Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ICONIX 2.3 GUIDE

Facility

$1,750.00

Hospital Charge Code	270680690
Hospital Revenue Code	272
Min. Negotiated Rate	$42.17
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$525.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$42.17
Rate for Payer: Wellpoint Medicaid Managed Care	$46.38

ICONIX NEEDLE iNTELLIBRIAN TEC

Facility

$2,447.80

Service Code	HCPCS C1713
Hospital Charge Code	270701807
Hospital Revenue Code	278
Min. Negotiated Rate	$58.99
Max. Negotiated Rate	$1,223.90
Rate for Payer: Aetna Commercial	$930.16
Rate for Payer: Aetna Medicare Advantage	$734.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$624.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$624.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$489.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$624.19
Rate for Payer: Cigna Commercial	$1,223.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$538.52
Rate for Payer: Qualcare PPO/HMO/WC	$367.17
Rate for Payer: UnitedHealthcare Community & State	$58.99
Rate for Payer: Wellpoint Medicaid Managed Care	$64.87

ICONIX NEEDLE iNTELLIBRIAN TEC

Facility

$2,447.80

Service Code	HCPCS C1713
Hospital Charge Code	270701807
Hospital Revenue Code	278
Min. Negotiated Rate	$367.17
Max. Negotiated Rate	$592.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$489.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$592.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$538.52
Rate for Payer: Qualcare PPO/HMO/WC	$367.17

I & D ABSCESS COMP MULTIPLE

Facility

$2,352.55

Service Code	HCPCS 10061
Hospital Charge Code	1600000566
Hospital Revenue Code	360
Min. Negotiated Rate	$352.88
Max. Negotiated Rate	$352.88
Rate for Payer: Qualcare PPO/HMO/WC	$352.88

I & D ABSCESS COMP MULTIPLE

Facility

$2,352.55

Service Code	HCPCS 10061
Hospital Charge Code	1600000566
Hospital Revenue Code	360
Min. Negotiated Rate	$56.70
Max. Negotiated Rate	$2,220.00
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	$1,016.00
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	$705.76
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$352.88
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$56.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$62.34

I&D ABSCESS/CYST COMPL/MULTI

Facility

$1,872.25

Service Code	HCPCS 10061
Hospital Charge Code	412310061
Hospital Revenue Code	761
Min. Negotiated Rate	$280.84
Max. Negotiated Rate	$280.84
Rate for Payer: Qualcare PPO/HMO/WC	$280.84

I&D ABSCESS/CYST COMPL/MULTI

Facility

$1,872.25

Service Code	HCPCS 10061
Hospital Charge Code	412310061
Hospital Revenue Code	761
Min. Negotiated Rate	$45.12
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	$214.18
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	$561.67
Rate for Payer: Oxford Commercial	$374.45
Rate for Payer: Qualcare PPO/HMO/WC	$280.84
Rate for Payer: UnitedHealthcare Commercial	$374.45
Rate for Payer: UnitedHealthcare Community & State	$45.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$49.61

I&D ABSC, SMPL OR SGL

Facility

$1,896.30

Service Code	HCPCS 10060
Hospital Charge Code	1600000462
Hospital Revenue Code	360
Min. Negotiated Rate	$284.44
Max. Negotiated Rate	$284.44
Rate for Payer: Qualcare PPO/HMO/WC	$284.44

I&D ABSC, SMPL OR SGL

Facility

$1,896.30

Service Code	HCPCS 10060
Hospital Charge Code	1600000462
Hospital Revenue Code	360
Min. Negotiated Rate	$45.70
Max. Negotiated Rate	$2,220.00
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	$1,016.00
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	$568.89
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$284.44
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$45.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$962.01
Rate for Payer: Wellpoint Medicaid Managed Care	$943.15

IDAMYCIN INJECTION/10MG

Facility

$2,582.00

Hospital Charge Code	60634917
Hospital Revenue Code	636
Min. Negotiated Rate	$387.30
Max. Negotiated Rate	$624.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.84
Rate for Payer: Qualcare PPO/HMO/WC	$387.30

IDAMYCIN INJECTION/10MG

Facility

$2,582.00

Hospital Charge Code	60634917
Hospital Revenue Code	636
Min. Negotiated Rate	$62.23
Max. Negotiated Rate	$1,291.00
Rate for Payer: Aetna Commercial	$981.16
Rate for Payer: Aetna Medicare Advantage	$774.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$658.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$658.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$658.41
Rate for Payer: Cigna Commercial	$1,291.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$624.84
Rate for Payer: Qualcare PPO/HMO/WC	$387.30
Rate for Payer: UnitedHealthcare Community & State	$62.23
Rate for Payer: Wellpoint Medicaid Managed Care	$68.42

IDARUCIZUMAB 50MG/ML INJ 50ML

Facility

$14,070.00

Service Code	HCPCS C9399
Hospital Charge Code	606380034
Hospital Revenue Code	636
Min. Negotiated Rate	$2,110.50
Max. Negotiated Rate	$3,404.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,404.94
Rate for Payer: Qualcare PPO/HMO/WC	$2,110.50

