Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

QHERIT EXPANDED CARRIER SCREEN

Facility

$12,242.80

Service Code	HCPCS 81443
Hospital Charge Code	401181443
Hospital Revenue Code	300
Min. Negotiated Rate	$101.00
Max. Negotiated Rate	$8,838.57
Rate for Payer: Aetna Commercial	$6,660.08
Rate for Payer: Aetna Medicare Advantage	$7,933.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,838.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,838.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,448.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,896.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,838.57
Rate for Payer: Cigna Commercial	$6,121.40
Rate for Payer: Cigna Medicare Advantage	$2,448.56
Rate for Payer: Clover Medicare Advantage	$2,326.13
Rate for Payer: EmblemHealth Commercial	$7,345.68
Rate for Payer: Humana Medicare Advantage	$2,522.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,448.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,672.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,836.42
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1,958.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,448.56
Rate for Payer: Wellcare Medicare Advantage	$2,448.56
Rate for Payer: Wellpoint Medicaid Managed Care	$324.43

Q-INFLUENZA A&B ANTIGEN ASSAY

Facility

$246.24

Service Code	HCPCS 87804
Hospital Charge Code	4013878042
Hospital Revenue Code	306
Min. Negotiated Rate	$6.53
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.02
Rate for Payer: Aetna Medicare Advantage	$53.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.74
Rate for Payer: Cigna Commercial	$123.12
Rate for Payer: Cigna Medicare Advantage	$16.55
Rate for Payer: Clover Medicare Advantage	$15.72
Rate for Payer: EmblemHealth Commercial	$49.65
Rate for Payer: Humana Medicare Advantage	$17.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.94
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.55
Rate for Payer: Wellcare Medicare Advantage	$16.55
Rate for Payer: Wellpoint Medicaid Managed Care	$6.53

Q-INFLUENZA A&B ANTIGEN ASSAY

Facility

$246.24

Service Code	HCPCS 87804
Hospital Charge Code	4013878042
Hospital Revenue Code	306
Min. Negotiated Rate	$36.94
Max. Negotiated Rate	$36.94
Rate for Payer: Qualcare PPO/HMO/WC	$36.94

QLASE LASER FIBER USED

Facility

$3,975.00

Hospital Charge Code	270677530
Hospital Revenue Code	272
Min. Negotiated Rate	$596.25
Max. Negotiated Rate	$596.25
Rate for Payer: Qualcare PPO/HMO/WC	$596.25

QLASE LASER FIBER USED

Facility

$3,975.00

Hospital Charge Code	270677530
Hospital Revenue Code	272
Min. Negotiated Rate	$95.80
Max. Negotiated Rate	$1,987.50
Rate for Payer: Aetna Commercial	$1,510.50
Rate for Payer: Aetna Medicare Advantage	$1,192.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,013.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,013.62
Rate for Payer: Cigna Commercial	$1,987.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,192.50
Rate for Payer: Oxford Commercial	$795.00
Rate for Payer: Qualcare PPO/HMO/WC	$596.25
Rate for Payer: UnitedHealthcare Commercial	$795.00
Rate for Payer: UnitedHealthcare Community & State	$95.80
Rate for Payer: Wellpoint Medicaid Managed Care	$105.34

QNS HPV HIGH RISK

Facility

$241.20

Service Code	HCPCS 87624
Hospital Charge Code	39900304
Hospital Revenue Code	306
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$126.66
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$120.60
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.36
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.18
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$6.39

QNS HPV HIGH RISK

Facility

$241.20

Service Code	HCPCS 87624
Hospital Charge Code	39900304
Hospital Revenue Code	306
Min. Negotiated Rate	$36.18
Max. Negotiated Rate	$36.18
Rate for Payer: Qualcare PPO/HMO/WC	$36.18

Q-RSV ASSAY W/OPTICAL OBSERVAT

Facility

$120.03

Service Code	HCPCS 87807
Hospital Charge Code	401387807
Hospital Revenue Code	306
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$35.63
Rate for Payer: Aetna Medicare Advantage	$42.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.29
Rate for Payer: Cigna Commercial	$60.02
Rate for Payer: Cigna Medicare Advantage	$13.10
Rate for Payer: Clover Medicare Advantage	$12.45
Rate for Payer: EmblemHealth Commercial	$39.30
Rate for Payer: Humana Medicare Advantage	$13.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.10
Rate for Payer: Wellcare Medicare Advantage	$13.10
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

Q-RSV ASSAY W/OPTICAL OBSERVAT

Facility

$120.03

Service Code	HCPCS 87807
Hospital Charge Code	401387807
Hospital Revenue Code	306
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

QT INFLIXIMAB W RFX AB/INFLIX

Facility

$1,222.50

Service Code	HCPCS 80299
Hospital Charge Code	3038549
Hospital Revenue Code	301
Min. Negotiated Rate	$183.38
Max. Negotiated Rate	$183.38
Rate for Payer: Qualcare PPO/HMO/WC	$183.38

QT INFLIXIMAB W RFX AB/INFLIX

Facility

$1,222.50

Service Code	HCPCS 80299
Hospital Charge Code	3038549
Hospital Revenue Code	301
Min. Negotiated Rate	$11.64
Max. Negotiated Rate	$611.25
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.28
Rate for Payer: Cigna Commercial	$611.25
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$366.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$183.38
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$32.40

