Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

THYREL TRH 500MCG/ML

Facility

$166.00

Hospital Charge Code	60635183
Hospital Revenue Code	250
Min. Negotiated Rate	$24.90
Max. Negotiated Rate	$24.90
Rate for Payer: Qualcare PPO/HMO/WC	$24.90

THYREL TRH 500MCG/ML

Facility

$166.00

Hospital Charge Code	60635183
Hospital Revenue Code	250
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$83.00
Rate for Payer: Aetna Commercial	$63.08
Rate for Payer: Aetna Medicare Advantage	$49.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.33
Rate for Payer: Cigna Commercial	$83.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.80
Rate for Payer: Oxford Commercial	$33.20
Rate for Payer: Qualcare PPO/HMO/WC	$24.90
Rate for Payer: UnitedHealthcare Commercial	$33.20
Rate for Payer: UnitedHealthcare Community & State	$4.00
Rate for Payer: Wellpoint Medicaid Managed Care	$4.40

THYRIOD IMAGING W/BLOOD FLOW

Facility

$12,000.00

Service Code	HCPCS 78014
Hospital Charge Code	4501041
Hospital Revenue Code	341
Min. Negotiated Rate	$210.02
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$210.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,600.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

THYRIOD IMAGING W/BLOOD FLOW

Facility

$12,000.00

Service Code	HCPCS 78014
Hospital Charge Code	4501041
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

THYRIOD IMAGING W/BLOOD FLOW

Facility

$12,000.00

Service Code	HCPCS 78013
Hospital Charge Code	4501040
Hospital Revenue Code	341
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

THYRIOD IMAGING W/BLOOD FLOW

Facility

$12,000.00

Service Code	HCPCS 78013
Hospital Charge Code	4501040
Hospital Revenue Code	341
Min. Negotiated Rate	$181.95
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$181.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,600.00
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

THYRIOD UPTAKE MEASUREMENT

Facility

$671.78

Service Code	HCPCS 78012
Hospital Charge Code	4501039
Hospital Revenue Code	341
Min. Negotiated Rate	$16.19
Max. Negotiated Rate	$5,021.00
Rate for Payer: Aetna Commercial	$1,291.84
Rate for Payer: Aetna Medicare Advantage	$1,538.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,714.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$474.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,714.39
Rate for Payer: Cigna Commercial	$952.02
Rate for Payer: Cigna Medicare Advantage	$332.46
Rate for Payer: Clover Medicare Advantage	$451.19
Rate for Payer: EmblemHealth Commercial	$1,424.82
Rate for Payer: Humana Medicare Advantage	$489.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$474.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.53
Rate for Payer: Oxford Commercial	$3,120.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.77
Rate for Payer: UnitedHealthcare Commercial	$5,021.00
Rate for Payer: UnitedHealthcare Community & State	$16.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$474.94
Rate for Payer: Wellcare Medicare Advantage	$474.94
Rate for Payer: Wellpoint Medicaid Managed Care	$17.80

THYRIOD UPTAKE MEASUREMENT

Facility

$671.78

Service Code	HCPCS 78012
Hospital Charge Code	4501039
Hospital Revenue Code	341
Min. Negotiated Rate	$100.77
Max. Negotiated Rate	$100.77
Rate for Payer: Qualcare PPO/HMO/WC	$100.77

THYROGLOBULIN

Facility

$110.40

Service Code	HCPCS 84432
Hospital Charge Code	39900139
Hospital Revenue Code	301
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.68
Rate for Payer: Aetna Medicare Advantage	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.97
Rate for Payer: Cigna Commercial	$55.20
Rate for Payer: Cigna Medicare Advantage	$16.06
Rate for Payer: Clover Medicare Advantage	$15.26
Rate for Payer: EmblemHealth Commercial	$48.18
Rate for Payer: Humana Medicare Advantage	$16.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.56
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.06
Rate for Payer: Wellcare Medicare Advantage	$16.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.93

THYROGLOBULIN

Facility

$116.85

Service Code	HCPCS 84432
Hospital Charge Code	3007896
Hospital Revenue Code	301
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

THYROGLOBULIN

Facility

$113.80

Service Code	HCPCS 84432
Hospital Charge Code	38477134
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.68
Rate for Payer: Aetna Medicare Advantage	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.97
Rate for Payer: Cigna Commercial	$56.90
Rate for Payer: Cigna Medicare Advantage	$16.06
Rate for Payer: Clover Medicare Advantage	$15.26
Rate for Payer: EmblemHealth Commercial	$48.18
Rate for Payer: Humana Medicare Advantage	$16.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.14
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.07
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.06
Rate for Payer: Wellcare Medicare Advantage	$16.06
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

THYROGLOBULIN

Facility

$116.85

Service Code	HCPCS 84432
Hospital Charge Code	3007896
Hospital Revenue Code	301
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.68
Rate for Payer: Aetna Medicare Advantage	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.97
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: Cigna Medicare Advantage	$16.06
Rate for Payer: Clover Medicare Advantage	$15.26
Rate for Payer: EmblemHealth Commercial	$48.18
Rate for Payer: Humana Medicare Advantage	$16.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.06
Rate for Payer: Wellcare Medicare Advantage	$16.06
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

