Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

NM MYOCARDIAL PLANAR STREE &

Facility

$12,000.00

Service Code	HCPCS 78454
Hospital Charge Code	4500351
Hospital Revenue Code	341
Min. Negotiated Rate	$232.32
Max. Negotiated Rate	$5,552.01
Rate for Payer: Aetna Commercial	$4,183.58
Rate for Payer: Aetna Medicare Advantage	$4,983.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,538.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$232.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,552.01
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: Cigna Medicare Advantage	$1,076.66
Rate for Payer: Clover Medicare Advantage	$1,461.18
Rate for Payer: EmblemHealth Commercial	$4,614.24
Rate for Payer: Humana Medicare Advantage	$1,584.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,538.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,600.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,538.08
Rate for Payer: Wellcare Medicare Advantage	$1,538.08
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

NM MYOCARDIAL SPECT REST OR EX

Facility

$12,000.00

Service Code	HCPCS 78452
Hospital Charge Code	4500476
Hospital Revenue Code	341
Min. Negotiated Rate	$289.20
Max. Negotiated Rate	$5,552.01
Rate for Payer: Aetna Commercial	$4,183.58
Rate for Payer: Aetna Medicare Advantage	$4,983.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,538.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,552.01
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: Cigna Medicare Advantage	$1,076.66
Rate for Payer: Clover Medicare Advantage	$1,461.18
Rate for Payer: EmblemHealth Commercial	$4,614.24
Rate for Payer: Humana Medicare Advantage	$1,584.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,538.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,600.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,538.08
Rate for Payer: Wellcare Medicare Advantage	$1,538.08
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

NM MYOCARDIAL SPECT REST OR EX

Facility

$12,000.00

Service Code	HCPCS 78452
Hospital Charge Code	4500476
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

NM MYOCARDIAL SPECT STRESS &

Facility

$12,000.00

Service Code	HCPCS 78452
Hospital Charge Code	4500484
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

NM MYOCARDIAL SPECT STRESS &

Facility

$12,000.00

Service Code	HCPCS 78452
Hospital Charge Code	4500484
Hospital Revenue Code	341
Min. Negotiated Rate	$289.20
Max. Negotiated Rate	$5,552.01
Rate for Payer: Aetna Commercial	$4,183.58
Rate for Payer: Aetna Medicare Advantage	$4,983.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,538.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$325.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,552.01
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: Cigna Medicare Advantage	$1,076.66
Rate for Payer: Clover Medicare Advantage	$1,461.18
Rate for Payer: EmblemHealth Commercial	$4,614.24
Rate for Payer: Humana Medicare Advantage	$1,584.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,538.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,600.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,538.08
Rate for Payer: Wellcare Medicare Advantage	$1,538.08
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

NM MYOCARDI PERF W WALL MOTI**

Facility

$160.00

Service Code	HCPCS 78478
Hospital Charge Code	4500898
Hospital Revenue Code	341
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

NM MYOCARDI PERF W WALL MOTI**

Facility

$160.00

Service Code	HCPCS 78478
Hospital Charge Code	4500898
Hospital Revenue Code	341
Min. Negotiated Rate	$3.86
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$3.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

NM MYOCARD PLANAR SINGLE STUDY

Facility

$6,289.55

Service Code	HCPCS 78453
Hospital Charge Code	5600194
Hospital Revenue Code	341
Min. Negotiated Rate	$139.39
Max. Negotiated Rate	$5,552.01
Rate for Payer: Aetna Commercial	$4,183.58
Rate for Payer: Aetna Medicare Advantage	$4,983.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,538.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$139.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,552.01
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: Cigna Medicare Advantage	$1,076.66
Rate for Payer: Clover Medicare Advantage	$1,461.18
Rate for Payer: EmblemHealth Commercial	$4,614.24
Rate for Payer: Humana Medicare Advantage	$1,584.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,538.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,886.87
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$943.43
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$151.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,538.08
Rate for Payer: Wellcare Medicare Advantage	$1,538.08
Rate for Payer: Wellpoint Medicaid Managed Care	$166.67

NM MYOCARD PLANAR SINGLE STUDY

Facility

$6,289.55

Service Code	HCPCS 78453
Hospital Charge Code	5600194
Hospital Revenue Code	341
Min. Negotiated Rate	$943.43
Max. Negotiated Rate	$943.43
Rate for Payer: Qualcare PPO/HMO/WC	$943.43

NM NERVOUS SYSTEM OTHER

Facility

$1,833.50

Service Code	HCPCS 78699
Hospital Charge Code	4500972
Hospital Revenue Code	341
Min. Negotiated Rate	$275.02
Max. Negotiated Rate	$275.02
Rate for Payer: Qualcare PPO/HMO/WC	$275.02

NM NERVOUS SYSTEM OTHER

Facility

$1,833.50

Service Code	HCPCS 78699
Hospital Charge Code	4500972
Hospital Revenue Code	341
Min. Negotiated Rate	$44.19
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.05
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$275.02
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$44.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$48.59

NM ONCOSCINT PER DOSE

Facility

$8,657.00

Service Code	HCPCS A4642
Hospital Charge Code	4509015
Hospital Revenue Code	343
Min. Negotiated Rate	$1,298.55
Max. Negotiated Rate	$1,298.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,298.55

