Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

AORTIC BODY 29MM ALTON

Facility

$69,995.00

Service Code	HCPCS C1768
Hospital Charge Code	270692801
Hospital Revenue Code	278
Min. Negotiated Rate	$10,499.25
Max. Negotiated Rate	$16,938.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,999.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,938.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15,398.90
Rate for Payer: Qualcare PPO/HMO/WC	$10,499.25

AORTIC BODY 29MM ALTON

Facility

$69,995.00

Service Code	HCPCS C1768
Hospital Charge Code	270692801
Hospital Revenue Code	278
Min. Negotiated Rate	$1,686.88
Max. Negotiated Rate	$34,997.50
Rate for Payer: Aetna Commercial	$26,598.10
Rate for Payer: Aetna Medicare Advantage	$20,998.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17,848.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17,848.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13,999.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17,848.72
Rate for Payer: Cigna Commercial	$34,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,938.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$15,398.90
Rate for Payer: Qualcare PPO/HMO/WC	$10,499.25
Rate for Payer: UnitedHealthcare Community & State	$1,686.88
Rate for Payer: Wellpoint Medicaid Managed Care	$1,854.87

AORTIC-THORACIC FLOURO

Facility

$3,032.40

Service Code	HCPCS 76000
Hospital Charge Code	7411165
Hospital Revenue Code	320
Min. Negotiated Rate	$454.86
Max. Negotiated Rate	$454.86
Rate for Payer: Qualcare PPO/HMO/WC	$454.86

AORTIC-THORACIC FLOURO

Facility

$3,032.40

Service Code	HCPCS 76000
Hospital Charge Code	7411165
Hospital Revenue Code	320
Min. Negotiated Rate	$73.08
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$198.43
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$909.72
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$454.86
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$73.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$80.36

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	5100490
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

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	5100490
Hospital Revenue Code	323
Min. Negotiated Rate	$292.72
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	$292.72
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

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	366875625
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

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	366875625
Hospital Revenue Code	323
Min. Negotiated Rate	$292.72
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	$292.72
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

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	74110052
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

AORTOGRAM ABD S&I

Facility

$21,359.77

Service Code	HCPCS 75625
Hospital Charge Code	74110052
Hospital Revenue Code	323
Min. Negotiated Rate	$292.72
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	$292.72
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

AORTOGRAM INJ

Facility

$256.00

Service Code	HCPCS 93567
Hospital Charge Code	5100052
Hospital Revenue Code	481
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

AORTOGRAM INJ

Facility

$256.00

Service Code	HCPCS 93567
Hospital Charge Code	5100052
Hospital Revenue Code	481
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$97.28
Rate for Payer: Aetna Medicare Advantage	$76.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.28
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$6.17
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

AORTOGRAM INJ

Facility

$256.00

Service Code	HCPCS 93567
Hospital Charge Code	74110011
Hospital Revenue Code	481
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$97.28
Rate for Payer: Aetna Medicare Advantage	$76.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.28
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$6.17
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

AORTOGRAM INJ

Facility

$256.00

Service Code	HCPCS 93567
Hospital Charge Code	74110011
Hospital Revenue Code	481
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

AORTOGRAPHY ABD AND BI LE S&I

Facility

$7,240.05

Service Code	HCPCS 75630
Hospital Charge Code	5100300
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

AORTOGRAPHY ABD AND BI LE S&I

Facility

$7,240.05

Service Code	HCPCS 75630
Hospital Charge Code	74110035
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

AORTOGRAPHY ABD AND BI LE S&I

Facility

$7,240.05

Service Code	HCPCS 75630
Hospital Charge Code	74110035
Hospital Revenue Code	323
Min. Negotiated Rate	$169.40
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	$169.40
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

AORTOGRAPHY ABD AND BI LE S&I

Facility

$7,240.05

Service Code	HCPCS 75630
Hospital Charge Code	5100300
Hospital Revenue Code	323
Min. Negotiated Rate	$169.40
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	$169.40
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

APACHE 7MM LORDOTIC CAGE

Facility

$7,000.00

Hospital Charge Code	270667748
Hospital Revenue Code	278
Min. Negotiated Rate	$1,050.00
Max. Negotiated Rate	$1,694.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00

APACHE 7MM LORDOTIC CAGE

Facility

$7,000.00

Hospital Charge Code	270667748
Hospital Revenue Code	278
Min. Negotiated Rate	$168.70
Max. Negotiated Rate	$3,500.00
Rate for Payer: Aetna Commercial	$2,660.00
Rate for Payer: Aetna Medicare Advantage	$2,100.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,785.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,785.00
Rate for Payer: Cigna Commercial	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,694.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,540.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,050.00
Rate for Payer: UnitedHealthcare Community & State	$168.70
Rate for Payer: Wellpoint Medicaid Managed Care	$185.50

APAPBUTALBITALCAFF325-50-40 PO

Facility

$10.72

Service Code	NDC 527169505
Hospital Charge Code	60627731
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$5.36
Rate for Payer: Aetna Commercial	$4.07
Rate for Payer: Aetna Medicare Advantage	$3.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.73
Rate for Payer: Cigna Commercial	$5.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.22
Rate for Payer: Oxford Commercial	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$1.61
Rate for Payer: UnitedHealthcare Commercial	$2.14
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

APAPBUTALBITALCAFF325-50-40 PO

Facility

$10.72

Service Code	NDC 527169505
Hospital Charge Code	60627731
Hospital Revenue Code	250
Min. Negotiated Rate	$1.61
Max. Negotiated Rate	$1.61
Rate for Payer: Qualcare PPO/HMO/WC	$1.61

APC ACTIV PROTEIN C RESISTANCE

Facility

$390.00

Service Code	HCPCS 85307
Hospital Charge Code	38478076
Hospital Revenue Code	305
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$41.67
Rate for Payer: Aetna Medicare Advantage	$49.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$55.30
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.32
Rate for Payer: Clover Medicare Advantage	$14.55
Rate for Payer: EmblemHealth Commercial	$45.96
Rate for Payer: Humana Medicare Advantage	$15.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.32
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	$12.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.32
Rate for Payer: Wellcare Medicare Advantage	$15.32
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

APC ACTIV PROTEIN C RESISTANCE

Facility

$390.00

Service Code	HCPCS 85307
Hospital Charge Code	38478076
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

APEX DBM FIBER PUTTY

Facility

$7,250.00

Hospital Charge Code	270702104
Hospital Revenue Code	278
Min. Negotiated Rate	$174.72
Max. Negotiated Rate	$3,625.00
Rate for Payer: Aetna Commercial	$2,755.00
Rate for Payer: Aetna Medicare Advantage	$2,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,848.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,848.75
Rate for Payer: Cigna Commercial	$3,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,754.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,595.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,087.50
Rate for Payer: UnitedHealthcare Community & State	$174.72
Rate for Payer: Wellpoint Medicaid Managed Care	$192.12

Know your out-of-pocket cost for care.

All Charges