Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

MICONAZOLE VAG SUPP 100MG

Facility

$19.85

Hospital Charge Code	6008957
Hospital Revenue Code	251
Min. Negotiated Rate	$2.98
Max. Negotiated Rate	$2.98
Rate for Payer: Qualcare PPO/HMO/WC	$2.98

MIC PLUS STREP PANEL

Facility

$66.25

Service Code	HCPCS 87184
Hospital Charge Code	3008747
Hospital Revenue Code	309
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$20.35
Rate for Payer: Aetna Medicare Advantage	$24.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.48
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	$27.00
Rate for Payer: Cigna Commercial	$33.12
Rate for Payer: Cigna Medicare Advantage	$7.48
Rate for Payer: Clover Medicare Advantage	$7.11
Rate for Payer: EmblemHealth Commercial	$22.44
Rate for Payer: Humana Medicare Advantage	$7.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.88
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.94
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.48
Rate for Payer: Wellcare Medicare Advantage	$7.48
Rate for Payer: Wellpoint Medicaid Managed Care	$1.76

MIC PLUS STREP PANEL

Facility

$66.25

Service Code	HCPCS 87184
Hospital Charge Code	3008747
Hospital Revenue Code	309
Min. Negotiated Rate	$9.94
Max. Negotiated Rate	$9.94
Rate for Payer: Qualcare PPO/HMO/WC	$9.94

MICR INTROD KIT 5FR UNIV SAFTY

Facility

$220.00

Hospital Charge Code	270649243
Hospital Revenue Code	272
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$33.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00

MICR INTROD KIT 5FR UNIV SAFTY

Facility

$220.00

Hospital Charge Code	270649243
Hospital Revenue Code	272
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$110.00
Rate for Payer: Aetna Commercial	$83.60
Rate for Payer: Aetna Medicare Advantage	$66.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.10
Rate for Payer: Cigna Commercial	$110.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.00
Rate for Payer: Oxford Commercial	$44.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.00
Rate for Payer: UnitedHealthcare Commercial	$44.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$5.83

MICROALBUMIN,24HU(W/O CR)

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	39900034
Hospital Revenue Code	307
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna Medicare Advantage	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.78
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.78
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	$4.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Medicare Advantage	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

MICROALBUMIN,24HU(W/O CR)

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	39900034
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MICROALBUMIN CREATININE RATIO

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39880002B
Hospital Revenue Code	301
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.70
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
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	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

MICROALBUMIN CREATININE RATIO

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39880002B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MICROALBUMIN CREATININE RATIO

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	39880002A
Hospital Revenue Code	307
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna Medicare Advantage	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.78
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.78
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	$4.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Medicare Advantage	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

MICROALBUMIN CREATININE RATIO

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	39880002A
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MICROALBUMIN, RANDOM URINE

Facility

$83.25

Service Code	HCPCS 82043
Hospital Charge Code	3009083
Hospital Revenue Code	307
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna Medicare Advantage	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$41.62
Rate for Payer: Cigna Medicare Advantage	$5.78
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Medicare Advantage	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$2.21

MICROALBUMIN, RANDOM URINE

Facility

$83.25

Service Code	HCPCS 82043
Hospital Charge Code	3009082B
Hospital Revenue Code	307
Min. Negotiated Rate	$12.49
Max. Negotiated Rate	$12.49
Rate for Payer: Qualcare PPO/HMO/WC	$12.49

MICROALBUMIN, RANDOM URINE

Facility

$83.25

Service Code	HCPCS 82043
Hospital Charge Code	3009083
Hospital Revenue Code	307
Min. Negotiated Rate	$12.49
Max. Negotiated Rate	$12.49
Rate for Payer: Qualcare PPO/HMO/WC	$12.49

MICROALBUMIN, RANDOM URINE

Facility

$83.25

Service Code	HCPCS 82043
Hospital Charge Code	3009082B
Hospital Revenue Code	307
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna Medicare Advantage	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$41.62
Rate for Payer: Cigna Medicare Advantage	$5.78
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Medicare Advantage	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$2.21

MICROALBUMIN (URINE) QUANT

Facility

$83.25

Service Code	HCPCS 82043
Hospital Charge Code	3009081
Hospital Revenue Code	307
Min. Negotiated Rate	$2.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna Medicare Advantage	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$41.62
Rate for Payer: Cigna Medicare Advantage	$5.78
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Medicare Advantage	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$2.21

MICROALBUMIN (URINE) QUANT

Facility

$83.25

Service Code	HCPCS 82043
Hospital Charge Code	3009081
Hospital Revenue Code	307
Min. Negotiated Rate	$12.49
Max. Negotiated Rate	$12.49
Rate for Payer: Qualcare PPO/HMO/WC	$12.49

MICROALBUMIN URINE QUANT

Facility

$511.00

Service Code	HCPCS 82043
Hospital Charge Code	38472927
Hospital Revenue Code	307
Min. Negotiated Rate	$76.65
Max. Negotiated Rate	$76.65
Rate for Payer: Qualcare PPO/HMO/WC	$76.65

MICROALBUMIN URINE QUANT

Facility

$511.00

Service Code	HCPCS 82043
Hospital Charge Code	38472927
Hospital Revenue Code	307
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$255.50
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna Medicare Advantage	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$255.50
Rate for Payer: Cigna Medicare Advantage	$5.78
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Medicare Advantage	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$13.54

MICROALBUMIN WITH CREATININE I

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	39990139A
Hospital Revenue Code	307
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna Medicare Advantage	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.78
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.78
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	$4.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Medicare Advantage	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

MICROALBUMIN WITH CREATININE I

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39990139B
Hospital Revenue Code	301
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.70
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
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	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

MICROALBUMIN WITH CREATININE I

Facility

$390.00

Service Code	HCPCS 82570
Hospital Charge Code	39990139B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MICROALBUMIN WITH CREATININE I

Facility

$390.00

Service Code	HCPCS 82043
Hospital Charge Code	39990139A
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MICROALBUMI QUANT.UR

Facility

$511.00

Service Code	HCPCS 82043
Hospital Charge Code	38479116
Hospital Revenue Code	307
Min. Negotiated Rate	$4.62
Max. Negotiated Rate	$255.50
Rate for Payer: Aetna Commercial	$15.72
Rate for Payer: Aetna Medicare Advantage	$18.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.86
Rate for Payer: Cigna Commercial	$255.50
Rate for Payer: Cigna Medicare Advantage	$5.78
Rate for Payer: Clover Medicare Advantage	$5.49
Rate for Payer: EmblemHealth Commercial	$17.34
Rate for Payer: Humana Medicare Advantage	$5.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$153.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$76.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.78
Rate for Payer: Wellcare Medicare Advantage	$5.78
Rate for Payer: Wellpoint Medicaid Managed Care	$13.54

MICROALBUMI QUANT.UR

Facility

$511.00

Service Code	HCPCS 82043
Hospital Charge Code	38479116
Hospital Revenue Code	307
Min. Negotiated Rate	$76.65
Max. Negotiated Rate	$76.65
Rate for Payer: Qualcare PPO/HMO/WC	$76.65

Know your out-of-pocket cost for care.

All Charges