Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CFH FP ARTHROCENTESIS SM JOINT

Facility

$175.91

Service Code	HCPCS 20600
Hospital Charge Code	83652093
Hospital Revenue Code	761
Min. Negotiated Rate	$26.39
Max. Negotiated Rate	$26.39
Rate for Payer: Qualcare PPO/HMO/WC	$26.39

CFH FP AUDIOMETRY

Facility

$101.70

Service Code	HCPCS 92552
Hospital Charge Code	83652363
Hospital Revenue Code	471
Min. Negotiated Rate	$2.45
Max. Negotiated Rate	$1,823.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.51
Rate for Payer: Oxford Commercial	$1,040.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.26
Rate for Payer: UnitedHealthcare Commercial	$1,823.00
Rate for Payer: UnitedHealthcare Community & State	$2.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

CFH FP AUDIOMETRY

Facility

$101.70

Service Code	HCPCS 92552
Hospital Charge Code	83652363
Hospital Revenue Code	471
Min. Negotiated Rate	$15.26
Max. Negotiated Rate	$15.26
Rate for Payer: Qualcare PPO/HMO/WC	$15.26

CFH FP AVULSION OF NAIL PL

Facility

$372.00

Service Code	HCPCS 11730
Hospital Charge Code	83652051
Hospital Revenue Code	761
Min. Negotiated Rate	$55.80
Max. Negotiated Rate	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$55.80

CFH FP AVULSION OF NAIL PL

Facility

$372.00

Service Code	HCPCS 11730
Hospital Charge Code	83652051
Hospital Revenue Code	761
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$860.41
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.60
Rate for Payer: Oxford Commercial	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$74.40
Rate for Payer: UnitedHealthcare Community & State	$8.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$9.86

CFH FP BRONCHODILATOR ADMIN.

Facility

$58.41

Service Code	HCPCS 94664
Hospital Charge Code	83652379
Hospital Revenue Code	419
Min. Negotiated Rate	$8.76
Max. Negotiated Rate	$8.76
Rate for Payer: Qualcare PPO/HMO/WC	$8.76

CFH FP BRONCHODILATOR ADMIN.

Facility

$58.41

Service Code	HCPCS 94664
Hospital Charge Code	83652379
Hospital Revenue Code	419
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$123.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.52
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.76
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$1.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1.55

CFH FP BX SKIN SINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	83652027
Hospital Revenue Code	761
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

CFH FP BX SKIN SINGLE LESION

Facility

$612.00

Service Code	HCPCS 11100
Hospital Charge Code	83652027
Hospital Revenue Code	761
Min. Negotiated Rate	$14.75
Max. Negotiated Rate	$1,058.74
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.60
Rate for Payer: Oxford Commercial	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$122.40
Rate for Payer: UnitedHealthcare Community & State	$14.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$16.22

CFH FP CERUMEN REMOVAL

Facility

$167.24

Service Code	HCPCS 69210
Hospital Charge Code	83652269
Hospital Revenue Code	761
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

CFH FP CERUMEN REMOVAL

Facility

$167.24

Service Code	HCPCS 69210
Hospital Charge Code	83652269
Hospital Revenue Code	761
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$252.97
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$55.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.17
Rate for Payer: Oxford Commercial	$33.45
Rate for Payer: Qualcare PPO/HMO/WC	$25.09
Rate for Payer: UnitedHealthcare Commercial	$33.45
Rate for Payer: UnitedHealthcare Community & State	$4.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$197.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.43

CFH FP CHEM CAUT.GRAN TISSUE

Facility

$612.00

Service Code	HCPCS 17250
Hospital Charge Code	83652087
Hospital Revenue Code	761
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

CFH FP CHEM CAUT.GRAN TISSUE

Facility

$612.00

Service Code	HCPCS 17250
Hospital Charge Code	83652087
Hospital Revenue Code	761
Min. Negotiated Rate	$14.75
Max. Negotiated Rate	$860.41
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$84.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.60
Rate for Payer: Oxford Commercial	$122.40
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$122.40
Rate for Payer: UnitedHealthcare Community & State	$14.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$16.22

CFH FP DEBRID SKIN 10% BODY

Facility

$297.00

Service Code	HCPCS 11000
Hospital Charge Code	83652013
Hospital Revenue Code	761
Min. Negotiated Rate	$44.55
Max. Negotiated Rate	$44.55
Rate for Payer: Qualcare PPO/HMO/WC	$44.55

