Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CH RITALIN

Facility

$524.00

Service Code	HCPCS 80299
Hospital Charge Code	397073154
Hospital Revenue Code	301
Min. Negotiated Rate	$78.60
Max. Negotiated Rate	$78.60
Rate for Payer: Qualcare PPO/HMO/WC	$78.60

CH RITALIN

Facility

$524.00

Service Code	HCPCS 80299
Hospital Charge Code	397073154
Hospital Revenue Code	301
Min. Negotiated Rate	$11.64
Max. Negotiated Rate	$262.00
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	$262.00
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	$157.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$78.60
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	$13.89

CH RITUXAN SENSITIVITY(CD20)

Facility

$340.00

Service Code	HCPCS 86356
Hospital Charge Code	397071507
Hospital Revenue Code	302
Min. Negotiated Rate	$51.00
Max. Negotiated Rate	$51.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00

CH RITUXAN SENSITIVITY(CD20)

Facility

$340.00

Service Code	HCPCS 86356
Hospital Charge Code	397071507
Hospital Revenue Code	302
Min. Negotiated Rate	$9.01
Max. Negotiated Rate	$170.00
Rate for Payer: Aetna Commercial	$72.84
Rate for Payer: Aetna Medicare Advantage	$86.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$96.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$96.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$96.67
Rate for Payer: Cigna Commercial	$170.00
Rate for Payer: Cigna Medicare Advantage	$26.78
Rate for Payer: Clover Medicare Advantage	$25.44
Rate for Payer: EmblemHealth Commercial	$80.34
Rate for Payer: Humana Medicare Advantage	$27.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.78
Rate for Payer: Wellcare Medicare Advantage	$26.78
Rate for Payer: Wellpoint Medicaid Managed Care	$9.01

CHROM ANALYSIS ADDL CELLS EA S

Facility

$134.54

Service Code	HCPCS 88285
Hospital Charge Code	38477154
Hospital Revenue Code	311
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$73.20
Rate for Payer: Aetna Medicare Advantage	$87.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.14
Rate for Payer: Cigna Commercial	$67.27
Rate for Payer: Cigna Medicare Advantage	$26.91
Rate for Payer: Clover Medicare Advantage	$25.56
Rate for Payer: EmblemHealth Commercial	$80.73
Rate for Payer: Humana Medicare Advantage	$27.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.18
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$21.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.91
Rate for Payer: Wellcare Medicare Advantage	$26.91
Rate for Payer: Wellpoint Medicaid Managed Care	$3.57

CHROM ANALYSIS ADDL CELLS EA S

Facility

$134.54

Service Code	HCPCS 88285
Hospital Charge Code	38477154
Hospital Revenue Code	311
Min. Negotiated Rate	$20.18
Max. Negotiated Rate	$20.18
Rate for Payer: Qualcare PPO/HMO/WC	$20.18

CHROM ANALYSIS ADDL HIGH RESOL

Facility

$243.85

Service Code	HCPCS 88289
Hospital Charge Code	38477191
Hospital Revenue Code	311
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$93.65
Rate for Payer: Aetna Medicare Advantage	$111.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.28
Rate for Payer: Cigna Commercial	$121.92
Rate for Payer: Cigna Medicare Advantage	$34.43
Rate for Payer: Clover Medicare Advantage	$32.71
Rate for Payer: EmblemHealth Commercial	$103.29
Rate for Payer: Humana Medicare Advantage	$35.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.58
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.43
Rate for Payer: Wellcare Medicare Advantage	$34.43
Rate for Payer: Wellpoint Medicaid Managed Care	$6.46

CHROM ANALYSIS ADDL HIGH RESOL

Facility

$243.85

Service Code	HCPCS 88289
Hospital Charge Code	38477191
Hospital Revenue Code	311
Min. Negotiated Rate	$36.58
Max. Negotiated Rate	$36.58
Rate for Payer: Qualcare PPO/HMO/WC	$36.58

CHROM ANALYSIS ADDL KARYOTYPES

Facility

$177.74

Service Code	HCPCS 88280
Hospital Charge Code	38477179
Hospital Revenue Code	311
Min. Negotiated Rate	$4.71
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$91.04
Rate for Payer: Aetna Medicare Advantage	$108.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.82
Rate for Payer: Cigna Commercial	$88.87
Rate for Payer: Cigna Medicare Advantage	$33.47
Rate for Payer: Clover Medicare Advantage	$31.80
Rate for Payer: EmblemHealth Commercial	$100.41
Rate for Payer: Humana Medicare Advantage	$34.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$33.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.66
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$26.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$33.47
Rate for Payer: Wellcare Medicare Advantage	$33.47
Rate for Payer: Wellpoint Medicaid Managed Care	$4.71

