Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INSERT SPINE FIX DEVICE 3-6

Facility

$25,282.63

Service Code	HCPCS 22842
Hospital Charge Code	16000469
Hospital Revenue Code	360
Min. Negotiated Rate	$3,792.39
Max. Negotiated Rate	$3,792.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39

INSERT SPINE FXTN DVC4-7 SEG

Facility

$25,282.63

Service Code	HCPCS 22846
Hospital Charge Code	162003
Hospital Revenue Code	360
Min. Negotiated Rate	$609.31
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$9,607.40
Rate for Payer: Aetna Medicare Advantage	$7,584.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,447.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,447.07
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	$6,447.07
Rate for Payer: Cigna Commercial	$12,641.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,584.79
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$609.31

INSERT SPINE FXTN DVC4-7 SEG

Facility

$25,282.63

Service Code	HCPCS 22846
Hospital Charge Code	162003
Hospital Revenue Code	360
Min. Negotiated Rate	$3,792.39
Max. Negotiated Rate	$3,792.39
Rate for Payer: Qualcare PPO/HMO/WC	$3,792.39

INSERT SUBQ CARD RHYTHM MON

Facility

$43,408.82

Service Code	HCPCS 33285
Hospital Charge Code	366833285
Hospital Revenue Code	361
Min. Negotiated Rate	$6,511.32
Max. Negotiated Rate	$6,511.32
Rate for Payer: Qualcare PPO/HMO/WC	$6,511.32

INSERT SUBQ CARD RHYTHM MON

Facility

$43,408.82

Service Code	HCPCS 33285
Hospital Charge Code	703033285
Hospital Revenue Code	481
Min. Negotiated Rate	$6,511.32
Max. Negotiated Rate	$6,511.32
Rate for Payer: Qualcare PPO/HMO/WC	$6,511.32

INSERT SUBQ CARD RHYTHM MON

Facility

$43,408.82

Service Code	HCPCS 33285
Hospital Charge Code	703033285
Hospital Revenue Code	481
Min. Negotiated Rate	$1,046.15
Max. Negotiated Rate	$35,488.33
Rate for Payer: Aetna Commercial	$26,741.35
Rate for Payer: Aetna Medicare Advantage	$31,853.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,831.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,488.33
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: Cigna Medicare Advantage	$9,831.38
Rate for Payer: Clover Medicare Advantage	$9,339.81
Rate for Payer: EmblemHealth Commercial	$29,494.14
Rate for Payer: Humana Medicare Advantage	$10,126.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,831.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,022.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,511.32
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,046.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare Medicare Advantage	$9,831.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1,150.33

INSERT SUBQ CARD RHYTHM MON

Facility

$43,408.82

Service Code	HCPCS 33285
Hospital Charge Code	411033285
Hospital Revenue Code	361
Min. Negotiated Rate	$6,511.32
Max. Negotiated Rate	$6,511.32
Rate for Payer: Qualcare PPO/HMO/WC	$6,511.32

INSERT SUBQ CARD RHYTHM MON

Facility

$43,408.82

Service Code	HCPCS 33285
Hospital Charge Code	403433285
Hospital Revenue Code	361
Min. Negotiated Rate	$1,046.15
Max. Negotiated Rate	$35,488.33
Rate for Payer: Aetna Commercial	$26,741.35
Rate for Payer: Aetna Medicare Advantage	$31,853.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,831.38
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	$35,488.33
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: Cigna Medicare Advantage	$9,831.38
Rate for Payer: Clover Medicare Advantage	$9,339.81
Rate for Payer: EmblemHealth Commercial	$29,494.14
Rate for Payer: Humana Medicare Advantage	$10,126.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,831.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,022.65
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,511.32
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,046.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare Medicare Advantage	$9,831.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1,150.33

INSERT SUBQ CARD RHYTHM MON

Facility

$43,408.82

Service Code	HCPCS 33285
Hospital Charge Code	366833285
Hospital Revenue Code	361
Min. Negotiated Rate	$1,046.15
Max. Negotiated Rate	$35,488.33
Rate for Payer: Aetna Commercial	$26,741.35
Rate for Payer: Aetna Medicare Advantage	$31,853.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,831.38
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	$35,488.33
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: Cigna Medicare Advantage	$9,831.38
Rate for Payer: Clover Medicare Advantage	$9,339.81
Rate for Payer: EmblemHealth Commercial	$29,494.14
Rate for Payer: Humana Medicare Advantage	$10,126.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,831.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,022.65
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,511.32
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,046.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare Medicare Advantage	$9,831.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1,150.33

INSERT SUBQ CARD RHYTHM MON

Facility

$43,408.82

Service Code	HCPCS 33285
Hospital Charge Code	403433285
Hospital Revenue Code	361
Min. Negotiated Rate	$6,511.32
Max. Negotiated Rate	$6,511.32
Rate for Payer: Qualcare PPO/HMO/WC	$6,511.32

