Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CULTURE,FUNGUS,BLOOD

Facility

$390.00

Service Code	HCPCS 87103
Hospital Charge Code	39900487
Hospital Revenue Code	309
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$55.65
Rate for Payer: Aetna Medicare Advantage	$66.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.85
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$20.46
Rate for Payer: Clover Medicare Advantage	$19.44
Rate for Payer: EmblemHealth Commercial	$61.38
Rate for Payer: Humana Medicare Advantage	$21.07
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.46
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	$16.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.46
Rate for Payer: Wellcare Medicare Advantage	$20.46
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CULTURE,FUNGUS,BLOOD

Facility

$390.00

Service Code	HCPCS 87103
Hospital Charge Code	39900487
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CULTURE,FUNGUS,MISC I

Facility

$390.00

Service Code	HCPCS 87102
Hospital Charge Code	3990160A
Hospital Revenue Code	309
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$22.88
Rate for Payer: Aetna Medicare Advantage	$27.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.36
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.41
Rate for Payer: Clover Medicare Advantage	$7.99
Rate for Payer: EmblemHealth Commercial	$25.23
Rate for Payer: Humana Medicare Advantage	$8.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.41
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	$6.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.41
Rate for Payer: Wellcare Medicare Advantage	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CULTURE,FUNGUS,MISC I

Facility

$390.00

Service Code	HCPCS 87102
Hospital Charge Code	3990160A
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CULTURE,FUNGUS,MISC II

Facility

$390.00

Service Code	HCPCS 87206
Hospital Charge Code	3990160B
Hospital Revenue Code	309
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.66
Rate for Payer: Aetna Medicare Advantage	$17.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.46
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.39
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.39
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	$4.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Medicare Advantage	$5.39
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CULTURE,FUNGUS,MISC II

Facility

$390.00

Service Code	HCPCS 87206
Hospital Charge Code	3990160B
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CULTURE,FUNGUS,RESPIRIRATORY I

Facility

$57.75

Service Code	HCPCS 87102
Hospital Charge Code	3990158A
Hospital Revenue Code	309
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$22.88
Rate for Payer: Aetna Medicare Advantage	$27.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.36
Rate for Payer: Cigna Commercial	$28.88
Rate for Payer: Cigna Medicare Advantage	$8.41
Rate for Payer: Clover Medicare Advantage	$7.99
Rate for Payer: EmblemHealth Commercial	$25.23
Rate for Payer: Humana Medicare Advantage	$8.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.66
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.41
Rate for Payer: Wellcare Medicare Advantage	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

CULTURE,FUNGUS,RESPIRIRATORY I

Facility

$57.75

Service Code	HCPCS 87102
Hospital Charge Code	3990158A
Hospital Revenue Code	309
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$8.66
Rate for Payer: Qualcare PPO/HMO/WC	$8.66

CULTURE,FUNGUS,TISSUE I

Facility

$57.75

Service Code	HCPCS 87102
Hospital Charge Code	3990159A
Hospital Revenue Code	309
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$22.88
Rate for Payer: Aetna Medicare Advantage	$27.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.36
Rate for Payer: Cigna Commercial	$28.88
Rate for Payer: Cigna Medicare Advantage	$8.41
Rate for Payer: Clover Medicare Advantage	$7.99
Rate for Payer: EmblemHealth Commercial	$25.23
Rate for Payer: Humana Medicare Advantage	$8.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.66
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.41
Rate for Payer: Wellcare Medicare Advantage	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

CULTURE,FUNGUS,TISSUE I

Facility

$57.75

Service Code	HCPCS 87102
Hospital Charge Code	3990159A
Hospital Revenue Code	309
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$8.66
Rate for Payer: Qualcare PPO/HMO/WC	$8.66

CULTURE,FUNGUS,TISSUE, I

Facility

$53.00

Service Code	HCPCS 87101
Hospital Charge Code	39990052A
Hospital Revenue Code	309
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$7.95
Rate for Payer: Qualcare PPO/HMO/WC	$7.95

CULTURE,FUNGUS,TISSUE, I

Facility

$53.00

Service Code	HCPCS 87101
Hospital Charge Code	39990052A
Hospital Revenue Code	309
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$20.97
Rate for Payer: Aetna Medicare Advantage	$24.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.83
Rate for Payer: Cigna Commercial	$26.50
Rate for Payer: Cigna Medicare Advantage	$7.71
Rate for Payer: Clover Medicare Advantage	$7.32
Rate for Payer: EmblemHealth Commercial	$23.13
Rate for Payer: Humana Medicare Advantage	$7.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.71
Rate for Payer: Wellcare Medicare Advantage	$7.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

