Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

TREAT PLEURODESIS W/AGENT

Facility

$2,912.40

Service Code	HCPCS 32560
Hospital Charge Code	160000236
Hospital Revenue Code	360
Min. Negotiated Rate	$436.86
Max. Negotiated Rate	$436.86
Rate for Payer: Qualcare PPO/HMO/WC	$436.86

TREAT PLEURODESIS W/AGENT

Facility

$1,613.00

Service Code	HCPCS 32560
Hospital Charge Code	7411387
Hospital Revenue Code	361
Min. Negotiated Rate	$241.95
Max. Negotiated Rate	$241.95
Rate for Payer: Qualcare PPO/HMO/WC	$241.95

TREAT PLEURODESIS W/AGENT

Facility

$1,613.00

Service Code	HCPCS 32560
Hospital Charge Code	7411387
Hospital Revenue Code	361
Min. Negotiated Rate	$38.87
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
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	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$483.90
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.95
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$38.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$42.74

TREAT PLEURODESIS W/AGENT

Facility

$2,912.40

Service Code	HCPCS 32560
Hospital Charge Code	160000236
Hospital Revenue Code	360
Min. Negotiated Rate	$70.19
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
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	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$873.72
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$436.86
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$70.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$77.18

TREAT PLEURODESIS W/AGENT

Facility

$1,613.00

Service Code	HCPCS 32560
Hospital Charge Code	2690045
Hospital Revenue Code	361
Min. Negotiated Rate	$241.95
Max. Negotiated Rate	$241.95
Rate for Payer: Qualcare PPO/HMO/WC	$241.95

TREAT PLEURODESIS W/AGENT

Facility

$1,613.00

Service Code	HCPCS 32560
Hospital Charge Code	2690045
Hospital Revenue Code	361
Min. Negotiated Rate	$38.87
Max. Negotiated Rate	$3,593.00
Rate for Payer: Aetna Commercial	$2,027.08
Rate for Payer: Aetna Medicare Advantage	$2,414.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,690.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$745.25
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	$2,690.13
Rate for Payer: Cigna Commercial	$1,493.86
Rate for Payer: Cigna Medicare Advantage	$745.25
Rate for Payer: Clover Medicare Advantage	$707.99
Rate for Payer: EmblemHealth Commercial	$2,235.75
Rate for Payer: Humana Medicare Advantage	$767.61
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$745.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$483.90
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$241.95
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$38.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$745.25
Rate for Payer: Wellcare Medicare Advantage	$745.25
Rate for Payer: Wellpoint Medicaid Managed Care	$42.74

TREAT SCAPULA FRACTURE

Facility

$26,701.00

Service Code	HCPCS 23585
Hospital Charge Code	16000678
Hospital Revenue Code	360
Min. Negotiated Rate	$643.49
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	$1,355.00
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	$8,010.30
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,005.15
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$643.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$707.58

TREAT SCAPULA FRACTURE

Facility

$26,701.00

Service Code	HCPCS 23585
Hospital Charge Code	16000678
Hospital Revenue Code	360
Min. Negotiated Rate	$4,005.15
Max. Negotiated Rate	$4,005.15
Rate for Payer: Qualcare PPO/HMO/WC	$4,005.15

TREAT SPINAL CANAL LESION

Facility

$4,033.08

Service Code	HCPCS 62282
Hospital Charge Code	1600000497
Hospital Revenue Code	360
Min. Negotiated Rate	$97.20
Max. Negotiated Rate	$3,793.00
Rate for Payer: Aetna Commercial	$2,858.12
Rate for Payer: Aetna Medicare Advantage	$3,404.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,050.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,793.00
Rate for Payer: Cigna Commercial	$2,106.27
Rate for Payer: Cigna Medicare Advantage	$1,050.78
Rate for Payer: Clover Medicare Advantage	$998.24
Rate for Payer: EmblemHealth Commercial	$3,152.34
Rate for Payer: Humana Medicare Advantage	$1,082.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,050.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,209.92
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$604.96
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$97.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,050.78
Rate for Payer: Wellcare Medicare Advantage	$1,050.78
Rate for Payer: Wellpoint Medicaid Managed Care	$106.88

TREAT SPINAL CANAL LESION

Facility

$4,033.08

Service Code	HCPCS 62282
Hospital Charge Code	1600000497
Hospital Revenue Code	360
Min. Negotiated Rate	$604.96
Max. Negotiated Rate	$604.96
Rate for Payer: Qualcare PPO/HMO/WC	$604.96

TREAT THUMB FRACTURE

Facility

$14,272.88

Service Code	HCPCS 26665
Hospital Charge Code	16000857
Hospital Revenue Code	360
Min. Negotiated Rate	$2,140.93
Max. Negotiated Rate	$2,140.93
Rate for Payer: Qualcare PPO/HMO/WC	$2,140.93

