Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CH CHOLESTEROL

Facility

$92.00

Service Code	HCPCS 82465
Hospital Charge Code	397071146
Hospital Revenue Code	301
Min. Negotiated Rate	$13.80
Max. Negotiated Rate	$13.80
Rate for Payer: Qualcare PPO/HMO/WC	$13.80

CH CHOLESTEROL

Facility

$92.00

Service Code	HCPCS 82465
Hospital Charge Code	397071146
Hospital Revenue Code	301
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.83
Rate for Payer: Aetna Medicare Advantage	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.70
Rate for Payer: Cigna Commercial	$46.00
Rate for Payer: Cigna Medicare Advantage	$4.35
Rate for Payer: Clover Medicare Advantage	$4.13
Rate for Payer: EmblemHealth Commercial	$13.05
Rate for Payer: Humana Medicare Advantage	$4.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.35
Rate for Payer: Wellcare Medicare Advantage	$4.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.44

CH CHOLESTEROL FLUID

Facility

$52.85

Service Code	HCPCS 82465
Hospital Charge Code	397073045
Hospital Revenue Code	301
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$7.93
Rate for Payer: Qualcare PPO/HMO/WC	$7.93

CH CHOLESTEROL FLUID

Facility

$52.85

Service Code	HCPCS 82465
Hospital Charge Code	397073045
Hospital Revenue Code	301
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.83
Rate for Payer: Aetna Medicare Advantage	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.70
Rate for Payer: Cigna Commercial	$26.43
Rate for Payer: Cigna Medicare Advantage	$4.35
Rate for Payer: Clover Medicare Advantage	$4.13
Rate for Payer: EmblemHealth Commercial	$13.05
Rate for Payer: Humana Medicare Advantage	$4.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.93
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.35
Rate for Payer: Wellcare Medicare Advantage	$4.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

CH CHOLINESTERASE PLASMA

Facility

$159.00

Service Code	HCPCS 82480
Hospital Charge Code	397071052
Hospital Revenue Code	301
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$21.41
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.41
Rate for Payer: Cigna Commercial	$79.50
Rate for Payer: Cigna Medicare Advantage	$7.87
Rate for Payer: Clover Medicare Advantage	$7.48
Rate for Payer: EmblemHealth Commercial	$23.61
Rate for Payer: Humana Medicare Advantage	$8.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.87
Rate for Payer: Wellcare Medicare Advantage	$7.87
Rate for Payer: Wellpoint Medicaid Managed Care	$4.21

CH CHOLINESTERASE PLASMA

Facility

$159.00

Service Code	HCPCS 82480
Hospital Charge Code	397071052
Hospital Revenue Code	301
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

CH CHOLINESTERASE RBC

Facility

$195.00

Service Code	HCPCS 82482
Hospital Charge Code	397072045
Hospital Revenue Code	301
Min. Negotiated Rate	$5.17
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$26.68
Rate for Payer: Aetna Medicare Advantage	$31.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.41
Rate for Payer: Cigna Commercial	$97.50
Rate for Payer: Cigna Medicare Advantage	$9.81
Rate for Payer: Clover Medicare Advantage	$9.32
Rate for Payer: EmblemHealth Commercial	$29.43
Rate for Payer: Humana Medicare Advantage	$10.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.81
Rate for Payer: Wellcare Medicare Advantage	$9.81
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

CH CHOLINESTERASE RBC

Facility

$195.00

Service Code	HCPCS 82482
Hospital Charge Code	397072045
Hospital Revenue Code	301
Min. Negotiated Rate	$29.25
Max. Negotiated Rate	$29.25
Rate for Payer: Qualcare PPO/HMO/WC	$29.25

CH CHROMATOGRAPHY

Facility

$111.00

Service Code	HCPCS 83021
Hospital Charge Code	397073651
Hospital Revenue Code	301
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

