Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

INSTRUMENT SET SEREW

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687872
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$412.50
Rate for Payer: Aetna Commercial	$313.50
Rate for Payer: Aetna Medicare Advantage	$247.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$210.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$210.38
Rate for Payer: Cigna Commercial	$412.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75
Rate for Payer: UnitedHealthcare Community & State	$19.88
Rate for Payer: Wellpoint Medicaid Managed Care	$21.86

INSTRUMENT SET SEREW

Facility

$825.00

Service Code	HCPCS C1713
Hospital Charge Code	270687872
Hospital Revenue Code	278
Min. Negotiated Rate	$123.75
Max. Negotiated Rate	$199.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$165.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$199.65
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$181.50
Rate for Payer: Qualcare PPO/HMO/WC	$123.75

INST SET CALCANEUS

Facility

$4,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270687870
Hospital Revenue Code	278
Min. Negotiated Rate	$106.64
Max. Negotiated Rate	$2,212.50
Rate for Payer: Aetna Commercial	$1,681.50
Rate for Payer: Aetna Medicare Advantage	$1,327.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,128.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,128.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$885.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,128.38
Rate for Payer: Cigna Commercial	$2,212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,070.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$973.50
Rate for Payer: Qualcare PPO/HMO/WC	$663.75
Rate for Payer: UnitedHealthcare Community & State	$106.64
Rate for Payer: Wellpoint Medicaid Managed Care	$117.26

INST SET CALCANEUS

Facility

$4,425.00

Service Code	HCPCS C1713
Hospital Charge Code	270687870
Hospital Revenue Code	278
Min. Negotiated Rate	$663.75
Max. Negotiated Rate	$1,070.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$885.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,070.85
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$973.50
Rate for Payer: Qualcare PPO/HMO/WC	$663.75

INS TUN INT PERIT CATH

Facility

$14,554.80

Service Code	HCPCS 49418
Hospital Charge Code	411049418
Hospital Revenue Code	361
Min. Negotiated Rate	$2,183.22
Max. Negotiated Rate	$2,183.22
Rate for Payer: Qualcare PPO/HMO/WC	$2,183.22

INS TUN INT PERIT CATH

Facility

$14,554.80

Service Code	HCPCS 49418
Hospital Charge Code	411049418
Hospital Revenue Code	361
Min. Negotiated Rate	$350.77
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,366.44
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,183.22
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$350.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$385.70

INS TUN INT PERIT CATH

Facility

$14,554.80

Service Code	HCPCS 49418
Hospital Charge Code	366849418
Hospital Revenue Code	361
Min. Negotiated Rate	$2,183.22
Max. Negotiated Rate	$2,183.22
Rate for Payer: Qualcare PPO/HMO/WC	$2,183.22

INS TUN INT PERIT CATH

Facility

$17,259.20

Service Code	HCPCS 49418
Hospital Charge Code	2690145
Hospital Revenue Code	361
Min. Negotiated Rate	$415.95
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,177.76
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$415.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$457.37

INS TUN INT PERIT CATH

Facility

$17,259.20

Service Code	HCPCS 49418
Hospital Charge Code	2690145
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

INS TUN INT PERIT CATH

Facility

$8,972.00

Service Code	HCPCS 49418
Hospital Charge Code	7411588
Hospital Revenue Code	361
Min. Negotiated Rate	$1,345.80
Max. Negotiated Rate	$1,345.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,345.80

INS TUN INT PERIT CATH

Facility

$17,259.20

Service Code	HCPCS 49418
Hospital Charge Code	321049418
Hospital Revenue Code	361
Min. Negotiated Rate	$2,588.88
Max. Negotiated Rate	$2,588.88
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88

INS TUN INT PERIT CATH

Facility

$17,259.20

Service Code	HCPCS 49418
Hospital Charge Code	321049418
Hospital Revenue Code	361
Min. Negotiated Rate	$415.95
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,177.76
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,588.88
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$415.95
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$457.37

