Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RHOGAM

Facility

$215.00

Service Code	HCPCS 90384
Hospital Charge Code	3100135
Hospital Revenue Code	250
Min. Negotiated Rate	$32.25
Max. Negotiated Rate	$32.25
Rate for Payer: Qualcare PPO/HMO/WC	$32.25

RHOGAM (1 VIAL)

Facility

$499.00

Hospital Charge Code	38471010
Hospital Revenue Code	636
Min. Negotiated Rate	$12.03
Max. Negotiated Rate	$249.50
Rate for Payer: Aetna Commercial	$189.62
Rate for Payer: Aetna Medicare Advantage	$149.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.25
Rate for Payer: Cigna Commercial	$249.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.76
Rate for Payer: Qualcare PPO/HMO/WC	$74.85
Rate for Payer: UnitedHealthcare Community & State	$12.03
Rate for Payer: Wellpoint Medicaid Managed Care	$13.22

RHOGAM (1 VIAL)

Facility

$499.00

Hospital Charge Code	38471010
Hospital Revenue Code	636
Min. Negotiated Rate	$74.85
Max. Negotiated Rate	$120.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.76
Rate for Payer: Qualcare PPO/HMO/WC	$74.85

RHOGAM WORK UP PANEL

Facility

$363.25

Service Code	HCPCS 86870
Hospital Charge Code	3100138
Hospital Revenue Code	300
Min. Negotiated Rate	$54.49
Max. Negotiated Rate	$54.49
Rate for Payer: Qualcare PPO/HMO/WC	$54.49

RHOGAM WORK UP PANEL

Facility

$363.25

Service Code	HCPCS 86870
Hospital Charge Code	3100138
Hospital Revenue Code	300
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$1,537.15
Rate for Payer: Aetna Commercial	$1,158.28
Rate for Payer: Aetna Medicare Advantage	$1,379.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,537.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,537.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$425.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,537.15
Rate for Payer: Cigna Commercial	$853.60
Rate for Payer: Cigna Medicare Advantage	$425.84
Rate for Payer: Clover Medicare Advantage	$404.55
Rate for Payer: EmblemHealth Commercial	$1,277.52
Rate for Payer: Humana Medicare Advantage	$438.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$425.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$425.84
Rate for Payer: Wellcare Medicare Advantage	$425.84
Rate for Payer: Wellpoint Medicaid Managed Care	$9.63

RHOTON-TYPE BALL DISS 71/2 STR

Facility

$818.25

Hospital Charge Code	270691413
Hospital Revenue Code	272
Min. Negotiated Rate	$122.74
Max. Negotiated Rate	$122.74
Rate for Payer: Qualcare PPO/HMO/WC	$122.74

RHOTON-TYPE BALL DISS 71/2 STR

Facility

$818.25

Hospital Charge Code	270691413
Hospital Revenue Code	272
Min. Negotiated Rate	$19.72
Max. Negotiated Rate	$409.12
Rate for Payer: Aetna Commercial	$310.94
Rate for Payer: Aetna Medicare Advantage	$245.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$208.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$208.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$208.65
Rate for Payer: Cigna Commercial	$409.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.47
Rate for Payer: Oxford Commercial	$163.65
Rate for Payer: Qualcare PPO/HMO/WC	$122.74
Rate for Payer: UnitedHealthcare Commercial	$163.65
Rate for Payer: UnitedHealthcare Community & State	$19.72
Rate for Payer: Wellpoint Medicaid Managed Care	$21.68

RH PHENO (RH PHENOTYPE PAT TES

Facility

$390.00

Service Code	HCPCS 86906
Hospital Charge Code	3100558
Hospital Revenue Code	300
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$21.08
Rate for Payer: Aetna Medicare Advantage	$25.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.98
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$7.75
Rate for Payer: Clover Medicare Advantage	$7.36
Rate for Payer: EmblemHealth Commercial	$23.25
Rate for Payer: Humana Medicare Advantage	$7.98
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.75
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	$6.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.75
Rate for Payer: Wellcare Medicare Advantage	$7.75
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

RH PHENO (RH PHENOTYPE PAT TES

Facility

$390.00

Service Code	HCPCS 86906
Hospital Charge Code	3100558
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

R HRT ART/GRFT ANGIO

Facility

$16,190.00

Service Code	HCPCS 93457
Hospital Charge Code	5100665
Hospital Revenue Code	481
Min. Negotiated Rate	$2,428.50
Max. Negotiated Rate	$2,428.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50

R HRT ART/GRFT ANGIO

Facility

$16,190.00

Service Code	HCPCS 93457
Hospital Charge Code	74110066
Hospital Revenue Code	481
Min. Negotiated Rate	$2,428.50
Max. Negotiated Rate	$2,428.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50

R HRT ART/GRFT ANGIO

Facility

$16,190.00

Service Code	HCPCS 93457
Hospital Charge Code	74110066
Hospital Revenue Code	481
Min. Negotiated Rate	$390.18
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,857.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$390.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$429.04

