Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

IR ANGIOGRAM ADRENAL LEFT

Facility

$7,240.05

Service Code	HCPCS 75731
Hospital Charge Code	7411694
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

IR ANGIOGRAM ADRENAL RIGHT

Facility

$7,240.05

Service Code	HCPCS 75731
Hospital Charge Code	7411695
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

IR ANGIOGRAM ADRENAL RIGHT

Facility

$7,240.05

Service Code	HCPCS 75731
Hospital Charge Code	2600011
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

IR ANGIOGRAM ADRENAL RIGHT

Facility

$7,240.05

Service Code	HCPCS 75731
Hospital Charge Code	2600011
Hospital Revenue Code	323
Min. Negotiated Rate	$174.49
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	$253.00
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	$2,625.82
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	$2,172.01
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$174.49
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	$191.86

IR ANGIOGRAM ADRENAL RIGHT

Facility

$7,240.05

Service Code	HCPCS 75731
Hospital Charge Code	7411695
Hospital Revenue Code	323
Min. Negotiated Rate	$174.49
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	$253.00
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	$2,625.82
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	$2,172.01
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$174.49
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	$191.86

IR ANGIOGRAM ARTEROVENUS SHUNT

Facility

$3,084.40

Hospital Charge Code	2600012
Hospital Revenue Code	323
Min. Negotiated Rate	$74.33
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$1,172.07
Rate for Payer: Aetna Medicare Advantage	$925.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$786.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$786.52
Rate for Payer: Cigna Commercial	$1,542.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$925.32
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$462.66
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$74.33
Rate for Payer: Wellpoint Medicaid Managed Care	$81.74

IR ANGIOGRAM ARTEROVENUS SHUNT

Facility

$3,084.40

Hospital Charge Code	2600012
Hospital Revenue Code	323
Min. Negotiated Rate	$462.66
Max. Negotiated Rate	$462.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.66

IR ANGIOGRAM BRACHIAL RETROGRD

Facility

$4,605.65

Service Code	HCPCS 75658
Hospital Charge Code	2600013
Hospital Revenue Code	323
Min. Negotiated Rate	$690.85
Max. Negotiated Rate	$690.85
Rate for Payer: Qualcare PPO/HMO/WC	$690.85

IR ANGIOGRAM BRACHIAL RETROGRD

Facility

$4,605.65

Service Code	HCPCS 75658
Hospital Charge Code	2600013
Hospital Revenue Code	323
Min. Negotiated Rate	$111.00
Max. Negotiated Rate	$2,302.82
Rate for Payer: Aetna Commercial	$1,750.15
Rate for Payer: Aetna Medicare Advantage	$1,381.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,174.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,174.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,174.44
Rate for Payer: Cigna Commercial	$2,302.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,381.69
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.85
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$111.00
Rate for Payer: Wellpoint Medicaid Managed Care	$122.05

IR ANGIOGRAM CERVICAL

Facility

$7,240.05

Hospital Charge Code	2600023
Hospital Revenue Code	323
Min. Negotiated Rate	$1,086.01
Max. Negotiated Rate	$1,086.01
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01

IR ANGIOGRAM CERVICAL

Facility

$7,240.05

Hospital Charge Code	2600023
Hospital Revenue Code	323
Min. Negotiated Rate	$174.49
Max. Negotiated Rate	$3,620.03
Rate for Payer: Aetna Commercial	$2,751.22
Rate for Payer: Aetna Medicare Advantage	$2,172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,846.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,846.21
Rate for Payer: Cigna Commercial	$3,620.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,172.01
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,086.01
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$174.49
Rate for Payer: Wellpoint Medicaid Managed Care	$191.86

IR ANGIOGRAM CERVICOCEREBRAL

Facility

$20,317.50

Service Code	HCPCS 75650
Hospital Charge Code	2600024
Hospital Revenue Code	323
Min. Negotiated Rate	$489.65
Max. Negotiated Rate	$10,158.75
Rate for Payer: Aetna Commercial	$7,720.65
Rate for Payer: Aetna Medicare Advantage	$6,095.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,180.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,180.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,180.96
Rate for Payer: Cigna Commercial	$10,158.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,095.25
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,047.62
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$489.65
Rate for Payer: Wellpoint Medicaid Managed Care	$538.41

