Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CH ACUTE LEUKEMIA PANEL

Facility

$2,111.00

Service Code	HCPCS 86849
Hospital Charge Code	397073143
Hospital Revenue Code	302
Min. Negotiated Rate	$316.65
Max. Negotiated Rate	$316.65
Rate for Payer: Qualcare PPO/HMO/WC	$316.65

CH ACUTE LEUKEMIA PANEL

Facility

$2,111.00

Service Code	HCPCS 86849
Hospital Charge Code	397073143
Hospital Revenue Code	302
Min. Negotiated Rate	$50.88
Max. Negotiated Rate	$1,055.50
Rate for Payer: Aetna Commercial	$802.18
Rate for Payer: Aetna Medicare Advantage	$633.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$538.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$538.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$538.30
Rate for Payer: Cigna Commercial	$1,055.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$633.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$316.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$50.88
Rate for Payer: Wellpoint Medicaid Managed Care	$55.94

CH ACUTE LEUKEMIA PROF B/BM

Facility

$1,066.00

Service Code	HCPCS 85018
Hospital Charge Code	397073097
Hospital Revenue Code	305
Min. Negotiated Rate	$1.90
Max. Negotiated Rate	$533.00
Rate for Payer: Aetna Commercial	$6.45
Rate for Payer: Aetna Medicare Advantage	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.55
Rate for Payer: Cigna Commercial	$533.00
Rate for Payer: Cigna Medicare Advantage	$2.37
Rate for Payer: Clover Medicare Advantage	$2.25
Rate for Payer: EmblemHealth Commercial	$7.11
Rate for Payer: Humana Medicare Advantage	$2.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$319.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$159.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.37
Rate for Payer: Wellcare Medicare Advantage	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$28.25

CH ACUTE LEUKEMIA PROF B/BM

Facility

$1,066.00

Service Code	HCPCS 85018
Hospital Charge Code	397073097
Hospital Revenue Code	305
Min. Negotiated Rate	$159.90
Max. Negotiated Rate	$159.90
Rate for Payer: Qualcare PPO/HMO/WC	$159.90

CH ACYLCARNITINE, PLASMA

Facility

$401.00

Service Code	HCPCS 82017
Hospital Charge Code	397071399
Hospital Revenue Code	307
Min. Negotiated Rate	$10.63
Max. Negotiated Rate	$200.50
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.90
Rate for Payer: Cigna Commercial	$200.50
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$10.63

CH ACYLCARNITINE, PLASMA

Facility

$401.00

Service Code	HCPCS 82017
Hospital Charge Code	397071399
Hospital Revenue Code	307
Min. Negotiated Rate	$60.15
Max. Negotiated Rate	$60.15
Rate for Payer: Qualcare PPO/HMO/WC	$60.15

CH ADDIS COUNT

Facility

$98.00

Service Code	HCPCS 89050
Hospital Charge Code	397073055
Hospital Revenue Code	300
Min. Negotiated Rate	$2.60
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$12.84
Rate for Payer: Aetna Medicare Advantage	$15.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.04
Rate for Payer: Cigna Commercial	$49.00
Rate for Payer: Cigna Medicare Advantage	$4.72
Rate for Payer: Clover Medicare Advantage	$4.48
Rate for Payer: EmblemHealth Commercial	$14.16
Rate for Payer: Humana Medicare Advantage	$4.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.72
Rate for Payer: Wellcare Medicare Advantage	$4.72
Rate for Payer: Wellpoint Medicaid Managed Care	$2.60

CH ADDIS COUNT

Facility

$98.00

Service Code	HCPCS 89050
Hospital Charge Code	397073055
Hospital Revenue Code	300
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$14.70
Rate for Payer: Qualcare PPO/HMO/WC	$14.70

CH ADENOSINE DEAMINASE

Facility

$107.00

Service Code	HCPCS 84311
Hospital Charge Code	397073676
Hospital Revenue Code	301
Min. Negotiated Rate	$16.05
Max. Negotiated Rate	$16.05
Rate for Payer: Qualcare PPO/HMO/WC	$16.05

CH ADENOSINE DEAMINASE

Facility

$107.00

Service Code	HCPCS 84311
Hospital Charge Code	397073676
Hospital Revenue Code	301
Min. Negotiated Rate	$2.84
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$22.03
Rate for Payer: Aetna Medicare Advantage	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.24
Rate for Payer: Cigna Commercial	$53.50
Rate for Payer: Cigna Medicare Advantage	$8.10
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Medicare Advantage	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2.84

CH ADENOSINE DEAMINASE,FLUID

Facility

$337.00

Service Code	HCPCS 84311
Hospital Charge Code	397071553
Hospital Revenue Code	301
Min. Negotiated Rate	$6.48
Max. Negotiated Rate	$168.50
Rate for Payer: Aetna Commercial	$22.03
Rate for Payer: Aetna Medicare Advantage	$26.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.24
Rate for Payer: Cigna Commercial	$168.50
Rate for Payer: Cigna Medicare Advantage	$8.10
Rate for Payer: Clover Medicare Advantage	$7.70
Rate for Payer: EmblemHealth Commercial	$24.30
Rate for Payer: Humana Medicare Advantage	$8.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.10
Rate for Payer: Wellcare Medicare Advantage	$8.10
Rate for Payer: Wellpoint Medicaid Managed Care	$8.93

