Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CULTURE BACTERIA XCPT BLOOD-SO

Facility

$103.94

Service Code	HCPCS 87075
Hospital Charge Code	40134469A
Hospital Revenue Code	306
Min. Negotiated Rate	$15.59
Max. Negotiated Rate	$15.59
Rate for Payer: Qualcare PPO/HMO/WC	$15.59

CULTURE BACTERIA XCPT BLOOD-SO

Facility

$63.93

Service Code	HCPCS 87075
Hospital Charge Code	40134446B
Hospital Revenue Code	306
Min. Negotiated Rate	$9.59
Max. Negotiated Rate	$9.59
Rate for Payer: Qualcare PPO/HMO/WC	$9.59

CULTURE, BLOOD

Facility

$667.56

Service Code	HCPCS 87040
Hospital Charge Code	3008851
Hospital Revenue Code	306
Min. Negotiated Rate	$100.13
Max. Negotiated Rate	$100.13
Rate for Payer: Qualcare PPO/HMO/WC	$100.13

CULTURE, BLOOD

Facility

$667.56

Service Code	HCPCS 87040
Hospital Charge Code	3008851
Hospital Revenue Code	306
Min. Negotiated Rate	$8.26
Max. Negotiated Rate	$333.78
Rate for Payer: Aetna Commercial	$28.07
Rate for Payer: Aetna Medicare Advantage	$33.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.25
Rate for Payer: Cigna Commercial	$333.78
Rate for Payer: Cigna Medicare Advantage	$10.32
Rate for Payer: Clover Medicare Advantage	$9.80
Rate for Payer: EmblemHealth Commercial	$30.96
Rate for Payer: Humana Medicare Advantage	$10.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.27
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.13
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.32
Rate for Payer: Wellcare Medicare Advantage	$10.32
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

CULTURE,BLOOD

Facility

$70.95

Service Code	HCPCS 87040
Hospital Charge Code	39900263
Hospital Revenue Code	306
Min. Negotiated Rate	$10.64
Max. Negotiated Rate	$10.64
Rate for Payer: Qualcare PPO/HMO/WC	$10.64

CULTURE,BLOOD

Facility

$70.95

Service Code	HCPCS 87040
Hospital Charge Code	39900263
Hospital Revenue Code	306
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$28.07
Rate for Payer: Aetna Medicare Advantage	$33.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.25
Rate for Payer: Cigna Commercial	$35.48
Rate for Payer: Cigna Medicare Advantage	$10.32
Rate for Payer: Clover Medicare Advantage	$9.80
Rate for Payer: EmblemHealth Commercial	$30.96
Rate for Payer: Humana Medicare Advantage	$10.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.64
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.32
Rate for Payer: Wellcare Medicare Advantage	$10.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

CULTURE, BODY FLUID

Facility

$667.59

Service Code	HCPCS 87070
Hospital Charge Code	3009503
Hospital Revenue Code	306
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$23.45
Rate for Payer: Aetna Medicare Advantage	$27.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.12
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$8.62
Rate for Payer: Clover Medicare Advantage	$8.19
Rate for Payer: EmblemHealth Commercial	$25.86
Rate for Payer: Humana Medicare Advantage	$8.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.62
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	$6.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.62
Rate for Payer: Wellcare Medicare Advantage	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

CULTURE, BODY FLUID

Facility

$667.59

Service Code	HCPCS 87070
Hospital Charge Code	3009503
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CULTURE, BONE MARROW

Facility

$148.87

Service Code	HCPCS 87040
Hospital Charge Code	3009925
Hospital Revenue Code	306
Min. Negotiated Rate	$22.33
Max. Negotiated Rate	$22.33
Rate for Payer: Qualcare PPO/HMO/WC	$22.33

CULTURE, BONE MARROW

Facility

$148.87

Service Code	HCPCS 87040
Hospital Charge Code	3009925
Hospital Revenue Code	306
Min. Negotiated Rate	$3.95
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$28.07
Rate for Payer: Aetna Medicare Advantage	$33.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.25
Rate for Payer: Cigna Commercial	$74.44
Rate for Payer: Cigna Medicare Advantage	$10.32
Rate for Payer: Clover Medicare Advantage	$9.80
Rate for Payer: EmblemHealth Commercial	$30.96
Rate for Payer: Humana Medicare Advantage	$10.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.32
Rate for Payer: Wellcare Medicare Advantage	$10.32
Rate for Payer: Wellpoint Medicaid Managed Care	$3.95

CULTURE, BRONCHIAL WASHING

Facility

$390.00

Service Code	HCPCS 87070
Hospital Charge Code	3009966
Hospital Revenue Code	306
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$23.45
Rate for Payer: Aetna Medicare Advantage	$27.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.12
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.62
Rate for Payer: Clover Medicare Advantage	$8.19
Rate for Payer: EmblemHealth Commercial	$25.86
Rate for Payer: Humana Medicare Advantage	$8.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.62
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	$6.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.62
Rate for Payer: Wellcare Medicare Advantage	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CULTURE, BRONCHIAL WASHING

Facility

$390.00

Service Code	HCPCS 87070
Hospital Charge Code	3009966
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Culture, Campylobacter

Facility

$82.19

Service Code	HCPCS 4475
Hospital Charge Code	3000075
Hospital Revenue Code	306
Min. Negotiated Rate	$12.33
Max. Negotiated Rate	$12.33
Rate for Payer: Qualcare PPO/HMO/WC	$12.33

