Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

OP TX MANDIB FX W MULTI OPS&FI

Facility

$42,339.20

Service Code	HCPCS 21470
Hospital Charge Code	1600000854
Hospital Revenue Code	360
Min. Negotiated Rate	$1,020.37
Max. Negotiated Rate	$25,386.70
Rate for Payer: Aetna Commercial	$19,129.52
Rate for Payer: Aetna Medicare Advantage	$22,786.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,386.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,386.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,032.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,742.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,386.70
Rate for Payer: Cigna Commercial	$14,097.46
Rate for Payer: Cigna Medicare Advantage	$7,032.91
Rate for Payer: Clover Medicare Advantage	$6,681.26
Rate for Payer: EmblemHealth Commercial	$21,098.73
Rate for Payer: Humana Medicare Advantage	$7,243.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,032.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,701.76
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$1,020.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,032.91
Rate for Payer: Wellcare Medicare Advantage	$7,032.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1,121.99

OP TX MANDIB FX W MULTI OPS&FI

Facility

$42,339.20

Service Code	HCPCS 21470
Hospital Charge Code	1600000854
Hospital Revenue Code	360
Min. Negotiated Rate	$6,350.88
Max. Negotiated Rate	$6,350.88
Rate for Payer: Qualcare PPO/HMO/WC	$6,350.88

OP TX OF NASAL FX; W OP TX SEP

Facility

$12,277.44

Service Code	HCPCS 21335
Hospital Charge Code	1600000740
Hospital Revenue Code	360
Min. Negotiated Rate	$295.89
Max. Negotiated Rate	$14,218.07
Rate for Payer: Aetna Commercial	$10,713.67
Rate for Payer: Aetna Medicare Advantage	$12,761.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,218.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,938.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,936.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,218.07
Rate for Payer: Cigna Commercial	$7,895.42
Rate for Payer: Cigna Medicare Advantage	$3,938.85
Rate for Payer: Clover Medicare Advantage	$3,741.91
Rate for Payer: EmblemHealth Commercial	$11,816.55
Rate for Payer: Humana Medicare Advantage	$4,057.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,938.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,683.23
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,841.62
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$295.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,938.85
Rate for Payer: Wellcare Medicare Advantage	$3,938.85
Rate for Payer: Wellpoint Medicaid Managed Care	$325.35

OP TX OF NASAL FX; W OP TX SEP

Facility

$12,277.44

Service Code	HCPCS 21335
Hospital Charge Code	1600000740
Hospital Revenue Code	360
Min. Negotiated Rate	$1,841.62
Max. Negotiated Rate	$1,841.62
Rate for Payer: Qualcare PPO/HMO/WC	$1,841.62

OP TX PATEL FX W IF &/REP

Facility

$12,280.69

Service Code	HCPCS 27524
Hospital Charge Code	16000425
Hospital Revenue Code	360
Min. Negotiated Rate	$1,842.10
Max. Negotiated Rate	$1,842.10
Rate for Payer: Qualcare PPO/HMO/WC	$1,842.10

OP TX PATEL FX W IF &/REP

Facility

$12,280.69

Service Code	HCPCS 27524
Hospital Charge Code	16000425
Hospital Revenue Code	360
Min. Negotiated Rate	$295.96
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,684.21
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,842.10
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$295.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$325.44

OPTX POST ANKLE FX

Facility

$26,295.79

Service Code	HCPCS 27769
Hospital Charge Code	16000900
Hospital Revenue Code	360
Min. Negotiated Rate	$3,944.37
Max. Negotiated Rate	$3,944.37
Rate for Payer: Qualcare PPO/HMO/WC	$3,944.37

OPTX POST ANKLE FX

Facility

$26,295.79

Service Code	HCPCS 27769
Hospital Charge Code	16000900
Hospital Revenue Code	360
Min. Negotiated Rate	$633.73
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,888.74
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,944.37
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$633.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$696.84

OP TX RDL&ULNR SHFT FX FIXJR/U

Facility

$63,943.60

Service Code	HCPCS 25575
Hospital Charge Code	16000552
Hospital Revenue Code	360
Min. Negotiated Rate	$9,591.54
Max. Negotiated Rate	$9,591.54
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54

OP TX RDL&ULNR SHFT FX FIXJR/U

Facility

$63,943.60

Service Code	HCPCS 25575
Hospital Charge Code	16000552
Hospital Revenue Code	360
Min. Negotiated Rate	$1,355.00
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19,183.08
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,541.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,694.51

OP TX SESAMOID FRACTURE

Facility

$30,274.24

Service Code	HCPCS 28531
Hospital Charge Code	16000913
Hospital Revenue Code	360
Min. Negotiated Rate	$4,541.14
Max. Negotiated Rate	$4,541.14
Rate for Payer: Qualcare PPO/HMO/WC	$4,541.14

OP TX SESAMOID FRACTURE

Facility

$30,274.24

Service Code	HCPCS 28531
Hospital Charge Code	16000913
Hospital Revenue Code	360
Min. Negotiated Rate	$729.61
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,082.27
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,541.14
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$729.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$802.27

OP TX TRANS-SCAPHRL FX DISLCAT

Facility

$23,899.60

Service Code	HCPCS 25685
Hospital Charge Code	16000697
Hospital Revenue Code	360
Min. Negotiated Rate	$3,584.94
Max. Negotiated Rate	$3,584.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94

OP TX TRANS-SCAPHRL FX DISLCAT

Facility

$23,899.60

Service Code	HCPCS 25685
Hospital Charge Code	16000697
Hospital Revenue Code	360
Min. Negotiated Rate	$575.98
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,169.88
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$575.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$633.34

OP TX TRMLELR ANKL W FX PSTLIP

Facility

$63,943.60

Service Code	HCPCS 27823
Hospital Charge Code	16000400
Hospital Revenue Code	360
Min. Negotiated Rate	$9,591.54
Max. Negotiated Rate	$9,591.54
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54

OP TX TRMLELR ANKL W FX PSTLIP

Facility

$63,943.60

Service Code	HCPCS 27823
Hospital Charge Code	16000400
Hospital Revenue Code	360
Min. Negotiated Rate	$1,355.00
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19,183.08
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,591.54
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,541.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,694.51

OP TX ULNAR STYL FX

Facility

$49,826.60

Service Code	HCPCS 25652
Hospital Charge Code	16000838
Hospital Revenue Code	360
Min. Negotiated Rate	$1,200.82
Max. Negotiated Rate	$31,117.67
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,117.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,117.67
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,947.98
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,473.99
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,200.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,320.40

OP TX ULNAR STYL FX

Facility

$49,826.60

Service Code	HCPCS 25652
Hospital Charge Code	16000838
Hospital Revenue Code	360
Min. Negotiated Rate	$7,473.99
Max. Negotiated Rate	$7,473.99
Rate for Payer: Qualcare PPO/HMO/WC	$7,473.99

OPUS MAGNUM IMPLANT/ANCHOR SCR

Facility

$983.00

Hospital Charge Code	270335285
Hospital Revenue Code	278
Min. Negotiated Rate	$147.45
Max. Negotiated Rate	$237.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$216.26
Rate for Payer: Qualcare PPO/HMO/WC	$147.45

OPUS MAGNUM IMPLANT/ANCHOR SCR

Facility

$983.00

Hospital Charge Code	270335285
Hospital Revenue Code	278
Min. Negotiated Rate	$23.69
Max. Negotiated Rate	$491.50
Rate for Payer: Aetna Commercial	$373.54
Rate for Payer: Aetna Medicare Advantage	$294.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$196.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.66
Rate for Payer: Cigna Commercial	$491.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$237.89
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$216.26
Rate for Payer: Qualcare PPO/HMO/WC	$147.45
Rate for Payer: UnitedHealthcare Community & State	$23.69
Rate for Payer: Wellpoint Medicaid Managed Care	$26.05

OPUS SMART STITCH CONNECTOR

Facility

$434.00

Hospital Charge Code	270335289
Hospital Revenue Code	272
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$65.10
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

OPUS SMART STITCH CONNECTOR

Facility

$434.00

Hospital Charge Code	270335289
Hospital Revenue Code	272
Min. Negotiated Rate	$10.46
Max. Negotiated Rate	$217.00
Rate for Payer: Aetna Commercial	$164.92
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.20
Rate for Payer: Oxford Commercial	$86.80
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Commercial	$86.80
Rate for Payer: UnitedHealthcare Community & State	$10.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.50

OPUS SMART SUTURE CARTDGE

Facility

$434.00

Hospital Charge Code	270335290
Hospital Revenue Code	272
Min. Negotiated Rate	$65.10
Max. Negotiated Rate	$65.10
Rate for Payer: Qualcare PPO/HMO/WC	$65.10

OPUS SMART SUTURE CARTDGE

Facility

$434.00

Hospital Charge Code	270335290
Hospital Revenue Code	272
Min. Negotiated Rate	$10.46
Max. Negotiated Rate	$217.00
Rate for Payer: Aetna Commercial	$164.92
Rate for Payer: Aetna Medicare Advantage	$130.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.67
Rate for Payer: Cigna Commercial	$217.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.20
Rate for Payer: Oxford Commercial	$86.80
Rate for Payer: Qualcare PPO/HMO/WC	$65.10
Rate for Payer: UnitedHealthcare Commercial	$86.80
Rate for Payer: UnitedHealthcare Community & State	$10.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.50

*****OR 4 TO 5 HOURS

Facility

$3,890.00

Hospital Charge Code	1600055
Hospital Revenue Code	360
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$1,945.00
Rate for Payer: Aetna Commercial	$1,478.20
Rate for Payer: Aetna Medicare Advantage	$1,167.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$991.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$991.95
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	$991.95
Rate for Payer: Cigna Commercial	$1,945.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,167.00
Rate for Payer: Qualcare PPO/HMO/WC	$583.50
Rate for Payer: UnitedHealthcare Community & State	$93.75
Rate for Payer: Wellpoint Medicaid Managed Care	$103.08

Know your out-of-pocket cost for care.

All Charges