Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

STENT VISI-PRO 5X27X80

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683566N
Hospital Revenue Code	278
Min. Negotiated Rate	$125.29
Max. Negotiated Rate	$2,599.45
Rate for Payer: Aetna Commercial	$1,975.58
Rate for Payer: Aetna Medicare Advantage	$1,559.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.72
Rate for Payer: Cigna Commercial	$2,599.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84
Rate for Payer: UnitedHealthcare Community & State	$125.29
Rate for Payer: Wellpoint Medicaid Managed Care	$137.77

STENT VISI-PRO 5X27X80

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683566
Hospital Revenue Code	278
Min. Negotiated Rate	$125.29
Max. Negotiated Rate	$2,599.45
Rate for Payer: Aetna Commercial	$1,975.58
Rate for Payer: Aetna Medicare Advantage	$1,559.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.72
Rate for Payer: Cigna Commercial	$2,599.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84
Rate for Payer: UnitedHealthcare Community & State	$125.29
Rate for Payer: Wellpoint Medicaid Managed Care	$137.77

STENT VISI-PRO 5X27X80

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683566N
Hospital Revenue Code	278
Min. Negotiated Rate	$779.84
Max. Negotiated Rate	$1,258.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84

STENT VISI-PRO 5X37X80

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683565
Hospital Revenue Code	278
Min. Negotiated Rate	$125.29
Max. Negotiated Rate	$2,599.45
Rate for Payer: Aetna Commercial	$1,975.58
Rate for Payer: Aetna Medicare Advantage	$1,559.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.72
Rate for Payer: Cigna Commercial	$2,599.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84
Rate for Payer: UnitedHealthcare Community & State	$125.29
Rate for Payer: Wellpoint Medicaid Managed Care	$137.77

STENT VISI-PRO 5X37X80

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683565N
Hospital Revenue Code	278
Min. Negotiated Rate	$779.84
Max. Negotiated Rate	$1,258.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84

STENT VISI-PRO 5X37X80

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683565
Hospital Revenue Code	278
Min. Negotiated Rate	$779.84
Max. Negotiated Rate	$1,258.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84

STENT VISI-PRO 5X37X80

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683565N
Hospital Revenue Code	278
Min. Negotiated Rate	$125.29
Max. Negotiated Rate	$2,599.45
Rate for Payer: Aetna Commercial	$1,975.58
Rate for Payer: Aetna Medicare Advantage	$1,559.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.72
Rate for Payer: Cigna Commercial	$2,599.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84
Rate for Payer: UnitedHealthcare Community & State	$125.29
Rate for Payer: Wellpoint Medicaid Managed Care	$137.77

STENT VISI-PRO 5X57X135

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683564N
Hospital Revenue Code	278
Min. Negotiated Rate	$779.84
Max. Negotiated Rate	$1,258.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84

STENT VISI-PRO 5X57X135

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683564
Hospital Revenue Code	278
Min. Negotiated Rate	$779.84
Max. Negotiated Rate	$1,258.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84

STENT VISI-PRO 5X57X135

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683564
Hospital Revenue Code	278
Min. Negotiated Rate	$125.29
Max. Negotiated Rate	$2,599.45
Rate for Payer: Aetna Commercial	$1,975.58
Rate for Payer: Aetna Medicare Advantage	$1,559.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.72
Rate for Payer: Cigna Commercial	$2,599.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84
Rate for Payer: UnitedHealthcare Community & State	$125.29
Rate for Payer: Wellpoint Medicaid Managed Care	$137.77

STENT VISI-PRO 5X57X135

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683564N
Hospital Revenue Code	278
Min. Negotiated Rate	$125.29
Max. Negotiated Rate	$2,599.45
Rate for Payer: Aetna Commercial	$1,975.58
Rate for Payer: Aetna Medicare Advantage	$1,559.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.72
Rate for Payer: Cigna Commercial	$2,599.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84
Rate for Payer: UnitedHealthcare Community & State	$125.29
Rate for Payer: Wellpoint Medicaid Managed Care	$137.77

STENT VISIPRO 6x17x80CM

Facility

$6,475.00

Service Code	HCPCS C1876
Hospital Charge Code	270660541S
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

STENT VISIPRO 6x17x80CM

Facility

$6,350.00

Service Code	HCPCS C1876
Hospital Charge Code	270660541
Hospital Revenue Code	278
Min. Negotiated Rate	$952.50
Max. Negotiated Rate	$1,536.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,536.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,397.00
Rate for Payer: Qualcare PPO/HMO/WC	$952.50