R HRT ART/GRFT ANGIO

Facility

$16,190.00

Service Code	HCPCS 93457
Hospital Charge Code	5100665
Hospital Revenue Code	481
Min. Negotiated Rate	$390.18
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,857.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$390.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$429.04

R HRT CATH CHD ABNL NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93594
Hospital Charge Code	411093594
Hospital Revenue Code	481
Min. Negotiated Rate	$620.27
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,721.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$620.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$682.03

R HRT CATH CHD ABNL NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93594
Hospital Charge Code	411093594
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

R HRT CATH CHD NML NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93593
Hospital Charge Code	411093593
Hospital Revenue Code	481
Min. Negotiated Rate	$620.27
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,721.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$620.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$682.03

R HRT CATH CHD NML NT CNJ

Facility

$25,737.16

Service Code	HCPCS 93593
Hospital Charge Code	411093593
Hospital Revenue Code	481
Min. Negotiated Rate	$3,860.57
Max. Negotiated Rate	$3,860.57
Rate for Payer: Qualcare PPO/HMO/WC	$3,860.57

R HRT CORONARY ARTERY ANGIO

Facility

$16,190.00

Service Code	HCPCS 93456
Hospital Charge Code	74110065
Hospital Revenue Code	481
Min. Negotiated Rate	$2,428.50
Max. Negotiated Rate	$2,428.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50

R HRT CORONARY ARTERY ANGIO

Facility

$16,190.00

Service Code	HCPCS 93456
Hospital Charge Code	5100664
Hospital Revenue Code	481
Min. Negotiated Rate	$390.18
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,857.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$390.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$429.04

R HRT CORONARY ARTERY ANGIO

Facility

$16,190.00

Service Code	HCPCS 93456
Hospital Charge Code	5100664
Hospital Revenue Code	481
Min. Negotiated Rate	$2,428.50
Max. Negotiated Rate	$2,428.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50

R HRT CORONARY ARTERY ANGIO

Facility

$16,190.00

Service Code	HCPCS 93456
Hospital Charge Code	74110065
Hospital Revenue Code	481
Min. Negotiated Rate	$390.18
Max. Negotiated Rate	$13,902.76
Rate for Payer: Aetna Commercial	$10,476.08
Rate for Payer: Aetna Medicare Advantage	$12,478.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,902.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,851.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,194.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,902.76
Rate for Payer: Cigna Commercial	$7,720.31
Rate for Payer: Cigna Medicare Advantage	$3,851.50
Rate for Payer: Clover Medicare Advantage	$3,658.93
Rate for Payer: EmblemHealth Commercial	$11,554.50
Rate for Payer: Humana Medicare Advantage	$3,967.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,851.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,857.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$6,600.00
Rate for Payer: Oxford Commercial	$7,559.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,428.50
Rate for Payer: UnitedHealthcare Commercial	$12,870.00
Rate for Payer: UnitedHealthcare Community & State	$390.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,851.50
Rate for Payer: Wellcare Medicare Advantage	$3,851.50
Rate for Payer: Wellpoint Medicaid Managed Care	$429.04

RHYTHM STRIPS EKG

Facility

$1.50

Hospital Charge Code	270658865
Hospital Revenue Code	270
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.23

RHYTHM STRIPS EKG

Facility

$1.50

Hospital Charge Code	270658865
Hospital Revenue Code	270
Min. Negotiated Rate	$0.04
Max. Negotiated Rate	$0.75
Rate for Payer: Aetna Commercial	$0.57
Rate for Payer: Aetna Medicare Advantage	$0.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.38
Rate for Payer: Cigna Commercial	$0.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.45
Rate for Payer: Oxford Commercial	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.23
Rate for Payer: UnitedHealthcare Commercial	$0.30
Rate for Payer: UnitedHealthcare Community & State	$0.04
Rate for Payer: Wellpoint Medicaid Managed Care	$0.04

RIABNI 100MG/10ML VIAL

Facility

$5,763.07

Service Code	HCPCS Q5123
Hospital Charge Code	606390460
Hospital Revenue Code	636
Min. Negotiated Rate	$864.46
Max. Negotiated Rate	$1,394.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,394.66
Rate for Payer: Qualcare PPO/HMO/WC	$864.46

RIABNI 100MG/10ML VIAL

Facility

$5,763.07

Service Code	HCPCS Q5123
Hospital Charge Code	606390460
Hospital Revenue Code	636
Min. Negotiated Rate	$19.25
Max. Negotiated Rate	$1,394.66
Rate for Payer: Aetna Commercial	$55.11
Rate for Payer: Aetna Medicare Advantage	$65.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.13
Rate for Payer: Cigna Medicare Advantage	$20.26
Rate for Payer: Clover Medicare Advantage	$19.25
Rate for Payer: EmblemHealth Commercial	$60.78
Rate for Payer: Humana Medicare Advantage	$20.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,394.66
Rate for Payer: Qualcare PPO/HMO/WC	$864.46
Rate for Payer: UnitedHealthcare Community & State	$138.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.26
Rate for Payer: Wellcare Medicare Advantage	$20.26
Rate for Payer: Wellpoint Medicaid Managed Care	$152.72

Know your out-of-pocket cost for care.

All Charges