INSERT SUBQ CARD RHYTHM MON

Facility

$43,408.82

Service Code	HCPCS 33285
Hospital Charge Code	411033285
Hospital Revenue Code	361
Min. Negotiated Rate	$1,046.15
Max. Negotiated Rate	$35,488.33
Rate for Payer: Aetna Commercial	$26,741.35
Rate for Payer: Aetna Medicare Advantage	$31,853.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,488.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,831.38
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	$35,488.33
Rate for Payer: Cigna Commercial	$19,706.96
Rate for Payer: Cigna Medicare Advantage	$9,831.38
Rate for Payer: Clover Medicare Advantage	$9,339.81
Rate for Payer: EmblemHealth Commercial	$29,494.14
Rate for Payer: Humana Medicare Advantage	$10,126.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,831.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,022.65
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,511.32
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,046.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,831.38
Rate for Payer: Wellcare Medicare Advantage	$9,831.38
Rate for Payer: Wellpoint Medicaid Managed Care	$1,150.33

INSERT SWAN GANZ CATH

Facility

$9,759.90

Service Code	HCPCS 93503
Hospital Charge Code	74110010
Hospital Revenue Code	481
Min. Negotiated Rate	$1,463.98
Max. Negotiated Rate	$1,463.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,463.98

INSERT SWAN GANZ CATH

Facility

$9,759.90

Service Code	HCPCS 93503
Hospital Charge Code	74110010
Hospital Revenue Code	481
Min. Negotiated Rate	$235.21
Max. Negotiated Rate	$6,750.64
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,750.64
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,927.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,463.98
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$235.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$258.64

INSERT SWAN GANZ CATH

Facility

$9,759.90

Service Code	HCPCS 93503
Hospital Charge Code	5100048
Hospital Revenue Code	481
Min. Negotiated Rate	$235.21
Max. Negotiated Rate	$6,750.64
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,750.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,750.64
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,927.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,463.98
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$235.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$258.64

INSERT SWAN GANZ CATH

Facility

$9,759.90

Service Code	HCPCS 93503
Hospital Charge Code	5100048
Hospital Revenue Code	481
Min. Negotiated Rate	$1,463.98
Max. Negotiated Rate	$1,463.98
Rate for Payer: Qualcare PPO/HMO/WC	$1,463.98

INSERT SZ 3 LEFT 20MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677841
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

INSERT SZ 3 LEFT 20MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677841
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

INSERT SZ 4 LEFT 17MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677860
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

INSERT SZ 4 LEFT 17MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677860
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

INSERT SZ 4 RIGHT

Facility

$2,143.90

Service Code	HCPCS C1776
Hospital Charge Code	270678418
Hospital Revenue Code	278
Min. Negotiated Rate	$321.58
Max. Negotiated Rate	$518.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$428.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$518.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$471.66
Rate for Payer: Qualcare PPO/HMO/WC	$321.58

INSERT SZ 4 RIGHT

Facility

$2,143.90

Service Code	HCPCS C1776
Hospital Charge Code	270678418
Hospital Revenue Code	278
Min. Negotiated Rate	$51.67
Max. Negotiated Rate	$1,071.95
Rate for Payer: Aetna Commercial	$814.68
Rate for Payer: Aetna Medicare Advantage	$643.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$546.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$546.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$428.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$546.69
Rate for Payer: Cigna Commercial	$1,071.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$518.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$471.66
Rate for Payer: Qualcare PPO/HMO/WC	$321.58
Rate for Payer: UnitedHealthcare Community & State	$51.67
Rate for Payer: Wellpoint Medicaid Managed Care	$56.81

INSERT SZ 5 LEFT 10MM

Facility

$4,500.00

Hospital Charge Code	270678258
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

INSERT SZ 5 LEFT 10MM

Facility

$4,500.00

Hospital Charge Code	270678258
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

INSERT SZ 5 LEFT 17MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677946
Hospital Revenue Code	278
Min. Negotiated Rate	$675.00
Max. Negotiated Rate	$1,089.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00

INSERT SZ 5 LEFT 17MM

Facility

$4,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270677946
Hospital Revenue Code	278
Min. Negotiated Rate	$108.45
Max. Negotiated Rate	$2,250.00
Rate for Payer: Aetna Commercial	$1,710.00
Rate for Payer: Aetna Medicare Advantage	$1,350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,147.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,147.50
Rate for Payer: Cigna Commercial	$2,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,089.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$990.00
Rate for Payer: Qualcare PPO/HMO/WC	$675.00
Rate for Payer: UnitedHealthcare Community & State	$108.45
Rate for Payer: Wellpoint Medicaid Managed Care	$119.25

Know your out-of-pocket cost for care.

All Charges