Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANTIMINTH SUSP/250G/5ML

Facility

$201.00

Hospital Charge Code	60634610
Hospital Revenue Code	250
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$100.50
Rate for Payer: Aetna Commercial	$76.38
Rate for Payer: Aetna Medicare Advantage	$60.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.26
Rate for Payer: Cigna Commercial	$100.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.30
Rate for Payer: Oxford Commercial	$40.20
Rate for Payer: Qualcare PPO/HMO/WC	$30.15
Rate for Payer: UnitedHealthcare Commercial	$40.20
Rate for Payer: UnitedHealthcare Community & State	$4.84
Rate for Payer: Wellpoint Medicaid Managed Care	$5.33

ANTIMINTH SUSP/250G/5ML

Facility

$201.00

Hospital Charge Code	60634610
Hospital Revenue Code	250
Min. Negotiated Rate	$30.15
Max. Negotiated Rate	$30.15
Rate for Payer: Qualcare PPO/HMO/WC	$30.15

ANTI-MITOCHONDRIAL AB SCREEN

Facility

$121.00

Service Code	HCPCS 83516
Hospital Charge Code	3003134
Hospital Revenue Code	302
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.36
Rate for Payer: Aetna Medicare Advantage	$37.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: Cigna Medicare Advantage	$11.53
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Medicare Advantage	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

ANTI-MITOCHONDRIAL AB SCREEN

Facility

$121.00

Service Code	HCPCS 83516
Hospital Charge Code	3003134
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

ANTIMONY (QUANT URINE)

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3007085
Hospital Revenue Code	301
Min. Negotiated Rate	$4.03
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.27
Rate for Payer: Cigna Commercial	$76.12
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.67
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.84
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$4.03

ANTIMONY (QUANT URINE)

Facility

$152.25

Service Code	HCPCS 83018
Hospital Charge Code	3007085
Hospital Revenue Code	301
Min. Negotiated Rate	$22.84
Max. Negotiated Rate	$22.84
Rate for Payer: Qualcare PPO/HMO/WC	$22.84

ANTI-MULLERIAN HORMONE

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	39900337
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ANTI-MULLERIAN HORMONE

Facility

$390.00

Service Code	HCPCS 83520
Hospital Charge Code	39900337
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ANTI MYELIN ANTIBODY, SERUM

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3007093
Hospital Revenue Code	302
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

ANTI MYELIN ANTIBODY, SERUM

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3007093
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

ANTI-MYELOPEROXIDASE AB

Facility

$308.00

Service Code	HCPCS 86021
Hospital Charge Code	38476055
Hospital Revenue Code	302
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$154.00
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.33
Rate for Payer: Cigna Commercial	$154.00
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$8.16

ANTI-MYELOPEROXIDASE AB

Facility

$308.00

Service Code	HCPCS 86021
Hospital Charge Code	38476055
Hospital Revenue Code	302
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.20

ANTIMYELOPEROXIDASE (MPO) ABS

Facility

$253.45

Service Code	HCPCS 83520
Hospital Charge Code	3038086
Hospital Revenue Code	301
Min. Negotiated Rate	$38.02
Max. Negotiated Rate	$38.02
Rate for Payer: Qualcare PPO/HMO/WC	$38.02

ANTIMYELOPEROXIDASE (MPO) ABS

Facility

$253.45

Service Code	HCPCS 83520
Hospital Charge Code	3038086
Hospital Revenue Code	301
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$126.72
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$126.72
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.03
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.02
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$6.72

ANTI-MYOCARDIAL AB SCREEN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3031051
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

ANTI-MYOCARDIAL AB SCREEN

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3031051
Hospital Revenue Code	302
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

ANTI-NEURONAL NUCLEAR AB SCR

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3031102
Hospital Revenue Code	302
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$60.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

ANTI-NEURONAL NUCLEAR AB SCR

Facility

$121.00

Service Code	HCPCS 86255
Hospital Charge Code	3031102
Hospital Revenue Code	302
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

ANTI-NEUTROPHIL CYTOPLASMIC AB

Facility

$405.00

Service Code	HCPCS 86021
Hospital Charge Code	38476008
Hospital Revenue Code	302
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$60.75
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

ANTI-NEUTROPHIL CYTOPLASMIC AB

Facility

$405.00

Service Code	HCPCS 86021
Hospital Charge Code	38476008
Hospital Revenue Code	302
Min. Negotiated Rate	$10.73
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.33
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$10.73

ANTI NUCLEAR AB (ANA) SCREEN

Facility

$164.85

Service Code	HCPCS 86039
Hospital Charge Code	3000320
Hospital Revenue Code	302
Min. Negotiated Rate	$24.73
Max. Negotiated Rate	$24.73
Rate for Payer: Qualcare PPO/HMO/WC	$24.73

ANTI NUCLEAR AB (ANA) SCREEN

Facility

$164.85

Service Code	HCPCS 86039
Hospital Charge Code	3000320
Hospital Revenue Code	302
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$30.36
Rate for Payer: Aetna Medicare Advantage	$36.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.28
Rate for Payer: Cigna Commercial	$82.42
Rate for Payer: Cigna Medicare Advantage	$11.16
Rate for Payer: Clover Medicare Advantage	$10.60
Rate for Payer: EmblemHealth Commercial	$33.48
Rate for Payer: Humana Medicare Advantage	$11.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.73
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.16
Rate for Payer: Wellcare Medicare Advantage	$11.16
Rate for Payer: Wellpoint Medicaid Managed Care	$4.37

ANTI NUCLEAR AB (ANA) TITER

Facility

$164.85

Service Code	HCPCS 86039
Hospital Charge Code	3031101
Hospital Revenue Code	302
Min. Negotiated Rate	$4.37
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$30.36
Rate for Payer: Aetna Medicare Advantage	$36.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.28
Rate for Payer: Cigna Commercial	$82.42
Rate for Payer: Cigna Medicare Advantage	$11.16
Rate for Payer: Clover Medicare Advantage	$10.60
Rate for Payer: EmblemHealth Commercial	$33.48
Rate for Payer: Humana Medicare Advantage	$11.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.73
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.16
Rate for Payer: Wellcare Medicare Advantage	$11.16
Rate for Payer: Wellpoint Medicaid Managed Care	$4.37

ANTI NUCLEAR AB (ANA) TITER

Facility

$164.85

Service Code	HCPCS 86039
Hospital Charge Code	3031101
Hospital Revenue Code	302
Min. Negotiated Rate	$24.73
Max. Negotiated Rate	$24.73
Rate for Payer: Qualcare PPO/HMO/WC	$24.73

ANTINUCLEAR ANTI (ANA)***

Facility

$53.00

Hospital Charge Code	3010329
Hospital Revenue Code	309
Min. Negotiated Rate	$1.28
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$20.14
Rate for Payer: Aetna Medicare Advantage	$15.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.52
Rate for Payer: Cigna Commercial	$26.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.28
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

Know your out-of-pocket cost for care.

All Charges