Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GLUCOSE

Facility

$156.00

Service Code	HCPCS 82947
Hospital Charge Code	38472302
Hospital Revenue Code	301
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.69
Rate for Payer: Aetna Medicare Advantage	$12.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.19
Rate for Payer: Cigna Commercial	$78.00
Rate for Payer: Cigna Medicare Advantage	$3.93
Rate for Payer: Clover Medicare Advantage	$3.73
Rate for Payer: EmblemHealth Commercial	$11.79
Rate for Payer: Humana Medicare Advantage	$4.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.93
Rate for Payer: Wellcare Medicare Advantage	$3.93
Rate for Payer: Wellpoint Medicaid Managed Care	$4.13

GLUCOSE 1/2 HR

Facility

$117.65

Service Code	HCPCS 82947
Hospital Charge Code	3008489
Hospital Revenue Code	301
Min. Negotiated Rate	$17.65
Max. Negotiated Rate	$17.65
Rate for Payer: Qualcare PPO/HMO/WC	$17.65

GLUCOSE 1/2 HR

Facility

$117.65

Service Code	HCPCS 82947
Hospital Charge Code	3008489
Hospital Revenue Code	301
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.69
Rate for Payer: Aetna Medicare Advantage	$12.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.19
Rate for Payer: Cigna Commercial	$58.83
Rate for Payer: Cigna Medicare Advantage	$3.93
Rate for Payer: Clover Medicare Advantage	$3.73
Rate for Payer: EmblemHealth Commercial	$11.79
Rate for Payer: Humana Medicare Advantage	$4.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.93
Rate for Payer: Wellcare Medicare Advantage	$3.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.12

GLUCOSE 1 HR

Facility

$117.65

Service Code	HCPCS 82947
Hospital Charge Code	3008497
Hospital Revenue Code	301
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.69
Rate for Payer: Aetna Medicare Advantage	$12.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.19
Rate for Payer: Cigna Commercial	$58.83
Rate for Payer: Cigna Medicare Advantage	$3.93
Rate for Payer: Clover Medicare Advantage	$3.73
Rate for Payer: EmblemHealth Commercial	$11.79
Rate for Payer: Humana Medicare Advantage	$4.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.93
Rate for Payer: Wellcare Medicare Advantage	$3.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.12

GLUCOSE 1 HR

Facility

$117.65

Service Code	HCPCS 82947
Hospital Charge Code	3008497
Hospital Revenue Code	301
Min. Negotiated Rate	$17.65
Max. Negotiated Rate	$17.65
Rate for Payer: Qualcare PPO/HMO/WC	$17.65

GLUCOSE,1HR O'SULL

Facility

$335.00

Service Code	HCPCS 82950
Hospital Charge Code	38479020
Hospital Revenue Code	301
Min. Negotiated Rate	$3.80
Max. Negotiated Rate	$167.50
Rate for Payer: Aetna Commercial	$12.92
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$167.50
Rate for Payer: Cigna Medicare Advantage	$4.75
Rate for Payer: Clover Medicare Advantage	$4.51
Rate for Payer: EmblemHealth Commercial	$14.25
Rate for Payer: Humana Medicare Advantage	$4.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.75
Rate for Payer: Wellcare Medicare Advantage	$4.75
Rate for Payer: Wellpoint Medicaid Managed Care	$8.88

GLUCOSE,1HR O'SULL

Facility

$335.00

Service Code	HCPCS 82950
Hospital Charge Code	38479020
Hospital Revenue Code	301
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$50.25
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

GLUCOSE,24HR URINE

Facility

$335.00

Hospital Charge Code	38479018
Hospital Revenue Code	301
Min. Negotiated Rate	$8.07
Max. Negotiated Rate	$167.50
Rate for Payer: Aetna Commercial	$127.30
Rate for Payer: Aetna Medicare Advantage	$100.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.42
Rate for Payer: Cigna Commercial	$167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.07
Rate for Payer: Wellpoint Medicaid Managed Care	$8.88

GLUCOSE,24HR URINE

Facility

$335.00

Hospital Charge Code	38479018
Hospital Revenue Code	301
Min. Negotiated Rate	$50.25
Max. Negotiated Rate	$50.25
Rate for Payer: Qualcare PPO/HMO/WC	$50.25

GLUCOSE, 2 HOUR POST PRANDIAL

Facility

$117.65

Service Code	HCPCS 82950
Hospital Charge Code	3030178
Hospital Revenue Code	301
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$12.92
Rate for Payer: Aetna Medicare Advantage	$15.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.15
Rate for Payer: Cigna Commercial	$58.83
Rate for Payer: Cigna Medicare Advantage	$4.75
Rate for Payer: Clover Medicare Advantage	$4.51
Rate for Payer: EmblemHealth Commercial	$14.25
Rate for Payer: Humana Medicare Advantage	$4.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.75
Rate for Payer: Wellcare Medicare Advantage	$4.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.12

GLUCOSE, 2 HOUR POST PRANDIAL

Facility

$117.65

Service Code	HCPCS 82950
Hospital Charge Code	3030178
Hospital Revenue Code	301
Min. Negotiated Rate	$17.65
Max. Negotiated Rate	$17.65
Rate for Payer: Qualcare PPO/HMO/WC	$17.65

GLUCOSE 2 HR

Facility

$117.65

Service Code	HCPCS 82947
Hospital Charge Code	3008505
Hospital Revenue Code	301
Min. Negotiated Rate	$17.65
Max. Negotiated Rate	$17.65
Rate for Payer: Qualcare PPO/HMO/WC	$17.65

