Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

RPR AA HRN 1ST < NCR/STRN

Facility

$25,012.88

Service Code	HCPCS 49592
Hospital Charge Code	1600000349
Hospital Revenue Code	360
Min. Negotiated Rate	$602.81
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,503.86
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,751.93
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$602.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$662.84

RPR AA HRN 1ST < NCR/STRN

Facility

$25,012.88

Service Code	HCPCS 49592
Hospital Charge Code	1600000349
Hospital Revenue Code	360
Min. Negotiated Rate	$3,751.93
Max. Negotiated Rate	$3,751.93
Rate for Payer: Qualcare PPO/HMO/WC	$3,751.93

RPR AA HRN RCR > 10 NCR/STRN

Facility

$5,275.64

Service Code	HCPCS 49618
Hospital Charge Code	16000151
Hospital Revenue Code	360
Min. Negotiated Rate	$791.35
Max. Negotiated Rate	$791.35
Rate for Payer: Qualcare PPO/HMO/WC	$791.35

RPR AA HRN RCR > 10 NCR/STRN

Facility

$5,275.64

Service Code	HCPCS 49618
Hospital Charge Code	16000151
Hospital Revenue Code	360
Min. Negotiated Rate	$127.14
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$2,004.74
Rate for Payer: Aetna Medicare Advantage	$1,582.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,345.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,345.29
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	$1,345.29
Rate for Payer: Cigna Commercial	$2,637.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,582.69
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$791.35
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$127.14
Rate for Payer: Wellpoint Medicaid Managed Care	$139.80

RPR AA HRN RCR 3-10 NCR/STRN

Facility

$3,654.36

Service Code	HCPCS 49616
Hospital Charge Code	16000993
Hospital Revenue Code	360
Min. Negotiated Rate	$548.15
Max. Negotiated Rate	$548.15
Rate for Payer: Qualcare PPO/HMO/WC	$548.15

RPR AA HRN RCR 3-10 NCR/STRN

Facility

$3,654.36

Service Code	HCPCS 49616
Hospital Charge Code	16000993
Hospital Revenue Code	360
Min. Negotiated Rate	$88.07
Max. Negotiated Rate	$14,834.00
Rate for Payer: Aetna Commercial	$1,388.66
Rate for Payer: Aetna Medicare Advantage	$1,096.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$931.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$931.86
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	$931.86
Rate for Payer: Cigna Commercial	$1,827.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,096.31
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$548.15
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$88.07
Rate for Payer: Wellpoint Medicaid Managed Care	$96.84

RPR AA HRN RCR < 3 NCR/STRN

Facility

$25,012.88

Service Code	HCPCS 49614
Hospital Charge Code	1600000300
Hospital Revenue Code	360
Min. Negotiated Rate	$602.81
Max. Negotiated Rate	$25,925.77
Rate for Payer: Aetna Commercial	$19,535.72
Rate for Payer: Aetna Medicare Advantage	$23,270.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,925.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,182.25
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	$25,925.77
Rate for Payer: Cigna Commercial	$14,396.79
Rate for Payer: Cigna Medicare Advantage	$7,182.25
Rate for Payer: Clover Medicare Advantage	$6,823.14
Rate for Payer: EmblemHealth Commercial	$21,546.75
Rate for Payer: Humana Medicare Advantage	$7,397.72
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,182.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,503.86
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,751.93
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$602.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,182.25
Rate for Payer: Wellcare Medicare Advantage	$7,182.25
Rate for Payer: Wellpoint Medicaid Managed Care	$662.84

RPR AA HRN RCR < 3 NCR/STRN

Facility

$25,012.88

Service Code	HCPCS 49614
Hospital Charge Code	1600000300
Hospital Revenue Code	360
Min. Negotiated Rate	$3,751.93
Max. Negotiated Rate	$3,751.93
Rate for Payer: Qualcare PPO/HMO/WC	$3,751.93

RPR AA HRN RCR < 3 RDC

Facility

$16,997.60

Service Code	HCPCS 49613
Hospital Charge Code	1600000579
Hospital Revenue Code	360
Min. Negotiated Rate	$409.64
Max. Negotiated Rate	$15,354.26
Rate for Payer: Aetna Commercial	$11,569.82
Rate for Payer: Aetna Medicare Advantage	$13,781.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,354.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,253.61
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	$15,354.26
Rate for Payer: Cigna Commercial	$8,526.35
Rate for Payer: Cigna Medicare Advantage	$4,253.61
Rate for Payer: Clover Medicare Advantage	$4,040.93
Rate for Payer: EmblemHealth Commercial	$12,760.83
Rate for Payer: Humana Medicare Advantage	$4,381.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,253.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,099.28
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,549.64
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$409.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,253.61
Rate for Payer: Wellcare Medicare Advantage	$4,253.61
Rate for Payer: Wellpoint Medicaid Managed Care	$450.44

RPR AA HRN RCR < 3 RDC

Facility

$16,997.60

Service Code	HCPCS 49613
Hospital Charge Code	1600000579
Hospital Revenue Code	360
Min. Negotiated Rate	$2,549.64
Max. Negotiated Rate	$2,549.64
Rate for Payer: Qualcare PPO/HMO/WC	$2,549.64