CHROM ANALYSIS ADDL KARYOTYPES

Facility

$177.74

Service Code	HCPCS 88280
Hospital Charge Code	38477179
Hospital Revenue Code	311
Min. Negotiated Rate	$26.66
Max. Negotiated Rate	$26.66
Rate for Payer: Qualcare PPO/HMO/WC	$26.66

CHROM. ANALYSIS AMNIOTIC FLD

Facility

$2,060.00

Service Code	HCPCS 88267
Hospital Charge Code	3031549
Hospital Revenue Code	311
Min. Negotiated Rate	$309.00
Max. Negotiated Rate	$309.00
Rate for Payer: Qualcare PPO/HMO/WC	$309.00

CHROM. ANALYSIS AMNIOTIC FLD

Facility

$2,060.00

Service Code	HCPCS 88267
Hospital Charge Code	3031549
Hospital Revenue Code	311
Min. Negotiated Rate	$54.59
Max. Negotiated Rate	$1,030.00
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	$1,030.00
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	$618.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$309.00
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	$54.59

CHROMATIN NUCLEOSOMAL AB

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	401186235
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHROMATIN NUCLEOSOMAL AB

Facility

$390.00

Service Code	HCPCS 86235
Hospital Charge Code	401186235
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$48.77
Rate for Payer: Aetna Medicare Advantage	$58.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.72
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.93
Rate for Payer: Clover Medicare Advantage	$17.03
Rate for Payer: EmblemHealth Commercial	$53.79
Rate for Payer: Humana Medicare Advantage	$18.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.93
Rate for Payer: Wellcare Medicare Advantage	$17.93
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CHROMATOGRAPHY,QUANT,COLUMN

Facility

$127.84

Service Code	HCPCS 82542
Hospital Charge Code	38476780
Hospital Revenue Code	301
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$19.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.18

CHROMATOGRAPHY,QUANT,COLUMN

Facility

$127.84

Service Code	HCPCS 82542
Hospital Charge Code	38476779
Hospital Revenue Code	301
Min. Negotiated Rate	$3.39
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
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	$86.96
Rate for Payer: Cigna Commercial	$63.92
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.18
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CHROMATOGRAPHY,QUANT,COLUMN

Facility

$127.84

Service Code	HCPCS 82542
Hospital Charge Code	38476779
Hospital Revenue Code	301
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$19.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.18

CHROMATOGRAPHY,QUANT,COLUMN

Facility

$127.84

Service Code	HCPCS 82542
Hospital Charge Code	38476780
Hospital Revenue Code	301
Min. Negotiated Rate	$3.39
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
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	$86.96
Rate for Payer: Cigna Commercial	$63.92
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.18
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CHROMATOGRAPHY QUANT COLUMN M

Facility

$127.84

Service Code	HCPCS 82542
Hospital Charge Code	38477149
Hospital Revenue Code	301
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$19.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.18

CHROMATOGRAPHY QUANT COLUMN M

Facility

$127.84

Service Code	HCPCS 82542
Hospital Charge Code	38477149
Hospital Revenue Code	301
Min. Negotiated Rate	$3.39
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
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	$86.96
Rate for Payer: Cigna Commercial	$63.92
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.18
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.39

CH ROMI

Facility

$1,013.58

Service Code	HCPCS 84484
Hospital Charge Code	397073189
Hospital Revenue Code	301
Min. Negotiated Rate	$9.98
Max. Negotiated Rate	$506.79
Rate for Payer: Aetna Commercial	$33.92
Rate for Payer: Aetna Medicare Advantage	$40.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.01
Rate for Payer: Cigna Commercial	$506.79
Rate for Payer: Cigna Medicare Advantage	$12.47
Rate for Payer: Clover Medicare Advantage	$11.85
Rate for Payer: EmblemHealth Commercial	$37.41
Rate for Payer: Humana Medicare Advantage	$12.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$304.07
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$152.04
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.47
Rate for Payer: Wellcare Medicare Advantage	$12.47
Rate for Payer: Wellpoint Medicaid Managed Care	$26.86

CH ROMI

Facility

$1,013.58

Service Code	HCPCS 84484
Hospital Charge Code	397073189
Hospital Revenue Code	301
Min. Negotiated Rate	$152.04
Max. Negotiated Rate	$152.04
Rate for Payer: Qualcare PPO/HMO/WC	$152.04

CHROMIUM

Facility

$139.40

Service Code	HCPCS 82495
Hospital Charge Code	39900061
Hospital Revenue Code	301
Min. Negotiated Rate	$20.91
Max. Negotiated Rate	$20.91
Rate for Payer: Qualcare PPO/HMO/WC	$20.91

CHROMIUM

Facility

$139.40

Service Code	HCPCS 82495
Hospital Charge Code	39900061
Hospital Revenue Code	301
Min. Negotiated Rate	$3.69
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	$69.70
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	$41.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.91
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	$3.69

CHROMIUM

Facility

$667.59

Service Code	HCPCS 82495
Hospital Charge Code	38473066
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Know your out-of-pocket cost for care.

All Charges