INS TUN INT PERIT CATH

Facility

$8,972.00

Service Code	HCPCS 49418
Hospital Charge Code	7411588
Hospital Revenue Code	361
Min. Negotiated Rate	$216.23
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,691.60
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,345.80
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$216.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$237.76

INS TUN INT PERIT CATH

Facility

$14,554.80

Service Code	HCPCS 49418
Hospital Charge Code	366849418
Hospital Revenue Code	361
Min. Negotiated Rate	$350.77
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,366.44
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,183.22
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$350.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$385.70

INS TUNN CNTRL VENOUS<5 YEARS

Facility

$12,618.93

Service Code	HCPCS 36560
Hospital Charge Code	2008005
Hospital Revenue Code	361
Min. Negotiated Rate	$1,892.84
Max. Negotiated Rate	$1,892.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,892.84

INS TUNN CNTRL VENOUS<5 YEARS

Facility

$12,618.93

Service Code	HCPCS 36560
Hospital Charge Code	2008005
Hospital Revenue Code	361
Min. Negotiated Rate	$304.12
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,785.68
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,892.84
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$304.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$334.40

INS TUNN CVAD W PORT AGE 5YR>

Facility

$37,793.28

Service Code	HCPCS 36561
Hospital Charge Code	1600000346
Hospital Revenue Code	360
Min. Negotiated Rate	$5,668.99
Max. Negotiated Rate	$5,668.99
Rate for Payer: Qualcare PPO/HMO/WC	$5,668.99

INS TUNN CVAD W PORT AGE 5YR>

Facility

$37,793.28

Service Code	HCPCS 36561
Hospital Charge Code	1600000346
Hospital Revenue Code	360
Min. Negotiated Rate	$910.82
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,337.98
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,668.99
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$910.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1,001.52

INS TUNNELED CV CATH AGE 5/>

Facility

$29,451.76

Service Code	HCPCS 36558
Hospital Charge Code	16000735
Hospital Revenue Code	360
Min. Negotiated Rate	$4,417.76
Max. Negotiated Rate	$4,417.76
Rate for Payer: Qualcare PPO/HMO/WC	$4,417.76

INS TUNNELED CV CATH AGE 5/>

Facility

$29,451.76

Service Code	HCPCS 36558
Hospital Charge Code	16000735
Hospital Revenue Code	360
Min. Negotiated Rate	$709.79
Max. Negotiated Rate	$13,540.60
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,540.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,540.60
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8,835.53
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,417.76
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$709.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$780.47

INSUFFLATOR AIR BULB

Facility

$29.29

Hospital Charge Code	270647038
Hospital Revenue Code	270
Min. Negotiated Rate	$4.39
Max. Negotiated Rate	$4.39
Rate for Payer: Qualcare PPO/HMO/WC	$4.39

INSUFFLATOR AIR BULB

Facility

$29.29

Hospital Charge Code	270647038
Hospital Revenue Code	270
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$14.64
Rate for Payer: Aetna Commercial	$11.13
Rate for Payer: Aetna Medicare Advantage	$8.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.47
Rate for Payer: Cigna Commercial	$14.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.79
Rate for Payer: Oxford Commercial	$5.86
Rate for Payer: Qualcare PPO/HMO/WC	$4.39
Rate for Payer: UnitedHealthcare Commercial	$5.86
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.78

INSUFFLATOR BULB & TUBE W/TIP

Facility

$44.00

Hospital Charge Code	270332342
Hospital Revenue Code	272
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$22.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$8.80
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$8.80
Rate for Payer: UnitedHealthcare Community & State	$1.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

INSUFFLATOR BULB & TUBE W/TIP

Facility

$44.00

Hospital Charge Code	270332342
Hospital Revenue Code	272
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

INSUFFLATOR HIGH FLOW PNEUMO

Facility

$213.29

Hospital Charge Code	270667863
Hospital Revenue Code	272
Min. Negotiated Rate	$31.99
Max. Negotiated Rate	$31.99
Rate for Payer: Qualcare PPO/HMO/WC	$31.99

Know your out-of-pocket cost for care.

All Charges