Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FP IND PSYCHTERAPHY 45-50MTS

Facility

$576.00

Service Code	HCPCS 90806
Hospital Charge Code	83652349
Hospital Revenue Code	914
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$86.40
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

FP IND PSYCHTERAPHY 45-50MTS

Facility

$576.00

Service Code	HCPCS 90806
Hospital Charge Code	83652349
Hospital Revenue Code	914
Min. Negotiated Rate	$13.88
Max. Negotiated Rate	$288.00
Rate for Payer: Aetna Commercial	$218.88
Rate for Payer: Aetna Medicare Advantage	$172.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.88
Rate for Payer: Cigna Commercial	$288.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.80
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Community & State	$13.88
Rate for Payer: Wellpoint Medicaid Managed Care	$15.26

FP IND. PSYCH THERAPY 20-30 MT

Facility

$476.00

Service Code	HCPCS 90804
Hospital Charge Code	83652345
Hospital Revenue Code	914
Min. Negotiated Rate	$11.47
Max. Negotiated Rate	$238.00
Rate for Payer: Aetna Commercial	$180.88
Rate for Payer: Aetna Medicare Advantage	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.38
Rate for Payer: Cigna Commercial	$238.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.80
Rate for Payer: Qualcare PPO/HMO/WC	$71.40
Rate for Payer: UnitedHealthcare Community & State	$11.47
Rate for Payer: Wellpoint Medicaid Managed Care	$12.61

FP IND. PSYCH THERAPY 20-30 MT

Facility

$476.00

Service Code	HCPCS 90804
Hospital Charge Code	83652345
Hospital Revenue Code	914
Min. Negotiated Rate	$71.40
Max. Negotiated Rate	$71.40
Rate for Payer: Qualcare PPO/HMO/WC	$71.40

FP IND PSY-THRPY INTRACT 45-50

Facility

$536.00

Service Code	HCPCS 90812
Hospital Charge Code	83652355
Hospital Revenue Code	914
Min. Negotiated Rate	$12.92
Max. Negotiated Rate	$268.00
Rate for Payer: Aetna Commercial	$203.68
Rate for Payer: Aetna Medicare Advantage	$160.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.68
Rate for Payer: Cigna Commercial	$268.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.80
Rate for Payer: Qualcare PPO/HMO/WC	$80.40
Rate for Payer: UnitedHealthcare Community & State	$12.92
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

FP IND PSY-THRPY INTRACT 45-50

Facility

$536.00

Service Code	HCPCS 90812
Hospital Charge Code	83652355
Hospital Revenue Code	914
Min. Negotiated Rate	$80.40
Max. Negotiated Rate	$80.40
Rate for Payer: Qualcare PPO/HMO/WC	$80.40

FP INDV PSY-THPY-INTACT 20-30

Facility

$399.00

Service Code	HCPCS 90810
Hospital Charge Code	83652353
Hospital Revenue Code	914
Min. Negotiated Rate	$9.62
Max. Negotiated Rate	$199.50
Rate for Payer: Aetna Commercial	$151.62
Rate for Payer: Aetna Medicare Advantage	$119.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$101.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$101.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$101.75
Rate for Payer: Cigna Commercial	$199.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.70
Rate for Payer: Qualcare PPO/HMO/WC	$59.85
Rate for Payer: UnitedHealthcare Community & State	$9.62
Rate for Payer: Wellpoint Medicaid Managed Care	$10.57

FP INDV PSY-THPY-INTACT 20-30

Facility

$399.00

Service Code	HCPCS 90810
Hospital Charge Code	83652353
Hospital Revenue Code	914
Min. Negotiated Rate	$59.85
Max. Negotiated Rate	$59.85
Rate for Payer: Qualcare PPO/HMO/WC	$59.85

FP INJ SNGL TENDON LGMT APONE

Facility

$185.05

Service Code	HCPCS 20550
Hospital Charge Code	87502555
Hospital Revenue Code	761
Min. Negotiated Rate	$27.76
Max. Negotiated Rate	$27.76
Rate for Payer: Qualcare PPO/HMO/WC	$27.76

FP INJ SNGL TENDON LGMT APONE

Facility

$185.05

Service Code	HCPCS 20550
Hospital Charge Code	87502555
Hospital Revenue Code	761
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.52
Rate for Payer: Oxford Commercial	$37.01
Rate for Payer: Qualcare PPO/HMO/WC	$27.76
Rate for Payer: UnitedHealthcare Commercial	$37.01
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

FP INJ;SNGL TENDON,LGMT;APONE

Facility

$185.05

Service Code	HCPCS 20550
Hospital Charge Code	83652089
Hospital Revenue Code	761
Min. Negotiated Rate	$4.46
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$55.52
Rate for Payer: Oxford Commercial	$37.01
Rate for Payer: Qualcare PPO/HMO/WC	$27.76
Rate for Payer: UnitedHealthcare Commercial	$37.01
Rate for Payer: UnitedHealthcare Community & State	$4.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$4.90

FP INJ;SNGL TENDON,LGMT;APONE

Facility

$185.05

Service Code	HCPCS 20550
Hospital Charge Code	83652089
Hospital Revenue Code	761
Min. Negotiated Rate	$27.76
Max. Negotiated Rate	$27.76
Rate for Payer: Qualcare PPO/HMO/WC	$27.76

