Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TENDON SEMITENDINOSUS 92-0784

Facility

$6,448.00

Hospital Charge Code	270628576
Hospital Revenue Code	278
Min. Negotiated Rate	$155.40
Max. Negotiated Rate	$3,224.00
Rate for Payer: Aetna Commercial	$2,450.24
Rate for Payer: Aetna Medicare Advantage	$1,934.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,644.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,289.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,644.24
Rate for Payer: Cigna Commercial	$3,224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,560.42
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,418.56
Rate for Payer: Qualcare PPO/HMO/WC	$967.20
Rate for Payer: UnitedHealthcare Community & State	$155.40
Rate for Payer: Wellpoint Medicaid Managed Care	$170.87

TENDON SHEATH 1 DIG AND/PALM

Facility

$14,854.00

Service Code	HCPCS 26020
Hospital Charge Code	16000839
Hospital Revenue Code	360
Min. Negotiated Rate	$2,228.10
Max. Negotiated Rate	$2,228.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10

TENDON SHEATH 1 DIG AND/PALM

Facility

$14,854.00

Service Code	HCPCS 26020
Hospital Charge Code	16000839
Hospital Revenue Code	360
Min. Negotiated Rate	$357.98
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	$4,456.20
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$357.98
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	$393.63

TENDON SHEATH INCISION

Facility

$14,854.00

Service Code	HCPCS 26055
Hospital Charge Code	16000224
Hospital Revenue Code	360
Min. Negotiated Rate	$357.98
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,456.20
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$357.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,404.80
Rate for Payer: Wellpoint Medicaid Managed Care	$4,318.43

TENDON SHEATH INCISION

Facility

$14,854.00

Service Code	HCPCS 26055
Hospital Charge Code	16000224
Hospital Revenue Code	360
Min. Negotiated Rate	$2,228.10
Max. Negotiated Rate	$2,228.10
Rate for Payer: Qualcare PPO/HMO/WC	$2,228.10

TENDON SHEATH INCISION

Facility

$6,974.20

Service Code	HCPCS 26055
Hospital Charge Code	412325055
Hospital Revenue Code	361
Min. Negotiated Rate	$1,046.13
Max. Negotiated Rate	$1,046.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.13

TENDON SHEATH INCISION

Facility

$6,974.20

Service Code	HCPCS 26055
Hospital Charge Code	412325055
Hospital Revenue Code	361
Min. Negotiated Rate	$168.08
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
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	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,092.26
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,046.13
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$168.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,404.80
Rate for Payer: Wellpoint Medicaid Managed Care	$4,318.43

TENDON SPACER HUNTER 4MMX24CM

Facility

$12,100.00

Service Code	HCPCS C1763
Hospital Charge Code	270696019
Hospital Revenue Code	278
Min. Negotiated Rate	$1,815.00
Max. Negotiated Rate	$2,928.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00

TENDON SPACER HUNTER 4MMX24CM

Facility

$12,100.00

Service Code	HCPCS C1763
Hospital Charge Code	270696019
Hospital Revenue Code	278
Min. Negotiated Rate	$291.61
Max. Negotiated Rate	$6,050.00
Rate for Payer: Aetna Commercial	$4,598.00
Rate for Payer: Aetna Medicare Advantage	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,420.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,085.50
Rate for Payer: Cigna Commercial	$6,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,928.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,815.00
Rate for Payer: UnitedHealthcare Community & State	$291.61
Rate for Payer: Wellpoint Medicaid Managed Care	$320.65

TENDON TIBIAL POST 10.5x260MM

Facility

$8,415.00

Service Code	HCPCS C1762
Hospital Charge Code	270676202
Hospital Revenue Code	278
Min. Negotiated Rate	$202.80
Max. Negotiated Rate	$4,207.50
Rate for Payer: Aetna Commercial	$3,197.70
Rate for Payer: Aetna Medicare Advantage	$2,524.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,145.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,145.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,145.82
Rate for Payer: Cigna Commercial	$4,207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,036.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,851.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,262.25
Rate for Payer: UnitedHealthcare Community & State	$202.80
Rate for Payer: Wellpoint Medicaid Managed Care	$223.00

TENDON TIBIAL POST 10.5x260MM

Facility

$8,415.00

Service Code	HCPCS C1762
Hospital Charge Code	270676202
Hospital Revenue Code	278
Min. Negotiated Rate	$1,262.25
Max. Negotiated Rate	$2,036.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,683.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,036.43
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,851.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,262.25

