Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PSYCH E/R GROUP****

Facility

$130.00

Hospital Charge Code	7500101
Hospital Revenue Code	914
Min. Negotiated Rate	$19.50
Max. Negotiated Rate	$19.50
Rate for Payer: Qualcare PPO/HMO/WC	$19.50

PSYCH E/R UP TO 1/2 HOUR***

Facility

$137.50

Hospital Charge Code	7500010
Hospital Revenue Code	914
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$20.62
Rate for Payer: Qualcare PPO/HMO/WC	$20.62

PSYCH E/R UP TO 1/2 HOUR***

Facility

$137.50

Hospital Charge Code	7500010
Hospital Revenue Code	914
Min. Negotiated Rate	$3.31
Max. Negotiated Rate	$68.75
Rate for Payer: Aetna Commercial	$52.25
Rate for Payer: Aetna Medicare Advantage	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35.06
Rate for Payer: Cigna Commercial	$68.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.25
Rate for Payer: Qualcare PPO/HMO/WC	$20.62
Rate for Payer: UnitedHealthcare Community & State	$3.31
Rate for Payer: Wellpoint Medicaid Managed Care	$3.64

PSYCH ER URINALYSIS,DIP STICK

Facility

$22.00

Service Code	HCPCS 81000
Hospital Charge Code	7508001
Hospital Revenue Code	307
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.93
Rate for Payer: Aetna Medicare Advantage	$13.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.51
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: Cigna Medicare Advantage	$4.02
Rate for Payer: Clover Medicare Advantage	$3.82
Rate for Payer: EmblemHealth Commercial	$12.06
Rate for Payer: Humana Medicare Advantage	$4.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.02
Rate for Payer: Wellcare Medicare Advantage	$4.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

PSYCH ER URINALYSIS,DIP STICK

Facility

$22.00

Service Code	HCPCS 81000
Hospital Charge Code	7508001
Hospital Revenue Code	307
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

PSYCH EVALUATION******

Facility

$207.90

Service Code	HCPCS 90801
Hospital Charge Code	50006
Hospital Revenue Code	910
Min. Negotiated Rate	$31.18
Max. Negotiated Rate	$31.18
Rate for Payer: Qualcare PPO/HMO/WC	$31.18

PSYCH EVALUATION******

Facility

$207.90

Service Code	HCPCS 90801
Hospital Charge Code	50006
Hospital Revenue Code	910
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$103.95
Rate for Payer: Aetna Commercial	$79.00
Rate for Payer: Aetna Medicare Advantage	$62.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.01
Rate for Payer: Cigna Commercial	$103.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.37
Rate for Payer: Qualcare PPO/HMO/WC	$31.18
Rate for Payer: UnitedHealthcare Community & State	$5.01
Rate for Payer: Wellpoint Medicaid Managed Care	$5.51

PSYCHIARIST EMERGENCY C****

Facility

$648.00

Hospital Charge Code	7500051
Hospital Revenue Code	914
Min. Negotiated Rate	$15.62
Max. Negotiated Rate	$324.00
Rate for Payer: Aetna Commercial	$246.24
Rate for Payer: Aetna Medicare Advantage	$194.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.24
Rate for Payer: Cigna Commercial	$324.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$194.40
Rate for Payer: Qualcare PPO/HMO/WC	$97.20
Rate for Payer: UnitedHealthcare Community & State	$15.62
Rate for Payer: Wellpoint Medicaid Managed Care	$17.17

PSYCHIARIST EMERGENCY C****

Facility

$648.00

Hospital Charge Code	7500051
Hospital Revenue Code	914
Min. Negotiated Rate	$97.20
Max. Negotiated Rate	$97.20
Rate for Payer: Qualcare PPO/HMO/WC	$97.20

PSYCHIATRIC DIAG EVAL NON MD

Facility

$550.00

Service Code	HCPCS 90791
Hospital Charge Code	84504005
Hospital Revenue Code	900
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$3,081.00
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$3,081.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$171.99
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

PSYCHIATRIC DIAG EVAL NON MD

Facility

$6,800.00

Service Code	HCPCS 90791
Hospital Charge Code	87506080
Hospital Revenue Code	900
Min. Negotiated Rate	$163.88
Max. Negotiated Rate	$3,081.00
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,040.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00
Rate for Payer: UnitedHealthcare Commercial	$3,081.00
Rate for Payer: UnitedHealthcare Community & State	$163.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$171.99
Rate for Payer: Wellpoint Medicaid Managed Care	$180.20

PSYCHIATRIC DIAG EVAL NON MD

Facility

$550.00

Service Code	HCPCS 90791
Hospital Charge Code	84504005
Hospital Revenue Code	900
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

PSYCHIATRIC DIAG EVAL NON MD

Facility

$6,800.00

Service Code	HCPCS 90791
Hospital Charge Code	87506080
Hospital Revenue Code	900
Min. Negotiated Rate	$1,020.00
Max. Negotiated Rate	$1,020.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00