IR ANGIOGRAM CERVICOCEREBRAL

Facility

$20,317.50

Service Code	HCPCS 75650
Hospital Charge Code	2600024
Hospital Revenue Code	323
Min. Negotiated Rate	$3,047.62
Max. Negotiated Rate	$3,047.62
Rate for Payer: Qualcare PPO/HMO/WC	$3,047.62

IR ANGIOGRAM EXTREMITY LEFT

Facility

$21,359.77

Service Code	HCPCS 75710
Hospital Charge Code	2600026
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

IR ANGIOGRAM EXTREMITY LEFT

Facility

$21,359.77

Service Code	HCPCS 75710
Hospital Charge Code	2600026
Hospital Revenue Code	323
Min. Negotiated Rate	$146.36
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	$146.36
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	$2,625.82
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	$6,407.93
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$514.77
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	$566.03

IR ANGIOGRAM EXTREMITY RIGHT

Facility

$21,359.77

Service Code	HCPCS 75710
Hospital Charge Code	2600027
Hospital Revenue Code	323
Min. Negotiated Rate	$3,203.97
Max. Negotiated Rate	$3,203.97
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97

IR ANGIOGRAM EXTREMITY RIGHT

Facility

$21,359.77

Service Code	HCPCS 75710
Hospital Charge Code	2600027
Hospital Revenue Code	323
Min. Negotiated Rate	$146.36
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	$146.36
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	$2,625.82
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	$6,407.93
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,203.97
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$514.77
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	$566.03

IR ANGIOGRAM EXTRMTY BILATERAL

Facility

$15,468.50

Service Code	HCPCS 75716
Hospital Charge Code	2600025
Hospital Revenue Code	323
Min. Negotiated Rate	$243.94
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	$243.94
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	$2,625.82
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	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
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	$409.92

IR ANGIOGRAM EXTRMTY BILATERAL

Facility

$15,468.50

Service Code	HCPCS 75716
Hospital Charge Code	2600025
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR ANGIOGRAM EXTRMTY BILATERAL

Facility

$15,468.50

Service Code	HCPCS 75716
Hospital Charge Code	321075716
Hospital Revenue Code	323
Min. Negotiated Rate	$243.94
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	$243.94
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	$2,625.82
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	$4,640.55
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$372.79
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	$409.92

IR ANGIOGRAM EXTRMTY BILATERAL

Facility

$15,468.50

Service Code	HCPCS 75716
Hospital Charge Code	321075716
Hospital Revenue Code	323
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR ANGIOGRAM INTERNAL MAMMARY

Facility

$3,084.40

Service Code	HCPCS 75756
Hospital Charge Code	2600028
Hospital Revenue Code	323
Min. Negotiated Rate	$74.33
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	$134.65
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	$2,625.82
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	$925.32
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$462.66
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$74.33
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	$81.74

IR ANGIOGRAM INTERNAL MAMMARY

Facility

$3,084.40

Service Code	HCPCS 75756
Hospital Charge Code	2600028
Hospital Revenue Code	323
Min. Negotiated Rate	$462.66
Max. Negotiated Rate	$462.66
Rate for Payer: Qualcare PPO/HMO/WC	$462.66

IR ANGIOGRAM INTERNAL MAMMARY

Facility

$13,882.20

Service Code	HCPCS 75756
Hospital Charge Code	7411701
Hospital Revenue Code	323
Min. Negotiated Rate	$134.65
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	$134.65
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	$2,625.82
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	$4,164.66
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,082.33
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$334.56
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	$367.88

IR ANGIOGRAM INTERNAL MAMMARY

Facility

$13,882.20

Service Code	HCPCS 75756
Hospital Charge Code	7411701
Hospital Revenue Code	323
Min. Negotiated Rate	$2,082.33
Max. Negotiated Rate	$2,082.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,082.33

Know your out-of-pocket cost for care.

All Charges