TENDRIL LEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233S
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TENDRIL LEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233N
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

TENDRIL LEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233N
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TENDRIL LEADS U PR 46

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270671233S
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

TENDRIL LEADS U PR 52

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443S
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

TENDRIL LEADS U PR 52

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443N
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TENDRIL LEADS U PR 52

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443N
Hospital Revenue Code	278
Min. Negotiated Rate	$72.30
Max. Negotiated Rate	$1,500.00
Rate for Payer: Aetna Commercial	$1,140.00
Rate for Payer: Aetna Medicare Advantage	$900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$765.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$765.00
Rate for Payer: Cigna Commercial	$1,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00
Rate for Payer: UnitedHealthcare Community & State	$72.30
Rate for Payer: Wellpoint Medicaid Managed Care	$79.50

TENDRIL LEADS U PR 52

Facility

$3,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443S
Hospital Revenue Code	278
Min. Negotiated Rate	$450.00
Max. Negotiated Rate	$726.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$726.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$660.00
Rate for Payer: Qualcare PPO/HMO/WC	$450.00

TENDRILLEADS U PR 52

Facility

$2,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443
Hospital Revenue Code	278
Min. Negotiated Rate	$300.00
Max. Negotiated Rate	$484.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00

TENDRILLEADS U PR 52

Facility

$2,000.00

Service Code	HCPCS C1898
Hospital Charge Code	270668443
Hospital Revenue Code	278
Min. Negotiated Rate	$48.20
Max. Negotiated Rate	$1,000.00
Rate for Payer: Aetna Commercial	$760.00
Rate for Payer: Aetna Medicare Advantage	$600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.00
Rate for Payer: Cigna Commercial	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$440.00
Rate for Payer: Qualcare PPO/HMO/WC	$300.00
Rate for Payer: UnitedHealthcare Community & State	$48.20
Rate for Payer: Wellpoint Medicaid Managed Care	$53.00

TENDRIL LEADS U PR 58

Facility

$4,515.00

Service Code	HCPCS C1898
Hospital Charge Code	270669000N
Hospital Revenue Code	278
Min. Negotiated Rate	$677.25
Max. Negotiated Rate	$1,092.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$903.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,092.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$993.30
Rate for Payer: Qualcare PPO/HMO/WC	$677.25

TENDRIL LEADS U PR 58

Facility

$4,515.00

Service Code	HCPCS C1898
Hospital Charge Code	270669000N
Hospital Revenue Code	278
Min. Negotiated Rate	$108.81
Max. Negotiated Rate	$2,257.50
Rate for Payer: Aetna Commercial	$1,715.70
Rate for Payer: Aetna Medicare Advantage	$1,354.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,151.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,151.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$903.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,151.33
Rate for Payer: Cigna Commercial	$2,257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,092.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$993.30
Rate for Payer: Qualcare PPO/HMO/WC	$677.25
Rate for Payer: UnitedHealthcare Community & State	$108.81
Rate for Payer: Wellpoint Medicaid Managed Care	$119.65

TENDRIL LEADS U PR 58

Facility

$4,515.00

Service Code	HCPCS C1898
Hospital Charge Code	270669000S
Hospital Revenue Code	278
Min. Negotiated Rate	$677.25
Max. Negotiated Rate	$1,092.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$903.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,092.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$993.30
Rate for Payer: Qualcare PPO/HMO/WC	$677.25

TENDRIL LEADS U PR 58

Facility

$4,515.00

Service Code	HCPCS C1898
Hospital Charge Code	270669000S
Hospital Revenue Code	278
Min. Negotiated Rate	$108.81
Max. Negotiated Rate	$2,257.50
Rate for Payer: Aetna Commercial	$1,715.70
Rate for Payer: Aetna Medicare Advantage	$1,354.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,151.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,151.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$903.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,151.33
Rate for Payer: Cigna Commercial	$2,257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,092.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$993.30
Rate for Payer: Qualcare PPO/HMO/WC	$677.25
Rate for Payer: UnitedHealthcare Community & State	$108.81
Rate for Payer: Wellpoint Medicaid Managed Care	$119.65

Know your out-of-pocket cost for care.

All Charges