CULTURE,FUNGUS,TISSUE II

Facility

$36.70

Service Code	HCPCS 87206
Hospital Charge Code	3990159B
Hospital Revenue Code	309
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.66
Rate for Payer: Aetna Medicare Advantage	$17.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.46
Rate for Payer: Cigna Commercial	$18.35
Rate for Payer: Cigna Medicare Advantage	$5.39
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Medicare Advantage	$5.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

CULTURE,FUNGUS,TISSUE II

Facility

$36.70

Service Code	HCPCS 87206
Hospital Charge Code	3990159B
Hospital Revenue Code	309
Min. Negotiated Rate	$5.50
Max. Negotiated Rate	$5.50
Rate for Payer: Qualcare PPO/HMO/WC	$5.50

CULTURE,FUNGUS,TISSUE, II

Facility

$57.75

Service Code	HCPCS 87102
Hospital Charge Code	39990052B
Hospital Revenue Code	309
Min. Negotiated Rate	$1.53
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$22.88
Rate for Payer: Aetna Medicare Advantage	$27.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.36
Rate for Payer: Cigna Commercial	$28.88
Rate for Payer: Cigna Medicare Advantage	$8.41
Rate for Payer: Clover Medicare Advantage	$7.99
Rate for Payer: EmblemHealth Commercial	$25.23
Rate for Payer: Humana Medicare Advantage	$8.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.66
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.41
Rate for Payer: Wellcare Medicare Advantage	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$1.53

CULTURE,FUNGUS,TISSUE, II

Facility

$57.75

Service Code	HCPCS 87102
Hospital Charge Code	39990052B
Hospital Revenue Code	309
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$8.66
Rate for Payer: Qualcare PPO/HMO/WC	$8.66

CULTURE, GBS

Facility

$196.35

Service Code	HCPCS 87186
Hospital Charge Code	3000024
Hospital Revenue Code	309
Min. Negotiated Rate	$5.20
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$23.53
Rate for Payer: Aetna Medicare Advantage	$28.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.22
Rate for Payer: Cigna Commercial	$98.17
Rate for Payer: Cigna Medicare Advantage	$8.65
Rate for Payer: Clover Medicare Advantage	$8.22
Rate for Payer: EmblemHealth Commercial	$25.95
Rate for Payer: Humana Medicare Advantage	$8.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.92
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.65
Rate for Payer: Wellcare Medicare Advantage	$8.65
Rate for Payer: Wellpoint Medicaid Managed Care	$5.20

CULTURE, GBS

Facility

$196.35

Service Code	HCPCS 87186
Hospital Charge Code	3000024
Hospital Revenue Code	309
Min. Negotiated Rate	$29.45
Max. Negotiated Rate	$29.45
Rate for Payer: Qualcare PPO/HMO/WC	$29.45

CULTURE, GC

Facility

$667.59

Service Code	HCPCS 87070
Hospital Charge Code	3009974
Hospital Revenue Code	306
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CULTURE, GC

Facility

$667.59

Service Code	HCPCS 87070
Hospital Charge Code	3009974
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, GENITAL

Facility

$93.65

Service Code	HCPCS 87070
Hospital Charge Code	3000023
Hospital Revenue Code	306
Min. Negotiated Rate	$14.05
Max. Negotiated Rate	$14.05
Rate for Payer: Qualcare PPO/HMO/WC	$14.05

CULTURE, GENITAL

Facility

$93.65

Service Code	HCPCS 87070
Hospital Charge Code	3000023
Hospital Revenue Code	306
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$124.00
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	$46.83
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	$28.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.05
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	$2.48

CULTURE GENITAL-SO

Facility

$92.80

Service Code	HCPCS 87070
Hospital Charge Code	40134558
Hospital Revenue Code	306
Min. Negotiated Rate	$13.92
Max. Negotiated Rate	$13.92
Rate for Payer: Qualcare PPO/HMO/WC	$13.92

CULTURE GENITAL-SO

Facility

$92.80

Service Code	HCPCS 87070
Hospital Charge Code	40134558
Hospital Revenue Code	306
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$124.00
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	$46.40
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	$27.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.92
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	$2.46

CULTURE, HERPES SIMPLEX

Facility

$253.45

Service Code	HCPCS 83520
Hospital Charge Code	3006814
Hospital Revenue Code	301
Min. Negotiated Rate	$38.02
Max. Negotiated Rate	$38.02
Rate for Payer: Qualcare PPO/HMO/WC	$38.02

Know your out-of-pocket cost for care.

All Charges