Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INCENTIVE SPIROMETER W/DEV****

Facility

$98.90

Hospital Charge Code	9500134
Hospital Revenue Code	419
Min. Negotiated Rate	$14.84
Max. Negotiated Rate	$14.84
Rate for Payer: Qualcare PPO/HMO/WC	$14.84

INCENTIVE SPIROMETER W/DEV****

Facility

$98.90

Hospital Charge Code	9500134
Hospital Revenue Code	419
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$37.58
Rate for Payer: Aetna Medicare Advantage	$29.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.22
Rate for Payer: Cigna Commercial	$49.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.67
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.84
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$2.38
Rate for Payer: Wellpoint Medicaid Managed Care	$2.62

INCIS 1 VERTEBRAL SEG LUMBAR

Facility

$6,759.00

Service Code	HCPCS 22214
Hospital Charge Code	1600000764
Hospital Revenue Code	360
Min. Negotiated Rate	$1,013.85
Max. Negotiated Rate	$1,013.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.85

INCIS 1 VERTEBRAL SEG LUMBAR

Facility

$6,759.00

Service Code	HCPCS 22214
Hospital Charge Code	1600000764
Hospital Revenue Code	360
Min. Negotiated Rate	$162.89
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,027.70
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,013.85
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$162.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$179.11

INCISE FOOT/TOE FASCIA

Facility

$26,594.63

Service Code	HCPCS 28008
Hospital Charge Code	16000235
Hospital Revenue Code	360
Min. Negotiated Rate	$3,989.19
Max. Negotiated Rate	$3,989.19
Rate for Payer: Qualcare PPO/HMO/WC	$3,989.19

INCISE FOOT/TOE FASCIA

Facility

$26,594.63

Service Code	HCPCS 28008
Hospital Charge Code	16000235
Hospital Revenue Code	360
Min. Negotiated Rate	$640.93
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,978.39
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,989.19
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$640.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$704.76

INCISE HAND/FINGER TENDON

Facility

$7,538.96

Service Code	HCPCS 26460
Hospital Charge Code	1600000395
Hospital Revenue Code	360
Min. Negotiated Rate	$181.69
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,261.69
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.84
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$181.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$199.78

INCISE HAND/FINGER TENDON

Facility

$7,538.96

Service Code	HCPCS 26460
Hospital Charge Code	1600000395
Hospital Revenue Code	360
Min. Negotiated Rate	$1,130.84
Max. Negotiated Rate	$1,130.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,130.84

INCISE TENDONS & MUSCLES

Facility

$9,222.50

Service Code	HCPCS 23406
Hospital Charge Code	1600000544
Hospital Revenue Code	360
Min. Negotiated Rate	$1,383.38
Max. Negotiated Rate	$1,383.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,383.38

INCISE TENDONS & MUSCLES

Facility

$9,222.50

Service Code	HCPCS 23406
Hospital Charge Code	1600000544
Hospital Revenue Code	360
Min. Negotiated Rate	$222.26
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,766.75
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,383.38
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$222.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$244.40

INCISE WRIST/FOREARM TENDON

Facility

$10,580.92

Service Code	HCPCS 25290
Hospital Charge Code	16000550
Hospital Revenue Code	360
Min. Negotiated Rate	$1,587.14
Max. Negotiated Rate	$1,587.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,587.14

INCISE WRIST/FOREARM TENDON

Facility

$10,580.92

Service Code	HCPCS 25290
Hospital Charge Code	16000550
Hospital Revenue Code	360
Min. Negotiated Rate	$255.00
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,174.28
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,587.14
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$255.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$280.39

INCISIONAL BIOPSY OF SKIN, EAC

Facility

$1,278.04

Service Code	HCPCS 11107
Hospital Charge Code	1600000602
Hospital Revenue Code	360
Min. Negotiated Rate	$30.80
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$485.66
Rate for Payer: Aetna Medicare Advantage	$383.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$325.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$325.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$325.90
Rate for Payer: Cigna Commercial	$639.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.41
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.71
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$30.80
Rate for Payer: Wellpoint Medicaid Managed Care	$33.87

INCISIONAL BIOPSY OF SKIN, EAC

Facility

$1,278.04

Service Code	HCPCS 11107
Hospital Charge Code	1600000602
Hospital Revenue Code	360
Min. Negotiated Rate	$191.71
Max. Negotiated Rate	$191.71
Rate for Payer: Qualcare PPO/HMO/WC	$191.71

