

Service Code	HCPCS J3490
Hospital Charge Code	41653032
Hospital Revenue Code	636
Min. Negotiated Rate	$25.98
Max. Negotiated Rate	$25.98
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.98
Rate for Payer: Hamaspik Choice Inc Medicare	$25.98

HAEMOPHILUS B CONJUGATE (PRP-T) VACCINE

Facility

$51.97

Service Code	HCPCS J3490
Hospital Charge Code	41653032
Hospital Revenue Code	636
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$33.78
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$28.58
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$25.98
Rate for Payer: Aetna Government	$25.98
Rate for Payer: Brighton Health Commercial	$31.18
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$25.98
Rate for Payer: Cigna LocalPlus Benefit Plan	$29.88
Rate for Payer: Group Health Inc Commercial	$25.98
Rate for Payer: Group Health Inc Medicare	$18.19
Rate for Payer: Hamaspik Choice Inc Medicaid	$25.98
Rate for Payer: Hamaspik Choice Inc Medicare	$25.98
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$33.78

HAEMOPHILUS B POLYSAC CONJ VAC 7.5 MCG/0.5 ML IM SUSP [126228]

Facility

$71.00

Service Code	NDC 00006489700
Hospital Charge Code	00006489700
Hospital Revenue Code	250
Min. Negotiated Rate	$24.85
Max. Negotiated Rate	$56.80
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$39.05
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$35.50
Rate for Payer: Aetna Government	$35.50
Rate for Payer: Brighton Health Commercial	$53.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$56.80
Rate for Payer: Cigna LocalPlus Benefit Plan	$48.28
Rate for Payer: Group Health Inc Commercial	$35.50
Rate for Payer: Group Health Inc Medicare	$24.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$35.50
Rate for Payer: Hamaspik Choice Inc Medicare	$35.50
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$46.15

HAEMOPHILUS B POLYSAC CONJ VAC IM SOLR [11931]

Facility

$15.35

Service Code	NDC 49281054503
Hospital Charge Code	49281054503
Hospital Revenue Code	250
Min. Negotiated Rate	$5.37
Max. Negotiated Rate	$12.28
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.44
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.68
Rate for Payer: Aetna Government	$7.68
Rate for Payer: Brighton Health Commercial	$11.52
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$12.28
Rate for Payer: Cigna LocalPlus Benefit Plan	$10.44
Rate for Payer: Group Health Inc Commercial	$7.68
Rate for Payer: Group Health Inc Medicare	$5.37
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.68
Rate for Payer: Hamaspik Choice Inc Medicare	$7.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.98

HALF PIN EXTERNAL FIXATION 6MM A

Facility

$581.35

Service Code	HCPCS C1713
Hospital Charge Code	64905981
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$610.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$319.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$348.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$290.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$334.28
Rate for Payer: EmblemHealth Commercial	$290.68
Rate for Payer: Fidelis Medicare Advantage	$610.42
Rate for Payer: Group Health Inc Commercial	$290.68
Rate for Payer: Group Health Inc Medicare	$203.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.68
Rate for Payer: Hamaspik Choice Inc Medicare	$290.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$377.88

HALF PIN EXTERNAL FIXATION 6MM A

Facility

$581.35

Service Code	HCPCS C1713
Hospital Charge Code	64905981
Hospital Revenue Code	278
Min. Negotiated Rate	$290.68
Max. Negotiated Rate	$290.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.68
Rate for Payer: Hamaspik Choice Inc Medicare	$290.68

HALF PIN EXTERNAL FIXATION 6MM B

Facility

$581.35

Service Code	HCPCS C1713
Hospital Charge Code	64905982
Hospital Revenue Code	278
Min. Negotiated Rate	$290.68
Max. Negotiated Rate	$290.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.68
Rate for Payer: Hamaspik Choice Inc Medicare	$290.68

HALF PIN EXTERNAL FIXATION 6MM B

Facility

$581.35

Service Code	HCPCS C1713
Hospital Charge Code	64905982
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$610.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$319.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$348.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$290.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$334.28
Rate for Payer: EmblemHealth Commercial	$290.68
Rate for Payer: Fidelis Medicare Advantage	$610.42
Rate for Payer: Group Health Inc Commercial	$290.68
Rate for Payer: Group Health Inc Medicare	$203.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.68
Rate for Payer: Hamaspik Choice Inc Medicare	$290.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$377.88

HALF PIN EXTERNAL FIXATION 6MM C

Facility

$581.35

Service Code	HCPCS C1713
Hospital Charge Code	64905983
Hospital Revenue Code	278
Min. Negotiated Rate	$290.68
Max. Negotiated Rate	$290.68
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.68
Rate for Payer: Hamaspik Choice Inc Medicare	$290.68