RPR CMPLX FCCMNAXGHF 1.1-2.5CM

Facility

$1,418.75

Service Code	HCPCS 13131
Hospital Charge Code	5700490
Hospital Revenue Code	450
Min. Negotiated Rate	$37.60
Max. Negotiated Rate	$1,743.30
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$256.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.30
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$212.81
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$37.60

RPR CMPLX FCCMNAXGHF 1.1-2.5CM

Facility

$1,418.75

Service Code	HCPCS 13131
Hospital Charge Code	5700490
Hospital Revenue Code	450
Min. Negotiated Rate	$212.81
Max. Negotiated Rate	$212.81
Rate for Payer: Qualcare PPO/HMO/WC	$212.81

RPR,COMPX,TRUNK,1.1CM TO 2.5CM

Facility

$5,066.40

Service Code	HCPCS 13100
Hospital Charge Code	1600000848
Hospital Revenue Code	360
Min. Negotiated Rate	$759.96
Max. Negotiated Rate	$759.96
Rate for Payer: Qualcare PPO/HMO/WC	$759.96

RPR,COMPX,TRUNK,1.1CM TO 2.5CM

Facility

$5,066.40

Service Code	HCPCS 13100
Hospital Charge Code	1600000848
Hospital Revenue Code	360
Min. Negotiated Rate	$122.10
Max. Negotiated Rate	$3,169.46
Rate for Payer: Aetna Commercial	$2,388.27
Rate for Payer: Aetna Medicare Advantage	$2,844.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,169.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$878.04
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	$3,169.46
Rate for Payer: Cigna Commercial	$1,760.02
Rate for Payer: Cigna Medicare Advantage	$878.04
Rate for Payer: Clover Medicare Advantage	$834.14
Rate for Payer: EmblemHealth Commercial	$2,634.12
Rate for Payer: Humana Medicare Advantage	$904.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$878.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,519.92
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$759.96
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$122.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$878.04
Rate for Payer: Wellcare Medicare Advantage	$878.04
Rate for Payer: Wellpoint Medicaid Managed Care	$134.26

RPR DISLOCATED PERONEAL TENDNS

Facility

$19,467.90

Service Code	HCPCS 27675
Hospital Charge Code	1600000267
Hospital Revenue Code	360
Min. Negotiated Rate	$2,920.18
Max. Negotiated Rate	$2,920.18
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18

RPR DISLOCATED PERONEAL TENDNS

Facility

$19,467.90

Service Code	HCPCS 27675
Hospital Charge Code	1600000267
Hospital Revenue Code	360
Min. Negotiated Rate	$469.18
Max. Negotiated Rate	$14,031.70
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,031.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,031.70
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,840.37
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$469.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$515.90

RPR NONUNION CARP NAVICULAR BN

Facility

$44,916.00

Service Code	HCPCS 25440
Hospital Charge Code	16000690
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

RPR NONUNION CARP NAVICULAR BN

Facility

$44,916.00

Service Code	HCPCS 25440
Hospital Charge Code	16000690
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

RPR PARASTOMAL HERNIA RDC

Facility

$58,232.00

Service Code	HCPCS 49621
Hospital Charge Code	1600000766
Hospital Revenue Code	360
Min. Negotiated Rate	$1,403.39
Max. Negotiated Rate	$29,116.00
Rate for Payer: Aetna Commercial	$22,128.16
Rate for Payer: Aetna Medicare Advantage	$17,469.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,849.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,849.16
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	$14,849.16
Rate for Payer: Cigna Commercial	$29,116.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,469.60
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,734.80
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,403.39
Rate for Payer: Wellpoint Medicaid Managed Care	$1,543.15

RPR PARASTOMAL HERNIA RDC

Facility

$58,232.00

Service Code	HCPCS 49621
Hospital Charge Code	1600000766
Hospital Revenue Code	360
Min. Negotiated Rate	$8,734.80
Max. Negotiated Rate	$8,734.80
Rate for Payer: Qualcare PPO/HMO/WC	$8,734.80

RPR, QUAL

Facility

$63.00

Service Code	HCPCS 86592
Hospital Charge Code	38476035
Hospital Revenue Code	302
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

RPR, QUAL

Facility

$63.00

Service Code	HCPCS 86592
Hospital Charge Code	38476035
Hospital Revenue Code	302
Min. Negotiated Rate	$1.67
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.67

RPR TARSOMETATARSAL JNT DISLCT

Facility

$48,992.10

Service Code	HCPCS 28615
Hospital Charge Code	16000576
Hospital Revenue Code	360
Min. Negotiated Rate	$7,348.81
Max. Negotiated Rate	$7,348.81
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81

RPR TARSOMETATARSAL JNT DISLCT

Facility

$48,992.10

Service Code	HCPCS 28615
Hospital Charge Code	16000576
Hospital Revenue Code	360
Min. Negotiated Rate	$1,180.71
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	$1,355.00
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	$14,697.63
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,348.81
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,180.71
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	$1,298.29

RPR TITER

Facility

$390.00

Service Code	HCPCS 86593
Hospital Charge Code	39900225
Hospital Revenue Code	302
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