Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

LAPARO ABLATE LIVER TUMOR RF

Facility

$61,304.40

Service Code	HCPCS 47370
Hospital Charge Code	1600000339
Hospital Revenue Code	360
Min. Negotiated Rate	$9,195.66
Max. Negotiated Rate	$9,195.66
Rate for Payer: Qualcare PPO/HMO/WC	$9,195.66

LAPARO RADICAL PROSTATECTOMY

Facility

$39,439.32

Service Code	HCPCS 55866
Hospital Charge Code	160000214
Hospital Revenue Code	360
Min. Negotiated Rate	$5,915.90
Max. Negotiated Rate	$5,915.90
Rate for Payer: Qualcare PPO/HMO/WC	$5,915.90

LAPARO RADICAL PROSTATECTOMY

Facility

$39,439.32

Service Code	HCPCS 55866
Hospital Charge Code	160000214
Hospital Revenue Code	360
Min. Negotiated Rate	$950.49
Max. Negotiated Rate	$45,585.17
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
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	$45,585.17
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,831.80
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,915.90
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$950.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1,045.14

LAPAROS,CHOLECYSTONTERSTMY

Facility

$8,594.70

Service Code	HCPCS 47570
Hospital Charge Code	1600000525
Hospital Revenue Code	360
Min. Negotiated Rate	$1,289.20
Max. Negotiated Rate	$1,289.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,289.20

LAPAROS,CHOLECYSTONTERSTMY

Facility

$8,594.70

Service Code	HCPCS 47570
Hospital Charge Code	1600000525
Hospital Revenue Code	360
Min. Negotiated Rate	$207.13
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$3,265.99
Rate for Payer: Aetna Medicare Advantage	$2,578.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,191.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,191.65
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	$2,191.65
Rate for Payer: Cigna Commercial	$4,297.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,578.41
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,289.20
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$207.13
Rate for Payer: Wellpoint Medicaid Managed Care	$227.76

LAPAROSCOPE PROCEDURE LIVER

Facility

$33,033.35

Service Code	HCPCS 47379
Hospital Charge Code	1600000403
Hospital Revenue Code	360
Min. Negotiated Rate	$4,955.00
Max. Negotiated Rate	$4,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,955.00

LAPAROSCOPE PROCEDURE LIVER

Facility

$33,033.35

Service Code	HCPCS 47379
Hospital Charge Code	1600000403
Hospital Revenue Code	360
Min. Negotiated Rate	$796.10
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,910.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,955.00
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$796.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$875.38

LAPAROSCOPE PROC INTESTINE

Facility

$22,659.64

Service Code	HCPCS 44238
Hospital Charge Code	16000974
Hospital Revenue Code	360
Min. Negotiated Rate	$546.10
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,797.89
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,398.95
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$546.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$600.48

LAPAROSCOPE PROC INTESTINE

Facility

$22,659.64

Service Code	HCPCS 44238
Hospital Charge Code	16000974
Hospital Revenue Code	360
Min. Negotiated Rate	$3,398.95
Max. Negotiated Rate	$3,398.95
Rate for Payer: Qualcare PPO/HMO/WC	$3,398.95

LAPAROSCOPE PROC RECTUM

Facility

$25,012.88

Service Code	HCPCS 45499
Hospital Charge Code	1600000554
Hospital Revenue Code	360
Min. Negotiated Rate	$602.81
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,503.86
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,751.93
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$602.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$662.84

LAPAROSCOPE PROC RECTUM

Facility

$25,012.88

Service Code	HCPCS 45499
Hospital Charge Code	1600000554
Hospital Revenue Code	360
Min. Negotiated Rate	$3,751.93
Max. Negotiated Rate	$3,751.93
Rate for Payer: Qualcare PPO/HMO/WC	$3,751.93

