Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ER-FB REMOVAL EAR-LT

Facility

$203.00

Hospital Charge Code	5792160
Hospital Revenue Code	450
Min. Negotiated Rate	$30.45
Max. Negotiated Rate	$30.45
Rate for Payer: Qualcare PPO/HMO/WC	$30.45

ER-FB REMOVAL - EAR-RT

Facility

$268.00

Hospital Charge Code	5792165
Hospital Revenue Code	450
Min. Negotiated Rate	$40.20
Max. Negotiated Rate	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$40.20

ER-FB REMOVAL - EAR-RT

Facility

$268.00

Hospital Charge Code	5792165
Hospital Revenue Code	450
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$101.84
Rate for Payer: Aetna Medicare Advantage	$80.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.34
Rate for Payer: Cigna Commercial	$134.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.20
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

ER FB REMOVAL FOOT COMPX

Facility

$4,486.70

Service Code	HCPCS 28193
Hospital Charge Code	5700767
Hospital Revenue Code	450
Min. Negotiated Rate	$118.90
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$673.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$118.90

ER FB REMOVAL FOOT COMPX

Facility

$4,486.70

Service Code	HCPCS 28193
Hospital Charge Code	5700767
Hospital Revenue Code	450
Min. Negotiated Rate	$673.00
Max. Negotiated Rate	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$673.00

ER FB REMOVAL FOOT DEEP

Facility

$9,570.65

Service Code	HCPCS 28192
Hospital Charge Code	5700766
Hospital Revenue Code	450
Min. Negotiated Rate	$1,435.60
Max. Negotiated Rate	$1,435.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,435.60

ER FB REMOVAL FOOT DEEP

Facility

$9,570.65

Service Code	HCPCS 28192
Hospital Charge Code	5700766
Hospital Revenue Code	450
Min. Negotiated Rate	$138.23
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,871.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,435.60
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$253.62

ER FB REMOVAL HIP/PELVIS SQ

Facility

$4,486.70

Service Code	HCPCS 27086
Hospital Charge Code	5700752
Hospital Revenue Code	450
Min. Negotiated Rate	$63.25
Max. Negotiated Rate	$12,456.64
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,456.64
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$673.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$118.90

ER FB REMOVAL HIP/PELVIS SQ

Facility

$4,486.70

Service Code	HCPCS 27086
Hospital Charge Code	5700752
Hospital Revenue Code	450
Min. Negotiated Rate	$673.00
Max. Negotiated Rate	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$673.00

ER FB REMOVAL LARYNX W SCOPE

Facility

$2,413.20

Service Code	HCPCS 31577
Hospital Charge Code	5700775
Hospital Revenue Code	450
Min. Negotiated Rate	$361.98
Max. Negotiated Rate	$361.98
Rate for Payer: Qualcare PPO/HMO/WC	$361.98

ER FB REMOVAL LARYNX W SCOPE

Facility

$2,413.20

Service Code	HCPCS 31577
Hospital Charge Code	5700775
Hospital Revenue Code	450
Min. Negotiated Rate	$63.95
Max. Negotiated Rate	$1,677.28
Rate for Payer: Aetna Commercial	$1,263.88
Rate for Payer: Aetna Medicare Advantage	$1,505.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,677.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,677.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$464.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$278.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,677.28
Rate for Payer: Cigna Commercial	$931.42
Rate for Payer: Cigna Medicare Advantage	$464.66
Rate for Payer: Clover Medicare Advantage	$441.43
Rate for Payer: EmblemHealth Commercial	$1,393.98
Rate for Payer: Humana Medicare Advantage	$478.60
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$464.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$723.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$361.98
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$464.66
Rate for Payer: Wellcare Medicare Advantage	$464.66
Rate for Payer: Wellpoint Medicaid Managed Care	$63.95

ER FB REMOVAL SHOULDER SQ

Facility

$4,486.70

Service Code	HCPCS 23330
Hospital Charge Code	5700730
Hospital Revenue Code	450
Min. Negotiated Rate	$73.18
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$73.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,346.01
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$673.00
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$118.90

ER FB REMOVAL SHOULDER SQ

Facility

$4,486.70

Service Code	HCPCS 23330
Hospital Charge Code	5700730
Hospital Revenue Code	450
Min. Negotiated Rate	$673.00
Max. Negotiated Rate	$673.00
Rate for Payer: Qualcare PPO/HMO/WC	$673.00

