St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

IMMUNOTHERAPY, MANY ANTIGENS

Facility

$57.15

Service Code	HCPCS 95125
Hospital Charge Code	30301422
Hospital Revenue Code	940
Min. Negotiated Rate	$10.94
Max. Negotiated Rate	$45.72
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$31.43
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$10.94
Rate for Payer: Aetna Government	$10.94
Rate for Payer: Brighton Health Commercial	$42.86
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$45.72
Rate for Payer: Cigna LocalPlus Benefit Plan	$38.86
Rate for Payer: Group Health Inc Commercial	$28.58
Rate for Payer: Group Health Inc Medicare	$20.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$28.58
Rate for Payer: Hamaspik Choice Inc Medicare	$28.58
Rate for Payer: United Healthcare Commercial	$28.58

IMMUNOTHERAPY,MULTI INJ

Facility

$115.43

Service Code	HCPCS 95117
Hospital Charge Code	30301417
Hospital Revenue Code	510
Rate for Payer: Cash Price	$54.93

IMMUNOTHERAPY,MULTI INJ

Facility

$115.43

Service Code	HCPCS 95117
Hospital Charge Code	30301417
Hospital Revenue Code	510
Min. Negotiated Rate	$38.45
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$54.93
Rate for Payer: Aetna Government	$54.93
Rate for Payer: Affinity Essential Plan 1&2	$38.45
Rate for Payer: Affinity Essential Plan 3&4	$38.45
Rate for Payer: Affinity Medicaid/CHP/HARP	$38.45
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$54.93
Rate for Payer: Cash Price	$54.93
Rate for Payer: Cash Price	$54.93
Rate for Payer: Cash Price	$54.93
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$54.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Elderplan Medicare Advantage	$54.93
Rate for Payer: Fidelis Essential Plan Aliesa	$46.69
Rate for Payer: Fidelis Essential Plan QHP	$48.89
Rate for Payer: Fidelis Medicare Advantage	$54.93
Rate for Payer: Fidelis Qualified Health Plan	$48.89
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	$57.72
Rate for Payer: Hamaspik Choice Inc Medicare	$54.93
Rate for Payer: Healthfirst Medicare Advantage	$46.69
Rate for Payer: Healthfirst QHP	$54.93
Rate for Payer: Humana Medicare	$56.03
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$54.93
Rate for Payer: Senior Whole Health Medicare Advantage	$54.93
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$54.93
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$54.93
Rate for Payer: Wellcare CHP/FHP/Medicaid	$43.94
Rate for Payer: Wellcare Medicare	$52.18

IMMUNOTHERAPY, ONE INJ

Facility

$115.43

Service Code	HCPCS 95115
Hospital Charge Code	30301416
Hospital Revenue Code	510
Rate for Payer: Cash Price	$54.93

IMMUNOTHERAPY, ONE INJ

Facility

$115.43

Service Code	HCPCS 95115
Hospital Charge Code	30301416
Hospital Revenue Code	510
Min. Negotiated Rate	$38.45
Max. Negotiated Rate	$250.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$63.49
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$54.93
Rate for Payer: Aetna Government	$54.93
Rate for Payer: Affinity Essential Plan 1&2	$38.45
Rate for Payer: Affinity Essential Plan 3&4	$38.45
Rate for Payer: Affinity Medicaid/CHP/HARP	$38.45
Rate for Payer: Brighton Health Commercial	$233.00
Rate for Payer: Cash Price	$54.93
Rate for Payer: Cash Price	$54.93
Rate for Payer: Cash Price	$54.93
Rate for Payer: Cash Price	$54.93
Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus	$54.93
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$204.58
Rate for Payer: Cigna LocalPlus Benefit Plan	$173.89
Rate for Payer: Elderplan Medicare Advantage	$54.93
Rate for Payer: Fidelis Essential Plan Aliesa	$46.69
Rate for Payer: Fidelis Essential Plan QHP	$48.89
Rate for Payer: Fidelis Medicare Advantage	$54.93
Rate for Payer: Fidelis Qualified Health Plan	$48.89
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	$57.72
Rate for Payer: Hamaspik Choice Inc Medicare	$54.93
Rate for Payer: Healthfirst Medicare Advantage	$46.69
Rate for Payer: Healthfirst QHP	$54.93
Rate for Payer: Humana Medicare	$56.03
Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage	$54.93
Rate for Payer: Senior Whole Health Medicare Advantage	$54.93
Rate for Payer: United Healthcare Commercial	$222.00
Rate for Payer: United Healthcare Medicare Advantage	$54.93
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$54.93
Rate for Payer: Wellcare CHP/FHP/Medicaid	$43.94
Rate for Payer: Wellcare Medicare	$52.18

