Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CH LEVEL 4 - GROSS & MICRO

Facility

$692.10

Service Code	HCPCS 88305TC
Hospital Charge Code	397061074
Hospital Revenue Code	310
Min. Negotiated Rate	$103.81
Max. Negotiated Rate	$103.81
Rate for Payer: Qualcare PPO/HMO/WC	$103.81

CH LEVEL 4 - GROSS & MICRO

Facility

$692.10

Service Code	HCPCS 88305TC
Hospital Charge Code	397061074
Hospital Revenue Code	310
Min. Negotiated Rate	$16.68
Max. Negotiated Rate	$346.05
Rate for Payer: Aetna Commercial	$263.00
Rate for Payer: Aetna Medicare Advantage	$207.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$176.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$176.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$176.49
Rate for Payer: Cigna Commercial	$346.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.63
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$103.81
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$16.68
Rate for Payer: Wellpoint Medicaid Managed Care	$18.34

CH LEVEL 4-GROSS & MICRO-ADD

Facility

$970.00

Service Code	HCPCS 8830591
Hospital Charge Code	397061086
Hospital Revenue Code	310
Min. Negotiated Rate	$23.38
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$23.38
Rate for Payer: Wellpoint Medicaid Managed Care	$25.70

CH LEVEL 4-GROSS & MICRO-ADD

Facility

$970.00

Service Code	HCPCS 8830591
Hospital Charge Code	397061086
Hospital Revenue Code	310
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

CH LEVEL 5 - GROSS & MICRO

Facility

$1,099.00

Service Code	HCPCS 88307
Hospital Charge Code	397061023
Hospital Revenue Code	310
Min. Negotiated Rate	$164.85
Max. Negotiated Rate	$164.85
Rate for Payer: Qualcare PPO/HMO/WC	$164.85

CH LEVEL 5 - GROSS & MICRO

Facility

$1,099.00

Service Code	HCPCS 88307
Hospital Charge Code	397061023
Hospital Revenue Code	310
Min. Negotiated Rate	$29.12
Max. Negotiated Rate	$1,537.15
Rate for Payer: Aetna Commercial	$1,158.28
Rate for Payer: Aetna Medicare Advantage	$1,379.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,537.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,537.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$425.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,537.15
Rate for Payer: Cigna Commercial	$853.60
Rate for Payer: Cigna Medicare Advantage	$425.84
Rate for Payer: Clover Medicare Advantage	$404.55
Rate for Payer: EmblemHealth Commercial	$1,277.52
Rate for Payer: Humana Medicare Advantage	$438.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$425.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$329.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$164.85
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$235.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$425.84
Rate for Payer: Wellcare Medicare Advantage	$425.84
Rate for Payer: Wellpoint Medicaid Managed Care	$29.12

CH LEVEL 5-GROSS & MICRO-ADD

Facility

$551.00

Service Code	HCPCS 8830791
Hospital Charge Code	397061087
Hospital Revenue Code	310
Min. Negotiated Rate	$13.28
Max. Negotiated Rate	$275.50
Rate for Payer: Aetna Commercial	$209.38
Rate for Payer: Aetna Medicare Advantage	$165.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.50
Rate for Payer: Cigna Commercial	$275.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.65
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$13.28
Rate for Payer: Wellpoint Medicaid Managed Care	$14.60

CH LEVEL 5-GROSS & MICRO-ADD

Facility

$551.00

Service Code	HCPCS 8830791
Hospital Charge Code	397061087
Hospital Revenue Code	310
Min. Negotiated Rate	$82.65
Max. Negotiated Rate	$82.65
Rate for Payer: Qualcare PPO/HMO/WC	$82.65

CH LEVEL 6 - GROSS & MICRO

Facility

$500.00

Service Code	HCPCS 88309
Hospital Charge Code	397061024
Hospital Revenue Code	310
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

CH LEVEL 6 - GROSS & MICRO

Facility

$500.00

Service Code	HCPCS 88309
Hospital Charge Code	397061024
Hospital Revenue Code	310
Min. Negotiated Rate	$13.25
Max. Negotiated Rate	$3,455.10
Rate for Payer: Aetna Commercial	$2,603.50
Rate for Payer: Aetna Medicare Advantage	$3,101.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,455.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,455.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$957.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,455.10
Rate for Payer: Cigna Commercial	$1,918.64
Rate for Payer: Cigna Medicare Advantage	$957.17
Rate for Payer: Clover Medicare Advantage	$909.31
Rate for Payer: EmblemHealth Commercial	$2,871.51
Rate for Payer: Humana Medicare Advantage	$985.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$957.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$352.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$957.17
Rate for Payer: Wellcare Medicare Advantage	$957.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

CH LEVETIRACETAM

Facility

$164.00

Service Code	HCPCS 80299
Hospital Charge Code	397073595
Hospital Revenue Code	301
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.28
Rate for Payer: Cigna Commercial	$82.00
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$4.35

CH LEVETIRACETAM

Facility

$164.00

Service Code	HCPCS 80299
Hospital Charge Code	397073595
Hospital Revenue Code	301
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$24.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.60

CH LIDOCAINE

Facility

$258.00

Service Code	HCPCS 80176
Hospital Charge Code	397071057
Hospital Revenue Code	301
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$129.00
Rate for Payer: Aetna Commercial	$39.96
Rate for Payer: Aetna Medicare Advantage	$47.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.03
Rate for Payer: Cigna Commercial	$129.00
Rate for Payer: Cigna Medicare Advantage	$14.69
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.07
Rate for Payer: Humana Medicare Advantage	$15.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.69
Rate for Payer: Wellcare Medicare Advantage	$14.69
Rate for Payer: Wellpoint Medicaid Managed Care	$6.84

