Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

IR PULMONARY ARTERY CATH SEL

Facility

IP

$414.45

Service Code	HCPCS 36014
Hospital Charge Code	366836014
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR PULMONARY ARTERY CATH SEL

Facility

IP

$414.00

Service Code	HCPCS 36014
Hospital Charge Code	321036014
Hospital Revenue Code	361
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$62.10
Rate for Payer: Qualcare PPO/HMO/WC	$62.10

IR PULMONARY ARTERY CATH SEL

Facility

IP

$414.00

Service Code	HCPCS 36014
Hospital Charge Code	2004497
Hospital Revenue Code	361
Min. Negotiated Rate	$62.10
Max. Negotiated Rate	$62.10
Rate for Payer: Qualcare PPO/HMO/WC	$62.10

IR PULMONARY ARTERY SEGMENTSEL

Facility

OP

$414.45

Service Code	HCPCS 36015
Hospital Charge Code	7411419
Hospital Revenue Code	361
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

IR PULMONARY ARTERY SEGMENTSEL

Facility

IP

$414.45

Service Code	HCPCS 36015
Hospital Charge Code	2004513
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR PULMONARY ARTERY SEGMENTSEL

Facility

OP

$414.45

Service Code	HCPCS 36015
Hospital Charge Code	2004513
Hospital Revenue Code	361
Min. Negotiated Rate	$9.99
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$157.49
Rate for Payer: Aetna Medicare Advantage	$124.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.68
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	$105.68
Rate for Payer: Cigna Commercial	$207.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$124.33
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.17
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$9.99
Rate for Payer: Wellpoint Medicaid Managed Care	$10.98

IR PULMONARY ARTERY SEGMENTSEL

Facility

IP

$414.45

Service Code	HCPCS 36015
Hospital Charge Code	7411419
Hospital Revenue Code	361
Min. Negotiated Rate	$62.17
Max. Negotiated Rate	$62.17
Rate for Payer: Qualcare PPO/HMO/WC	$62.17

IR PUNCT ASP ABSCES/HEM/BULLA/

Facility

OP

$1,839.20

Service Code	HCPCS 10160
Hospital Charge Code	321010160
Hospital Revenue Code	361
Min. Negotiated Rate	$44.32
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$551.76
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.88
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$44.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,037.98

IR PUNCT ASP ABSCES/HEM/BULLA/

Facility

IP

$1,839.20

Service Code	HCPCS 10160
Hospital Charge Code	2670055
Hospital Revenue Code	361
Min. Negotiated Rate	$275.88
Max. Negotiated Rate	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$275.88

IR PUNCT ASP ABSCES/HEM/BULLA/

Facility

OP

$1,141.35

Service Code	HCPCS 10160
Hospital Charge Code	7411336
Hospital Revenue Code	361
Min. Negotiated Rate	$27.51
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$342.40
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$171.20
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$27.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,037.98

IR PUNCT ASP ABSCES/HEM/BULLA/

Facility

IP

$1,839.20

Service Code	HCPCS 10160
Hospital Charge Code	321010160
Hospital Revenue Code	361
Min. Negotiated Rate	$275.88
Max. Negotiated Rate	$275.88
Rate for Payer: Qualcare PPO/HMO/WC	$275.88

IR PUNCT ASP ABSCES/HEM/BULLA/

Facility

IP

$1,141.35

Service Code	HCPCS 10160
Hospital Charge Code	7411336
Hospital Revenue Code	361
Min. Negotiated Rate	$171.20
Max. Negotiated Rate	$171.20
Rate for Payer: Qualcare PPO/HMO/WC	$171.20

IR PUNCT ASP ABSCES/HEM/BULLA/

Facility

OP

$1,839.20

Service Code	HCPCS 10160
Hospital Charge Code	2670055
Hospital Revenue Code	361
Min. Negotiated Rate	$44.32
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
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	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$551.76
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.88
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$44.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$1,058.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1,037.98

IR-PUNCTURE CLEAR LUNG-LT

Facility

OP

$834.00

Hospital Charge Code	2691030
Hospital Revenue Code	761
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$417.00
Rate for Payer: Aetna Commercial	$316.92
Rate for Payer: Aetna Medicare Advantage	$250.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$212.67
Rate for Payer: Cigna Commercial	$417.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.20
Rate for Payer: Oxford Commercial	$166.80
Rate for Payer: Qualcare PPO/HMO/WC	$125.10
Rate for Payer: UnitedHealthcare Commercial	$166.80
Rate for Payer: UnitedHealthcare Community & State	$20.10
Rate for Payer: Wellpoint Medicaid Managed Care	$22.10

