Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GRAFT OVATION IX ILIAC 12X

Facility

$23,495.00

Service Code	HCPCS C1768
Hospital Charge Code	270686738
Hospital Revenue Code	278
Min. Negotiated Rate	$3,524.25
Max. Negotiated Rate	$5,685.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,699.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,685.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$5,168.90
Rate for Payer: Qualcare PPO/HMO/WC	$3,524.25

GRAFT PASTE BONE 1 CC

Facility

$1,185.00

Service Code	HCPCS C1713
Hospital Charge Code	270656923
Hospital Revenue Code	278
Min. Negotiated Rate	$28.56
Max. Negotiated Rate	$592.50
Rate for Payer: Aetna Commercial	$450.30
Rate for Payer: Aetna Medicare Advantage	$355.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$302.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$302.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$237.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$302.18
Rate for Payer: Cigna Commercial	$592.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$260.70
Rate for Payer: Qualcare PPO/HMO/WC	$177.75
Rate for Payer: UnitedHealthcare Community & State	$28.56
Rate for Payer: Wellpoint Medicaid Managed Care	$31.40

GRAFT PASTE BONE 1 CC

Facility

$1,185.00

Service Code	HCPCS C1713
Hospital Charge Code	270656923
Hospital Revenue Code	278
Min. Negotiated Rate	$177.75
Max. Negotiated Rate	$286.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$237.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$286.77
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$260.70
Rate for Payer: Qualcare PPO/HMO/WC	$177.75

GRAFT PATELLA RT PAR80

Facility

$56,875.50

Service Code	HCPCS C1713
Hospital Charge Code	270694007
Hospital Revenue Code	278
Min. Negotiated Rate	$8,531.33
Max. Negotiated Rate	$13,763.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,375.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,763.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,512.61
Rate for Payer: Qualcare PPO/HMO/WC	$8,531.33

GRAFT PATELLA RT PAR80

Facility

$56,875.50

Service Code	HCPCS C1713
Hospital Charge Code	270694007
Hospital Revenue Code	278
Min. Negotiated Rate	$1,370.70
Max. Negotiated Rate	$28,437.75
Rate for Payer: Aetna Commercial	$21,612.69
Rate for Payer: Aetna Medicare Advantage	$17,062.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,503.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,503.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,375.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,503.25
Rate for Payer: Cigna Commercial	$28,437.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,763.87
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$12,512.61
Rate for Payer: Qualcare PPO/HMO/WC	$8,531.33
Rate for Payer: UnitedHealthcare Community & State	$1,370.70
Rate for Payer: Wellpoint Medicaid Managed Care	$1,507.20

GRAFT PLACENTAL TISSUE MATRIX

Facility

$9,500.00

Service Code	HCPCS Q4139
Hospital Charge Code	270673755
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$2,299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,090.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

GRAFT PLACENTAL TISSUE MATRIX

Facility

$9,500.00

Service Code	HCPCS Q4139
Hospital Charge Code	270673755
Hospital Revenue Code	278
Min. Negotiated Rate	$228.95
Max. Negotiated Rate	$4,750.00
Rate for Payer: Aetna Commercial	$3,610.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,090.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

GRAFT PREPERATION SET FEE

Facility

$500.00

Hospital Charge Code	270645772
Hospital Revenue Code	278
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

GRAFT PREPERATION SET FEE

Facility

$500.00

Hospital Charge Code	270645772
Hospital Revenue Code	278
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$121.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$110.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

GRAFT PREP STATION BASE

Facility

$3,125.00

Hospital Charge Code	270691451
Hospital Revenue Code	272
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$468.75
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

GRAFT PREP STATION BASE

Facility

$3,125.00

Hospital Charge Code	270691451
Hospital Revenue Code	272
Min. Negotiated Rate	$75.31
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$937.50
Rate for Payer: Oxford Commercial	$625.00
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Commercial	$625.00
Rate for Payer: UnitedHealthcare Community & State	$75.31
Rate for Payer: Wellpoint Medicaid Managed Care	$82.81

GRAFT PRIMATRIX 20X25CM

Facility

$44,913.20

Service Code	HCPCS Q4110
Hospital Charge Code	270695270
Hospital Revenue Code	278
Min. Negotiated Rate	$6,736.98
Max. Negotiated Rate	$10,868.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,982.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,868.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,880.90
Rate for Payer: Qualcare PPO/HMO/WC	$6,736.98

