AMBETTER COMM/EXCH - ALL PLANS: disclosed hospital rates

iDirect answer

Based on the published hospital price files, AMBETTER COMM/EXCH - ALL PLANS appears in disclosed negotiated rates across 1 hospital and 78 services. This is public hospital price transparency data, not a guaranteed estimate of your bill.

Actual patient responsibility may vary based on your insurance plan, deductible, coinsurance, network status, diagnosis, setting, bundled services, clinical circumstances, and hospital billing practices.

78 prices shown.

Service	Hospital	Code	List price	Cash price	Negotiated range	Allowed (median)
3-D printed anatomic model; first individually prepared and processed component of anatomic structure Outpatient	Mount Sinai Hospital Medical Center	0559T CDM	$57.48	$40.24	$22.99 – $180	—
Acne surgery Outpatient	Mount Sinai Hospital Medical Center	10040 CDM	$285	$200	$114 – $896	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0001A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0002A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0003A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0004A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0011A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0012A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0013A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0021A CDM	$40.00	$28.00	$16.00 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0022A CDM	$40.00	$28.00	$16.00 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0031A CDM	$40.00	$28.00	$16.00 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0034A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0051A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0052A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0053A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0054A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0064A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0071A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0072A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0073A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0074A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0081A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0082A CDM	$47.05	$32.94	$18.82 – $159	—
Administration of severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccine by intramuscular injection, single dose Outpatient	Mount Sinai Hospital Medical Center	0083A CDM	$47.05	$32.94	$18.82 – $159	—