FP I&REMOVAL FB SUB C COMPLIC

Facility

$8,995.35

Service Code	HCPCS 10121
Hospital Charge Code	87502430
Hospital Revenue Code	761
Min. Negotiated Rate	$216.79
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	$2,698.61
Rate for Payer: Oxford Commercial	$1,799.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,349.30
Rate for Payer: UnitedHealthcare Commercial	$1,799.07
Rate for Payer: UnitedHealthcare Community & State	$216.79
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	$238.38

FP I&REMOVAL FB SUB C COMPLIC

Facility

$8,995.35

Service Code	HCPCS 10121
Hospital Charge Code	87502430
Hospital Revenue Code	761
Min. Negotiated Rate	$1,349.30
Max. Negotiated Rate	$1,349.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,349.30

FP I&REMOVAL FB.SUBC COMPLICAT

Facility

$1,490.00

Service Code	HCPCS 10121
Hospital Charge Code	83652007
Hospital Revenue Code	761
Min. Negotiated Rate	$35.91
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	$447.00
Rate for Payer: Oxford Commercial	$298.00
Rate for Payer: Qualcare PPO/HMO/WC	$223.50
Rate for Payer: UnitedHealthcare Commercial	$298.00
Rate for Payer: UnitedHealthcare Community & State	$35.91
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	$39.48

FP I&REMOVAL FB.SUBC COMPLICAT

Facility

$1,490.00

Service Code	HCPCS 10121
Hospital Charge Code	83652007
Hospital Revenue Code	761
Min. Negotiated Rate	$223.50
Max. Negotiated Rate	$223.50
Rate for Payer: Qualcare PPO/HMO/WC	$223.50

FP I& REMOVAL FB SUB CUT SIMPL

Facility

$1,822.15

Service Code	HCPCS 10120
Hospital Charge Code	87502425
Hospital Revenue Code	761
Min. Negotiated Rate	$273.32
Max. Negotiated Rate	$273.32
Rate for Payer: Qualcare PPO/HMO/WC	$273.32

FP I& REMOVAL FB SUB CUT SIMPL

Facility

$1,822.15

Service Code	HCPCS 10120
Hospital Charge Code	87502425
Hospital Revenue Code	761
Min. Negotiated Rate	$43.91
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$546.64
Rate for Payer: Oxford Commercial	$364.43
Rate for Payer: Qualcare PPO/HMO/WC	$273.32
Rate for Payer: UnitedHealthcare Commercial	$364.43
Rate for Payer: UnitedHealthcare Community & State	$43.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$48.29

FP NAIL EXCISION/PARTIAL/COMP

Facility

$2,081.00

Service Code	HCPCS 11750
Hospital Charge Code	87502495
Hospital Revenue Code	761
Min. Negotiated Rate	$50.15
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$237.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.30
Rate for Payer: Oxford Commercial	$416.20
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Commercial	$416.20
Rate for Payer: UnitedHealthcare Community & State	$50.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$55.15

FP NAIL EXCISION/PARTIAL/COMP

Facility

$2,081.00

Service Code	HCPCS 11750
Hospital Charge Code	83652057
Hospital Revenue Code	761
Min. Negotiated Rate	$50.15
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$237.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.30
Rate for Payer: Oxford Commercial	$416.20
Rate for Payer: Qualcare PPO/HMO/WC	$312.15
Rate for Payer: UnitedHealthcare Commercial	$416.20
Rate for Payer: UnitedHealthcare Community & State	$50.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$55.15

FP NAIL EXCISION/PARTIAL/COMP

Facility

$2,081.00

Service Code	HCPCS 11750
Hospital Charge Code	83652057
Hospital Revenue Code	761
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

FP NAIL EXCISION/PARTIAL/COMP

Facility

$2,081.00

Service Code	HCPCS 11750
Hospital Charge Code	87502495
Hospital Revenue Code	761
Min. Negotiated Rate	$312.15
Max. Negotiated Rate	$312.15
Rate for Payer: Qualcare PPO/HMO/WC	$312.15

FP PARING BENIGN 2-4 LESIONS

Facility

$650.00

Service Code	HCPCS 11056
Hospital Charge Code	87502560
Hospital Revenue Code	761
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

FP PARING BENIGN 2-4 LESIONS

Facility

$650.00

Service Code	HCPCS 11056
Hospital Charge Code	87502560
Hospital Revenue Code	761
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$860.41
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$61.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

FP PARING BENIGN > 4 LESIONS

Facility

$1,400.00

Service Code	HCPCS 11057
Hospital Charge Code	83652025
Hospital Revenue Code	761
Min. Negotiated Rate	$33.74
Max. Negotiated Rate	$860.41
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$860.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$76.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$860.41
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$420.00
Rate for Payer: Oxford Commercial	$280.00
Rate for Payer: Qualcare PPO/HMO/WC	$210.00
Rate for Payer: UnitedHealthcare Commercial	$280.00
Rate for Payer: UnitedHealthcare Community & State	$33.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$37.10

Know your out-of-pocket cost for care.

All Charges