Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ECHINOC AB EIA REFLEX TO WBLOT

Facility

$236.16

Service Code	HCPCS 86682
Hospital Charge Code	401186682
Hospital Revenue Code	302
Min. Negotiated Rate	$6.26
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$35.39
Rate for Payer: Aetna Medicare Advantage	$42.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.96
Rate for Payer: Cigna Commercial	$118.08
Rate for Payer: Cigna Medicare Advantage	$13.01
Rate for Payer: Clover Medicare Advantage	$12.36
Rate for Payer: EmblemHealth Commercial	$39.03
Rate for Payer: Humana Medicare Advantage	$13.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.85
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.42
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.01
Rate for Payer: Wellcare Medicare Advantage	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$6.26

ECHINOCOCCUS AB

Facility

$268.85

Service Code	HCPCS 86682
Hospital Charge Code	3006616
Hospital Revenue Code	302
Min. Negotiated Rate	$7.12
Max. Negotiated Rate	$134.43
Rate for Payer: Aetna Commercial	$35.39
Rate for Payer: Aetna Medicare Advantage	$42.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.96
Rate for Payer: Cigna Commercial	$134.43
Rate for Payer: Cigna Medicare Advantage	$13.01
Rate for Payer: Clover Medicare Advantage	$12.36
Rate for Payer: EmblemHealth Commercial	$39.03
Rate for Payer: Humana Medicare Advantage	$13.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.01
Rate for Payer: Wellcare Medicare Advantage	$13.01
Rate for Payer: Wellpoint Medicaid Managed Care	$7.12

ECHINOCOCCUS AB

Facility

$268.85

Service Code	HCPCS 86682
Hospital Charge Code	3006616
Hospital Revenue Code	302
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$40.33
Rate for Payer: Qualcare PPO/HMO/WC	$40.33

ECHO 2D LIMITED/FOLLOW UP

Facility

$1,174.45

Service Code	HCPCS 93308
Hospital Charge Code	94053115
Hospital Revenue Code	483
Min. Negotiated Rate	$28.30
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$873.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$352.33
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$176.17
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$28.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$31.12

ECHO 2D LIMITED/FOLLOW UP

Facility

$5,900.00

Service Code	HCPCS 93308
Hospital Charge Code	5300084
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

ECHO 2D LIMITED/FOLLOW UP

Facility

$1,174.45

Service Code	HCPCS 93308
Hospital Charge Code	94053115
Hospital Revenue Code	483
Min. Negotiated Rate	$176.17
Max. Negotiated Rate	$176.17
Rate for Payer: Qualcare PPO/HMO/WC	$176.17

ECHO 2D LIMITED/FOLLOW UP

Facility

$5,900.00

Service Code	HCPCS 93308
Hospital Charge Code	5300084
Hospital Revenue Code	483
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$873.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$142.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$156.35

ECHO 2D M MODE

Facility

$5,900.00

Service Code	HCPCS 93307
Hospital Charge Code	5300082
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

ECHO 2D M MODE

Facility

$5,900.00

Service Code	HCPCS 93307
Hospital Charge Code	5300082
Hospital Revenue Code	483
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$631.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$142.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$156.35

ECHO 2D M MODE

Facility

$2,401.15

Service Code	HCPCS 93307
Hospital Charge Code	94053110
Hospital Revenue Code	483
Min. Negotiated Rate	$57.87
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$631.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$720.35
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$360.17
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$57.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$63.63

ECHO 2D M MODE

Facility

$2,401.15

Service Code	HCPCS 93307
Hospital Charge Code	94053110
Hospital Revenue Code	483
Min. Negotiated Rate	$360.17
Max. Negotiated Rate	$360.17
Rate for Payer: Qualcare PPO/HMO/WC	$360.17

ECHO B-MTRC FP-SO 14

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691145
Hospital Revenue Code	278
Min. Negotiated Rate	$4,621.50
Max. Negotiated Rate	$7,456.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,778.20
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50