THYROGLOBULIN

Facility

$110.40

Service Code	HCPCS 84432
Hospital Charge Code	39900139
Hospital Revenue Code	301
Min. Negotiated Rate	$16.56
Max. Negotiated Rate	$16.56
Rate for Payer: Qualcare PPO/HMO/WC	$16.56

THYROGLOBULIN

Facility

$113.80

Service Code	HCPCS 84432
Hospital Charge Code	38477134
Hospital Revenue Code	301
Min. Negotiated Rate	$17.07
Max. Negotiated Rate	$17.07
Rate for Payer: Qualcare PPO/HMO/WC	$17.07

THYROGLOBULIN AB

Facility

$390.00

Service Code	HCPCS 86800
Hospital Charge Code	39900259
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$43.28
Rate for Payer: Aetna Medicare Advantage	$51.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.43
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.91
Rate for Payer: Clover Medicare Advantage	$15.11
Rate for Payer: EmblemHealth Commercial	$47.73
Rate for Payer: Humana Medicare Advantage	$16.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.91
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	$12.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.91
Rate for Payer: Wellcare Medicare Advantage	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

THYROGLOBULIN AB

Facility

$390.00

Service Code	HCPCS 86800
Hospital Charge Code	39900259
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

THYROGLOBULIN AB (SERUM)

Facility

$116.85

Service Code	HCPCS 86800
Hospital Charge Code	3007895
Hospital Revenue Code	302
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.28
Rate for Payer: Aetna Medicare Advantage	$51.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.43
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: Cigna Medicare Advantage	$15.91
Rate for Payer: Clover Medicare Advantage	$15.11
Rate for Payer: EmblemHealth Commercial	$47.73
Rate for Payer: Humana Medicare Advantage	$16.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.91
Rate for Payer: Wellcare Medicare Advantage	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

THYROGLOBULIN AB (SERUM)

Facility

$116.85

Service Code	HCPCS 86800
Hospital Charge Code	3007895
Hospital Revenue Code	302
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

THYROGLOBULIN LC/MS SERUM

Facility

$230.00

Service Code	HCPCS 84432
Hospital Charge Code	401184432
Hospital Revenue Code	301
Min. Negotiated Rate	$34.50
Max. Negotiated Rate	$34.50
Rate for Payer: Qualcare PPO/HMO/WC	$34.50

THYROGLOBULIN LC/MS SERUM

Facility

$230.00

Service Code	HCPCS 84432
Hospital Charge Code	401184432
Hospital Revenue Code	301
Min. Negotiated Rate	$6.09
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.68
Rate for Payer: Aetna Medicare Advantage	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.97
Rate for Payer: Cigna Commercial	$115.00
Rate for Payer: Cigna Medicare Advantage	$16.06
Rate for Payer: Clover Medicare Advantage	$15.26
Rate for Payer: EmblemHealth Commercial	$48.18
Rate for Payer: Humana Medicare Advantage	$16.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.06
Rate for Payer: Wellcare Medicare Advantage	$16.06
Rate for Payer: Wellpoint Medicaid Managed Care	$6.09

THYROGLOBULIN PANEL

Facility

$116.85

Service Code	HCPCS 86800
Hospital Charge Code	3035136B
Hospital Revenue Code	302
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

THYROGLOBULIN PANEL

Facility

$116.85

Service Code	HCPCS 86800
Hospital Charge Code	3035136B
Hospital Revenue Code	302
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.28
Rate for Payer: Aetna Medicare Advantage	$51.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.43
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: Cigna Medicare Advantage	$15.91
Rate for Payer: Clover Medicare Advantage	$15.11
Rate for Payer: EmblemHealth Commercial	$47.73
Rate for Payer: Humana Medicare Advantage	$16.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.91
Rate for Payer: Wellcare Medicare Advantage	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

THYROGLOBULIN PANEL

Facility

$116.85

Service Code	HCPCS 84432
Hospital Charge Code	3035136A
Hospital Revenue Code	301
Min. Negotiated Rate	$17.53
Max. Negotiated Rate	$17.53
Rate for Payer: Qualcare PPO/HMO/WC	$17.53

THYROGLOBULIN PANEL

Facility

$116.85

Service Code	HCPCS 84432
Hospital Charge Code	3035136A
Hospital Revenue Code	301
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.68
Rate for Payer: Aetna Medicare Advantage	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.97
Rate for Payer: Cigna Commercial	$58.42
Rate for Payer: Cigna Medicare Advantage	$16.06
Rate for Payer: Clover Medicare Advantage	$15.26
Rate for Payer: EmblemHealth Commercial	$48.18
Rate for Payer: Humana Medicare Advantage	$16.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.06
Rate for Payer: Wellcare Medicare Advantage	$16.06
Rate for Payer: Wellpoint Medicaid Managed Care	$3.10

THYROGLOBULIN PROFILE I

Facility

$667.59

Service Code	HCPCS 84432
Hospital Charge Code	39990076A
Hospital Revenue Code	301
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$43.68
Rate for Payer: Aetna Medicare Advantage	$52.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.97
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$16.06
Rate for Payer: Clover Medicare Advantage	$15.26
Rate for Payer: EmblemHealth Commercial	$48.18
Rate for Payer: Humana Medicare Advantage	$16.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.06
Rate for Payer: Wellcare Medicare Advantage	$16.06
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

Know your out-of-pocket cost for care.

All Charges