CH LIDOCAINE

Facility

$258.00

Service Code	HCPCS 80176
Hospital Charge Code	397071057
Hospital Revenue Code	301
Min. Negotiated Rate	$38.70
Max. Negotiated Rate	$38.70
Rate for Payer: Qualcare PPO/HMO/WC	$38.70

CH LIGHT CHAINS KAPPA

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	397073161
Hospital Revenue Code	301
Min. Negotiated Rate	$144.15
Max. Negotiated Rate	$144.15
Rate for Payer: Qualcare PPO/HMO/WC	$144.15

CH LIGHT CHAINS KAPPA

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	397073161
Hospital Revenue Code	301
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$480.50
Rate for Payer: Aetna Commercial	$36.99
Rate for Payer: Aetna Medicare Advantage	$44.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.09
Rate for Payer: Cigna Commercial	$480.50
Rate for Payer: Cigna Medicare Advantage	$13.60
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$288.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Medicare Advantage	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$25.47

CH LIGHT CHAINS LAMBDA

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	397073162
Hospital Revenue Code	301
Min. Negotiated Rate	$144.15
Max. Negotiated Rate	$144.15
Rate for Payer: Qualcare PPO/HMO/WC	$144.15

CH LIGHT CHAINS LAMBDA

Facility

$961.00

Service Code	HCPCS 83883
Hospital Charge Code	397073162
Hospital Revenue Code	301
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$480.50
Rate for Payer: Aetna Commercial	$36.99
Rate for Payer: Aetna Medicare Advantage	$44.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.09
Rate for Payer: Cigna Commercial	$480.50
Rate for Payer: Cigna Medicare Advantage	$13.60
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$288.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Medicare Advantage	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$25.47

CH LIGHT CHAIN TYPE URINE

Facility

$123.00

Service Code	HCPCS 83883
Hospital Charge Code	397071343
Hospital Revenue Code	301
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$171.49
Rate for Payer: Aetna Commercial	$36.99
Rate for Payer: Aetna Medicare Advantage	$44.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.09
Rate for Payer: Cigna Commercial	$61.50
Rate for Payer: Cigna Medicare Advantage	$13.60
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Medicare Advantage	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$3.26

CH LIGHT CHAIN TYPE URINE

Facility

$123.00

Service Code	HCPCS 83883
Hospital Charge Code	397071343
Hospital Revenue Code	301
Min. Negotiated Rate	$18.45
Max. Negotiated Rate	$18.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.45

CH LIPASE

Facility

$462.12

Service Code	HCPCS 83690
Hospital Charge Code	397071033
Hospital Revenue Code	301
Min. Negotiated Rate	$69.32
Max. Negotiated Rate	$69.32
Rate for Payer: Qualcare PPO/HMO/WC	$69.32

CH LIPASE

Facility

$462.12

Service Code	HCPCS 83690
Hospital Charge Code	397071033
Hospital Revenue Code	301
Min. Negotiated Rate	$5.51
Max. Negotiated Rate	$231.06
Rate for Payer: Aetna Commercial	$18.74
Rate for Payer: Aetna Medicare Advantage	$22.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.87
Rate for Payer: Cigna Commercial	$231.06
Rate for Payer: Cigna Medicare Advantage	$6.89
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.32
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.89
Rate for Payer: Wellcare Medicare Advantage	$6.89
Rate for Payer: Wellpoint Medicaid Managed Care	$12.25

CH LIPASE, PLEURAL FLUID

Facility

$462.12

Service Code	HCPCS 83690
Hospital Charge Code	397071454
Hospital Revenue Code	301
Min. Negotiated Rate	$69.32
Max. Negotiated Rate	$69.32
Rate for Payer: Qualcare PPO/HMO/WC	$69.32

CH LIPASE, PLEURAL FLUID

Facility

$462.12

Service Code	HCPCS 83690
Hospital Charge Code	397071454
Hospital Revenue Code	301
Min. Negotiated Rate	$5.51
Max. Negotiated Rate	$231.06
Rate for Payer: Aetna Commercial	$18.74
Rate for Payer: Aetna Medicare Advantage	$22.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.87
Rate for Payer: Cigna Commercial	$231.06
Rate for Payer: Cigna Medicare Advantage	$6.89
Rate for Payer: Clover Medicare Advantage	$6.55
Rate for Payer: EmblemHealth Commercial	$20.67
Rate for Payer: Humana Medicare Advantage	$7.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$69.32
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.89
Rate for Payer: Wellcare Medicare Advantage	$6.89
Rate for Payer: Wellpoint Medicaid Managed Care	$12.25

CH LIPID PANEL

Facility

$894.84

Service Code	HCPCS 80061
Hospital Charge Code	397073040
Hospital Revenue Code	301
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$447.42
Rate for Payer: Aetna Commercial	$36.42
Rate for Payer: Aetna Medicare Advantage	$43.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.33
Rate for Payer: Cigna Commercial	$447.42
Rate for Payer: Cigna Medicare Advantage	$13.39
Rate for Payer: Clover Medicare Advantage	$12.72
Rate for Payer: EmblemHealth Commercial	$40.17
Rate for Payer: Humana Medicare Advantage	$13.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$134.23
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.39
Rate for Payer: Wellcare Medicare Advantage	$13.39
Rate for Payer: Wellpoint Medicaid Managed Care	$23.71

Know your out-of-pocket cost for care.

All Charges