Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TCD COMPLETE STUDY

Facility

$789.00

Service Code	HCPCS 93886
Hospital Charge Code	74117029
Hospital Revenue Code	920
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

TCD COMPLETE STUDY

Facility

$789.00

Service Code	HCPCS 93886
Hospital Charge Code	74117029
Hospital Revenue Code	920
Min. Negotiated Rate	$19.01
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$19.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$20.91

TCD COMPLETE STUDY

Facility

$789.00

Service Code	HCPCS 93886
Hospital Charge Code	74116029
Hospital Revenue Code	920
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

TCD COMPLETE STUDY

Facility

$789.00

Service Code	HCPCS 93886
Hospital Charge Code	74116029
Hospital Revenue Code	920
Min. Negotiated Rate	$19.01
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$19.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$20.91

TCD COMPLETE STUDY

Facility

$789.00

Service Code	HCPCS 93886
Hospital Charge Code	74115029
Hospital Revenue Code	920
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

TCD COMPLETE STUDY

Facility

$5,100.00

Service Code	HCPCS 93886
Hospital Charge Code	2692025
Hospital Revenue Code	920
Min. Negotiated Rate	$122.91
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

TCD COMPLETE STUDY

Facility

$789.00

Service Code	HCPCS 93886
Hospital Charge Code	74115029
Hospital Revenue Code	920
Min. Negotiated Rate	$19.01
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$771.04
Rate for Payer: Aetna Medicare Advantage	$918.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,023.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$283.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$569.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,023.24
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: Cigna Medicare Advantage	$283.47
Rate for Payer: Clover Medicare Advantage	$269.30
Rate for Payer: EmblemHealth Commercial	$850.41
Rate for Payer: Humana Medicare Advantage	$291.97
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$283.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$236.70
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$19.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$283.47
Rate for Payer: Wellcare Medicare Advantage	$283.47
Rate for Payer: Wellpoint Medicaid Managed Care	$20.91

TCD COMPLETE STUDY

Facility

$5,100.00

Service Code	HCPCS 93886
Hospital Charge Code	2692025
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

TCD LIMITED STUDY

Facility

$5,100.00

Service Code	HCPCS 93888
Hospital Charge Code	2692030
Hospital Revenue Code	920
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

TCD LIMITED STUDY

Facility

$5,100.00

Service Code	HCPCS 93888
Hospital Charge Code	2692030
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

TCD LIMITED STUDY

Facility

$517.00

Service Code	HCPCS 93888
Hospital Charge Code	74117030
Hospital Revenue Code	920
Min. Negotiated Rate	$77.55
Max. Negotiated Rate	$77.55
Rate for Payer: Qualcare PPO/HMO/WC	$77.55

TCD LIMITED STUDY

Facility

$517.00

Service Code	HCPCS 93888
Hospital Charge Code	74116030
Hospital Revenue Code	920
Min. Negotiated Rate	$77.55
Max. Negotiated Rate	$77.55
Rate for Payer: Qualcare PPO/HMO/WC	$77.55

TCD LIMITED STUDY

Facility

$5,100.00

Service Code	HCPCS 93888
Hospital Charge Code	74115030
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

TCD LIMITED STUDY

Facility

$5,100.00

Service Code	HCPCS 93888
Hospital Charge Code	74115030
Hospital Revenue Code	920
Min. Negotiated Rate	$117.99
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

TCD LIMITED STUDY

Facility

$517.00

Service Code	HCPCS 93888
Hospital Charge Code	74116030
Hospital Revenue Code	920
Min. Negotiated Rate	$12.46
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.55
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$12.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$13.70

TCD LIMITED STUDY

Facility

$517.00

Service Code	HCPCS 93888
Hospital Charge Code	74117030
Hospital Revenue Code	920
Min. Negotiated Rate	$12.46
Max. Negotiated Rate	$2,301.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$155.10
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.55
Rate for Payer: UnitedHealthcare Commercial	$2,301.00
Rate for Payer: UnitedHealthcare Community & State	$12.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$13.70

T CELLS CD4 & CD8,INCL RATIO

Facility

$599.00

Service Code	HCPCS 86360
Hospital Charge Code	38476263
Hospital Revenue Code	302
Min. Negotiated Rate	$89.85
Max. Negotiated Rate	$89.85
Rate for Payer: Qualcare PPO/HMO/WC	$89.85