IMMUOHSTOCHMCAL ANTB ADDT'L SLIDE

Facility

$278.38

Service Code	HCPCS 88341
Hospital Charge Code	40635429
Hospital Revenue Code	312
Min. Negotiated Rate	$56.35
Max. Negotiated Rate	$222.70
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$153.11
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$56.35
Rate for Payer: Aetna Government	$56.35
Rate for Payer: Brighton Health Commercial	$208.78
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$222.70
Rate for Payer: Cigna LocalPlus Benefit Plan	$189.30
Rate for Payer: Group Health Inc Commercial	$139.19
Rate for Payer: Group Health Inc Medicare	$97.43
Rate for Payer: Hamaspik Choice Inc Medicaid	$139.19
Rate for Payer: Hamaspik Choice Inc Medicare	$139.19

IMP ABUT RETAINER/PFM FPD/NOBLE

Facility

$1,276.00

Service Code	HCPCS D6069
Hospital Charge Code	42303344
Hospital Revenue Code	361
Min. Negotiated Rate	$382.19
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$701.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$382.19
Rate for Payer: Aetna Government	$382.19
Rate for Payer: Brighton Health Commercial	$957.00
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: Group Health Inc Commercial	$638.00
Rate for Payer: Group Health Inc Medicare	$446.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$638.00
Rate for Payer: Hamaspik Choice Inc Medicare	$638.00

IMP ABUT RET CAS BASE METAL FNOB

Facility

$2,500.00

Service Code	HCPCS D6074
Hospital Charge Code	42303442
Hospital Revenue Code	361
Min. Negotiated Rate	$361.42
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,375.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$361.42
Rate for Payer: Aetna Government	$361.42
Rate for Payer: Brighton Health Commercial	$1,875.00
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: Group Health Inc Commercial	$1,250.00
Rate for Payer: Group Health Inc Medicare	$875.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,250.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,250.00

IMP ABUT. RET CAST BASE METAL FPD

Facility

$1,276.00

Service Code	HCPCS D6073
Hospital Charge Code	42303348
Hospital Revenue Code	361
Min. Negotiated Rate	$340.55
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$701.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$340.55
Rate for Payer: Aetna Government	$340.55
Rate for Payer: Brighton Health Commercial	$957.00
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: Group Health Inc Commercial	$638.00
Rate for Payer: Group Health Inc Medicare	$446.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$638.00
Rate for Payer: Hamaspik Choice Inc Medicare	$638.00

IMP ABUT. RET CAST NOBLE METL FPD

Facility

$1,276.00

Service Code	HCPCS D6072
Hospital Charge Code	42303347
Hospital Revenue Code	361
Min. Negotiated Rate	$372.69
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$701.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$372.69
Rate for Payer: Aetna Government	$372.69
Rate for Payer: Brighton Health Commercial	$957.00
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: Group Health Inc Commercial	$638.00
Rate for Payer: Group Health Inc Medicare	$446.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$638.00
Rate for Payer: Hamaspik Choice Inc Medicare	$638.00