LAPAROSCOPIC ADJ GASTRIC BAND

Facility

$53,712.80

Service Code	HCPCS 43770
Hospital Charge Code	1600163
Hospital Revenue Code	361
Min. Negotiated Rate	$1,294.48
Max. Negotiated Rate	$45,585.17
Rate for Payer: Aetna Commercial	$34,349.57
Rate for Payer: Aetna Medicare Advantage	$40,916.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45,585.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,628.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12,971.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45,585.17
Rate for Payer: Cigna Commercial	$25,313.84
Rate for Payer: Cigna Medicare Advantage	$12,628.52
Rate for Payer: Clover Medicare Advantage	$11,997.09
Rate for Payer: EmblemHealth Commercial	$37,885.56
Rate for Payer: Humana Medicare Advantage	$13,007.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,628.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,113.84
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,056.92
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,294.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,628.52
Rate for Payer: Wellcare Medicare Advantage	$12,628.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1,423.39

LAPAROSCOPIC ADJ GASTRIC BAND

Facility

$53,712.80

Service Code	HCPCS 43770
Hospital Charge Code	1600163
Hospital Revenue Code	361
Min. Negotiated Rate	$8,056.92
Max. Negotiated Rate	$8,056.92
Rate for Payer: Qualcare PPO/HMO/WC	$8,056.92

LAPAROSCOPIC CHOLANG CATH

Facility

$437.00

Hospital Charge Code	270332580
Hospital Revenue Code	272
Min. Negotiated Rate	$65.55
Max. Negotiated Rate	$65.55
Rate for Payer: Qualcare PPO/HMO/WC	$65.55

LAPAROSCOPIC CHOLANG CATH

Facility

$437.00

Hospital Charge Code	270332580
Hospital Revenue Code	272
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$218.50
Rate for Payer: Aetna Commercial	$166.06
Rate for Payer: Aetna Medicare Advantage	$131.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$111.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$111.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$111.44
Rate for Payer: Cigna Commercial	$218.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.10
Rate for Payer: Oxford Commercial	$87.40
Rate for Payer: Qualcare PPO/HMO/WC	$65.55
Rate for Payer: UnitedHealthcare Commercial	$87.40
Rate for Payer: UnitedHealthcare Community & State	$10.53
Rate for Payer: Wellpoint Medicaid Managed Care	$11.58

LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC

Facility

$56,809.37

Service Code	MSDRG 418
Min. Negotiated Rate	$17,297.72
Max. Negotiated Rate	$56,809.37
Rate for Payer: Aetna Commercial	$39,291.84
Rate for Payer: Aetna Medicare Advantage	$56,809.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37,915.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37,915.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,208.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37,915.43
Rate for Payer: Cigna Commercial	$31,656.60
Rate for Payer: Cigna Medicare Advantage	$18,208.13
Rate for Payer: Clover Medicare Advantage	$17,297.72
Rate for Payer: EmblemHealth Commercial	$54,624.39
Rate for Payer: Humana Medicare Advantage	$18,754.37
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,208.13
Rate for Payer: Oxford Commercial	$22,752.02
Rate for Payer: UnitedHealthcare Commercial	$39,896.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,208.13
Rate for Payer: Wellcare Medicare Advantage	$18,208.13

LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC

Facility

$79,266.47

Service Code	MSDRG 417
Min. Negotiated Rate	$24,135.62
Max. Negotiated Rate	$79,266.47
Rate for Payer: Aetna Commercial	$54,722.43
Rate for Payer: Aetna Medicare Advantage	$79,266.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53,965.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53,965.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,405.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53,965.52
Rate for Payer: Cigna Commercial	$44,659.09
Rate for Payer: Cigna Medicare Advantage	$25,405.92
Rate for Payer: Clover Medicare Advantage	$24,135.62
Rate for Payer: EmblemHealth Commercial	$76,217.76
Rate for Payer: Humana Medicare Advantage	$26,168.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,405.92
Rate for Payer: Oxford Commercial	$32,097.08
Rate for Payer: UnitedHealthcare Commercial	$56,283.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,405.92
Rate for Payer: Wellcare Medicare Advantage	$25,405.92

LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC

Facility

$46,278.99

Service Code	MSDRG 419
Min. Negotiated Rate	$14,091.36
Max. Negotiated Rate	$46,278.99
Rate for Payer: Aetna Commercial	$32,056.26
Rate for Payer: Aetna Medicare Advantage	$46,278.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,471.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,471.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,833.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,471.91
Rate for Payer: Cigna Commercial	$25,559.58
Rate for Payer: Cigna Medicare Advantage	$14,833.01
Rate for Payer: Clover Medicare Advantage	$14,091.36
Rate for Payer: EmblemHealth Commercial	$44,499.03
Rate for Payer: Humana Medicare Advantage	$15,278.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,833.01
Rate for Payer: Oxford Commercial	$18,370.01
Rate for Payer: UnitedHealthcare Commercial	$32,212.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,833.01
Rate for Payer: Wellcare Medicare Advantage	$14,833.01

LAPAROSCOPIC ELECTRODE

Facility

$874.00

Hospital Charge Code	270332563
Hospital Revenue Code	272
Min. Negotiated Rate	$131.10
Max. Negotiated Rate	$131.10
Rate for Payer: Qualcare PPO/HMO/WC	$131.10

LAPAROSCOPIC ELECTRODE

Facility

$874.00

Hospital Charge Code	270332563
Hospital Revenue Code	272
Min. Negotiated Rate	$21.06
Max. Negotiated Rate	$437.00
Rate for Payer: Aetna Commercial	$332.12
Rate for Payer: Aetna Medicare Advantage	$262.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$222.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$222.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$222.87
Rate for Payer: Cigna Commercial	$437.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$262.20
Rate for Payer: Oxford Commercial	$174.80
Rate for Payer: Qualcare PPO/HMO/WC	$131.10
Rate for Payer: UnitedHealthcare Commercial	$174.80
Rate for Payer: UnitedHealthcare Community & State	$21.06
Rate for Payer: Wellpoint Medicaid Managed Care	$23.16

LAPAROSCOPIC GASTRIC BANDING

Facility

$37,500.00

Hospital Charge Code	1600160
Hospital Revenue Code	360
Min. Negotiated Rate	$903.75
Max. Negotiated Rate	$18,750.00
Rate for Payer: Aetna Commercial	$14,250.00
Rate for Payer: Aetna Medicare Advantage	$11,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,562.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,562.50
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	$9,562.50
Rate for Payer: Cigna Commercial	$18,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,250.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00
Rate for Payer: UnitedHealthcare Community & State	$903.75
Rate for Payer: Wellpoint Medicaid Managed Care	$993.75

LAPAROSCOPIC GASTRIC BANDING

Facility

$37,500.00

Hospital Charge Code	1600160
Hospital Revenue Code	360
Min. Negotiated Rate	$5,625.00
Max. Negotiated Rate	$5,625.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,625.00

LAPAROSCOPIC PROC

Facility

$5,638.40

Service Code	HCPCS 45400
Hospital Charge Code	1600000551
Hospital Revenue Code	360
Min. Negotiated Rate	$135.89
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$2,142.59
Rate for Payer: Aetna Medicare Advantage	$1,691.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,437.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,437.79
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	$1,437.79
Rate for Payer: Cigna Commercial	$2,819.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,691.52
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$845.76
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$135.89
Rate for Payer: Wellpoint Medicaid Managed Care	$149.42

LAPAROSCOPIC PROC

Facility

$5,638.40

Service Code	HCPCS 45400
Hospital Charge Code	1600000551
Hospital Revenue Code	360
Min. Negotiated Rate	$845.76
Max. Negotiated Rate	$845.76
Rate for Payer: Qualcare PPO/HMO/WC	$845.76

LAPAROSCOPIC TUBING

Facility

$65.41

Hospital Charge Code	270664808
Hospital Revenue Code	270
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.70
Rate for Payer: Aetna Commercial	$24.86
Rate for Payer: Aetna Medicare Advantage	$19.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.68
Rate for Payer: Cigna Commercial	$32.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.62
Rate for Payer: Oxford Commercial	$13.08
Rate for Payer: Qualcare PPO/HMO/WC	$9.81
Rate for Payer: UnitedHealthcare Commercial	$13.08
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.73

Know your out-of-pocket cost for care.

All Charges