Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TIBIA ADAPTIS INFINITY SZ3

Facility

$59,635.00

Service Code	HCPCS C1776
Hospital Charge Code	270698106
Hospital Revenue Code	278
Min. Negotiated Rate	$1,437.20
Max. Negotiated Rate	$29,817.50
Rate for Payer: Aetna Commercial	$22,661.30
Rate for Payer: Aetna Medicare Advantage	$17,890.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,206.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,206.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,927.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,206.92
Rate for Payer: Cigna Commercial	$29,817.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,431.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13,119.70
Rate for Payer: Qualcare PPO/HMO/WC	$8,945.25
Rate for Payer: UnitedHealthcare Community & State	$1,437.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1,580.33

TIBIA ADAPTIS INFINITY SZ3

Facility

$59,635.00

Service Code	HCPCS C1776
Hospital Charge Code	270698106
Hospital Revenue Code	278
Min. Negotiated Rate	$8,945.25
Max. Negotiated Rate	$14,431.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,927.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,431.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$13,119.70
Rate for Payer: Qualcare PPO/HMO/WC	$8,945.25

TIBIA ANKLE JT TM PROLONG SZ5

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697285
Hospital Revenue Code	278
Min. Negotiated Rate	$277.15
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$4,370.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,530.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00
Rate for Payer: UnitedHealthcare Community & State	$277.15
Rate for Payer: Wellpoint Medicaid Managed Care	$304.75

TIBIA ANKLE JT TM PROLONG SZ5

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697285
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,530.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

TIBIA ANKLE JT TM SZ5

Facility

$22,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270697283
Hospital Revenue Code	278
Min. Negotiated Rate	$3,300.00
Max. Negotiated Rate	$5,324.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00

TIBIA ANKLE JT TM SZ5

Facility

$22,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270697283
Hospital Revenue Code	278
Min. Negotiated Rate	$530.20
Max. Negotiated Rate	$11,000.00
Rate for Payer: Aetna Commercial	$8,360.00
Rate for Payer: Aetna Medicare Advantage	$6,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,610.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,610.00
Rate for Payer: Cigna Commercial	$11,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,324.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,840.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,300.00
Rate for Payer: UnitedHealthcare Community & State	$530.20
Rate for Payer: Wellpoint Medicaid Managed Care	$583.00

TIBIA ARTHROSCOPY SURGERY

Facility

$50,586.00

Service Code	HCPCS 29855
Hospital Charge Code	1600000769
Hospital Revenue Code	360
Min. Negotiated Rate	$7,587.90
Max. Negotiated Rate	$7,587.90
Rate for Payer: Qualcare PPO/HMO/WC	$7,587.90

TIBIA ARTHROSCOPY SURGERY

Facility

$50,586.00

Service Code	HCPCS 29855
Hospital Charge Code	1600000769
Hospital Revenue Code	360
Min. Negotiated Rate	$1,219.12
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	$15,175.80
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,587.90
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$1,219.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,880.57
Rate for Payer: Wellpoint Medicaid Managed Care	$15,569.19

TIBIA BASE FIXED BEARING SZ 7

Facility

$8,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270673972
Hospital Revenue Code	278
Min. Negotiated Rate	$1,237.50
Max. Negotiated Rate	$1,996.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50

TIBIA BASE FIXED BEARING SZ 7

Facility

$8,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270673972
Hospital Revenue Code	278
Min. Negotiated Rate	$198.82
Max. Negotiated Rate	$4,125.00
Rate for Payer: Aetna Commercial	$3,135.00
Rate for Payer: Aetna Medicare Advantage	$2,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,103.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,103.75
Rate for Payer: Cigna Commercial	$4,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,996.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,815.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,237.50
Rate for Payer: UnitedHealthcare Community & State	$198.82
Rate for Payer: Wellpoint Medicaid Managed Care	$218.62

TIBIA COMPON TRIATHLON SZ3

Facility

$6,837.70

Service Code	HCPCS C1776
Hospital Charge Code	270692077
Hospital Revenue Code	278
Min. Negotiated Rate	$1,025.65
Max. Negotiated Rate	$1,654.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,367.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,654.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,504.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.65

TIBIA COMPON TRIATHLON SZ3

Facility

$6,837.70

Service Code	HCPCS C1776
Hospital Charge Code	270692077
Hospital Revenue Code	278
Min. Negotiated Rate	$164.79
Max. Negotiated Rate	$3,418.85
Rate for Payer: Aetna Commercial	$2,598.33
Rate for Payer: Aetna Medicare Advantage	$2,051.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,743.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,743.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,367.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,743.61
Rate for Payer: Cigna Commercial	$3,418.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,654.72
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,504.29
Rate for Payer: Qualcare PPO/HMO/WC	$1,025.65
Rate for Payer: UnitedHealthcare Community & State	$164.79
Rate for Payer: Wellpoint Medicaid Managed Care	$181.20

