Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

IR XPOSE FOR ENDOPROSTH FEM

Facility

IP

$1,600.00

Service Code	HCPCS 34812
Hospital Charge Code	7411398
Hospital Revenue Code	361
Min. Negotiated Rate	$240.00
Max. Negotiated Rate	$240.00
Rate for Payer: Qualcare PPO/HMO/WC	$240.00

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

OP

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	7411786
Hospital Revenue Code	361
Min. Negotiated Rate	$77.12
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,216.00
Rate for Payer: Aetna Medicare Advantage	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$816.00
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	$816.00
Rate for Payer: Cigna Commercial	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$960.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00
Rate for Payer: UnitedHealthcare Community & State	$77.12
Rate for Payer: Wellpoint Medicaid Managed Care	$84.80

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

IP

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	2011289
Hospital Revenue Code	361
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$480.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

OP

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	321034812B
Hospital Revenue Code	361
Min. Negotiated Rate	$77.12
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,216.00
Rate for Payer: Aetna Medicare Advantage	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$816.00
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	$816.00
Rate for Payer: Cigna Commercial	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$960.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00
Rate for Payer: UnitedHealthcare Community & State	$77.12
Rate for Payer: Wellpoint Medicaid Managed Care	$84.80

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

IP

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	321034812B
Hospital Revenue Code	361
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$480.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

IP

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	7411786
Hospital Revenue Code	361
Min. Negotiated Rate	$480.00
Max. Negotiated Rate	$480.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00

IR XPOSE FOR ENDOPROSTH FEM BI

Facility

OP

$3,200.00

Service Code	HCPCS 3481250
Hospital Charge Code	2011289
Hospital Revenue Code	361
Min. Negotiated Rate	$77.12
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,216.00
Rate for Payer: Aetna Medicare Advantage	$960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$816.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$816.00
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	$816.00
Rate for Payer: Cigna Commercial	$1,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$960.00
Rate for Payer: Qualcare PPO/HMO/WC	$480.00
Rate for Payer: UnitedHealthcare Community & State	$77.12
Rate for Payer: Wellpoint Medicaid Managed Care	$84.80

IR XPOSE FOR ENDOPROSTH ILIAC

Facility

IP

$21,560.00

Service Code	HCPCS 34820
Hospital Charge Code	5700213
Hospital Revenue Code	361
Min. Negotiated Rate	$3,234.00
Max. Negotiated Rate	$3,234.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,234.00

IR XPOSE FOR ENDOPROSTH ILIAC

Facility

OP

$21,560.00

Service Code	HCPCS 34820
Hospital Charge Code	5700213
Hospital Revenue Code	361
Min. Negotiated Rate	$519.60
Max. Negotiated Rate	$10,780.00
Rate for Payer: Aetna Commercial	$8,192.80
Rate for Payer: Aetna Medicare Advantage	$6,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,497.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,497.80
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	$5,497.80
Rate for Payer: Cigna Commercial	$10,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,468.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,234.00
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$519.60
Rate for Payer: Wellpoint Medicaid Managed Care	$571.34

IR XPOSE FOR ENDOPROSTH ILIAC

Facility

OP

$21,560.00

Service Code	HCPCS 34820
Hospital Charge Code	7411399
Hospital Revenue Code	361
Min. Negotiated Rate	$519.60
Max. Negotiated Rate	$10,780.00
Rate for Payer: Aetna Commercial	$8,192.80
Rate for Payer: Aetna Medicare Advantage	$6,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,497.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,497.80
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	$5,497.80
Rate for Payer: Cigna Commercial	$10,780.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,468.00
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,234.00
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$519.60
Rate for Payer: Wellpoint Medicaid Managed Care	$571.34

IR XPOSE FOR ENDOPROSTH ILIAC

Facility

IP

$21,560.00

Service Code	HCPCS 34820
Hospital Charge Code	7411399
Hospital Revenue Code	361
Min. Negotiated Rate	$3,234.00
Max. Negotiated Rate	$3,234.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,234.00

ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC

Facility

IP

$58,929.66

Service Code	MSDRG 062
Min. Negotiated Rate	$17,943.32
Max. Negotiated Rate	$58,929.66
Rate for Payer: Aetna Medicare Advantage	$58,929.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43,498.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43,498.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,887.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43,498.07
Rate for Payer: Cigna Commercial	$32,884.24
Rate for Payer: Cigna Medicare Advantage	$18,887.71
Rate for Payer: Clover Medicare Advantage	$17,943.32
Rate for Payer: EmblemHealth Commercial	$56,663.13
Rate for Payer: Humana Medicare Advantage	$19,454.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,887.71
Rate for Payer: Oxford Commercial	$23,634.34
Rate for Payer: UnitedHealthcare Commercial	$41,443.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,887.71
Rate for Payer: Wellcare Medicare Advantage	$18,887.71

ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC

Facility

IP

$91,248.11

Service Code	MSDRG 061
Min. Negotiated Rate	$27,783.88
Max. Negotiated Rate	$91,248.11
Rate for Payer: Aetna Medicare Advantage	$91,248.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65,130.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65,130.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29,246.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65,130.80
Rate for Payer: Cigna Commercial	$51,596.37
Rate for Payer: Cigna Medicare Advantage	$29,246.19
Rate for Payer: Clover Medicare Advantage	$27,783.88
Rate for Payer: EmblemHealth Commercial	$87,738.57
Rate for Payer: Humana Medicare Advantage	$30,123.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29,246.19
Rate for Payer: Oxford Commercial	$37,083.00
Rate for Payer: UnitedHealthcare Commercial	$65,026.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$29,246.19
Rate for Payer: Wellcare Medicare Advantage	$29,246.19

ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC

Facility

IP

$47,507.24

Service Code	MSDRG 063
Min. Negotiated Rate	$14,465.35
Max. Negotiated Rate	$47,507.24
Rate for Payer: Aetna Medicare Advantage	$47,507.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,658.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,658.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,226.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,658.89
Rate for Payer: Cigna Commercial	$26,270.71
Rate for Payer: Cigna Medicare Advantage	$15,226.68
Rate for Payer: Clover Medicare Advantage	$14,465.35
Rate for Payer: EmblemHealth Commercial	$45,680.04
Rate for Payer: Humana Medicare Advantage	$15,683.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,226.68
Rate for Payer: Oxford Commercial	$18,881.11
Rate for Payer: UnitedHealthcare Commercial	$33,108.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,226.68
Rate for Payer: Wellcare Medicare Advantage	$15,226.68

IS CROSSMATCH

Facility

IP

$652.55

Service Code	HCPCS 86920
Hospital Charge Code	3100625
Hospital Revenue Code	300
Min. Negotiated Rate	$97.88
Max. Negotiated Rate	$97.88
Rate for Payer: Qualcare PPO/HMO/WC	$97.88

IS CROSSMATCH

Facility

OP

$652.55

Service Code	HCPCS 86920
Hospital Charge Code	3100625
Hospital Revenue Code	300
Min. Negotiated Rate	$12.00
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.88
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$17.29

ISLET CELL AB SCRN W/REFL

Facility

IP

$390.00

Service Code	HCPCS 86341
Hospital Charge Code	39900369
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ISLET CELL AB SCRN W/REFL

Facility

OP

$390.00

Service Code	HCPCS 86341
Hospital Charge Code	39900369
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$64.11
Rate for Payer: Aetna Medicare Advantage	$76.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.57
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	$85.08
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$23.57
Rate for Payer: Clover Medicare Advantage	$22.39
Rate for Payer: EmblemHealth Commercial	$70.71
Rate for Payer: Humana Medicare Advantage	$24.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23.57
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	$18.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.57
Rate for Payer: Wellcare Medicare Advantage	$23.57
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ISLET CELL ANTIBODY

Facility

OP

$224.00

Service Code	HCPCS 86341
Hospital Charge Code	38476220
Hospital Revenue Code	302
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$64.11
Rate for Payer: Aetna Medicare Advantage	$76.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.57
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	$85.08
Rate for Payer: Cigna Commercial	$112.00
Rate for Payer: Cigna Medicare Advantage	$23.57
Rate for Payer: Clover Medicare Advantage	$22.39
Rate for Payer: EmblemHealth Commercial	$70.71
Rate for Payer: Humana Medicare Advantage	$24.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.57
Rate for Payer: Wellcare Medicare Advantage	$23.57
Rate for Payer: Wellpoint Medicaid Managed Care	$5.94

ISLET CELL ANTIBODY

Facility

IP

$224.00

Service Code	HCPCS 86341
Hospital Charge Code	38476220
Hospital Revenue Code	302
Min. Negotiated Rate	$33.60
Max. Negotiated Rate	$33.60
Rate for Payer: Qualcare PPO/HMO/WC	$33.60

ISLET CELL ANTIBODY***

Facility

OP

$138.00

Hospital Charge Code	3010568
Hospital Revenue Code	301
Min. Negotiated Rate	$3.33
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$52.44
Rate for Payer: Aetna Medicare Advantage	$41.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.19
Rate for Payer: Cigna Commercial	$69.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.33
Rate for Payer: Wellpoint Medicaid Managed Care	$3.66

ISLET CELL ANTIBODY***

Facility

IP

$138.00

Hospital Charge Code	3010568
Hospital Revenue Code	301
Min. Negotiated Rate	$20.70
Max. Negotiated Rate	$20.70
Rate for Payer: Qualcare PPO/HMO/WC	$20.70

ISMOTIC

Facility

IP

$114.00

Hospital Charge Code	60635138
Hospital Revenue Code	250
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

ISMOTIC

Facility

OP

$114.00

Hospital Charge Code	60635138
Hospital Revenue Code	250
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$57.00
Rate for Payer: Aetna Commercial	$43.32
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.07
Rate for Payer: Cigna Commercial	$57.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.20
Rate for Payer: Oxford Commercial	$22.80
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Commercial	$22.80
Rate for Payer: UnitedHealthcare Community & State	$2.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

I SNARE SYSTEM 25G 5MM

Facility

IP

$425.00

Hospital Charge Code	270680913
Hospital Revenue Code	272
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75