Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NASAL/SINUS ENDOSCOPY SURG

Facility

$40,761.60

Service Code	HCPCS 31287
Hospital Charge Code	1600000722
Hospital Revenue Code	360
Min. Negotiated Rate	$982.35
Max. Negotiated Rate	$30,265.35
Rate for Payer: Aetna Commercial	$22,805.70
Rate for Payer: Aetna Medicare Advantage	$27,165.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,265.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,384.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,355.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,265.35
Rate for Payer: Cigna Commercial	$16,806.60
Rate for Payer: Cigna Medicare Advantage	$8,384.45
Rate for Payer: Clover Medicare Advantage	$7,965.23
Rate for Payer: EmblemHealth Commercial	$25,153.35
Rate for Payer: Humana Medicare Advantage	$8,635.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,384.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,228.48
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,114.24
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$982.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,384.45
Rate for Payer: Wellcare Medicare Advantage	$8,384.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1,080.18

NASAL/SINUS ENDOSCOPY SURG

Facility

$13,338.00

Service Code	HCPCS 31291
Hospital Charge Code	1600000662
Hospital Revenue Code	360
Min. Negotiated Rate	$2,000.70
Max. Negotiated Rate	$2,000.70
Rate for Payer: Qualcare PPO/HMO/WC	$2,000.70

NASAL SPLINT BLANK 3X3 BLUSH

Facility

$33.00

Hospital Charge Code	270332219
Hospital Revenue Code	272
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

NASAL SPLINT BLANK 3X3 BLUSH

Facility

$33.00

Hospital Charge Code	270332219
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

NASAL SPRAY/15ML

Facility

$2.00

Hospital Charge Code	60634603
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.60
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

NASAL SPRAY/15ML

Facility

$2.00

Hospital Charge Code	60634603
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

NASAL TRACHEAL TUBE 4.0MM 17FR

Facility

$99.00

Hospital Charge Code	270332014
Hospital Revenue Code	272
Min. Negotiated Rate	$2.39
Max. Negotiated Rate	$49.50
Rate for Payer: Aetna Commercial	$37.62
Rate for Payer: Aetna Medicare Advantage	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.25
Rate for Payer: Cigna Commercial	$49.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.70
Rate for Payer: Oxford Commercial	$19.80
Rate for Payer: Qualcare PPO/HMO/WC	$14.85
Rate for Payer: UnitedHealthcare Commercial	$19.80
Rate for Payer: UnitedHealthcare Community & State	$2.39
Rate for Payer: Wellpoint Medicaid Managed Care	$2.62

NASAL TRACHEAL TUBE 4.0MM 17FR

Facility

$99.00

Hospital Charge Code	270332014
Hospital Revenue Code	272
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$14.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.85

NASH FIBROSURE I

Facility

$205.65

Service Code	HCPCS 82172
Hospital Charge Code	3038530A
Hospital Revenue Code	301
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.36
Rate for Payer: Aetna Medicare Advantage	$68.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.13
Rate for Payer: Cigna Commercial	$102.83
Rate for Payer: Cigna Medicare Advantage	$21.09
Rate for Payer: Clover Medicare Advantage	$20.04
Rate for Payer: EmblemHealth Commercial	$63.27
Rate for Payer: Humana Medicare Advantage	$21.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.09
Rate for Payer: Wellcare Medicare Advantage	$21.09
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

NASH FIBROSURE I

Facility

$205.65

Service Code	HCPCS 82172
Hospital Charge Code	3038530A
Hospital Revenue Code	301
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

NASH FIBROSURE II

Facility

$54.45

Service Code	HCPCS 82247
Hospital Charge Code	3038530B
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

NASH FIBROSURE II

Facility

$54.45

Service Code	HCPCS 82247
Hospital Charge Code	3038530B
Hospital Revenue Code	301
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.65
Rate for Payer: Aetna Medicare Advantage	$16.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.12
Rate for Payer: Cigna Commercial	$27.23
Rate for Payer: Cigna Medicare Advantage	$5.02
Rate for Payer: Clover Medicare Advantage	$4.77
Rate for Payer: EmblemHealth Commercial	$15.06
Rate for Payer: Humana Medicare Advantage	$5.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.02
Rate for Payer: Wellcare Medicare Advantage	$5.02
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

NASH FIBROSURE III

Facility

$52.85

Service Code	HCPCS 82465
Hospital Charge Code	3038530C
Hospital Revenue Code	301
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.83
Rate for Payer: Aetna Medicare Advantage	$14.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.35
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	$15.70
Rate for Payer: Cigna Commercial	$26.43
Rate for Payer: Cigna Medicare Advantage	$4.35
Rate for Payer: Clover Medicare Advantage	$4.13
Rate for Payer: EmblemHealth Commercial	$13.05
Rate for Payer: Humana Medicare Advantage	$4.48
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.93
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.35
Rate for Payer: Wellcare Medicare Advantage	$4.35
Rate for Payer: Wellpoint Medicaid Managed Care	$1.40