TIBIA EMPOWER COATED

Facility

$11,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270691775
Hospital Revenue Code	278
Min. Negotiated Rate	$278.36
Max. Negotiated Rate	$5,775.00
Rate for Payer: Aetna Commercial	$4,389.00
Rate for Payer: Aetna Medicare Advantage	$3,465.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,945.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,310.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,945.25
Rate for Payer: Cigna Commercial	$5,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,795.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,732.50
Rate for Payer: UnitedHealthcare Community & State	$278.36
Rate for Payer: Wellpoint Medicaid Managed Care	$306.07

TIBIA EMPOWER COATED

Facility

$11,550.00

Service Code	HCPCS C1776
Hospital Charge Code	270691775
Hospital Revenue Code	278
Min. Negotiated Rate	$1,732.50
Max. Negotiated Rate	$2,795.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,310.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,795.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,541.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,732.50

TIBIA INSERT PSN SUR VE 7 20MM

Facility

$18,668.75

Service Code	HCPCS C1776
Hospital Charge Code	270698344
Hospital Revenue Code	278
Min. Negotiated Rate	$449.92
Max. Negotiated Rate	$9,334.38
Rate for Payer: Aetna Commercial	$7,094.12
Rate for Payer: Aetna Medicare Advantage	$5,600.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,760.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,760.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,733.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,760.53
Rate for Payer: Cigna Commercial	$9,334.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,517.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,107.12
Rate for Payer: Qualcare PPO/HMO/WC	$2,800.31
Rate for Payer: UnitedHealthcare Community & State	$449.92
Rate for Payer: Wellpoint Medicaid Managed Care	$494.72

TIBIA INSERT PSN SUR VE 7 20MM

Facility

$18,668.75

Service Code	HCPCS C1776
Hospital Charge Code	270698344
Hospital Revenue Code	278
Min. Negotiated Rate	$2,800.31
Max. Negotiated Rate	$4,517.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,733.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,517.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,107.12
Rate for Payer: Qualcare PPO/HMO/WC	$2,800.31

TIBIA INSERT PSN SUR VE 7 20MM

Facility

$18,668.75

Service Code	HCPCS C1776
Hospital Charge Code	698344
Hospital Revenue Code	278
Min. Negotiated Rate	$2,800.31
Max. Negotiated Rate	$4,517.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,733.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,517.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,107.12
Rate for Payer: Qualcare PPO/HMO/WC	$2,800.31

TIBIA INSERT PSN SUR VE 7 20MM

Facility

$18,668.75

Service Code	HCPCS C1776
Hospital Charge Code	698344
Hospital Revenue Code	278
Min. Negotiated Rate	$449.92
Max. Negotiated Rate	$9,334.38
Rate for Payer: Aetna Commercial	$7,094.12
Rate for Payer: Aetna Medicare Advantage	$5,600.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,760.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,760.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,733.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,760.53
Rate for Payer: Cigna Commercial	$9,334.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,517.84
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,107.12
Rate for Payer: Qualcare PPO/HMO/WC	$2,800.31
Rate for Payer: UnitedHealthcare Community & State	$449.92
Rate for Payer: Wellpoint Medicaid Managed Care	$494.72

TIBIA INS MP EVO CS 12MM SZ5RT

Facility

$8,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697692
Hospital Revenue Code	278
Min. Negotiated Rate	$1,275.00
Max. Negotiated Rate	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00

TIBIA INS MP EVO CS 12MM SZ5RT

Facility

$8,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270697692
Hospital Revenue Code	278
Min. Negotiated Rate	$204.85
Max. Negotiated Rate	$4,250.00
Rate for Payer: Aetna Commercial	$3,230.00
Rate for Payer: Aetna Medicare Advantage	$2,550.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,167.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,167.50
Rate for Payer: Cigna Commercial	$4,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,057.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,870.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,275.00
Rate for Payer: UnitedHealthcare Community & State	$204.85
Rate for Payer: Wellpoint Medicaid Managed Care	$225.25

TIBIA INST PSN ASF VE6-9 14MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270698345
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

TIBIA INST PSN ASF VE6-9 14MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270698345
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

TIBIA INST PSN ASF VE6-9 14MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	698345
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

TIBIA INST PSN ASF VE6-9 14MM

Facility

$6,000.00

Service Code	HCPCS C1776
Hospital Charge Code	698345
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

TIBIAL 146550

Facility

$2,872.00

Hospital Charge Code	270609693
Hospital Revenue Code	278
Min. Negotiated Rate	$69.22
Max. Negotiated Rate	$1,436.00
Rate for Payer: Aetna Commercial	$1,091.36
Rate for Payer: Aetna Medicare Advantage	$861.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$732.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$732.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$574.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$732.36
Rate for Payer: Cigna Commercial	$1,436.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$631.84
Rate for Payer: Qualcare PPO/HMO/WC	$430.80
Rate for Payer: UnitedHealthcare Community & State	$69.22
Rate for Payer: Wellpoint Medicaid Managed Care	$76.11

Know your out-of-pocket cost for care.

All Charges