CH CHROMATOGRAPHY

Facility

$111.00

Service Code	HCPCS 83021
Hospital Charge Code	397073651
Hospital Revenue Code	301
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$49.12
Rate for Payer: Aetna Medicare Advantage	$58.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.19
Rate for Payer: Cigna Commercial	$55.50
Rate for Payer: Cigna Medicare Advantage	$18.06
Rate for Payer: Clover Medicare Advantage	$17.16
Rate for Payer: EmblemHealth Commercial	$54.18
Rate for Payer: Humana Medicare Advantage	$18.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.06
Rate for Payer: Wellcare Medicare Advantage	$18.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.94

CH CHROMIUM SERUM

Facility

$174.00

Service Code	HCPCS 82495
Hospital Charge Code	397072046
Hospital Revenue Code	301
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

CH CHROMIUM SERUM

Facility

$174.00

Service Code	HCPCS 82495
Hospital Charge Code	397072046
Hospital Revenue Code	301
Min. Negotiated Rate	$4.61
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$55.16
Rate for Payer: Aetna Medicare Advantage	$65.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.20
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: Cigna Medicare Advantage	$20.28
Rate for Payer: Clover Medicare Advantage	$19.27
Rate for Payer: EmblemHealth Commercial	$60.84
Rate for Payer: Humana Medicare Advantage	$20.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.28
Rate for Payer: Wellcare Medicare Advantage	$20.28
Rate for Payer: Wellpoint Medicaid Managed Care	$4.61

CH CHROMIUM, URINE

Facility

$759.00

Service Code	HCPCS 82495
Hospital Charge Code	397073088
Hospital Revenue Code	301
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$379.50
Rate for Payer: Aetna Commercial	$55.16
Rate for Payer: Aetna Medicare Advantage	$65.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.20
Rate for Payer: Cigna Commercial	$379.50
Rate for Payer: Cigna Medicare Advantage	$20.28
Rate for Payer: Clover Medicare Advantage	$19.27
Rate for Payer: EmblemHealth Commercial	$60.84
Rate for Payer: Humana Medicare Advantage	$20.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$227.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$113.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.28
Rate for Payer: Wellcare Medicare Advantage	$20.28
Rate for Payer: Wellpoint Medicaid Managed Care	$20.11

CH CHROMIUM, URINE

Facility

$759.00

Service Code	HCPCS 82495
Hospital Charge Code	397073088
Hospital Revenue Code	301
Min. Negotiated Rate	$113.85
Max. Negotiated Rate	$113.85
Rate for Payer: Qualcare PPO/HMO/WC	$113.85

CH CHROMOGRANIN A

Facility

$277.00

Service Code	HCPCS 83519
Hospital Charge Code	397073568
Hospital Revenue Code	301
Min. Negotiated Rate	$41.55
Max. Negotiated Rate	$41.55
Rate for Payer: Qualcare PPO/HMO/WC	$41.55

CH CHROMOGRANIN A

Facility

$277.00

Service Code	HCPCS 83519
Hospital Charge Code	397073568
Hospital Revenue Code	301
Min. Negotiated Rate	$7.34
Max. Negotiated Rate	$138.50
Rate for Payer: Aetna Commercial	$50.05
Rate for Payer: Aetna Medicare Advantage	$59.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.42
Rate for Payer: Cigna Commercial	$138.50
Rate for Payer: Cigna Medicare Advantage	$18.40
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Medicare Advantage	$18.40
Rate for Payer: Wellpoint Medicaid Managed Care	$7.34

CH CHROMOSOME AMNIOTIC FLUID

Facility

$1,800.00

Service Code	HCPCS 88267
Hospital Charge Code	397071334
Hospital Revenue Code	311
Min. Negotiated Rate	$47.70
Max. Negotiated Rate	$900.00
Rate for Payer: Aetna Commercial	$512.91
Rate for Payer: Aetna Medicare Advantage	$610.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$680.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$680.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$188.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$680.68
Rate for Payer: Cigna Commercial	$900.00
Rate for Payer: Cigna Medicare Advantage	$188.57
Rate for Payer: Clover Medicare Advantage	$179.14
Rate for Payer: EmblemHealth Commercial	$565.71
Rate for Payer: Humana Medicare Advantage	$194.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$188.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$540.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$150.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$188.57
Rate for Payer: Wellcare Medicare Advantage	$188.57
Rate for Payer: Wellpoint Medicaid Managed Care	$47.70

