Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NCAL BX SKN SINGLE LES

Facility

$1,278.04

Service Code	HCPCS 11106
Hospital Charge Code	16000164
Hospital Revenue Code	360
Min. Negotiated Rate	$30.80
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
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	$3,169.46
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.41
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.71
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$30.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$33.87

NCAL BX SKN SINGLE LES

Facility

$1,278.04

Service Code	HCPCS 11106
Hospital Charge Code	1600000335
Hospital Revenue Code	360
Min. Negotiated Rate	$30.80
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
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	$3,169.46
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.41
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$191.71
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$30.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$33.87

NCB CABL BUTTON POLY LOCK PLT

Facility

$714.00

Service Code	HCPCS C1713
Hospital Charge Code	270679953
Hospital Revenue Code	278
Min. Negotiated Rate	$107.10
Max. Negotiated Rate	$172.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.08
Rate for Payer: Qualcare PPO/HMO/WC	$107.10

NCB CABL BUTTON POLY LOCK PLT

Facility

$714.00

Service Code	HCPCS C1713
Hospital Charge Code	270679953
Hospital Revenue Code	278
Min. Negotiated Rate	$17.21
Max. Negotiated Rate	$357.00
Rate for Payer: Aetna Commercial	$271.32
Rate for Payer: Aetna Medicare Advantage	$214.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$182.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$182.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$182.07
Rate for Payer: Cigna Commercial	$357.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.79
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$157.08
Rate for Payer: Qualcare PPO/HMO/WC	$107.10
Rate for Payer: UnitedHealthcare Community & State	$17.21
Rate for Payer: Wellpoint Medicaid Managed Care	$18.92

NCB CORT SCREW 5.0X38MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704130
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X38MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704130
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

NCB CORT SCREW 5.0X40MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704131
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X40MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704131
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

NCB CORT SCREW 5.0X42MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704133
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

NCB CORT SCREW 5.0X42MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704133
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X46MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704134
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

NCB CORT SCREW 5.0X46MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704134
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X48MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704135
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

NCB CORT SCREW 5.0X48MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704135
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X50MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704132
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

NCB CORT SCREW 5.0X50MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704132
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X65MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704136
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5.0X65MM SELF T

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270704136
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

NCB CORT SCREW 5 X34MM SELFTAP

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270679961
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB CORT SCREW 5 X34MM SELFTAP

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270679961
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

NCB CORT SCREW 5X36MM SELFTAP

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270679962
Hospital Revenue Code	278
Min. Negotiated Rate	$29.48
Max. Negotiated Rate	$611.70
Rate for Payer: Aetna Commercial	$464.89
Rate for Payer: Aetna Medicare Advantage	$367.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$311.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$311.97
Rate for Payer: Cigna Commercial	$611.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51
Rate for Payer: UnitedHealthcare Community & State	$29.48
Rate for Payer: Wellpoint Medicaid Managed Care	$32.42

NCB CORT SCREW 5X36MM SELFTAP

Facility

$1,223.40

Service Code	HCPCS C1713
Hospital Charge Code	270679962
Hospital Revenue Code	278
Min. Negotiated Rate	$183.51
Max. Negotiated Rate	$296.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$244.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$296.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$269.15
Rate for Payer: Qualcare PPO/HMO/WC	$183.51

NCB DRILL BIT 4.3MM X 195MM

Facility

$901.45

Hospital Charge Code	270679965
Hospital Revenue Code	272
Min. Negotiated Rate	$21.72
Max. Negotiated Rate	$450.73
Rate for Payer: Aetna Commercial	$342.55
Rate for Payer: Aetna Medicare Advantage	$270.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.87
Rate for Payer: Cigna Commercial	$450.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$270.44
Rate for Payer: Oxford Commercial	$180.29
Rate for Payer: Qualcare PPO/HMO/WC	$135.22
Rate for Payer: UnitedHealthcare Commercial	$180.29
Rate for Payer: UnitedHealthcare Community & State	$21.72
Rate for Payer: Wellpoint Medicaid Managed Care	$23.89

NCB DRILL BIT 4.3MM X 195MM

Facility

$901.45

Hospital Charge Code	270679965
Hospital Revenue Code	272
Min. Negotiated Rate	$135.22
Max. Negotiated Rate	$135.22
Rate for Payer: Qualcare PPO/HMO/WC	$135.22

NCB LOCKING SCREW CAP

Facility

$637.50

Service Code	HCPCS C1713
Hospital Charge Code	270679963
Hospital Revenue Code	278
Min. Negotiated Rate	$15.36
Max. Negotiated Rate	$318.75
Rate for Payer: Aetna Commercial	$242.25
Rate for Payer: Aetna Medicare Advantage	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$162.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$162.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$162.56
Rate for Payer: Cigna Commercial	$318.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.28
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$140.25
Rate for Payer: Qualcare PPO/HMO/WC	$95.62
Rate for Payer: UnitedHealthcare Community & State	$15.36
Rate for Payer: Wellpoint Medicaid Managed Care	$16.89

Know your out-of-pocket cost for care.

All Charges