Culture, Campylobacter

Facility

$82.19

Service Code	HCPCS 4475
Hospital Charge Code	3000075
Hospital Revenue Code	306
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.23
Rate for Payer: Aetna Medicare Advantage	$24.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.96
Rate for Payer: Cigna Commercial	$41.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.18

CULTURE CAMPYLOBACTER

Facility

$390.00

Service Code	HCPCS 87046
Hospital Charge Code	401187046B
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CULTURE CAMPYLOBACTER

Facility

$390.00

Service Code	HCPCS 87046
Hospital Charge Code	401187046B
Hospital Revenue Code	306
Min. Negotiated Rate	$7.55
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$25.68
Rate for Payer: Aetna Medicare Advantage	$30.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.44
Rate for Payer: Clover Medicare Advantage	$8.97
Rate for Payer: EmblemHealth Commercial	$28.32
Rate for Payer: Humana Medicare Advantage	$9.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.44
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	$7.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.44
Rate for Payer: Wellcare Medicare Advantage	$9.44
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CULTURE, CAMPYLOBACTER

Facility

$390.00

Service Code	HCPCS 87046
Hospital Charge Code	39990244
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CULTURE, CAMPYLOBACTER

Facility

$390.00

Service Code	HCPCS 87046
Hospital Charge Code	39990244
Hospital Revenue Code	309
Min. Negotiated Rate	$7.55
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$25.68
Rate for Payer: Aetna Medicare Advantage	$30.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.08
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.44
Rate for Payer: Clover Medicare Advantage	$8.97
Rate for Payer: EmblemHealth Commercial	$28.32
Rate for Payer: Humana Medicare Advantage	$9.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.44
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	$7.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.44
Rate for Payer: Wellcare Medicare Advantage	$9.44
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CULTURE, CHLAMYDIA

Facility

$225.65

Service Code	HCPCS 87110
Hospital Charge Code	3006764
Hospital Revenue Code	309
Min. Negotiated Rate	$33.85
Max. Negotiated Rate	$33.85
Rate for Payer: Qualcare PPO/HMO/WC	$33.85

CULTURE, CHLAMYDIA

Facility

$225.65

Service Code	HCPCS 87110
Hospital Charge Code	3006764
Hospital Revenue Code	309
Min. Negotiated Rate	$5.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$53.31
Rate for Payer: Aetna Medicare Advantage	$63.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.60
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	$70.75
Rate for Payer: Cigna Commercial	$112.83
Rate for Payer: Cigna Medicare Advantage	$19.60
Rate for Payer: Clover Medicare Advantage	$18.62
Rate for Payer: EmblemHealth Commercial	$58.80
Rate for Payer: Humana Medicare Advantage	$20.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.60
Rate for Payer: Wellcare Medicare Advantage	$19.60
Rate for Payer: Wellpoint Medicaid Managed Care	$5.98

CULTURE, CLOSTRIDIUM DIFFICILE

Facility

$179.25

Service Code	HCPCS 87075
Hospital Charge Code	3009123
Hospital Revenue Code	309
Min. Negotiated Rate	$26.89
Max. Negotiated Rate	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$26.89

CULTURE, CLOSTRIDIUM DIFFICILE

Facility

$179.25

Service Code	HCPCS 87075
Hospital Charge Code	3009123
Hospital Revenue Code	309
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.76
Rate for Payer: Aetna Medicare Advantage	$30.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.18
Rate for Payer: Cigna Commercial	$89.62
Rate for Payer: Cigna Medicare Advantage	$9.47
Rate for Payer: Clover Medicare Advantage	$9.00
Rate for Payer: EmblemHealth Commercial	$28.41
Rate for Payer: Humana Medicare Advantage	$9.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.47
Rate for Payer: Wellcare Medicare Advantage	$9.47
Rate for Payer: Wellpoint Medicaid Managed Care	$4.75

CULTURE, CMV

Facility

$213.00

Service Code	HCPCS 87252
Hospital Charge Code	38475010
Hospital Revenue Code	309
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$31.95
Rate for Payer: Qualcare PPO/HMO/WC	$31.95

CULTURE, CMV

Facility

$213.00

Service Code	HCPCS 87252
Hospital Charge Code	38475010
Hospital Revenue Code	309
Min. Negotiated Rate	$5.64
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$70.91
Rate for Payer: Aetna Medicare Advantage	$84.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.10
Rate for Payer: Cigna Commercial	$106.50
Rate for Payer: Cigna Medicare Advantage	$26.07
Rate for Payer: Clover Medicare Advantage	$24.77
Rate for Payer: EmblemHealth Commercial	$78.21
Rate for Payer: Humana Medicare Advantage	$26.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.07
Rate for Payer: Wellcare Medicare Advantage	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$5.64

CULTURE, CMV, CYTOMEGALOVIRUS

Facility

$287.25

Service Code	HCPCS 87252
Hospital Charge Code	3006608
Hospital Revenue Code	309
Min. Negotiated Rate	$7.61
Max. Negotiated Rate	$143.62
Rate for Payer: Aetna Commercial	$70.91
Rate for Payer: Aetna Medicare Advantage	$84.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$57.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.10
Rate for Payer: Cigna Commercial	$143.62
Rate for Payer: Cigna Medicare Advantage	$26.07
Rate for Payer: Clover Medicare Advantage	$24.77
Rate for Payer: EmblemHealth Commercial	$78.21
Rate for Payer: Humana Medicare Advantage	$26.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$26.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.17
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.09
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.07
Rate for Payer: Wellcare Medicare Advantage	$26.07
Rate for Payer: Wellpoint Medicaid Managed Care	$7.61

Know your out-of-pocket cost for care.

All Charges