TREAT THUMB FRACTURE

Facility

$14,272.88

Service Code	HCPCS 26665
Hospital Charge Code	16000857
Hospital Revenue Code	360
Min. Negotiated Rate	$343.98
Max. Negotiated Rate	$14,834.00
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	$1,626.00
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	$4,281.86
Rate for Payer: Oxford Commercial	$8,679.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,140.93
Rate for Payer: UnitedHealthcare Commercial	$14,834.00
Rate for Payer: UnitedHealthcare Community & State	$343.98
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	$378.23

TREAT TOE DISLOCATION

Facility

$3,213.34

Service Code	HCPCS 28635
Hospital Charge Code	16000914
Hospital Revenue Code	360
Min. Negotiated Rate	$482.00
Max. Negotiated Rate	$482.00
Rate for Payer: Qualcare PPO/HMO/WC	$482.00

TREAT TOE DISLOCATION

Facility

$3,213.34

Service Code	HCPCS 28635
Hospital Charge Code	16000914
Hospital Revenue Code	360
Min. Negotiated Rate	$77.44
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	$862.00
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	$964.00
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$482.00
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$77.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$85.15

TREAT TOE DISLOCATION REQ ANES

Facility

$8,575.05

Service Code	HCPCS 28635
Hospital Charge Code	5792293
Hospital Revenue Code	450
Min. Negotiated Rate	$135.98
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	$135.98
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	$2,572.51
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,286.26
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellpoint Medicaid Managed Care	$227.24

TREAT TOE DISLOCATION REQ ANES

Facility

$8,575.05

Service Code	HCPCS 28635
Hospital Charge Code	5792293
Hospital Revenue Code	450
Min. Negotiated Rate	$1,286.26
Max. Negotiated Rate	$1,286.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,286.26

TREAT TOE FRACTURE

Facility

$23,899.60

Service Code	HCPCS 28525
Hospital Charge Code	16000575
Hospital Revenue Code	360
Min. Negotiated Rate	$3,584.94
Max. Negotiated Rate	$3,584.94
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94

TREAT TOE FRACTURE

Facility

$23,899.60

Service Code	HCPCS 28525
Hospital Charge Code	16000575
Hospital Revenue Code	360
Min. Negotiated Rate	$575.98
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	$1,355.00
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	$7,169.88
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,584.94
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$575.98
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	$633.34

TREAT UTERUS INFECTION

Facility

$48,126.45

Service Code	HCPCS 59830
Hospital Charge Code	1600000321
Hospital Revenue Code	360
Min. Negotiated Rate	$7,218.97
Max. Negotiated Rate	$7,218.97
Rate for Payer: Qualcare PPO/HMO/WC	$7,218.97

TREAT UTERUS INFECTION

Facility

$48,126.45

Service Code	HCPCS 59830
Hospital Charge Code	1600000321
Hospital Revenue Code	360
Min. Negotiated Rate	$1,159.85
Max. Negotiated Rate	$24,063.22
Rate for Payer: Aetna Commercial	$18,288.05
Rate for Payer: Aetna Medicare Advantage	$14,437.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,272.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,272.24
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	$12,272.24
Rate for Payer: Cigna Commercial	$24,063.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14,437.93
Rate for Payer: Oxford Commercial	$6,055.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,218.97
Rate for Payer: UnitedHealthcare Commercial	$10,232.00
Rate for Payer: UnitedHealthcare Community & State	$1,159.85
Rate for Payer: Wellpoint Medicaid Managed Care	$1,275.35

TRECATOR-SC/250MG/TAB

Facility

$6.00

Hospital Charge Code	60634054
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

TRECATOR-SC/250MG/TAB

Facility

$6.00

Hospital Charge Code	60634054
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

TREK/MINI TREK 1.20MM X06MM

Facility

$500.00

Hospital Charge Code	270666645
Hospital Revenue Code	279
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

TREK/MINI TREK 1.20MM X06MM

Facility

$500.00

Hospital Charge Code	270666645
Hospital Revenue Code	279
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$250.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$150.00
Rate for Payer: Oxford Commercial	$100.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$100.00
Rate for Payer: UnitedHealthcare Community & State	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$13.25

TREL-XPRESS 300C DMB

Facility

$4,465.00

Hospital Charge Code	270660818
Hospital Revenue Code	278
Min. Negotiated Rate	$107.61
Max. Negotiated Rate	$2,232.50
Rate for Payer: Aetna Commercial	$1,696.70
Rate for Payer: Aetna Medicare Advantage	$1,339.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,138.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,138.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$893.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,138.58
Rate for Payer: Cigna Commercial	$2,232.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,080.53
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$982.30
Rate for Payer: Qualcare PPO/HMO/WC	$669.75
Rate for Payer: UnitedHealthcare Community & State	$107.61
Rate for Payer: Wellpoint Medicaid Managed Care	$118.32

Know your out-of-pocket cost for care.

All Charges