HALF PIN EXTERNAL FIXATION 6MM C

Facility

$581.35

Service Code	HCPCS C1713
Hospital Charge Code	64905983
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$610.42
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$319.74
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$348.81
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$290.68
Rate for Payer: Cigna LocalPlus Benefit Plan	$334.28
Rate for Payer: EmblemHealth Commercial	$290.68
Rate for Payer: Fidelis Medicare Advantage	$610.42
Rate for Payer: Group Health Inc Commercial	$290.68
Rate for Payer: Group Health Inc Medicare	$203.47
Rate for Payer: Hamaspik Choice Inc Medicaid	$290.68
Rate for Payer: Hamaspik Choice Inc Medicare	$290.68
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$377.88

HALFPIN EXT FIXATION 3MM D

Facility

$195.00

Hospital Charge Code	64904679
Hospital Revenue Code	270
Min. Negotiated Rate	$68.25
Max. Negotiated Rate	$156.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$107.25
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$97.50
Rate for Payer: Aetna Government	$97.50
Rate for Payer: Brighton Health Commercial	$146.25
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$156.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$132.60
Rate for Payer: Group Health Inc Commercial	$97.50
Rate for Payer: Group Health Inc Medicare	$68.25
Rate for Payer: Hamaspik Choice Inc Medicaid	$97.50
Rate for Payer: Hamaspik Choice Inc Medicare	$97.50

HALFPIN EXT FIXATION 4MM D

Facility

$269.50

Hospital Charge Code	64904099
Hospital Revenue Code	270
Min. Negotiated Rate	$94.32
Max. Negotiated Rate	$215.60
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$148.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.75
Rate for Payer: Aetna Government	$134.75
Rate for Payer: Brighton Health Commercial	$202.12
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$215.60
Rate for Payer: Cigna LocalPlus Benefit Plan	$183.26
Rate for Payer: Group Health Inc Commercial	$134.75
Rate for Payer: Group Health Inc Medicare	$94.32
Rate for Payer: Hamaspik Choice Inc Medicaid	$134.75
Rate for Payer: Hamaspik Choice Inc Medicare	$134.75

HALFPIN EXT FIXATION 4MM D

Facility

$289.25

Hospital Charge Code	64904196
Hospital Revenue Code	270
Min. Negotiated Rate	$101.24
Max. Negotiated Rate	$231.40
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$159.09
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$144.62
Rate for Payer: Aetna Government	$144.62
Rate for Payer: Brighton Health Commercial	$216.94
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$231.40
Rate for Payer: Cigna LocalPlus Benefit Plan	$196.69
Rate for Payer: Group Health Inc Commercial	$144.62
Rate for Payer: Group Health Inc Medicare	$101.24
Rate for Payer: Hamaspik Choice Inc Medicaid	$144.62
Rate for Payer: Hamaspik Choice Inc Medicare	$144.62

HALF PIN EXT FIXATION 5MM

Facility

$333.13

Hospital Charge Code	64904584
Hospital Revenue Code	270
Min. Negotiated Rate	$116.60
Max. Negotiated Rate	$266.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$183.22
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$166.56
Rate for Payer: Aetna Government	$166.56
Rate for Payer: Brighton Health Commercial	$249.85
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$266.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$226.53
Rate for Payer: Group Health Inc Commercial	$166.56
Rate for Payer: Group Health Inc Medicare	$116.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$166.56
Rate for Payer: Hamaspik Choice Inc Medicare	$166.56

HALFPIN EXT FIXATION 5MM D

Facility

$349.38

Hospital Charge Code	64904062
Hospital Revenue Code	270
Min. Negotiated Rate	$122.28
Max. Negotiated Rate	$279.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$192.16
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$174.69
Rate for Payer: Aetna Government	$174.69
Rate for Payer: Brighton Health Commercial	$262.04
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$279.50
Rate for Payer: Cigna LocalPlus Benefit Plan	$237.58
Rate for Payer: Group Health Inc Commercial	$174.69
Rate for Payer: Group Health Inc Medicare	$122.28
Rate for Payer: Hamaspik Choice Inc Medicaid	$174.69
Rate for Payer: Hamaspik Choice Inc Medicare	$174.69

HALF PIN FIX 4MM DIA 120MM

Facility

$352.63

Hospital Charge Code	64905221
Hospital Revenue Code	270
Min. Negotiated Rate	$123.42
Max. Negotiated Rate	$282.10
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$193.95
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$176.32
Rate for Payer: Aetna Government	$176.32
Rate for Payer: Brighton Health Commercial	$264.47
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$282.10
Rate for Payer: Cigna LocalPlus Benefit Plan	$239.79
Rate for Payer: Group Health Inc Commercial	$176.32
Rate for Payer: Group Health Inc Medicare	$123.42
Rate for Payer: Hamaspik Choice Inc Medicaid	$176.32
Rate for Payer: Hamaspik Choice Inc Medicare	$176.32

Know your out-of-pocket cost for care.

All Charges