IDARUCIZUMAB 50MG/ML INJ 50ML

Facility

$14,070.00

Service Code	HCPCS C9399
Hospital Charge Code	606380034
Hospital Revenue Code	636
Min. Negotiated Rate	$339.09
Max. Negotiated Rate	$7,035.00
Rate for Payer: Aetna Commercial	$5,346.60
Rate for Payer: Aetna Medicare Advantage	$4,221.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,587.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,587.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,587.85
Rate for Payer: Cigna Commercial	$7,035.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,404.94
Rate for Payer: Qualcare PPO/HMO/WC	$2,110.50
Rate for Payer: UnitedHealthcare Community & State	$339.09
Rate for Payer: Wellpoint Medicaid Managed Care	$372.86

ID BAND YELLOW ADULT SENTRY

Facility

$192.10

Hospital Charge Code	270652389
Hospital Revenue Code	270
Min. Negotiated Rate	$28.82
Max. Negotiated Rate	$28.82
Rate for Payer: Qualcare PPO/HMO/WC	$28.82

ID BAND YELLOW ADULT SENTRY

Facility

$192.10

Hospital Charge Code	270652389
Hospital Revenue Code	270
Min. Negotiated Rate	$4.63
Max. Negotiated Rate	$96.05
Rate for Payer: Aetna Commercial	$73.00
Rate for Payer: Aetna Medicare Advantage	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.99
Rate for Payer: Cigna Commercial	$96.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.63
Rate for Payer: Oxford Commercial	$38.42
Rate for Payer: Qualcare PPO/HMO/WC	$28.82
Rate for Payer: UnitedHealthcare Commercial	$38.42
Rate for Payer: UnitedHealthcare Community & State	$4.63
Rate for Payer: Wellpoint Medicaid Managed Care	$5.09

I&D BARTHOLIN GLAND

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	412356420
Hospital Revenue Code	361
Min. Negotiated Rate	$22.71
Max. Negotiated Rate	$2,220.00
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) NJ Health	$862.00
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	$282.64
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$141.32
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$22.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$24.97

I&D BARTHOLIN GLAND

Facility

$942.15

Service Code	HCPCS 56420
Hospital Charge Code	412356420
Hospital Revenue Code	361
Min. Negotiated Rate	$141.32
Max. Negotiated Rate	$141.32
Rate for Payer: Qualcare PPO/HMO/WC	$141.32

I&D BARTHOLIN'S GLND ABSCESS

Facility

$1,872.73

Service Code	HCPCS 56420
Hospital Charge Code	1600000705
Hospital Revenue Code	360
Min. Negotiated Rate	$45.13
Max. Negotiated Rate	$2,220.00
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) NJ Health	$862.00
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	$561.82
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$280.91
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$45.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$49.63

I&D BARTHOLIN'S GLND ABSCESS

Facility

$1,872.73

Service Code	HCPCS 56420
Hospital Charge Code	1600000705
Hospital Revenue Code	360
Min. Negotiated Rate	$280.91
Max. Negotiated Rate	$280.91
Rate for Payer: Qualcare PPO/HMO/WC	$280.91

I&D BARTHOLOINS CYST

Facility

$1,068.55

Service Code	HCPCS 56420
Hospital Charge Code	87502585
Hospital Revenue Code	761
Min. Negotiated Rate	$160.28
Max. Negotiated Rate	$160.28
Rate for Payer: Qualcare PPO/HMO/WC	$160.28

I&D BARTHOLOINS CYST

Facility

$1,068.55

Service Code	HCPCS 56420
Hospital Charge Code	87502585
Hospital Revenue Code	761
Min. Negotiated Rate	$25.75
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	$320.56
Rate for Payer: Oxford Commercial	$213.71
Rate for Payer: Qualcare PPO/HMO/WC	$160.28
Rate for Payer: UnitedHealthcare Commercial	$213.71
Rate for Payer: UnitedHealthcare Community & State	$25.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$240.18
Rate for Payer: Wellcare Medicare Advantage	$240.18
Rate for Payer: Wellpoint Medicaid Managed Care	$28.32

ID BY PROBE

Facility

$137.85

Service Code	HCPCS 87149
Hospital Charge Code	39900273
Hospital Revenue Code	309
Min. Negotiated Rate	$20.68
Max. Negotiated Rate	$20.68
Rate for Payer: Qualcare PPO/HMO/WC	$20.68

ID BY PROBE

Facility

$137.85

Service Code	HCPCS 87149
Hospital Charge Code	39900273
Hospital Revenue Code	309
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$54.54
Rate for Payer: Aetna Medicare Advantage	$64.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.37
Rate for Payer: Cigna Commercial	$68.92
Rate for Payer: Cigna Medicare Advantage	$20.05
Rate for Payer: Clover Medicare Advantage	$19.05
Rate for Payer: EmblemHealth Commercial	$60.15
Rate for Payer: Humana Medicare Advantage	$20.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.35
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.68
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.05
Rate for Payer: Wellcare Medicare Advantage	$20.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3.65

I&D CPLX POSTOP WND INF

Facility

$9,748.92

Service Code	HCPCS 10180
Hospital Charge Code	16000463
Hospital Revenue Code	360
Min. Negotiated Rate	$1,462.34
Max. Negotiated Rate	$1,462.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.34

I&D CPLX POSTOP WND INF

Facility

$9,748.92

Service Code	HCPCS 10180
Hospital Charge Code	16000463
Hospital Revenue Code	360
Min. Negotiated Rate	$234.95
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	$1,016.00
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	$2,924.68
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,462.34
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$234.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$635.06
Rate for Payer: Wellpoint Medicaid Managed Care	$622.61

Know your out-of-pocket cost for care.

All Charges