T CELLS CD4 & CD8,INCL RATIO

Facility

$599.00

Service Code	HCPCS 86360
Hospital Charge Code	38476263
Hospital Revenue Code	302
Min. Negotiated Rate	$15.87
Max. Negotiated Rate	$299.50
Rate for Payer: Aetna Commercial	$127.79
Rate for Payer: Aetna Medicare Advantage	$152.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$169.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$169.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$46.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$169.58
Rate for Payer: Cigna Commercial	$299.50
Rate for Payer: Cigna Medicare Advantage	$46.98
Rate for Payer: Clover Medicare Advantage	$44.63
Rate for Payer: EmblemHealth Commercial	$140.94
Rate for Payer: Humana Medicare Advantage	$48.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$46.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$37.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$46.98
Rate for Payer: Wellcare Medicare Advantage	$46.98
Rate for Payer: Wellpoint Medicaid Managed Care	$15.87

T CELLS TOTAL COUNT

Facility

$431.00

Service Code	HCPCS 86359
Hospital Charge Code	38476262
Hospital Revenue Code	302
Min. Negotiated Rate	$64.65
Max. Negotiated Rate	$64.65
Rate for Payer: Qualcare PPO/HMO/WC	$64.65

T CELLS TOTAL COUNT

Facility

$431.00

Service Code	HCPCS 86359
Hospital Charge Code	38476262
Hospital Revenue Code	302
Min. Negotiated Rate	$11.42
Max. Negotiated Rate	$215.50
Rate for Payer: Aetna Commercial	$102.63
Rate for Payer: Aetna Medicare Advantage	$122.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.19
Rate for Payer: Cigna Commercial	$215.50
Rate for Payer: Cigna Medicare Advantage	$37.73
Rate for Payer: Clover Medicare Advantage	$35.84
Rate for Payer: EmblemHealth Commercial	$113.19
Rate for Payer: Humana Medicare Advantage	$38.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$30.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$37.73
Rate for Payer: Wellcare Medicare Advantage	$37.73
Rate for Payer: Wellpoint Medicaid Managed Care	$11.42

T CELLS, TOTAL COUNT

Facility

$432.00

Service Code	HCPCS 86539
Hospital Charge Code	38476296
Hospital Revenue Code	302
Min. Negotiated Rate	$10.41
Max. Negotiated Rate	$216.00
Rate for Payer: Aetna Commercial	$164.16
Rate for Payer: Aetna Medicare Advantage	$129.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.16
Rate for Payer: Cigna Commercial	$216.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$64.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.41
Rate for Payer: Wellpoint Medicaid Managed Care	$11.45

T CELLS, TOTAL COUNT

Facility

$432.00

Service Code	HCPCS 86539
Hospital Charge Code	38476296
Hospital Revenue Code	302
Min. Negotiated Rate	$64.80
Max. Negotiated Rate	$64.80
Rate for Payer: Qualcare PPO/HMO/WC	$64.80

TCM 12 LEAD EKG W INTERP

Facility

$2,050.00

Service Code	HCPCS 93000
Hospital Charge Code	93950113
Hospital Revenue Code	730
Min. Negotiated Rate	$49.41
Max. Negotiated Rate	$1,025.00
Rate for Payer: Aetna Commercial	$779.00
Rate for Payer: Aetna Medicare Advantage	$615.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$522.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$170.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$522.75
Rate for Payer: Cigna Commercial	$1,025.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$615.00
Rate for Payer: Oxford Commercial	$531.00
Rate for Payer: Qualcare PPO/HMO/WC	$307.50
Rate for Payer: UnitedHealthcare Commercial	$697.00
Rate for Payer: UnitedHealthcare Community & State	$49.41
Rate for Payer: Wellpoint Medicaid Managed Care	$54.33

TCM 12 LEAD EKG W INTERP

Facility

$2,050.00

Service Code	HCPCS 93000
Hospital Charge Code	93950113
Hospital Revenue Code	730
Min. Negotiated Rate	$307.50
Max. Negotiated Rate	$307.50
Rate for Payer: Qualcare PPO/HMO/WC	$307.50

TCM APIRATION SYNOVIAL CYST

Facility

$372.00

Service Code	HCPCS 20612
Hospital Charge Code	93950039
Hospital Revenue Code	761
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$1,316.35
Rate for Payer: Aetna Commercial	$991.90
Rate for Payer: Aetna Medicare Advantage	$1,181.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,316.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$364.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,316.35
Rate for Payer: Cigna Commercial	$730.97
Rate for Payer: Cigna Medicare Advantage	$364.67
Rate for Payer: Clover Medicare Advantage	$346.44
Rate for Payer: EmblemHealth Commercial	$1,094.01
Rate for Payer: Humana Medicare Advantage	$375.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$364.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$111.60
Rate for Payer: Oxford Commercial	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$55.80
Rate for Payer: UnitedHealthcare Commercial	$74.40
Rate for Payer: UnitedHealthcare Community & State	$8.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$364.67
Rate for Payer: Wellcare Medicare Advantage	$364.67
Rate for Payer: Wellpoint Medicaid Managed Care	$9.86

Know your out-of-pocket cost for care.

All Charges