GRAFT PRIMATRIX 20X25CM

Facility

$44,913.20

Service Code	HCPCS Q4110
Hospital Charge Code	270695270
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$10,868.99
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,982.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,868.99
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,880.90
Rate for Payer: Qualcare PPO/HMO/WC	$6,736.98
Rate for Payer: UnitedHealthcare Community & State	$1,082.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$1,190.20

GRAFT PRIMATRIX 2x2cm

Facility

$2,125.00

Hospital Charge Code	270673683
Hospital Revenue Code	636
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

GRAFT PRIMATRIX 2x2cm

Facility

$2,125.00

Hospital Charge Code	270673683
Hospital Revenue Code	636
Min. Negotiated Rate	$51.21
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$51.21
Rate for Payer: Wellpoint Medicaid Managed Care	$56.31

GRAFT PRIMATRIX 3x3cm

Facility

$2,480.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673684
Hospital Revenue Code	278
Min. Negotiated Rate	$59.77
Max. Negotiated Rate	$600.16
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$545.60
Rate for Payer: Qualcare PPO/HMO/WC	$372.00
Rate for Payer: UnitedHealthcare Community & State	$59.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$65.72

GRAFT PRIMATRIX 3x3cm

Facility

$2,480.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673684
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$600.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$545.60
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

GRAFT PRIMATRIX 4 X 4 CM

Facility

$4,989.40

Service Code	HCPCS Q4110
Hospital Charge Code	270689733
Hospital Revenue Code	278
Min. Negotiated Rate	$120.24
Max. Negotiated Rate	$1,207.43
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$997.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,207.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,097.67
Rate for Payer: Qualcare PPO/HMO/WC	$748.41
Rate for Payer: UnitedHealthcare Community & State	$120.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$132.22

GRAFT PRIMATRIX 4 X 4 CM

Facility

$4,989.40

Service Code	HCPCS Q4110
Hospital Charge Code	270689733
Hospital Revenue Code	278
Min. Negotiated Rate	$748.41
Max. Negotiated Rate	$1,207.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$997.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,207.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,097.67
Rate for Payer: Qualcare PPO/HMO/WC	$748.41

GRAFT PRIMATRIX 4X4 CM

Facility

$3,850.00

Service Code	HCPCS Q4110
Hospital Charge Code	270684069
Hospital Revenue Code	278
Min. Negotiated Rate	$577.50
Max. Negotiated Rate	$931.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$577.50

GRAFT PRIMATRIX 4X4 CM

Facility

$3,850.00

Service Code	HCPCS Q4110
Hospital Charge Code	270684069
Hospital Revenue Code	278
Min. Negotiated Rate	$92.78
Max. Negotiated Rate	$931.70
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$577.50
Rate for Payer: UnitedHealthcare Community & State	$92.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$102.03

GRAFT PRIMATRIX 4x4cm

Facility

$3,850.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673685
Hospital Revenue Code	278
Min. Negotiated Rate	$92.78
Max. Negotiated Rate	$931.70
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$577.50
Rate for Payer: UnitedHealthcare Community & State	$92.78
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$102.03

GRAFT PRIMATRIX 4x4cm

Facility

$3,850.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673685
Hospital Revenue Code	278
Min. Negotiated Rate	$577.50
Max. Negotiated Rate	$931.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$847.00
Rate for Payer: Qualcare PPO/HMO/WC	$577.50

GRAFT PRIMATRIX 5x5CM/SQ CM

Facility

$4,460.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673686
Hospital Revenue Code	278
Min. Negotiated Rate	$669.00
Max. Negotiated Rate	$1,079.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$981.20
Rate for Payer: Qualcare PPO/HMO/WC	$669.00

GRAFT PRIMATRIX 5x5CM/SQ CM

Facility

$4,460.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673686
Hospital Revenue Code	278
Min. Negotiated Rate	$107.49
Max. Negotiated Rate	$1,079.32
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$533.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$533.66
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.32
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$981.20
Rate for Payer: Qualcare PPO/HMO/WC	$669.00
Rate for Payer: UnitedHealthcare Community & State	$107.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$118.19

Know your out-of-pocket cost for care.

All Charges