IMP ABUT. RET/PFM FPD BASE METAL

Facility

$1,276.00

Service Code	HCPCS D6070
Hospital Charge Code	42303345
Hospital Revenue Code	361
Min. Negotiated Rate	$360.95
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$701.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$360.95
Rate for Payer: Aetna Government	$360.95
Rate for Payer: Brighton Health Commercial	$957.00
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: Group Health Inc Commercial	$638.00
Rate for Payer: Group Health Inc Medicare	$446.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$638.00
Rate for Payer: Hamaspik Choice Inc Medicare	$638.00

IMP ABUT. RET/PFM FPD NOBLE METAL

Facility

$1,276.00

Service Code	HCPCS D6071
Hospital Charge Code	42303346
Hospital Revenue Code	361
Min. Negotiated Rate	$368.19
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$701.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$368.19
Rate for Payer: Aetna Government	$368.19
Rate for Payer: Brighton Health Commercial	$957.00
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: Group Health Inc Commercial	$638.00
Rate for Payer: Group Health Inc Medicare	$446.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$638.00
Rate for Payer: Hamaspik Choice Inc Medicare	$638.00

IMP ABUT SUPP. CAST NOBEL MET CR

Facility

$2,000.00

Service Code	HCPCS D6064
Hospital Charge Code	42303340
Hospital Revenue Code	361
Min. Negotiated Rate	$334.39
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$334.39
Rate for Payer: Aetna Government	$334.39
Rate for Payer: Brighton Health Commercial	$1,500.00
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: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

IMP ABUT. SUPPORT CAST BASE METAL

Facility

$2,000.00

Service Code	HCPCS D6063
Hospital Charge Code	42303339
Hospital Revenue Code	361
Min. Negotiated Rate	$319.66
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$319.66
Rate for Payer: Aetna Government	$319.66
Rate for Payer: Brighton Health Commercial	$1,500.00
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: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

IMP. ABUT. SUPPORTED PFM HI NOBLE

Facility

$2,000.00

Service Code	HCPCS D6059
Hospital Charge Code	42303335
Hospital Revenue Code	361
Min. Negotiated Rate	$382.19
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$382.19
Rate for Payer: Aetna Government	$382.19
Rate for Payer: Brighton Health Commercial	$1,500.00
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: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

IMP. ABUT SUPPORT PFM BASE METAL

Facility

$2,000.00

Service Code	HCPCS D6060
Hospital Charge Code	42303336
Hospital Revenue Code	361
Min. Negotiated Rate	$360.95
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$360.95
Rate for Payer: Aetna Government	$360.95
Rate for Payer: Brighton Health Commercial	$1,500.00
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: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

IMP. ABUT. SUPPORT PFM NOBLE

Facility

$2,000.00

Service Code	HCPCS D6061
Hospital Charge Code	42303337
Hospital Revenue Code	361
Min. Negotiated Rate	$368.19
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$368.19
Rate for Payer: Aetna Government	$368.19
Rate for Payer: Brighton Health Commercial	$1,500.00
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: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

IMP ABUT SUPP. RETAINER/PORC FPD

Facility

$1,276.00

Service Code	HCPCS D6068
Hospital Charge Code	42303343
Hospital Revenue Code	361
Min. Negotiated Rate	$383.61
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$701.80
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$383.61
Rate for Payer: Aetna Government	$383.61
Rate for Payer: Brighton Health Commercial	$957.00
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: Group Health Inc Commercial	$638.00
Rate for Payer: Group Health Inc Medicare	$446.60
Rate for Payer: Hamaspik Choice Inc Medicaid	$638.00
Rate for Payer: Hamaspik Choice Inc Medicare	$638.00

IMP. ABUT SUPPRT CAST HI NOBLE CR

Facility

$2,000.00

Service Code	HCPCS D6062
Hospital Charge Code	42303338
Hospital Revenue Code	361
Min. Negotiated Rate	$367.24
Max. Negotiated Rate	$2,915.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$1,100.00
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$367.24
Rate for Payer: Aetna Government	$367.24
Rate for Payer: Brighton Health Commercial	$1,500.00
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: Group Health Inc Commercial	$1,000.00
Rate for Payer: Group Health Inc Medicare	$700.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$1,000.00
Rate for Payer: Hamaspik Choice Inc Medicare	$1,000.00

