Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

IR DIR FLOUR GUIDANCE,SPINE/IN

Facility

IP

$5,100.00

Service Code	HCPCS 77003
Hospital Charge Code	411077003
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR DIR FLOUR GUIDANCE,SPINE/IN

Facility

OP

$5,100.00

Service Code	HCPCS 77003
Hospital Charge Code	411077003
Hospital Revenue Code	320
Min. Negotiated Rate	$39.15
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

IR DIR FLOUR GUIDANCE,SPINE/IN

Facility

OP

$5,100.00

Service Code	HCPCS 77003
Hospital Charge Code	366877003
Hospital Revenue Code	320
Min. Negotiated Rate	$39.15
Max. Negotiated Rate	$2,550.00
Rate for Payer: Aetna Commercial	$1,938.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$2,550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

IR DIR FLOUR GUIDANCE,SPINE/IN

Facility

IP

$5,100.00

Service Code	HCPCS 77003
Hospital Charge Code	321077003
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR DIR FLOUR GUIDANCE,SPINE/IN

Facility

IP

$1,508.00

Service Code	HCPCS 77003
Hospital Charge Code	7411756
Hospital Revenue Code	320
Min. Negotiated Rate	$226.20
Max. Negotiated Rate	$226.20
Rate for Payer: Qualcare PPO/HMO/WC	$226.20

IR DIR FLOUR GUIDANCE,SPINE/IN

Facility

OP

$1,508.00

Service Code	HCPCS 77003
Hospital Charge Code	7411756
Hospital Revenue Code	320
Min. Negotiated Rate	$36.34
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$573.04
Rate for Payer: Aetna Medicare Advantage	$452.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.54
Rate for Payer: Cigna Commercial	$754.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$452.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$226.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$36.34
Rate for Payer: Wellpoint Medicaid Managed Care	$39.96

IR DIR-PERC TRANSCATH RETRVL F

Facility

OP

$2,238.00

Service Code	HCPCS 75961
Hospital Charge Code	2670065
Hospital Revenue Code	320
Min. Negotiated Rate	$53.94
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$850.44
Rate for Payer: Aetna Medicare Advantage	$671.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.69
Rate for Payer: Cigna Commercial	$1,119.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$671.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$335.70
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$53.94
Rate for Payer: Wellpoint Medicaid Managed Care	$59.31

IR DIR-PERC TRANSCATH RETRVL F

Facility

IP

$2,238.00

Service Code	HCPCS 75961
Hospital Charge Code	2670065
Hospital Revenue Code	320
Min. Negotiated Rate	$335.70
Max. Negotiated Rate	$335.70
Rate for Payer: Qualcare PPO/HMO/WC	$335.70

IR DIR-US GUIDNC NDLE PLACEMEN

Facility

OP

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	321076942
Hospital Revenue Code	402
Min. Negotiated Rate	$71.63
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

IR DIR-US GUIDNC NDLE PLACEMEN

Facility

IP

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	321076942
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

IR DIR-US GUIDNC NDLE PLACEMEN

Facility

IP

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2670095
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

IR DIR-US GUIDNC NDLE PLACEMEN

Facility

OP

$6,700.00

Service Code	HCPCS 76942
Hospital Charge Code	2670095
Hospital Revenue Code	402
Min. Negotiated Rate	$71.63
Max. Negotiated Rate	$3,350.00
Rate for Payer: Aetna Commercial	$2,546.00
Rate for Payer: Aetna Medicare Advantage	$2,010.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,708.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,708.50
Rate for Payer: Cigna Commercial	$3,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,010.00
Rate for Payer: Oxford Commercial	$1,746.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,517.00
Rate for Payer: UnitedHealthcare Community & State	$161.47
Rate for Payer: Wellpoint Medicaid Managed Care	$177.55

IR DIR-VENOUS SAMPLING

Facility

IP

$12,400.74

Service Code	HCPCS 75893
Hospital Charge Code	2670025
Hospital Revenue Code	320
Min. Negotiated Rate	$1,860.11
Max. Negotiated Rate	$1,860.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,860.11

IR DIR-VENOUS SAMPLING

Facility

IP

$12,400.74

Service Code	HCPCS 75893
Hospital Charge Code	7411727
Hospital Revenue Code	320
Min. Negotiated Rate	$1,860.11
Max. Negotiated Rate	$1,860.11
Rate for Payer: Qualcare PPO/HMO/WC	$1,860.11

IR DIR-VENOUS SAMPLING

Facility

OP

$12,400.74

Service Code	HCPCS 75893
Hospital Charge Code	7411727
Hospital Revenue Code	320
Min. Negotiated Rate	$203.28
Max. Negotiated Rate	$23,862.86
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,862.86
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$4,627.53
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,720.22
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,860.11
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$298.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$328.62

IR DIR-VENOUS SAMPLING

Facility

OP

$12,400.74

Service Code	HCPCS 75893
Hospital Charge Code	2670025
Hospital Revenue Code	320
Min. Negotiated Rate	$203.28
Max. Negotiated Rate	$23,862.86
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,862.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$203.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,862.86
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$4,627.53
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,720.22
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,860.11
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$298.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$328.62

IR DISKOGRAPHY,CERVICAL/THORAC

Facility

OP

$9,928.00

Service Code	HCPCS 72285
Hospital Charge Code	7411662
Hospital Revenue Code	320
Min. Negotiated Rate	$96.80
Max. Negotiated Rate	$8,374.11
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,374.11
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$1,623.92
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,978.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$239.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,656.68
Rate for Payer: Wellpoint Medicaid Managed Care	$263.09

IR DISKOGRAPHY,CERVICAL/THORAC

Facility

IP

$9,928.00

Service Code	HCPCS 72285
Hospital Charge Code	7411662
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY,CERVICAL/THORAC

Facility

IP

$9,928.00

Service Code	HCPCS 72285
Hospital Charge Code	2680255
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY,CERVICAL/THORAC

Facility

OP

$9,928.00

Service Code	HCPCS 72285
Hospital Charge Code	2680255
Hospital Revenue Code	320
Min. Negotiated Rate	$96.80
Max. Negotiated Rate	$8,374.11
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,374.11
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$1,623.92
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,978.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$239.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,656.68
Rate for Payer: Wellpoint Medicaid Managed Care	$263.09

IR DISKOGRAPHY LUMBAR

Facility

IP

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	2680260
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY LUMBAR

Facility

IP

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	7411663
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY LUMBAR

Facility

IP

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	411072295
Hospital Revenue Code	320
Min. Negotiated Rate	$1,489.20
Max. Negotiated Rate	$1,489.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20

IR DISKOGRAPHY LUMBAR

Facility

OP

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	366872295
Hospital Revenue Code	320
Min. Negotiated Rate	$96.80
Max. Negotiated Rate	$8,374.11
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,374.11
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$1,623.92
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,978.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$239.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$556.68
Rate for Payer: Wellpoint Medicaid Managed Care	$263.09

IR DISKOGRAPHY LUMBAR

Facility

OP

$9,928.00

Service Code	HCPCS 72295
Hospital Charge Code	411072295
Hospital Revenue Code	320
Min. Negotiated Rate	$96.80
Max. Negotiated Rate	$8,374.11
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$96.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,374.11
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$1,623.92
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,978.40
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,489.20
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$239.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$556.68
Rate for Payer: Wellpoint Medicaid Managed Care	$263.09