GLUCOSE 2 HR

Facility

$117.65

Service Code	HCPCS 82947
Hospital Charge Code	3008505
Hospital Revenue Code	301
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.69
Rate for Payer: Aetna Medicare Advantage	$12.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.19
Rate for Payer: Cigna Commercial	$58.83
Rate for Payer: Cigna Medicare Advantage	$3.93
Rate for Payer: Clover Medicare Advantage	$3.73
Rate for Payer: EmblemHealth Commercial	$11.79
Rate for Payer: Humana Medicare Advantage	$4.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.93
Rate for Payer: Wellcare Medicare Advantage	$3.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.12

GLUCOSE 2HR PP

Facility

$156.00

Service Code	HCPCS 82947
Hospital Charge Code	38479000
Hospital Revenue Code	301
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.69
Rate for Payer: Aetna Medicare Advantage	$12.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.19
Rate for Payer: Cigna Commercial	$78.00
Rate for Payer: Cigna Medicare Advantage	$3.93
Rate for Payer: Clover Medicare Advantage	$3.73
Rate for Payer: EmblemHealth Commercial	$11.79
Rate for Payer: Humana Medicare Advantage	$4.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.93
Rate for Payer: Wellcare Medicare Advantage	$3.93
Rate for Payer: Wellpoint Medicaid Managed Care	$4.13

GLUCOSE 2HR PP

Facility

$156.00

Service Code	HCPCS 82947
Hospital Charge Code	38479000
Hospital Revenue Code	301
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

GLUCOSE 3 HR

Facility

$304.85

Service Code	HCPCS 82951
Hospital Charge Code	3008513
Hospital Revenue Code	301
Min. Negotiated Rate	$45.73
Max. Negotiated Rate	$45.73
Rate for Payer: Qualcare PPO/HMO/WC	$45.73

GLUCOSE 3 HR

Facility

$304.85

Service Code	HCPCS 82951
Hospital Charge Code	3008513
Hospital Revenue Code	301
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$152.43
Rate for Payer: Aetna Commercial	$35.01
Rate for Payer: Aetna Medicare Advantage	$41.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.46
Rate for Payer: Cigna Commercial	$152.43
Rate for Payer: Cigna Medicare Advantage	$12.87
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.73
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.87
Rate for Payer: Wellcare Medicare Advantage	$12.87
Rate for Payer: Wellpoint Medicaid Managed Care	$8.08

GLUCOSE,3HR

Facility

$403.00

Service Code	HCPCS 82952
Hospital Charge Code	38479023
Hospital Revenue Code	301
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$201.50
Rate for Payer: Aetna Commercial	$10.66
Rate for Payer: Aetna Medicare Advantage	$12.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.15
Rate for Payer: Cigna Commercial	$201.50
Rate for Payer: Cigna Medicare Advantage	$3.92
Rate for Payer: Clover Medicare Advantage	$3.72
Rate for Payer: EmblemHealth Commercial	$11.76
Rate for Payer: Humana Medicare Advantage	$4.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.92
Rate for Payer: Wellcare Medicare Advantage	$3.92
Rate for Payer: Wellpoint Medicaid Managed Care	$10.68

GLUCOSE,3HR

Facility

$403.00

Service Code	HCPCS 82952
Hospital Charge Code	38479023
Hospital Revenue Code	301
Min. Negotiated Rate	$60.45
Max. Negotiated Rate	$60.45
Rate for Payer: Qualcare PPO/HMO/WC	$60.45

GLUCOSE 4HR

Facility

$304.85

Service Code	HCPCS 82951
Hospital Charge Code	3008521
Hospital Revenue Code	301
Min. Negotiated Rate	$45.73
Max. Negotiated Rate	$45.73
Rate for Payer: Qualcare PPO/HMO/WC	$45.73

GLUCOSE 4HR

Facility

$304.85

Service Code	HCPCS 82951
Hospital Charge Code	3008521
Hospital Revenue Code	301
Min. Negotiated Rate	$8.08
Max. Negotiated Rate	$152.43
Rate for Payer: Aetna Commercial	$35.01
Rate for Payer: Aetna Medicare Advantage	$41.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.46
Rate for Payer: Cigna Commercial	$152.43
Rate for Payer: Cigna Medicare Advantage	$12.87
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$91.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.73
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.87
Rate for Payer: Wellcare Medicare Advantage	$12.87
Rate for Payer: Wellpoint Medicaid Managed Care	$8.08

GLUCOSE,4HR

Facility

$403.00

Service Code	HCPCS 82952
Hospital Charge Code	38479024
Hospital Revenue Code	301
Min. Negotiated Rate	$60.45
Max. Negotiated Rate	$60.45
Rate for Payer: Qualcare PPO/HMO/WC	$60.45

GLUCOSE,4HR

Facility

$403.00

Service Code	HCPCS 82952
Hospital Charge Code	38479024
Hospital Revenue Code	301
Min. Negotiated Rate	$1.94
Max. Negotiated Rate	$201.50
Rate for Payer: Aetna Commercial	$10.66
Rate for Payer: Aetna Medicare Advantage	$12.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.15
Rate for Payer: Cigna Commercial	$201.50
Rate for Payer: Cigna Medicare Advantage	$3.92
Rate for Payer: Clover Medicare Advantage	$3.72
Rate for Payer: EmblemHealth Commercial	$11.76
Rate for Payer: Humana Medicare Advantage	$4.04
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.92
Rate for Payer: Wellcare Medicare Advantage	$3.92
Rate for Payer: Wellpoint Medicaid Managed Care	$10.68

GLUCOSE 5 GM TAB

Facility

$2.00

Hospital Charge Code	83652565
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.60
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

GLUCOSE 5 GM TAB

Facility

$2.00

Hospital Charge Code	83652565
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

Know your out-of-pocket cost for care.

All Charges