CH ADENOSINE DEAMINASE,FLUID

Facility

$337.00

Service Code	HCPCS 84311
Hospital Charge Code	397071553
Hospital Revenue Code	301
Min. Negotiated Rate	$50.55
Max. Negotiated Rate	$50.55
Rate for Payer: Qualcare PPO/HMO/WC	$50.55

CH ADENOVIRUS DNA,QI, RT PCR

Facility

$877.00

Hospital Charge Code	3970725
Hospital Revenue Code	301
Min. Negotiated Rate	$21.14
Max. Negotiated Rate	$438.50
Rate for Payer: Aetna Commercial	$333.26
Rate for Payer: Aetna Medicare Advantage	$263.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.63
Rate for Payer: Cigna Commercial	$438.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$263.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$131.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.14
Rate for Payer: Wellpoint Medicaid Managed Care	$23.24

CH ADENOVIRUS DNA,QI, RT PCR

Facility

$877.00

Hospital Charge Code	3970725
Hospital Revenue Code	301
Min. Negotiated Rate	$131.55
Max. Negotiated Rate	$131.55
Rate for Payer: Qualcare PPO/HMO/WC	$131.55

CH ADENOVIRUS DNA,QN,RT-PCR

Facility

$1,114.00

Service Code	HCPCS 87799
Hospital Charge Code	397071410
Hospital Revenue Code	306
Min. Negotiated Rate	$167.10
Max. Negotiated Rate	$167.10
Rate for Payer: Qualcare PPO/HMO/WC	$167.10

CH ADENOVIRUS DNA,QN,RT-PCR

Facility

$1,114.00

Service Code	HCPCS 87799
Hospital Charge Code	397071410
Hospital Revenue Code	306
Min. Negotiated Rate	$29.52
Max. Negotiated Rate	$557.00
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.64
Rate for Payer: Cigna Commercial	$557.00
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$29.52

CH AFP MATERNAL

Facility

$210.00

Service Code	HCPCS 82105
Hospital Charge Code	397073037
Hospital Revenue Code	301
Min. Negotiated Rate	$5.57
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.61
Rate for Payer: Aetna Medicare Advantage	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.53
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: Cigna Medicare Advantage	$16.77
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Medicare Advantage	$16.77
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

CH AFP MATERNAL

Facility

$210.00

Service Code	HCPCS 82105
Hospital Charge Code	397073037
Hospital Revenue Code	301
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

CH AFP XTRA

Facility

$233.00

Service Code	HCPCS 82105
Hospital Charge Code	397073173
Hospital Revenue Code	301
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.61
Rate for Payer: Aetna Medicare Advantage	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.53
Rate for Payer: Cigna Commercial	$116.50
Rate for Payer: Cigna Medicare Advantage	$16.77
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Medicare Advantage	$16.77
Rate for Payer: Wellpoint Medicaid Managed Care	$6.17

CH AFP XTRA

Facility

$233.00

Service Code	HCPCS 82105
Hospital Charge Code	397073173
Hospital Revenue Code	301
Min. Negotiated Rate	$34.95
Max. Negotiated Rate	$34.95
Rate for Payer: Qualcare PPO/HMO/WC	$34.95

CHAIR BEACH POSITONER LOANER

Facility

$1,250.00

Hospital Charge Code	270648818
Hospital Revenue Code	271
Min. Negotiated Rate	$187.50
Max. Negotiated Rate	$187.50
Rate for Payer: Qualcare PPO/HMO/WC	$187.50

CHAIR BEACH POSITONER LOANER

Facility

$1,250.00

Hospital Charge Code	270648818
Hospital Revenue Code	271
Min. Negotiated Rate	$30.12
Max. Negotiated Rate	$625.00
Rate for Payer: Aetna Commercial	$475.00
Rate for Payer: Aetna Medicare Advantage	$375.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$318.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$318.75
Rate for Payer: Cigna Commercial	$625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$375.00
Rate for Payer: Oxford Commercial	$250.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.50
Rate for Payer: UnitedHealthcare Commercial	$250.00
Rate for Payer: UnitedHealthcare Community & State	$30.12
Rate for Payer: Wellpoint Medicaid Managed Care	$33.12

CH ALBUMIN

Facility

$36.00

Service Code	HCPCS 82040
Hospital Charge Code	397071261
Hospital Revenue Code	307
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

CH ALBUMIN

Facility

$36.00

Service Code	HCPCS 82040
Hospital Charge Code	397071261
Hospital Revenue Code	307
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.46
Rate for Payer: Aetna Medicare Advantage	$16.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.87
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: Cigna Medicare Advantage	$4.95
Rate for Payer: Clover Medicare Advantage	$4.70
Rate for Payer: EmblemHealth Commercial	$14.85
Rate for Payer: Humana Medicare Advantage	$5.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.95
Rate for Payer: Wellcare Medicare Advantage	$4.95
Rate for Payer: Wellpoint Medicaid Managed Care	$0.95

CH ALBUMIN CSF

Facility

$90.00

Service Code	HCPCS 82042
Hospital Charge Code	397073234
Hospital Revenue Code	307
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$21.16
Rate for Payer: Aetna Medicare Advantage	$25.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.08
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: Cigna Medicare Advantage	$7.78
Rate for Payer: Clover Medicare Advantage	$7.39
Rate for Payer: EmblemHealth Commercial	$23.34
Rate for Payer: Humana Medicare Advantage	$8.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.78
Rate for Payer: Wellcare Medicare Advantage	$7.78
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

Know your out-of-pocket cost for care.

All Charges