STENT VISIPRO 6x17x80CM

Facility

$6,350.00

Service Code	HCPCS C1876
Hospital Charge Code	270660541
Hospital Revenue Code	278
Min. Negotiated Rate	$153.03
Max. Negotiated Rate	$3,175.00
Rate for Payer: Aetna Commercial	$2,413.00
Rate for Payer: Aetna Medicare Advantage	$1,905.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,619.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,619.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,619.25
Rate for Payer: Cigna Commercial	$3,175.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,536.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,397.00
Rate for Payer: Qualcare PPO/HMO/WC	$952.50
Rate for Payer: UnitedHealthcare Community & State	$153.03
Rate for Payer: Wellpoint Medicaid Managed Care	$168.28

STENT VISIPRO 6x17x80CM

Facility

$6,475.00

Service Code	HCPCS C1876
Hospital Charge Code	270660541S
Hospital Revenue Code	278
Min. Negotiated Rate	$156.05
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Community & State	$156.05
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

STENT VISI-PRO 6x27x80cm

Facility

$6,475.00

Service Code	HCPCS C1876
Hospital Charge Code	270660539S
Hospital Revenue Code	278
Min. Negotiated Rate	$156.05
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Community & State	$156.05
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

STENT VISI-PRO 6x27x80cm

Facility

$6,475.00

Service Code	HCPCS C1876
Hospital Charge Code	270660539S
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

STENT VISI-PRO 6x27x80cm

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270660539
Hospital Revenue Code	278
Min. Negotiated Rate	$779.84
Max. Negotiated Rate	$1,258.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84

STENT VISI-PRO 6x27x80cm

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270660539
Hospital Revenue Code	278
Min. Negotiated Rate	$125.29
Max. Negotiated Rate	$2,599.45
Rate for Payer: Aetna Commercial	$1,975.58
Rate for Payer: Aetna Medicare Advantage	$1,559.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.72
Rate for Payer: Cigna Commercial	$2,599.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84
Rate for Payer: UnitedHealthcare Community & State	$125.29
Rate for Payer: Wellpoint Medicaid Managed Care	$137.77

STENT VISI-PRO 6x37x80cm

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270660540
Hospital Revenue Code	278
Min. Negotiated Rate	$779.84
Max. Negotiated Rate	$1,258.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84

STENT VISI-PRO 6x37x80cm

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270660540
Hospital Revenue Code	278
Min. Negotiated Rate	$125.29
Max. Negotiated Rate	$2,599.45
Rate for Payer: Aetna Commercial	$1,975.58
Rate for Payer: Aetna Medicare Advantage	$1,559.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.72
Rate for Payer: Cigna Commercial	$2,599.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84
Rate for Payer: UnitedHealthcare Community & State	$125.29
Rate for Payer: Wellpoint Medicaid Managed Care	$137.77

STENT VISI-PRO 6x37x80cm

Facility

$6,475.00

Service Code	HCPCS C1876
Hospital Charge Code	270660540S
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

STENT VISI-PRO 6x37x80cm

Facility

$6,475.00

Service Code	HCPCS C1876
Hospital Charge Code	270660540S
Hospital Revenue Code	278
Min. Negotiated Rate	$156.05
Max. Negotiated Rate	$3,237.50
Rate for Payer: Aetna Commercial	$2,460.50
Rate for Payer: Aetna Medicare Advantage	$1,942.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,651.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,651.12
Rate for Payer: Cigna Commercial	$3,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,424.50
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Community & State	$156.05
Rate for Payer: Wellpoint Medicaid Managed Care	$171.59

STENT VISI-PRO 6X57X80

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683563N
Hospital Revenue Code	278
Min. Negotiated Rate	$125.29
Max. Negotiated Rate	$2,599.45
Rate for Payer: Aetna Commercial	$1,975.58
Rate for Payer: Aetna Medicare Advantage	$1,559.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.72
Rate for Payer: Cigna Commercial	$2,599.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84
Rate for Payer: UnitedHealthcare Community & State	$125.29
Rate for Payer: Wellpoint Medicaid Managed Care	$137.77

STENT VISI-PRO 6X57X80

Facility

$5,198.90

Service Code	HCPCS C1876
Hospital Charge Code	270683563
Hospital Revenue Code	278
Min. Negotiated Rate	$125.29
Max. Negotiated Rate	$2,599.45
Rate for Payer: Aetna Commercial	$1,975.58
Rate for Payer: Aetna Medicare Advantage	$1,559.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,325.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,039.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,325.72
Rate for Payer: Cigna Commercial	$2,599.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,258.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,143.76
Rate for Payer: Qualcare PPO/HMO/WC	$779.84
Rate for Payer: UnitedHealthcare Community & State	$125.29
Rate for Payer: Wellpoint Medicaid Managed Care	$137.77

Know your out-of-pocket cost for care.

All Charges