QUACEPSPLASTY

Facility

$44,916.00

Service Code	HCPCS 27430
Hospital Charge Code	16000886
Hospital Revenue Code	360
Min. Negotiated Rate	$1,082.48
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	$13,474.80
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$1,082.48
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	$1,190.27

QUACEPSPLASTY

Facility

$44,916.00

Service Code	HCPCS 27430
Hospital Charge Code	16000886
Hospital Revenue Code	360
Min. Negotiated Rate	$6,737.40
Max. Negotiated Rate	$6,737.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40

QUADLINK IMPLANT 11MM

Facility

$10,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270695228
Hospital Revenue Code	278
Min. Negotiated Rate	$1,631.25
Max. Negotiated Rate	$2,631.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,392.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25

QUADLINK IMPLANT 11MM

Facility

$10,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270695228
Hospital Revenue Code	278
Min. Negotiated Rate	$262.09
Max. Negotiated Rate	$5,437.50
Rate for Payer: Aetna Commercial	$4,132.50
Rate for Payer: Aetna Medicare Advantage	$3,262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,773.12
Rate for Payer: Cigna Commercial	$5,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,392.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25
Rate for Payer: UnitedHealthcare Community & State	$262.09
Rate for Payer: Wellpoint Medicaid Managed Care	$288.19

QUADLINK IMPLANT 8MM

Facility

$10,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270695230
Hospital Revenue Code	278
Min. Negotiated Rate	$262.09
Max. Negotiated Rate	$5,437.50
Rate for Payer: Aetna Commercial	$4,132.50
Rate for Payer: Aetna Medicare Advantage	$3,262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,773.12
Rate for Payer: Cigna Commercial	$5,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,392.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25
Rate for Payer: UnitedHealthcare Community & State	$262.09
Rate for Payer: Wellpoint Medicaid Managed Care	$288.19

QUADLINK IMPLANT 8MM

Facility

$10,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270695230
Hospital Revenue Code	278
Min. Negotiated Rate	$1,631.25
Max. Negotiated Rate	$2,631.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,392.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25

QUADLINK IMPLANT SYSTEM 9MM

Facility

$10,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270696481
Hospital Revenue Code	278
Min. Negotiated Rate	$262.09
Max. Negotiated Rate	$5,437.50
Rate for Payer: Aetna Commercial	$4,132.50
Rate for Payer: Aetna Medicare Advantage	$3,262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,773.12
Rate for Payer: Cigna Commercial	$5,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,392.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25
Rate for Payer: UnitedHealthcare Community & State	$262.09
Rate for Payer: Wellpoint Medicaid Managed Care	$288.19

QUADLINK IMPLANT SYSTEM 9MM

Facility

$10,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270696481
Hospital Revenue Code	278
Min. Negotiated Rate	$1,631.25
Max. Negotiated Rate	$2,631.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,392.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25

QUADLINK IMPL SYS ALL INSIDE W

Facility

$14,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270704140
Hospital Revenue Code	278
Min. Negotiated Rate	$344.03
Max. Negotiated Rate	$7,137.50
Rate for Payer: Aetna Commercial	$5,424.50
Rate for Payer: Aetna Medicare Advantage	$4,282.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,640.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,640.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,855.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,640.12
Rate for Payer: Cigna Commercial	$7,137.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,454.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,140.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,141.25
Rate for Payer: UnitedHealthcare Community & State	$344.03
Rate for Payer: Wellpoint Medicaid Managed Care	$378.29

QUADLINK IMPL SYS ALL INSIDE W

Facility

$14,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270704140
Hospital Revenue Code	278
Min. Negotiated Rate	$2,141.25
Max. Negotiated Rate	$3,454.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,855.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,454.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,140.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,141.25

QUADLINK KIT 10MM

Facility

$10,875.00

Service Code	HCPCS L8699
Hospital Charge Code	270696143
Hospital Revenue Code	278
Min. Negotiated Rate	$262.09
Max. Negotiated Rate	$5,437.50
Rate for Payer: Aetna Commercial	$4,132.50
Rate for Payer: Aetna Medicare Advantage	$3,262.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,773.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,175.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,773.12
Rate for Payer: Cigna Commercial	$5,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,392.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25
Rate for Payer: UnitedHealthcare Community & State	$262.09
Rate for Payer: Wellpoint Medicaid Managed Care	$288.19

QUADLINK KIT 10MM

Facility

$10,875.00

Service Code	HCPCS L8699
Hospital Charge Code	270696143
Hospital Revenue Code	278
Min. Negotiated Rate	$1,631.25
Max. Negotiated Rate	$2,631.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,631.75
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,392.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,631.25

QUAD SCREEN I

Facility

$390.00

Service Code	HCPCS 82105
Hospital Charge Code	39990125A
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.61
Rate for Payer: Aetna Medicare Advantage	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.53
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.77
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Medicare Advantage	$16.77
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

QUAD SCREEN I

Facility

$390.00

Service Code	HCPCS 82105
Hospital Charge Code	39990125A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges