Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

REM IMP CERUMEN/IRRIG UNI

Facility

$329.60

Service Code	HCPCS 69209
Hospital Charge Code	5792275
Hospital Revenue Code	450
Min. Negotiated Rate	$49.44
Max. Negotiated Rate	$49.44
Rate for Payer: Qualcare PPO/HMO/WC	$49.44

REM IMP CERUMEN/IRRIG UNI

Facility

$329.60

Service Code	HCPCS 69209
Hospital Charge Code	5792275
Hospital Revenue Code	450
Min. Negotiated Rate	$8.73
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$190.62
Rate for Payer: Aetna Medicare Advantage	$227.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$252.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$70.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$252.97
Rate for Payer: Cigna Commercial	$140.48
Rate for Payer: Cigna Medicare Advantage	$70.08
Rate for Payer: Clover Medicare Advantage	$66.58
Rate for Payer: EmblemHealth Commercial	$210.24
Rate for Payer: Humana Medicare Advantage	$72.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$70.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.88
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.44
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$70.08
Rate for Payer: Wellcare Medicare Advantage	$70.08
Rate for Payer: Wellpoint Medicaid Managed Care	$8.73

REM IMPLANT FROM FINGER ORHAND

Facility

$13,615.50

Service Code	HCPCS 26320
Hospital Charge Code	16000474
Hospital Revenue Code	360
Min. Negotiated Rate	$328.13
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,084.65
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$328.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$360.81

REM IMPLANT FROM FINGER ORHAND

Facility

$13,615.50

Service Code	HCPCS 26320
Hospital Charge Code	16000474
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

REM MAMMARY IMPLANT

Facility

$31,541.30

Service Code	HCPCS 19328
Hospital Charge Code	16000536
Hospital Revenue Code	360
Min. Negotiated Rate	$760.15
Max. Negotiated Rate	$16,791.02
Rate for Payer: Aetna Commercial	$12,652.46
Rate for Payer: Aetna Medicare Advantage	$15,071.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,791.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,791.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,651.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,791.02
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: Cigna Medicare Advantage	$4,651.64
Rate for Payer: Clover Medicare Advantage	$4,419.06
Rate for Payer: EmblemHealth Commercial	$13,954.92
Rate for Payer: Humana Medicare Advantage	$4,791.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,651.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,462.39
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,731.19
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$760.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,651.64
Rate for Payer: Wellcare Medicare Advantage	$4,651.64
Rate for Payer: Wellpoint Medicaid Managed Care	$835.84

REM MAMMARY IMPLANT

Facility

$31,541.30

Service Code	HCPCS 19328
Hospital Charge Code	16000536
Hospital Revenue Code	360
Min. Negotiated Rate	$4,731.19
Max. Negotiated Rate	$4,731.19
Rate for Payer: Qualcare PPO/HMO/WC	$4,731.19

REM MAMMARY IMPL MATEAL

Facility

$31,541.30

Service Code	HCPCS 19330
Hospital Charge Code	16000664
Hospital Revenue Code	360
Min. Negotiated Rate	$4,731.19
Max. Negotiated Rate	$4,731.19
Rate for Payer: Qualcare PPO/HMO/WC	$4,731.19

REM MAMMARY IMPL MATEAL

Facility

$31,541.30

Service Code	HCPCS 19330
Hospital Charge Code	16000664
Hospital Revenue Code	360
Min. Negotiated Rate	$760.15
Max. Negotiated Rate	$16,791.02
Rate for Payer: Aetna Commercial	$12,652.46
Rate for Payer: Aetna Medicare Advantage	$15,071.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,791.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,791.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,651.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,791.02
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: Cigna Medicare Advantage	$4,651.64
Rate for Payer: Clover Medicare Advantage	$4,419.06
Rate for Payer: EmblemHealth Commercial	$13,954.92
Rate for Payer: Humana Medicare Advantage	$4,791.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,651.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,462.39
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,731.19
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$760.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,651.64
Rate for Payer: Wellcare Medicare Advantage	$4,651.64
Rate for Payer: Wellpoint Medicaid Managed Care	$835.84

REMODULIN 15MG/3ML SYRNGE

Facility

$4,271.00

Hospital Charge Code	60635640
Hospital Revenue Code	636
Min. Negotiated Rate	$640.65
Max. Negotiated Rate	$1,033.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,033.58
Rate for Payer: Qualcare PPO/HMO/WC	$640.65

REMODULIN 15MG/3ML SYRNGE

Facility

$4,271.00

Hospital Charge Code	60635640
Hospital Revenue Code	636
Min. Negotiated Rate	$102.93
Max. Negotiated Rate	$2,135.50
Rate for Payer: Aetna Commercial	$1,622.98
Rate for Payer: Aetna Medicare Advantage	$1,281.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,089.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,089.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,089.11
Rate for Payer: Cigna Commercial	$2,135.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,033.58
Rate for Payer: Qualcare PPO/HMO/WC	$640.65
Rate for Payer: UnitedHealthcare Community & State	$102.93
Rate for Payer: Wellpoint Medicaid Managed Care	$113.18

REMODULIN 5MG/ML VIAL

Facility

$4,271.00

Hospital Charge Code	60635651
Hospital Revenue Code	636
Min. Negotiated Rate	$102.93
Max. Negotiated Rate	$2,135.50
Rate for Payer: Aetna Commercial	$1,622.98
Rate for Payer: Aetna Medicare Advantage	$1,281.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,089.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,089.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,089.11
Rate for Payer: Cigna Commercial	$2,135.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,033.58
Rate for Payer: Qualcare PPO/HMO/WC	$640.65
Rate for Payer: UnitedHealthcare Community & State	$102.93
Rate for Payer: Wellpoint Medicaid Managed Care	$113.18