NASH FIBROSURE III

Facility

$52.85

Service Code	HCPCS 82465
Hospital Charge Code	3038530C
Hospital Revenue Code	301
Min. Negotiated Rate	$7.93
Max. Negotiated Rate	$7.93
Rate for Payer: Qualcare PPO/HMO/WC	$7.93

NASH FIBROSURE IV

Facility

$117.65

Service Code	HCPCS 82947
Hospital Charge Code	3038530D
Hospital Revenue Code	301
Min. Negotiated Rate	$17.65
Max. Negotiated Rate	$17.65
Rate for Payer: Qualcare PPO/HMO/WC	$17.65

NASH FIBROSURE IV

Facility

$117.65

Service Code	HCPCS 82947
Hospital Charge Code	3038530D
Hospital Revenue Code	301
Min. Negotiated Rate	$3.12
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.69
Rate for Payer: Aetna Medicare Advantage	$12.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.19
Rate for Payer: Cigna Commercial	$58.83
Rate for Payer: Cigna Medicare Advantage	$3.93
Rate for Payer: Clover Medicare Advantage	$3.73
Rate for Payer: EmblemHealth Commercial	$11.79
Rate for Payer: Humana Medicare Advantage	$4.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.93
Rate for Payer: Wellcare Medicare Advantage	$3.93
Rate for Payer: Wellpoint Medicaid Managed Care	$3.12

NASH FIBROSURE IX

Facility

$47.25

Service Code	HCPCS 84460
Hospital Charge Code	3038530I
Hospital Revenue Code	301
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

NASH FIBROSURE IX

Facility

$47.25

Service Code	HCPCS 84460
Hospital Charge Code	3038530I
Hospital Revenue Code	301
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.42
Rate for Payer: Aetna Medicare Advantage	$17.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.30
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	$19.13
Rate for Payer: Cigna Commercial	$23.62
Rate for Payer: Cigna Medicare Advantage	$5.30
Rate for Payer: Clover Medicare Advantage	$5.04
Rate for Payer: EmblemHealth Commercial	$15.90
Rate for Payer: Humana Medicare Advantage	$5.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.30
Rate for Payer: Wellcare Medicare Advantage	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

NASH FIBROSURE V

Facility

$65.65

Service Code	HCPCS 82977
Hospital Charge Code	3038530E
Hospital Revenue Code	301
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

NASH FIBROSURE V

Facility

$65.65

Service Code	HCPCS 82977
Hospital Charge Code	3038530E
Hospital Revenue Code	301
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$19.58
Rate for Payer: Aetna Medicare Advantage	$23.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.99
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: Cigna Medicare Advantage	$7.20
Rate for Payer: Clover Medicare Advantage	$6.84
Rate for Payer: EmblemHealth Commercial	$21.60
Rate for Payer: Humana Medicare Advantage	$7.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.20
Rate for Payer: Wellcare Medicare Advantage	$7.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

NASH FIBROSURE VI

Facility

$119.25

Service Code	HCPCS 83010
Hospital Charge Code	3038530F
Hospital Revenue Code	301
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

NASH FIBROSURE VI

Facility

$119.25

Service Code	HCPCS 83010
Hospital Charge Code	3038530F
Hospital Revenue Code	301
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.22
Rate for Payer: Aetna Medicare Advantage	$40.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.41
Rate for Payer: Cigna Commercial	$59.62
Rate for Payer: Cigna Medicare Advantage	$12.58
Rate for Payer: Clover Medicare Advantage	$11.95
Rate for Payer: EmblemHealth Commercial	$37.74
Rate for Payer: Humana Medicare Advantage	$12.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.58
Rate for Payer: Wellcare Medicare Advantage	$12.58
Rate for Payer: Wellpoint Medicaid Managed Care	$3.16

NASH FIBROSURE VII

Facility

$150.00

Service Code	HCPCS 83883
Hospital Charge Code	3038530G
Hospital Revenue Code	301
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

NASH FIBROSURE VII

Facility

$150.00

Service Code	HCPCS 83883
Hospital Charge Code	3038530G
Hospital Revenue Code	301
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$171.49
Rate for Payer: Aetna Commercial	$36.99
Rate for Payer: Aetna Medicare Advantage	$44.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$171.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.09
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: Cigna Medicare Advantage	$13.60
Rate for Payer: Clover Medicare Advantage	$12.92
Rate for Payer: EmblemHealth Commercial	$40.80
Rate for Payer: Humana Medicare Advantage	$14.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.60
Rate for Payer: Wellcare Medicare Advantage	$13.60
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

NASH FIBROSURE VIII

Facility

$47.25

Service Code	HCPCS 84450
Hospital Charge Code	3038530H
Hospital Revenue Code	301
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$124.00
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	$23.62
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	$14.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
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	$1.25

Know your out-of-pocket cost for care.

All Charges