IMPACTION TOOL

Facility

$1,664.00

Service Code	HCPCS C1713
Hospital Charge Code	40006123
Hospital Revenue Code	278
Min. Negotiated Rate	$134.20
Max. Negotiated Rate	$1,747.20
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$915.20
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$134.20
Rate for Payer: Aetna Government	$134.20
Rate for Payer: Brighton Health Commercial	$998.40
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$832.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$956.80
Rate for Payer: EmblemHealth Commercial	$832.00
Rate for Payer: Fidelis Medicare Advantage	$1,747.20
Rate for Payer: Group Health Inc Commercial	$832.00
Rate for Payer: Group Health Inc Medicare	$582.40
Rate for Payer: Hamaspik Choice Inc Medicaid	$832.00
Rate for Payer: Hamaspik Choice Inc Medicare	$832.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1,081.60

IMPACTION TOOL

Facility

$1,664.00

Service Code	HCPCS C1713
Hospital Charge Code	40006123
Hospital Revenue Code	278
Min. Negotiated Rate	$832.00
Max. Negotiated Rate	$832.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$832.00
Rate for Payer: Hamaspik Choice Inc Medicare	$832.00

IMPLANT 10MM MBA

Facility

$6,247.50

Service Code	HCPCS C1789
Hospital Charge Code	64902030
Hospital Revenue Code	278
Min. Negotiated Rate	$402.32
Max. Negotiated Rate	$6,559.88
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$3,436.12
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$402.32
Rate for Payer: Aetna Government	$402.32
Rate for Payer: Brighton Health Commercial	$3,748.50
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$3,123.75
Rate for Payer: Cigna LocalPlus Benefit Plan	$3,592.31
Rate for Payer: EmblemHealth Commercial	$3,123.75
Rate for Payer: Fidelis Medicare Advantage	$6,559.88
Rate for Payer: Group Health Inc Commercial	$3,123.75
Rate for Payer: Group Health Inc Medicare	$2,186.62
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,123.75
Rate for Payer: Hamaspik Choice Inc Medicare	$3,123.75
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$4,060.88

IMPLANT 10MM MBA

Facility

$6,247.50

Service Code	HCPCS C1789
Hospital Charge Code	64902030
Hospital Revenue Code	278
Min. Negotiated Rate	$3,123.75
Max. Negotiated Rate	$3,123.75
Rate for Payer: Hamaspik Choice Inc Medicaid	$3,123.75
Rate for Payer: Hamaspik Choice Inc Medicare	$3,123.75

IMPLANTABLE LOOP RECORDER

Facility

$10,590.00

Service Code	HCPCS C1764
Hospital Charge Code	66574700
Hospital Revenue Code	278
Min. Negotiated Rate	$5,295.00
Max. Negotiated Rate	$5,295.00
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,295.00

IMPLANTABLE LOOP RECORDER

Facility

$10,590.00

Service Code	HCPCS C1764
Hospital Charge Code	66574700
Hospital Revenue Code	278
Min. Negotiated Rate	$3,706.50
Max. Negotiated Rate	$11,119.50
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$5,824.50
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4,126.13
Rate for Payer: Aetna Government	$4,126.13
Rate for Payer: Brighton Health Commercial	$6,354.00
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$5,295.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$6,089.25
Rate for Payer: EmblemHealth Commercial	$5,295.00
Rate for Payer: Fidelis Medicare Advantage	$11,119.50
Rate for Payer: Group Health Inc Commercial	$5,295.00
Rate for Payer: Group Health Inc Medicare	$3,706.50
Rate for Payer: Hamaspik Choice Inc Medicaid	$5,295.00
Rate for Payer: Hamaspik Choice Inc Medicare	$5,295.00
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$6,883.50

Know your out-of-pocket cost for care.

All Charges