REMODULIN 5MG/ML VIAL

Facility

$4,271.00

Hospital Charge Code	60635651
Hospital Revenue Code	636
Min. Negotiated Rate	$640.65
Max. Negotiated Rate	$1,033.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,033.58
Rate for Payer: Qualcare PPO/HMO/WC	$640.65

REMOTE CNTRL PRECISION SPECTRA

Facility

$6,750.00

Hospital Charge Code	270675555
Hospital Revenue Code	272
Min. Negotiated Rate	$1,012.50
Max. Negotiated Rate	$1,012.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50

REMOTE CNTRL PRECISION SPECTRA

Facility

$6,750.00

Hospital Charge Code	270675555
Hospital Revenue Code	272
Min. Negotiated Rate	$162.68
Max. Negotiated Rate	$3,375.00
Rate for Payer: Aetna Commercial	$2,565.00
Rate for Payer: Aetna Medicare Advantage	$2,025.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,721.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,721.25
Rate for Payer: Cigna Commercial	$3,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,025.00
Rate for Payer: Oxford Commercial	$1,350.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,012.50
Rate for Payer: UnitedHealthcare Commercial	$1,350.00
Rate for Payer: UnitedHealthcare Community & State	$162.68
Rate for Payer: Wellpoint Medicaid Managed Care	$178.88

REMOTE CONTROL

Facility

$4,400.00

Service Code	HCPCS C1778
Hospital Charge Code	270702121
Hospital Revenue Code	278
Min. Negotiated Rate	$660.00
Max. Negotiated Rate	$1,064.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$660.00

REMOTE CONTROL

Facility

$4,400.00

Service Code	HCPCS C1778
Hospital Charge Code	270702121
Hospital Revenue Code	278
Min. Negotiated Rate	$106.04
Max. Negotiated Rate	$2,200.00
Rate for Payer: Aetna Commercial	$1,672.00
Rate for Payer: Aetna Medicare Advantage	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,122.00
Rate for Payer: Cigna Commercial	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$660.00
Rate for Payer: UnitedHealthcare Community & State	$106.04
Rate for Payer: Wellpoint Medicaid Managed Care	$116.60

REMOTE CONTROL

Facility

$4,400.00

Hospital Charge Code	270703590
Hospital Revenue Code	278
Min. Negotiated Rate	$660.00
Max. Negotiated Rate	$1,064.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$660.00

REMOTE CONTROL

Facility

$4,400.00

Hospital Charge Code	270703590
Hospital Revenue Code	278
Min. Negotiated Rate	$106.04
Max. Negotiated Rate	$2,200.00
Rate for Payer: Aetna Commercial	$1,672.00
Rate for Payer: Aetna Medicare Advantage	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,122.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$880.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,122.00
Rate for Payer: Cigna Commercial	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,064.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$660.00
Rate for Payer: UnitedHealthcare Community & State	$106.04
Rate for Payer: Wellpoint Medicaid Managed Care	$116.60

REMOVAL BILIARY DRG CATH

Facility

$4,605.35

Service Code	HCPCS 47537
Hospital Charge Code	7411566
Hospital Revenue Code	361
Min. Negotiated Rate	$690.80
Max. Negotiated Rate	$690.80
Rate for Payer: Qualcare PPO/HMO/WC	$690.80

REMOVAL BILIARY DRG CATH

Facility

$4,605.35

Service Code	HCPCS 47537
Hospital Charge Code	2600237
Hospital Revenue Code	361
Min. Negotiated Rate	$690.80
Max. Negotiated Rate	$690.80
Rate for Payer: Qualcare PPO/HMO/WC	$690.80

REMOVAL BILIARY DRG CATH

Facility

$4,605.35

Service Code	HCPCS 47537
Hospital Charge Code	2600237
Hospital Revenue Code	361
Min. Negotiated Rate	$110.99
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,381.61
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.80
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$110.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$122.04

REMOVAL BILIARY DRG CATH

Facility

$2,844.79

Service Code	HCPCS 47537
Hospital Charge Code	2011568
Hospital Revenue Code	361
Min. Negotiated Rate	$68.56
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$853.44
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$426.72
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$68.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$75.39

REMOVAL BILIARY DRG CATH

Facility

$4,605.35

Service Code	HCPCS 47537
Hospital Charge Code	7411566
Hospital Revenue Code	361
Min. Negotiated Rate	$110.99
Max. Negotiated Rate	$5,311.00
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
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	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,381.61
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$690.80
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$110.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$122.04

REMOVAL BILIARY DRG CATH

Facility

$2,844.79

Service Code	HCPCS 47537
Hospital Charge Code	2011568
Hospital Revenue Code	361
Min. Negotiated Rate	$426.72
Max. Negotiated Rate	$426.72
Rate for Payer: Qualcare PPO/HMO/WC	$426.72

REMOVAL BLADDER LESION

Facility

$16,842.20

Service Code	HCPCS 51525
Hospital Charge Code	1600000812
Hospital Revenue Code	360
Min. Negotiated Rate	$405.90
Max. Negotiated Rate	$10,232.00
Rate for Payer: Aetna Commercial	$6,400.04
Rate for Payer: Aetna Medicare Advantage	$5,052.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,294.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,294.76
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	$4,294.76
Rate for Payer: Cigna Commercial	$8,421.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,052.66
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,526.33
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$405.90
Rate for Payer: Wellpoint Medicaid Managed Care	$446.32

Know your out-of-pocket cost for care.

All Charges