ECHO B-MTRC FP-SO 14

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691145
Hospital Revenue Code	278
Min. Negotiated Rate	$742.52
Max. Negotiated Rate	$15,405.00
Rate for Payer: Aetna Commercial	$11,707.80
Rate for Payer: Aetna Medicare Advantage	$9,243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,856.55
Rate for Payer: Cigna Commercial	$15,405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,778.20
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50
Rate for Payer: UnitedHealthcare Community & State	$742.52
Rate for Payer: Wellpoint Medicaid Managed Care	$816.47

ECHO BMTRC MP FP SZ 10

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691565
Hospital Revenue Code	278
Min. Negotiated Rate	$4,621.50
Max. Negotiated Rate	$7,456.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,778.20
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50

ECHO BMTRC MP FP SZ 10

Facility

$30,810.00

Service Code	HCPCS C1776
Hospital Charge Code	270691565
Hospital Revenue Code	278
Min. Negotiated Rate	$742.52
Max. Negotiated Rate	$15,405.00
Rate for Payer: Aetna Commercial	$11,707.80
Rate for Payer: Aetna Medicare Advantage	$9,243.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,856.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6,162.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,856.55
Rate for Payer: Cigna Commercial	$15,405.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,456.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,778.20
Rate for Payer: Qualcare PPO/HMO/WC	$4,621.50
Rate for Payer: UnitedHealthcare Community & State	$742.52
Rate for Payer: Wellpoint Medicaid Managed Care	$816.47

ECHO BUNDLE

Facility

$8,497.67

Hospital Charge Code	EXP5300
Hospital Revenue Code	483
Min. Negotiated Rate	$204.79
Max. Negotiated Rate	$4,248.84
Rate for Payer: Aetna Commercial	$3,229.11
Rate for Payer: Aetna Medicare Advantage	$2,549.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,166.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,166.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,166.91
Rate for Payer: Cigna Commercial	$4,248.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,549.30
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.65
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$204.79
Rate for Payer: Wellpoint Medicaid Managed Care	$225.19

ECHO BUNDLE

Facility

$8,497.67

Hospital Charge Code	EXP5300
Hospital Revenue Code	483
Min. Negotiated Rate	$1,274.65
Max. Negotiated Rate	$1,274.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,274.65

ECHOCARDIOGRAM/CARDDOPPLER/COL

Facility

$5,900.00

Service Code	HCPCS 93306
Hospital Charge Code	36540002
Hospital Revenue Code	483
Min. Negotiated Rate	$885.00
Max. Negotiated Rate	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00

ECHOCARDIOGRAM/CARDDOPPLER/COL

Facility

$5,900.00

Service Code	HCPCS 93306
Hospital Charge Code	36540002
Hospital Revenue Code	483
Min. Negotiated Rate	$142.19
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,146.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,770.00
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.00
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$142.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$156.35

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	74116025
Hospital Revenue Code	483
Min. Negotiated Rate	$191.32
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,146.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,381.56
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$191.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$210.37

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	5300080
Hospital Revenue Code	483
Min. Negotiated Rate	$191.32
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,146.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,381.56
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$191.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$210.37

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	74115025
Hospital Revenue Code	483
Min. Negotiated Rate	$191.32
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,146.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,381.56
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$191.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$210.37

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	74115025
Hospital Revenue Code	483
Min. Negotiated Rate	$1,190.78
Max. Negotiated Rate	$1,190.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	94053105
Hospital Revenue Code	483
Min. Negotiated Rate	$1,190.78
Max. Negotiated Rate	$1,190.78
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78

ECHO COMP W/ M MODE/C FLOW/DOP

Facility

$7,938.54

Service Code	HCPCS 93306
Hospital Charge Code	94053105
Hospital Revenue Code	483
Min. Negotiated Rate	$191.32
Max. Negotiated Rate	$2,656.00
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,146.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$649.16
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,381.56
Rate for Payer: Oxford Commercial	$1,514.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,190.78
Rate for Payer: UnitedHealthcare Commercial	$2,656.00
Rate for Payer: UnitedHealthcare Community & State	$191.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$210.37

Know your out-of-pocket cost for care.

All Charges