Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HPV mRNA E6/E7, RECTAL

Facility

$175.45

Service Code	HCPCS 87624
Hospital Charge Code	401387624
Hospital Revenue Code	306
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$126.66
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$87.72
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.63
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.32
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$4.65

HPV RNA, HR E6/E7 TMA

Facility

$390.00

Service Code	HCPCS 87624
Hospital Charge Code	39900302
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HPV RNA, HR E6/E7 TMA

Facility

$390.00

Service Code	HCPCS 87624
Hospital Charge Code	39900302
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

HPV TYPES 16/18

Facility

$390.00

Service Code	HCPCS 87625XU
Hospital Charge Code	39708053D
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HPV TYPES 16/18

Facility

$390.00

Service Code	HCPCS 87625XU
Hospital Charge Code	39708053D
Hospital Revenue Code	306
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

HPV TYPES 16 & 18 ONLY

Facility

$390.00

Service Code	HCPCS 87625
Hospital Charge Code	3039036
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HPV TYPES 16 & 18 ONLY

Facility

$190.45

Service Code	HCPCS 87625
Hospital Charge Code	397061380
Hospital Revenue Code	306
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

HPV TYPES 16 & 18 ONLY

Facility

$241.20

Service Code	HCPCS 87625
Hospital Charge Code	39990236
Hospital Revenue Code	306
Min. Negotiated Rate	$36.18
Max. Negotiated Rate	$36.18
Rate for Payer: Qualcare PPO/HMO/WC	$36.18

HPV TYPES 16 & 18 ONLY

Facility

$390.00

Service Code	HCPCS 87625
Hospital Charge Code	3039036
Hospital Revenue Code	306
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$110.30
Rate for Payer: Aetna Medicare Advantage	$131.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.37
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$40.55
Rate for Payer: Clover Medicare Advantage	$38.52
Rate for Payer: EmblemHealth Commercial	$121.65
Rate for Payer: Humana Medicare Advantage	$41.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$40.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$32.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.55
Rate for Payer: Wellcare Medicare Advantage	$40.55
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

HPV TYPES 16 & 18 ONLY

Facility

$190.45

Service Code	HCPCS 87625
Hospital Charge Code	38430036
Hospital Revenue Code	306
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$146.37
Rate for Payer: Aetna Commercial	$110.30
Rate for Payer: Aetna Medicare Advantage	$131.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.37
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: Cigna Medicare Advantage	$40.55
Rate for Payer: Clover Medicare Advantage	$38.52
Rate for Payer: EmblemHealth Commercial	$121.65
Rate for Payer: Humana Medicare Advantage	$41.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$40.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$32.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.55
Rate for Payer: Wellcare Medicare Advantage	$40.55
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

HPV TYPES 16 & 18 ONLY

Facility

$190.45

Service Code	HCPCS 87625
Hospital Charge Code	397061380
Hospital Revenue Code	306
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$146.37
Rate for Payer: Aetna Commercial	$110.30
Rate for Payer: Aetna Medicare Advantage	$131.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.37
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: Cigna Medicare Advantage	$40.55
Rate for Payer: Clover Medicare Advantage	$38.52
Rate for Payer: EmblemHealth Commercial	$121.65
Rate for Payer: Humana Medicare Advantage	$41.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$40.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$32.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.55
Rate for Payer: Wellcare Medicare Advantage	$40.55
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

HPV TYPES 16 & 18 ONLY

Facility

$190.45

Service Code	HCPCS 87625
Hospital Charge Code	38430036
Hospital Revenue Code	306
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

HPV TYPES 16 & 18 ONLY

Facility

$241.20

Service Code	HCPCS 87625
Hospital Charge Code	39990236
Hospital Revenue Code	306
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$146.37
Rate for Payer: Aetna Commercial	$110.30
Rate for Payer: Aetna Medicare Advantage	$131.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$40.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.37
Rate for Payer: Cigna Commercial	$120.60
Rate for Payer: Cigna Medicare Advantage	$40.55
Rate for Payer: Clover Medicare Advantage	$38.52
Rate for Payer: EmblemHealth Commercial	$121.65
Rate for Payer: Humana Medicare Advantage	$41.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$40.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.18
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$32.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$40.55
Rate for Payer: Wellcare Medicare Advantage	$40.55
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

H PYLORI

Facility

$18.60

Hospital Charge Code	270626321
Hospital Revenue Code	270
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$9.30
Rate for Payer: Aetna Commercial	$7.07
Rate for Payer: Aetna Medicare Advantage	$5.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.74
Rate for Payer: Cigna Commercial	$9.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.58
Rate for Payer: Oxford Commercial	$3.72
Rate for Payer: Qualcare PPO/HMO/WC	$2.79
Rate for Payer: UnitedHealthcare Commercial	$3.72
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.49

H PYLORI

Facility

$18.60

Hospital Charge Code	270626321
Hospital Revenue Code	270
Min. Negotiated Rate	$2.79
Max. Negotiated Rate	$2.79
Rate for Payer: Qualcare PPO/HMO/WC	$2.79

H. PYLORI AB (IGA)

Facility

$390.00

Service Code	HCPCS 86677
Hospital Charge Code	39900376
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

H. PYLORI AB (IGA)

Facility

$390.00

Service Code	HCPCS 86677
Hospital Charge Code	39900376
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.82
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

H. PYLORI AB(IGA)

Facility

$390.00

Service Code	HCPCS 86677
Hospital Charge Code	3035113
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

H. PYLORI AB(IGA)

Facility

$390.00

Service Code	HCPCS 86677
Hospital Charge Code	3035113
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.82
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

H.PYLORI AB (IGG),IB

Facility

$390.00

Service Code	HCPCS 86677
Hospital Charge Code	39900377
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.82
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

H.PYLORI AB (IGG),IB

Facility

$390.00

Service Code	HCPCS 86677
Hospital Charge Code	39900377
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

H.PYLORI AB (IGM)

Facility

$390.00

Service Code	HCPCS 86677
Hospital Charge Code	39900237
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.82
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

H.PYLORI AB (IGM)

Facility

$390.00

Service Code	HCPCS 86677
Hospital Charge Code	39900237
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

H.PYLORI,AB,IGM

Facility

$1,080.00

Service Code	HCPCS 86677
Hospital Charge Code	38479103
Hospital Revenue Code	302
Min. Negotiated Rate	$162.00
Max. Negotiated Rate	$162.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00

H.PYLORI,AB,IGM

Facility

$1,080.00

Service Code	HCPCS 86677
Hospital Charge Code	38479103
Hospital Revenue Code	302
Min. Negotiated Rate	$13.48
Max. Negotiated Rate	$540.00
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.82
Rate for Payer: Cigna Commercial	$540.00
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$28.62

Know your out-of-pocket cost for care.

All Charges