CFH FP DEBRID SKIN 10% BODY

Facility

$297.00

Service Code	HCPCS 11000
Hospital Charge Code	83652013
Hospital Revenue Code	761
Min. Negotiated Rate	$7.16
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$89.10
Rate for Payer: Oxford Commercial	$59.40
Rate for Payer: Qualcare PPO/HMO/WC	$44.55
Rate for Payer: UnitedHealthcare Commercial	$59.40
Rate for Payer: UnitedHealthcare Community & State	$7.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,639.38
Rate for Payer: Wellpoint Medicaid Managed Care	$7.87

CFH FP DRESS/DEBRID LARGE

Facility

$612.00

Service Code	HCPCS 16030
Hospital Charge Code	83652079
Hospital Revenue Code	361
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

CFH FP DRESS/DEBRID LARGE

Facility

$612.00

Service Code	HCPCS 16030
Hospital Charge Code	83652079
Hospital Revenue Code	361
Min. Negotiated Rate	$14.75
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.60
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$14.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$16.22

CFH FP DRESSING/DEBRID MEDIUM

Facility

$612.00

Service Code	HCPCS 16020
Hospital Charge Code	83652077
Hospital Revenue Code	361
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

CFH FP DRESSING/DEBRID MEDIUM

Facility

$612.00

Service Code	HCPCS 16020
Hospital Charge Code	83652077
Hospital Revenue Code	361
Min. Negotiated Rate	$14.75
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.60
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$14.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$16.22

CFH FP EKG 12 LEADS

Facility

$658.00

Service Code	HCPCS 93005
Hospital Charge Code	83652369
Hospital Revenue Code	730
Min. Negotiated Rate	$15.86
Max. Negotiated Rate	$697.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$197.40
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$98.70
Rate for Payer: UnitedHealthcare Commercial	$697.00
Rate for Payer: UnitedHealthcare Community & State	$15.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$17.44

CFH FP EKG 12 LEADS

Facility

$658.00

Service Code	HCPCS 93005
Hospital Charge Code	83652369
Hospital Revenue Code	730
Min. Negotiated Rate	$98.70
Max. Negotiated Rate	$98.70
Rate for Payer: Qualcare PPO/HMO/WC	$98.70

CFH FP EKG-INTER&REPORT ONLY

Facility

$49.00

Service Code	HCPCS 93010
Hospital Charge Code	83652371
Hospital Revenue Code	730
Min. Negotiated Rate	$1.18
Max. Negotiated Rate	$697.00
Rate for Payer: Aetna Commercial	$18.62
Rate for Payer: Aetna Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.49
Rate for Payer: Cigna Commercial	$24.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.70
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.35
Rate for Payer: UnitedHealthcare Commercial	$697.00
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.30

CFH FP EKG-INTER&REPORT ONLY

Facility

$49.00

Service Code	HCPCS 93010
Hospital Charge Code	83652371
Hospital Revenue Code	730
Min. Negotiated Rate	$7.35
Max. Negotiated Rate	$7.35
Rate for Payer: Qualcare PPO/HMO/WC	$7.35

CFH FP ER HIGH SEVERITY

Professional

Both

$369.00

Service Code	HCPCS 99284
Hospital Charge Code	83652455
Hospital Revenue Code	981
Min. Negotiated Rate	$77.06
Max. Negotiated Rate	$368.37
Rate for Payer: Aetna Commercial	$129.98
Rate for Payer: Aetna Medicare Advantage	$124.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$368.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$368.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$368.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$368.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$368.37
Rate for Payer: Cigna Commercial	$263.84
Rate for Payer: Cigna Medicare Advantage	$263.84
Rate for Payer: Clover Medicare Advantage	$123.08
Rate for Payer: Fidelis All Plans	$77.06
Rate for Payer: UnitedHealthcare Commercial	$124.66
Rate for Payer: UnitedHealthcare Community & State	$124.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.66
Rate for Payer: Wellpoint Medicaid Managed Care	$114.61

CFH FP ER MODERATE SEVERITY

Professional

Both

$237.00

Service Code	HCPCS 99283
Hospital Charge Code	83652451
Hospital Revenue Code	981
Min. Negotiated Rate	$45.12
Max. Negotiated Rate	$195.47
Rate for Payer: Aetna Commercial	$69.36
Rate for Payer: Aetna Medicare Advantage	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$195.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$195.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$195.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$195.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$195.47
Rate for Payer: Cigna Commercial	$155.45
Rate for Payer: Cigna Medicare Advantage	$155.45
Rate for Payer: Clover Medicare Advantage	$72.21
Rate for Payer: Fidelis All Plans	$45.12
Rate for Payer: Marpai Administrators LLC Commercial	$53.33
Rate for Payer: UnitedHealthcare Commercial	$97.09
Rate for Payer: UnitedHealthcare Community & State	$97.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$97.09
Rate for Payer: Wellpoint Medicaid Managed Care	$73.68

Know your out-of-pocket cost for care.

All Charges