Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

QUAD SCREEN II

Facility

$390.00

Service Code	HCPCS 82677
Hospital Charge Code	39990125B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

QUAD SCREEN II

Facility

$390.00

Service Code	HCPCS 82677
Hospital Charge Code	39990125B
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$65.77
Rate for Payer: Aetna Medicare Advantage	$78.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.28
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$24.18
Rate for Payer: Clover Medicare Advantage	$22.97
Rate for Payer: EmblemHealth Commercial	$72.54
Rate for Payer: Humana Medicare Advantage	$24.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.18
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	$19.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.18
Rate for Payer: Wellcare Medicare Advantage	$24.18
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

QUAD SCREEN III

Facility

$390.00

Service Code	HCPCS 84702
Hospital Charge Code	39990125C
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.33
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
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	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

QUAD SCREEN III

Facility

$390.00

Service Code	HCPCS 84702
Hospital Charge Code	39990125C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

QUAD SCREEN IV

Facility

$390.00

Service Code	HCPCS 86336
Hospital Charge Code	39990125D
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

QUAD SCREEN IV

Facility

$390.00

Service Code	HCPCS 86336
Hospital Charge Code	39990125D
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$42.40
Rate for Payer: Aetna Medicare Advantage	$50.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.28
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.59
Rate for Payer: Clover Medicare Advantage	$14.81
Rate for Payer: EmblemHealth Commercial	$46.77
Rate for Payer: Humana Medicare Advantage	$16.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.59
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	$12.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.59
Rate for Payer: Wellcare Medicare Advantage	$15.59
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

QUALITATIVE MULTIALLERGEN SCRN

Facility

$74.45

Service Code	HCPCS 86005
Hospital Charge Code	3031400A
Hospital Revenue Code	305
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$21.68
Rate for Payer: Aetna Medicare Advantage	$25.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.77
Rate for Payer: Cigna Commercial	$37.23
Rate for Payer: Cigna Medicare Advantage	$7.97
Rate for Payer: Clover Medicare Advantage	$7.57
Rate for Payer: EmblemHealth Commercial	$23.91
Rate for Payer: Humana Medicare Advantage	$8.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.17
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.97
Rate for Payer: Wellcare Medicare Advantage	$7.97
Rate for Payer: Wellpoint Medicaid Managed Care	$1.97

QUALITATIVE MULTIALLERGEN SCRN

Facility

$74.45

Service Code	HCPCS 86005
Hospital Charge Code	3031400A
Hospital Revenue Code	305
Min. Negotiated Rate	$11.17
Max. Negotiated Rate	$11.17
Rate for Payer: Qualcare PPO/HMO/WC	$11.17

QUANT DIF PULM PERF & VENT

Facility

$1,899.00

Service Code	HCPCS 78598
Hospital Charge Code	4508025
Hospital Revenue Code	341
Min. Negotiated Rate	$45.77
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,754.56
Rate for Payer: Aetna Medicare Advantage	$2,089.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,328.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,328.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$645.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$261.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,328.47
Rate for Payer: Cigna Commercial	$1,293.03
Rate for Payer: Cigna Medicare Advantage	$451.54
Rate for Payer: Clover Medicare Advantage	$612.81
Rate for Payer: EmblemHealth Commercial	$1,935.18
Rate for Payer: Humana Medicare Advantage	$664.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$645.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$569.70
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$284.85
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$45.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$645.06
Rate for Payer: Wellcare Medicare Advantage	$645.06
Rate for Payer: Wellpoint Medicaid Managed Care	$50.32

QUANT DIF PULM PERF & VENT

Facility

$1,899.00

Service Code	HCPCS 78598
Hospital Charge Code	4508025
Hospital Revenue Code	341
Min. Negotiated Rate	$284.85
Max. Negotiated Rate	$284.85
Rate for Payer: Qualcare PPO/HMO/WC	$284.85

QUANTIFERON TB GOLD

Facility

$438.95

Service Code	HCPCS 86480
Hospital Charge Code	3037020
Hospital Revenue Code	302
Min. Negotiated Rate	$65.84
Max. Negotiated Rate	$65.84
Rate for Payer: Qualcare PPO/HMO/WC	$65.84

QUANTIFERON TB GOLD

Facility

$438.95

Service Code	HCPCS 86480
Hospital Charge Code	3037020
Hospital Revenue Code	302
Min. Negotiated Rate	$11.63
Max. Negotiated Rate	$223.73
Rate for Payer: Aetna Commercial	$168.59
Rate for Payer: Aetna Medicare Advantage	$200.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.73
Rate for Payer: Cigna Commercial	$219.47
Rate for Payer: Cigna Medicare Advantage	$61.98
Rate for Payer: Clover Medicare Advantage	$58.88
Rate for Payer: EmblemHealth Commercial	$185.94
Rate for Payer: Humana Medicare Advantage	$63.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$131.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.84
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$49.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.98
Rate for Payer: Wellcare Medicare Advantage	$61.98
Rate for Payer: Wellpoint Medicaid Managed Care	$11.63

QUANTIFERON-TB GOLD

Facility

$426.00

Service Code	HCPCS 86480
Hospital Charge Code	39900223
Hospital Revenue Code	302
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$63.90
Rate for Payer: Qualcare PPO/HMO/WC	$63.90