NM ONCOSCINT PER DOSE

Facility

$8,657.00

Service Code	HCPCS A4642
Hospital Charge Code	4509015
Hospital Revenue Code	343
Min. Negotiated Rate	$208.63
Max. Negotiated Rate	$4,328.50
Rate for Payer: Aetna Commercial	$3,289.66
Rate for Payer: Aetna Medicare Advantage	$2,597.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,207.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,207.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,207.53
Rate for Payer: Cigna Commercial	$4,328.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,597.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,298.55
Rate for Payer: UnitedHealthcare Community & State	$208.63
Rate for Payer: Wellpoint Medicaid Managed Care	$229.41

NM PARATHYROID IMAGING

Facility

$12,000.00

Service Code	HCPCS 78070
Hospital Charge Code	4500591
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

NM PARATHYROID IMAGING

Facility

$12,000.00

Service Code	HCPCS 78070
Hospital Charge Code	4500591
Hospital Revenue Code	341
Min. Negotiated Rate	$71.63
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,600.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

NM PERITONEAL VENOUS SHUNT PAT

Facility

$12,000.00

Service Code	HCPCS 78291
Hospital Charge Code	4500894
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

NM PERITONEAL VENOUS SHUNT PAT

Facility

$12,000.00

Service Code	HCPCS 78291
Hospital Charge Code	4500894
Hospital Revenue Code	341
Min. Negotiated Rate	$62.34
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,600.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

NMP FIBERS (LONG)-SMALL.

Facility

$14,450.00

Service Code	HCPCS C1765
Hospital Charge Code	270703660
Hospital Revenue Code	278
Min. Negotiated Rate	$2,167.50
Max. Negotiated Rate	$3,496.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,890.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,496.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,179.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,167.50

NMP FIBERS (LONG)-SMALL.

Facility

$14,450.00

Service Code	HCPCS C1765
Hospital Charge Code	270703660
Hospital Revenue Code	278
Min. Negotiated Rate	$348.25
Max. Negotiated Rate	$7,225.00
Rate for Payer: Aetna Commercial	$5,491.00
Rate for Payer: Aetna Medicare Advantage	$4,335.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,684.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,684.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,890.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,684.75
Rate for Payer: Cigna Commercial	$7,225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,496.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,179.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,167.50
Rate for Payer: UnitedHealthcare Community & State	$348.25
Rate for Payer: Wellpoint Medicaid Managed Care	$382.93

NMP FIBERS (LONG)- XSMALL

Facility

$7,225.00

Hospital Charge Code	270702965
Hospital Revenue Code	278
Min. Negotiated Rate	$1,083.75
Max. Negotiated Rate	$1,748.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,748.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,589.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.75

NMP FIBERS (LONG)- XSMALL

Facility

$7,225.00

Hospital Charge Code	270702965
Hospital Revenue Code	278
Min. Negotiated Rate	$174.12
Max. Negotiated Rate	$3,612.50
Rate for Payer: Aetna Commercial	$2,745.50
Rate for Payer: Aetna Medicare Advantage	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,842.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,842.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,842.38
Rate for Payer: Cigna Commercial	$3,612.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,748.45
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,589.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,083.75
Rate for Payer: UnitedHealthcare Community & State	$174.12
Rate for Payer: Wellpoint Medicaid Managed Care	$191.46

NMP FIBERS (LONH) MEDIUM

Facility

$20,400.00

Service Code	HCPCS C1762
Hospital Charge Code	270704153
Hospital Revenue Code	278
Min. Negotiated Rate	$491.64
Max. Negotiated Rate	$10,200.00
Rate for Payer: Aetna Commercial	$7,752.00
Rate for Payer: Aetna Medicare Advantage	$6,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,202.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,202.00
Rate for Payer: Cigna Commercial	$10,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,936.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,488.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,060.00
Rate for Payer: UnitedHealthcare Community & State	$491.64
Rate for Payer: Wellpoint Medicaid Managed Care	$540.60

NMP FIBERS (LONH) MEDIUM

Facility

$20,400.00

Service Code	HCPCS C1762
Hospital Charge Code	270704153
Hospital Revenue Code	278
Min. Negotiated Rate	$3,060.00
Max. Negotiated Rate	$4,936.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,936.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,488.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,060.00

NM PLASMA VOLUME

Facility

$1,222.15

Service Code	HCPCS 78110
Hospital Charge Code	4500974
Hospital Revenue Code	341
Min. Negotiated Rate	$29.45
Max. Negotiated Rate	$5,552.01
Rate for Payer: Aetna Commercial	$4,183.58
Rate for Payer: Aetna Medicare Advantage	$4,983.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,552.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,538.08
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	$5,552.01
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: Cigna Medicare Advantage	$1,076.66
Rate for Payer: Clover Medicare Advantage	$1,461.18
Rate for Payer: EmblemHealth Commercial	$4,614.24
Rate for Payer: Humana Medicare Advantage	$1,584.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,538.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.64
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.32
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$29.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,538.08
Rate for Payer: Wellcare Medicare Advantage	$1,538.08
Rate for Payer: Wellpoint Medicaid Managed Care	$32.39

NM PLASMA VOLUME

Facility

$1,222.15

Service Code	HCPCS 78110
Hospital Charge Code	4500974
Hospital Revenue Code	341
Min. Negotiated Rate	$183.32
Max. Negotiated Rate	$183.32
Rate for Payer: Qualcare PPO/HMO/WC	$183.32

Know your out-of-pocket cost for care.

All Charges