Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CLUSTER SHELL CEMENTLESS 60MM

Facility

$5,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270706143
Hospital Revenue Code	278
Min. Negotiated Rate	$132.55
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Community & State	$132.55
Rate for Payer: Wellpoint Medicaid Managed Care	$145.75

CLUSTER SHELL CEMENTLESS 60MM

Facility

$5,500.00

Service Code	HCPCS C1765
Hospital Charge Code	270706143
Hospital Revenue Code	278
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$1,331.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,331.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

C-MATCH REINSTATE RESLTD UNITS

Facility

$100.00

Service Code	HCPCS 86920
Hospital Charge Code	3100344
Hospital Revenue Code	300
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

C-MATCH REINSTATE RESLTD UNITS

Facility

$100.00

Service Code	HCPCS 86920
Hospital Charge Code	3100344
Hospital Revenue Code	300
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

CMFLG TAILORSPLNT 3/32 2.4MM

Facility

$410.75

Hospital Charge Code	270663150
Hospital Revenue Code	270
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$205.38
Rate for Payer: Aetna Commercial	$156.09
Rate for Payer: Aetna Medicare Advantage	$123.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$104.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$104.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$104.74
Rate for Payer: Cigna Commercial	$205.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.22
Rate for Payer: Oxford Commercial	$82.15
Rate for Payer: Qualcare PPO/HMO/WC	$61.61
Rate for Payer: UnitedHealthcare Commercial	$82.15
Rate for Payer: UnitedHealthcare Community & State	$9.90
Rate for Payer: Wellpoint Medicaid Managed Care	$10.88

CMFLG TAILORSPLNT 3/32 2.4MM

Facility

$410.75

Hospital Charge Code	270663150
Hospital Revenue Code	270
Min. Negotiated Rate	$61.61
Max. Negotiated Rate	$61.61
Rate for Payer: Qualcare PPO/HMO/WC	$61.61

CMNTLESFMORLSTEMSTD2SZ14CORAIL

Facility

$42,030.00

Hospital Charge Code	270663841
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.92
Max. Negotiated Rate	$21,015.00
Rate for Payer: Aetna Commercial	$15,971.40
Rate for Payer: Aetna Medicare Advantage	$12,609.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,717.65
Rate for Payer: Cigna Commercial	$21,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,171.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,246.60
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50
Rate for Payer: UnitedHealthcare Community & State	$1,012.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1,113.80

CMNTLESFMORLSTEMSTD2SZ14CORAIL

Facility

$42,030.00

Hospital Charge Code	270663841
Hospital Revenue Code	278
Min. Negotiated Rate	$6,304.50
Max. Negotiated Rate	$10,171.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,406.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,171.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,246.60
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50

C MOTOR EVOKED UPPR&LWR LIMBS

Facility

$5,325.60

Service Code	HCPCS 95939
Hospital Charge Code	321095939
Hospital Revenue Code	920
Min. Negotiated Rate	$798.84
Max. Negotiated Rate	$798.84
Rate for Payer: Qualcare PPO/HMO/WC	$798.84

C MOTOR EVOKED UPPR&LWR LIMBS

Facility

$5,325.60

Service Code	HCPCS 95939
Hospital Charge Code	321095939
Hospital Revenue Code	920
Min. Negotiated Rate	$128.35
Max. Negotiated Rate	$3,682.65
Rate for Payer: Aetna Commercial	$2,774.97
Rate for Payer: Aetna Medicare Advantage	$3,305.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,682.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,682.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,020.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$397.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,682.65
Rate for Payer: Cigna Commercial	$2,044.99
Rate for Payer: Cigna Medicare Advantage	$1,020.21
Rate for Payer: Clover Medicare Advantage	$969.20
Rate for Payer: EmblemHealth Commercial	$3,060.63
Rate for Payer: Humana Medicare Advantage	$1,050.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,020.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.68
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$798.84
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$128.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,020.21
Rate for Payer: Wellcare Medicare Advantage	$1,020.21
Rate for Payer: Wellpoint Medicaid Managed Care	$141.13

CMPLX REPAIR TRUNK 2.6-7.5 cm

Facility

$5,105.84

Service Code	HCPCS 13101
Hospital Charge Code	16000198
Hospital Revenue Code	360
Min. Negotiated Rate	$765.88
Max. Negotiated Rate	$765.88
Rate for Payer: Qualcare PPO/HMO/WC	$765.88