QUANTIFERON-TB GOLD

Facility

$426.00

Service Code	HCPCS 86480
Hospital Charge Code	39900223
Hospital Revenue Code	302
Min. Negotiated Rate	$11.29
Max. Negotiated Rate	$223.73
Rate for Payer: Aetna Commercial	$168.59
Rate for Payer: Aetna Medicare Advantage	$200.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.73
Rate for Payer: Cigna Commercial	$213.00
Rate for Payer: Cigna Medicare Advantage	$61.98
Rate for Payer: Clover Medicare Advantage	$58.88
Rate for Payer: EmblemHealth Commercial	$185.94
Rate for Payer: Humana Medicare Advantage	$63.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$49.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.98
Rate for Payer: Wellcare Medicare Advantage	$61.98
Rate for Payer: Wellpoint Medicaid Managed Care	$11.29

QUANTIFERON-TB GOLD PLUS

Facility

$426.00

Service Code	HCPCS 86480
Hospital Charge Code	401186480
Hospital Revenue Code	306
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$63.90
Rate for Payer: Qualcare PPO/HMO/WC	$63.90

QUANTIFERON-TB GOLD PLUS

Facility

$426.00

Service Code	HCPCS 86480
Hospital Charge Code	401186480
Hospital Revenue Code	306
Min. Negotiated Rate	$11.29
Max. Negotiated Rate	$223.73
Rate for Payer: Aetna Commercial	$168.59
Rate for Payer: Aetna Medicare Advantage	$200.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$78.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.73
Rate for Payer: Cigna Commercial	$213.00
Rate for Payer: Cigna Medicare Advantage	$61.98
Rate for Payer: Clover Medicare Advantage	$58.88
Rate for Payer: EmblemHealth Commercial	$185.94
Rate for Payer: Humana Medicare Advantage	$63.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$49.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.98
Rate for Payer: Wellcare Medicare Advantage	$61.98
Rate for Payer: Wellpoint Medicaid Managed Care	$11.29

QUANTIFICATION EA ORGANISM

Facility

$394.00

Service Code	HCPCS 87799
Hospital Charge Code	38478100
Hospital Revenue Code	306
Min. Negotiated Rate	$59.10
Max. Negotiated Rate	$59.10
Rate for Payer: Qualcare PPO/HMO/WC	$59.10

QUANTIFICATION EA ORGANISM

Facility

$394.00

Service Code	HCPCS 87799
Hospital Charge Code	38478100
Hospital Revenue Code	306
Min. Negotiated Rate	$10.44
Max. Negotiated Rate	$197.00
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.64
Rate for Payer: Cigna Commercial	$197.00
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$10.44

QUANTITATIVE HPLC

Facility

$256.00

Service Code	HCPCS 82542
Hospital Charge Code	3035159B
Hospital Revenue Code	301
Min. Negotiated Rate	$6.78
Max. Negotiated Rate	$128.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.96
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

QUANTITATIVE HPLC

Facility

$256.00

Service Code	HCPCS 82542
Hospital Charge Code	3035159B
Hospital Revenue Code	301
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

QUANTITATIVE HPLC

Facility

$256.00

Service Code	HCPCS 82542
Hospital Charge Code	3035159A
Hospital Revenue Code	301
Min. Negotiated Rate	$6.78
Max. Negotiated Rate	$128.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.96
Rate for Payer: Cigna Commercial	$128.00
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$6.78

QUANTITATIVE HPLC

Facility

$256.00

Service Code	HCPCS 82542
Hospital Charge Code	3035159A
Hospital Revenue Code	301
Min. Negotiated Rate	$38.40
Max. Negotiated Rate	$38.40
Rate for Payer: Qualcare PPO/HMO/WC	$38.40

QUANT LIPOPROOTEINS BY ULTRA

Facility

$175.79

Service Code	HCPCS 83701
Hospital Charge Code	38474063
Hospital Revenue Code	301
Min. Negotiated Rate	$4.66
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$92.10
Rate for Payer: Aetna Medicare Advantage	$109.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$33.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122.22
Rate for Payer: Cigna Commercial	$87.89
Rate for Payer: Cigna Medicare Advantage	$33.86
Rate for Payer: Clover Medicare Advantage	$32.17
Rate for Payer: EmblemHealth Commercial	$101.58
Rate for Payer: Humana Medicare Advantage	$34.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$33.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$52.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.37
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$27.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$33.86
Rate for Payer: Wellcare Medicare Advantage	$33.86
Rate for Payer: Wellpoint Medicaid Managed Care	$4.66

QUANT LIPOPROOTEINS BY ULTRA

Facility

$175.79

Service Code	HCPCS 83701
Hospital Charge Code	38474063
Hospital Revenue Code	301
Min. Negotiated Rate	$26.37
Max. Negotiated Rate	$26.37
Rate for Payer: Qualcare PPO/HMO/WC	$26.37

QUARRTO LINK ANCHOR 4.5MM SP

Facility

$2,275.00

Service Code	HCPCS C1713
Hospital Charge Code	270683673
Hospital Revenue Code	278
Min. Negotiated Rate	$341.25
Max. Negotiated Rate	$550.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$455.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$550.55
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$500.50
Rate for Payer: Qualcare PPO/HMO/WC	$341.25

Know your out-of-pocket cost for care.

All Charges