PSYCHIATRIC DIAG EVAL NON MD

Facility

$6,800.00

Service Code	HCPCS 90791
Hospital Charge Code	4546768
Hospital Revenue Code	900
Min. Negotiated Rate	$1,020.00
Max. Negotiated Rate	$1,020.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00

PSYCHIATRIC DIAG EVAL NON MD

Facility

$6,800.00

Service Code	HCPCS 90791
Hospital Charge Code	4546768
Hospital Revenue Code	900
Min. Negotiated Rate	$163.88
Max. Negotiated Rate	$3,081.00
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$267.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,040.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00
Rate for Payer: UnitedHealthcare Commercial	$3,081.00
Rate for Payer: UnitedHealthcare Community & State	$163.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$171.99
Rate for Payer: Wellpoint Medicaid Managed Care	$180.20

PSYCHIATRIC DIAG EVAL W/MS

Facility

$1,296.00

Service Code	HCPCS 90792
Hospital Charge Code	87504010
Hospital Revenue Code	900
Min. Negotiated Rate	$31.23
Max. Negotiated Rate	$3,081.00
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$663.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$388.80
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$194.40
Rate for Payer: UnitedHealthcare Commercial	$3,081.00
Rate for Payer: UnitedHealthcare Community & State	$31.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$437.76
Rate for Payer: Wellpoint Medicaid Managed Care	$34.34

PSYCHIATRIC DIAG EVAL W/MS

Facility

$6,800.00

Service Code	HCPCS 90792
Hospital Charge Code	87506020
Hospital Revenue Code	900
Min. Negotiated Rate	$163.88
Max. Negotiated Rate	$3,081.00
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$663.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,040.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00
Rate for Payer: UnitedHealthcare Commercial	$3,081.00
Rate for Payer: UnitedHealthcare Community & State	$163.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$437.76
Rate for Payer: Wellpoint Medicaid Managed Care	$180.20

PSYCHIATRIC DIAG EVAL W/MS

Facility

$6,800.00

Service Code	HCPCS 90792
Hospital Charge Code	84511003
Hospital Revenue Code	900
Min. Negotiated Rate	$1,020.00
Max. Negotiated Rate	$1,020.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00

PSYCHIATRIC DIAG EVAL W/MS

Facility

$6,800.00

Service Code	HCPCS 90792
Hospital Charge Code	84511003
Hospital Revenue Code	900
Min. Negotiated Rate	$163.88
Max. Negotiated Rate	$3,081.00
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$663.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,040.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00
Rate for Payer: UnitedHealthcare Commercial	$3,081.00
Rate for Payer: UnitedHealthcare Community & State	$163.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$437.76
Rate for Payer: Wellpoint Medicaid Managed Care	$180.20

PSYCHIATRIC DIAG EVAL W/MS

Facility

$550.00

Service Code	HCPCS 90792
Hospital Charge Code	84504010
Hospital Revenue Code	900
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$3,081.00
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$663.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$3,081.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$437.76
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

PSYCHIATRIC DIAG EVAL W/MS

Facility

$550.00

Service Code	HCPCS 90792
Hospital Charge Code	84504010
Hospital Revenue Code	900
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

PSYCHIATRIC DIAG EVAL W/MS

Facility

$6,800.00

Service Code	HCPCS 90792
Hospital Charge Code	84509003
Hospital Revenue Code	900
Min. Negotiated Rate	$1,020.00
Max. Negotiated Rate	$1,020.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00

PSYCHIATRIC DIAG EVAL W/MS

Facility

$550.00

Service Code	HCPCS 90792
Hospital Charge Code	84517003
Hospital Revenue Code	900
Min. Negotiated Rate	$13.26
Max. Negotiated Rate	$3,081.00
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$663.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$165.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$82.50
Rate for Payer: UnitedHealthcare Commercial	$3,081.00
Rate for Payer: UnitedHealthcare Community & State	$13.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$437.76
Rate for Payer: Wellpoint Medicaid Managed Care	$14.57

PSYCHIATRIC DIAG EVAL W/MS

Facility

$550.00

Service Code	HCPCS 90792
Hospital Charge Code	84518003
Hospital Revenue Code	900
Min. Negotiated Rate	$82.50
Max. Negotiated Rate	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$82.50

PSYCHIATRIC DIAG EVAL W/MS

Facility

$6,800.00

Service Code	HCPCS 90792
Hospital Charge Code	84509003
Hospital Revenue Code	900
Min. Negotiated Rate	$163.88
Max. Negotiated Rate	$3,081.00
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$761.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$663.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$761.18
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,040.00
Rate for Payer: Oxford Commercial	$1,757.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.00
Rate for Payer: UnitedHealthcare Commercial	$3,081.00
Rate for Payer: UnitedHealthcare Community & State	$163.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$437.76
Rate for Payer: Wellpoint Medicaid Managed Care	$180.20

Know your out-of-pocket cost for care.

All Charges