INCISIONAL BX SKIN 1ST LESION

Facility

$1,841.39

Service Code	HCPCS 11106
Hospital Charge Code	395011106
Hospital Revenue Code	761
Min. Negotiated Rate	$44.38
Max. Negotiated Rate	$3,169.46
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$169.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,169.46
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.42
Rate for Payer: Oxford Commercial	$368.28
Rate for Payer: Qualcare PPO/HMO/WC	$276.21
Rate for Payer: UnitedHealthcare Commercial	$368.28
Rate for Payer: UnitedHealthcare Community & State	$44.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$48.80

INCISIONAL BX SKIN 1ST LESION

Facility

$1,841.39

Service Code	HCPCS 11106
Hospital Charge Code	395011106
Hospital Revenue Code	761
Min. Negotiated Rate	$276.21
Max. Negotiated Rate	$276.21
Rate for Payer: Qualcare PPO/HMO/WC	$276.21

INCISIONAL BX SKIN 1ST LESION

Facility

$1,841.39

Service Code	HCPCS 11106
Hospital Charge Code	450211106
Hospital Revenue Code	761
Min. Negotiated Rate	$44.38
Max. Negotiated Rate	$3,169.46
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$169.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,169.46
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.42
Rate for Payer: Oxford Commercial	$368.28
Rate for Payer: Qualcare PPO/HMO/WC	$276.21
Rate for Payer: UnitedHealthcare Commercial	$368.28
Rate for Payer: UnitedHealthcare Community & State	$44.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$48.80

INCISIONAL BX SKIN 1ST LESION

Facility

$1,841.39

Service Code	HCPCS 11106
Hospital Charge Code	303511106
Hospital Revenue Code	510
Min. Negotiated Rate	$276.21
Max. Negotiated Rate	$276.21
Rate for Payer: Qualcare PPO/HMO/WC	$276.21

INCISIONAL BX SKIN 1ST LESION

Facility

$9,500.00

Service Code	HCPCS 11106
Hospital Charge Code	404311106
Hospital Revenue Code	361
Min. Negotiated Rate	$228.95
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,169.46
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,850.00
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$228.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$251.75

INCISIONAL BX SKIN 1ST LESION

Facility

$9,500.00

Service Code	HCPCS 11106
Hospital Charge Code	404311106
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

INCISIONAL BX SKIN 1ST LESION

Facility

$1,841.39

Service Code	HCPCS 11106
Hospital Charge Code	450211106
Hospital Revenue Code	761
Min. Negotiated Rate	$276.21
Max. Negotiated Rate	$276.21
Rate for Payer: Qualcare PPO/HMO/WC	$276.21

INCISIONAL BX SKIN 1ST LESION

Facility

$1,841.39

Service Code	HCPCS 11106
Hospital Charge Code	412311106
Hospital Revenue Code	361
Min. Negotiated Rate	$276.21
Max. Negotiated Rate	$276.21
Rate for Payer: Qualcare PPO/HMO/WC	$276.21

INCISIONAL BX SKIN 1ST LESION

Facility

$1,841.39

Service Code	HCPCS 11106
Hospital Charge Code	412311106
Hospital Revenue Code	361
Min. Negotiated Rate	$44.38
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,169.46
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.42
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$276.21
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$44.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$48.80

INCISIONAL BX SKIN 1ST LESION

Facility

$1,841.39

Service Code	HCPCS 11106
Hospital Charge Code	303511106
Hospital Revenue Code	510
Min. Negotiated Rate	$44.38
Max. Negotiated Rate	$3,169.46
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$169.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,169.46
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$552.42
Rate for Payer: Qualcare PPO/HMO/WC	$276.21
Rate for Payer: UnitedHealthcare Community & State	$44.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$48.80

INCISIONAL BX SKIN EA ADD LES

Facility

$920.69

Service Code	HCPCS 11107
Hospital Charge Code	412311107
Hospital Revenue Code	361
Min. Negotiated Rate	$138.10
Max. Negotiated Rate	$138.10
Rate for Payer: Qualcare PPO/HMO/WC	$138.10

Know your out-of-pocket cost for care.

All Charges