IR-PUNCTURE CLEAR LUNG-LT

Facility

IP

$834.00

Hospital Charge Code	2691030
Hospital Revenue Code	761
Min. Negotiated Rate	$125.10
Max. Negotiated Rate	$125.10
Rate for Payer: Qualcare PPO/HMO/WC	$125.10

IR-PUNCTURE CLEAR LUNG-RT

Facility

IP

$834.00

Hospital Charge Code	2691035
Hospital Revenue Code	361
Min. Negotiated Rate	$125.10
Max. Negotiated Rate	$125.10
Rate for Payer: Qualcare PPO/HMO/WC	$125.10

IR-PUNCTURE CLEAR LUNG-RT

Facility

OP

$834.00

Hospital Charge Code	2691035
Hospital Revenue Code	361
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$316.92
Rate for Payer: Aetna Medicare Advantage	$250.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$212.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$212.67
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	$212.67
Rate for Payer: Cigna Commercial	$417.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$250.20
Rate for Payer: Qualcare PPO/HMO/WC	$125.10
Rate for Payer: UnitedHealthcare Community & State	$20.10
Rate for Payer: Wellpoint Medicaid Managed Care	$22.10

IR RAD EX ABCESS, FIST OR SINU

Facility

OP

$724.85

Service Code	HCPCS 76080
Hospital Charge Code	2002330
Hospital Revenue Code	320
Min. Negotiated Rate	$17.47
Max. Negotiated Rate	$2,343.27
Rate for Payer: Aetna Commercial	$1,765.72
Rate for Payer: Aetna Medicare Advantage	$2,103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,343.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$649.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,343.27
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: Cigna Medicare Advantage	$454.41
Rate for Payer: Clover Medicare Advantage	$616.70
Rate for Payer: EmblemHealth Commercial	$1,947.48
Rate for Payer: Humana Medicare Advantage	$668.63
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$649.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.46
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.73
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$17.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$649.16
Rate for Payer: Wellcare Medicare Advantage	$649.16
Rate for Payer: Wellpoint Medicaid Managed Care	$19.21

IR RAD EX ABCESS, FIST OR SINU

Facility

IP

$724.85

Service Code	HCPCS 76080
Hospital Charge Code	2002330
Hospital Revenue Code	320
Min. Negotiated Rate	$108.73
Max. Negotiated Rate	$108.73
Rate for Payer: Qualcare PPO/HMO/WC	$108.73

IRRADIATED LEUKO REDUCED PLTPH

Facility

OP

$1,358.79

Hospital Charge Code	3100130
Hospital Revenue Code	390
Min. Negotiated Rate	$32.75
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$516.34
Rate for Payer: Aetna Medicare Advantage	$407.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$346.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$346.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$346.49
Rate for Payer: Cigna Commercial	$679.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$407.64
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$203.82
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$32.75
Rate for Payer: Wellpoint Medicaid Managed Care	$36.01

IRRADIATED LEUKO REDUCED PLTPH

Facility

IP

$1,358.79

Hospital Charge Code	3100130
Hospital Revenue Code	390
Min. Negotiated Rate	$203.82
Max. Negotiated Rate	$203.82
Rate for Payer: Qualcare PPO/HMO/WC	$203.82

IRRADIATION OF BLD OR BLD PROD

Facility

OP

$182.00

Service Code	HCPCS 86945
Hospital Charge Code	38471079
Hospital Revenue Code	302
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$160.16
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.16
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.82

IRRADIATION OF BLD OR BLD PROD

Facility

IP

$182.00

Service Code	HCPCS 86945
Hospital Charge Code	38471079
Hospital Revenue Code	302
Min. Negotiated Rate	$27.30
Max. Negotiated Rate	$27.30
Rate for Payer: Qualcare PPO/HMO/WC	$27.30

IRRADIATION PROC/BLD PROD

Facility

OP

$96.85

Service Code	HCPCS 86945
Hospital Charge Code	3100229
Hospital Revenue Code	302
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$160.16
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.16
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.57

IRRADIATION PROC/BLD PROD

Facility

IP

$96.85

Service Code	HCPCS 86945
Hospital Charge Code	3100229
Hospital Revenue Code	302
Min. Negotiated Rate	$14.53
Max. Negotiated Rate	$14.53
Rate for Payer: Qualcare PPO/HMO/WC	$14.53