ER FB REMOVA TGH OR KNEE DEEP

Facility

$12,792.55

Service Code	HCPCS 27372
Hospital Charge Code	5700759
Hospital Revenue Code	450
Min. Negotiated Rate	$1,918.88
Max. Negotiated Rate	$1,918.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,918.88

ER FB REMOVA TGH OR KNEE DEEP

Facility

$12,792.55

Service Code	HCPCS 27372
Hospital Charge Code	5700759
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$12,456.64
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,456.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,456.64
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,837.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,918.88
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$339.00

ER FB REMOV HIP/PELVIS DEEP

Facility

$12,041.50

Service Code	HCPCS 27087
Hospital Charge Code	5700753
Hospital Revenue Code	450
Min. Negotiated Rate	$1,806.22
Max. Negotiated Rate	$1,806.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,806.22

ER FB REMOV HIP/PELVIS DEEP

Facility

$12,041.50

Service Code	HCPCS 27087
Hospital Charge Code	5700753
Hospital Revenue Code	450
Min. Negotiated Rate	$117.90
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$117.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,612.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,806.22
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$319.10

ER FB REMOV MOUTH EMBED SIM

Facility

$3,717.20

Service Code	HCPCS 40804
Hospital Charge Code	5700790
Hospital Revenue Code	450
Min. Negotiated Rate	$557.58
Max. Negotiated Rate	$557.58
Rate for Payer: Qualcare PPO/HMO/WC	$557.58

ER FB REMOV MOUTH EMBED SIM

Facility

$3,717.20

Service Code	HCPCS 40804
Hospital Charge Code	5700790
Hospital Revenue Code	450
Min. Negotiated Rate	$48.79
Max. Negotiated Rate	$3,889.52
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,115.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$557.58
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$98.51

ER FB SQ TISSUE COMPLEX

Facility

$5,127.50

Service Code	HCPCS 10121
Hospital Charge Code	5700505
Hospital Revenue Code	450
Min. Negotiated Rate	$769.12
Max. Negotiated Rate	$769.12
Rate for Payer: Qualcare PPO/HMO/WC	$769.12

ER FB SQ TISSUE COMPLEX

Facility

$5,127.50

Service Code	HCPCS 10121
Hospital Charge Code	5700505
Hospital Revenue Code	450
Min. Negotiated Rate	$135.88
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$295.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,538.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$769.12
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,474.27
Rate for Payer: Wellpoint Medicaid Managed Care	$135.88

ER-FELON/FINGR ABSCES-BIL

Facility

$3,801.00

Hospital Charge Code	5790475
Hospital Revenue Code	450
Min. Negotiated Rate	$100.73
Max. Negotiated Rate	$1,900.50
Rate for Payer: Aetna Commercial	$1,444.38
Rate for Payer: Aetna Medicare Advantage	$1,140.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$969.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$969.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$969.25
Rate for Payer: Cigna Commercial	$1,900.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,140.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$570.15
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$100.73

ER-FELON/FINGR ABSCES-BIL

Facility

$3,801.00

Hospital Charge Code	5790475
Hospital Revenue Code	450
Min. Negotiated Rate	$570.15
Max. Negotiated Rate	$570.15
Rate for Payer: Qualcare PPO/HMO/WC	$570.15

ER-FEMALE GENITAL-OTHER

Facility

$963.00

Service Code	HCPCS 58999
Hospital Charge Code	5790205
Hospital Revenue Code	450
Min. Negotiated Rate	$144.45
Max. Negotiated Rate	$144.45
Rate for Payer: Qualcare PPO/HMO/WC	$144.45

ER-FEMALE GENITAL-OTHER

Facility

$963.00

Service Code	HCPCS 58999
Hospital Charge Code	5790205
Hospital Revenue Code	450
Min. Negotiated Rate	$25.52
Max. Negotiated Rate	$866.98
Rate for Payer: Aetna Commercial	$653.29
Rate for Payer: Aetna Medicare Advantage	$778.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$866.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$866.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$240.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$866.98
Rate for Payer: Cigna Commercial	$481.45
Rate for Payer: Cigna Medicare Advantage	$240.18
Rate for Payer: Clover Medicare Advantage	$228.17
Rate for Payer: EmblemHealth Commercial	$720.54
Rate for Payer: Humana Medicare Advantage	$247.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$240.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$288.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$144.45
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$25.52

Know your out-of-pocket cost for care.

All Charges