CMPLX REPAIR TRUNK 2.6-7.5 cm

Facility

$5,105.84

Service Code	HCPCS 13101
Hospital Charge Code	16000198
Hospital Revenue Code	360
Min. Negotiated Rate	$123.05
Max. Negotiated Rate	$3,169.46
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,169.46
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,531.75
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.88
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$123.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$135.30

CMPLX RPR TRUNK ADDL 5CM/<

Facility

$4,899.30

Service Code	HCPCS 13102
Hospital Charge Code	16000261
Hospital Revenue Code	360
Min. Negotiated Rate	$734.89
Max. Negotiated Rate	$734.89
Rate for Payer: Qualcare PPO/HMO/WC	$734.89

CMPLX RPR TRUNK ADDL 5CM/<

Facility

$4,899.30

Service Code	HCPCS 13102
Hospital Charge Code	16000261
Hospital Revenue Code	360
Min. Negotiated Rate	$118.07
Max. Negotiated Rate	$2,449.65
Rate for Payer: Aetna Commercial	$1,861.73
Rate for Payer: Aetna Medicare Advantage	$1,469.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,249.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,249.32
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	$1,249.32
Rate for Payer: Cigna Commercial	$2,449.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,469.79
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$734.89
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$118.07
Rate for Payer: Wellpoint Medicaid Managed Care	$129.83

C MRSA SCREEN

Facility

$735.08

Service Code	HCPCS 87081
Hospital Charge Code	3008878
Hospital Revenue Code	309
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$367.54
Rate for Payer: Aetna Commercial	$18.03
Rate for Payer: Aetna Medicare Advantage	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.93
Rate for Payer: Cigna Commercial	$367.54
Rate for Payer: Cigna Medicare Advantage	$6.63
Rate for Payer: Clover Medicare Advantage	$6.30
Rate for Payer: EmblemHealth Commercial	$19.89
Rate for Payer: Humana Medicare Advantage	$6.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$220.52
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$110.26
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.63
Rate for Payer: Wellcare Medicare Advantage	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$19.48

C MRSA SCREEN

Facility

$735.08

Service Code	HCPCS 87081
Hospital Charge Code	3008878
Hospital Revenue Code	309
Min. Negotiated Rate	$110.26
Max. Negotiated Rate	$110.26
Rate for Payer: Qualcare PPO/HMO/WC	$110.26

CMV AB CSF

Facility

$188.85

Service Code	HCPCS 86644
Hospital Charge Code	3035093
Hospital Revenue Code	302
Min. Negotiated Rate	$28.33
Max. Negotiated Rate	$28.33
Rate for Payer: Qualcare PPO/HMO/WC	$28.33

CMV AB CSF

Facility

$188.85

Service Code	HCPCS 86644
Hospital Charge Code	3035093
Hospital Revenue Code	302
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$46.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.94
Rate for Payer: Cigna Commercial	$94.42
Rate for Payer: Cigna Medicare Advantage	$14.39
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Medicare Advantage	$14.39
Rate for Payer: Wellpoint Medicaid Managed Care	$5.00

CMV AB (IGG)

Facility

$390.00

Service Code	HCPCS 86644
Hospital Charge Code	39900231
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$46.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.94
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.39
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.39
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	$11.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Medicare Advantage	$14.39
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CMV AB (IGG)

Facility

$390.00

Service Code	HCPCS 86644
Hospital Charge Code	39900231
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CMV AB (IGG,IGM) I

Facility

$667.59

Service Code	HCPCS 86644
Hospital Charge Code	39990092A
Hospital Revenue Code	302
Min. Negotiated Rate	$11.51
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$46.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.94
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$14.39
Rate for Payer: Clover Medicare Advantage	$13.67
Rate for Payer: EmblemHealth Commercial	$43.17
Rate for Payer: Humana Medicare Advantage	$14.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.39
Rate for Payer: Wellcare Medicare Advantage	$14.39
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

CMV AB (IGG,IGM) I

Facility

$667.59

Service Code	HCPCS 86644
Hospital Charge Code	39990092A
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CMV AB (IGG,IGM) II

Facility

$667.59

Service Code	HCPCS 86645
Hospital Charge Code	39990092B
Hospital Revenue Code	302
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CMV AB (IGG,IGM) II

Facility

$667.59

Service Code	HCPCS 86645
Hospital Charge Code	39990092B
Hospital Revenue Code	302
Min. Negotiated Rate	$13.48
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.82
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

CMV AB (IGM)

Facility

$390.00

Service Code	HCPCS 86645
Hospital Charge Code	39900232
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.82
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
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	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

Know your out-of-pocket cost for care.

All Charges