CH CHROMOSOME AMNIOTIC FLUID

Facility

$1,800.00

Service Code	HCPCS 88267
Hospital Charge Code	397071334
Hospital Revenue Code	311
Min. Negotiated Rate	$270.00
Max. Negotiated Rate	$270.00
Rate for Payer: Qualcare PPO/HMO/WC	$270.00

CH CHROMOSOME ANAL PHILADEL

Facility

$2,714.00

Service Code	HCPCS 88237
Hospital Charge Code	397071332
Hospital Revenue Code	311
Min. Negotiated Rate	$71.92
Max. Negotiated Rate	$1,357.00
Rate for Payer: Aetna Commercial	$391.00
Rate for Payer: Aetna Medicare Advantage	$465.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$518.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$518.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$518.89
Rate for Payer: Cigna Commercial	$1,357.00
Rate for Payer: Cigna Medicare Advantage	$143.75
Rate for Payer: Clover Medicare Advantage	$136.56
Rate for Payer: EmblemHealth Commercial	$431.25
Rate for Payer: Humana Medicare Advantage	$148.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$143.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$814.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$407.10
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$115.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$143.75
Rate for Payer: Wellcare Medicare Advantage	$143.75
Rate for Payer: Wellpoint Medicaid Managed Care	$71.92

CH CHROMOSOME ANAL PHILADEL

Facility

$2,714.00

Service Code	HCPCS 88237
Hospital Charge Code	397071332
Hospital Revenue Code	311
Min. Negotiated Rate	$407.10
Max. Negotiated Rate	$407.10
Rate for Payer: Qualcare PPO/HMO/WC	$407.10

CH CHROMOSOME ANALYSIS

Facility

$1,108.00

Service Code	HCPCS 88267
Hospital Charge Code	397073330
Hospital Revenue Code	311
Min. Negotiated Rate	$29.36
Max. Negotiated Rate	$680.68
Rate for Payer: Aetna Commercial	$512.91
Rate for Payer: Aetna Medicare Advantage	$610.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$680.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$680.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$188.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$680.68
Rate for Payer: Cigna Commercial	$554.00
Rate for Payer: Cigna Medicare Advantage	$188.57
Rate for Payer: Clover Medicare Advantage	$179.14
Rate for Payer: EmblemHealth Commercial	$565.71
Rate for Payer: Humana Medicare Advantage	$194.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$188.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$332.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$166.20
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$150.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$188.57
Rate for Payer: Wellcare Medicare Advantage	$188.57
Rate for Payer: Wellpoint Medicaid Managed Care	$29.36

CH CHROMOSOME ANALYSIS

Facility

$1,593.00

Service Code	HCPCS 88262
Hospital Charge Code	397073335
Hospital Revenue Code	311
Min. Negotiated Rate	$238.95
Max. Negotiated Rate	$238.95
Rate for Payer: Qualcare PPO/HMO/WC	$238.95

CH CHROMOSOME ANALYSIS

Facility

$796.00

Service Code	HCPCS 88281
Hospital Charge Code	397073331
Hospital Revenue Code	311
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$302.48
Rate for Payer: Aetna Medicare Advantage	$238.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$202.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$202.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$202.98
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$238.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$19.18
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

CH CHROMOSOME ANALYSIS

Facility

$1,593.00

Service Code	HCPCS 88262
Hospital Charge Code	397073327
Hospital Revenue Code	311
Min. Negotiated Rate	$238.95
Max. Negotiated Rate	$238.95
Rate for Payer: Qualcare PPO/HMO/WC	$238.95

CH CHROMOSOME ANALYSIS

Facility

$1,593.00

Service Code	HCPCS 88262
Hospital Charge Code	397073314
Hospital Revenue Code	311
Min. Negotiated Rate	$238.95
Max. Negotiated Rate	$238.95
Rate for Payer: Qualcare PPO/HMO/WC	$238.95

Know your out-of-pocket cost for care.

All Charges