Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

VASCU EMBO OR OCCLU

Facility

$56,620.95

Service Code	HCPCS 37244
Hospital Charge Code	5701100
Hospital Revenue Code	361
Min. Negotiated Rate	$1,364.56
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16,986.28
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,364.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASCU EMBO OR OCCLU

Facility

$52,513.90

Service Code	HCPCS 37244
Hospital Charge Code	7411534
Hospital Revenue Code	361
Min. Negotiated Rate	$1,265.58
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,754.17
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$7,877.09
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,265.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASCU EMBO OR OCCLU

Facility

$56,620.95

Service Code	HCPCS 37244
Hospital Charge Code	5701100
Hospital Revenue Code	361
Min. Negotiated Rate	$8,493.14
Max. Negotiated Rate	$8,493.14
Rate for Payer: Qualcare PPO/HMO/WC	$8,493.14

VASCU EMBO OR OCCLU

Facility

$52,513.90

Service Code	HCPCS 37244
Hospital Charge Code	7411534
Hospital Revenue Code	361
Min. Negotiated Rate	$7,877.09
Max. Negotiated Rate	$7,877.09
Rate for Payer: Qualcare PPO/HMO/WC	$7,877.09

VASCULAR DILATOR 5FR

Facility

$27.61

Hospital Charge Code	270675442
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.80
Rate for Payer: Aetna Commercial	$10.49
Rate for Payer: Aetna Medicare Advantage	$8.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.04
Rate for Payer: Cigna Commercial	$13.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.28
Rate for Payer: Oxford Commercial	$5.52
Rate for Payer: Qualcare PPO/HMO/WC	$4.14
Rate for Payer: UnitedHealthcare Commercial	$5.52
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.73

VASCULAR DILATOR 5FR

Facility

$27.61

Hospital Charge Code	270675442
Hospital Revenue Code	272
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$4.14
Rate for Payer: Qualcare PPO/HMO/WC	$4.14

VASCULAR DILATOR 6FR 0.038IN

Facility

$27.61

Hospital Charge Code	270673020
Hospital Revenue Code	272
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$13.80
Rate for Payer: Aetna Commercial	$10.49
Rate for Payer: Aetna Medicare Advantage	$8.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.04
Rate for Payer: Cigna Commercial	$13.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.28
Rate for Payer: Oxford Commercial	$5.52
Rate for Payer: Qualcare PPO/HMO/WC	$4.14
Rate for Payer: UnitedHealthcare Commercial	$5.52
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.73

VASCULAR DILATOR 6FR 0.038IN

Facility

$27.61

Hospital Charge Code	270673020
Hospital Revenue Code	272
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$4.14
Rate for Payer: Qualcare PPO/HMO/WC	$4.14

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	5701110
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	321037241
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	321037241
Hospital Revenue Code	361
Min. Negotiated Rate	$1,367.11
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,017.92
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,367.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	5701110
Hospital Revenue Code	361
Min. Negotiated Rate	$1,367.11
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,017.92
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,367.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	7411528
Hospital Revenue Code	361
Min. Negotiated Rate	$1,367.11
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,017.92
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,367.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASCULAR EMBOLIZATION

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	7411528
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASCULAR EMBOLIZATION/OCCLUSN

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	7411529
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASCULAR EMBOLIZATION/OCCLUSN

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	7411529
Hospital Revenue Code	361
Min. Negotiated Rate	$1,367.11
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,017.92
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,367.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASCULAR EMBOLIZATION/OCCLUSN

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	2692118
Hospital Revenue Code	361
Min. Negotiated Rate	$8,508.96
Max. Negotiated Rate	$8,508.96
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96

VASCULAR EMBOLIZATION/OCCLUSN

Facility

$56,726.40

Service Code	HCPCS 37241
Hospital Charge Code	2692118
Hospital Revenue Code	361
Min. Negotiated Rate	$1,367.11
Max. Negotiated Rate	$49,506.31
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,506.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,506.31
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17,017.92
Rate for Payer: Oxford Commercial	$9,689.00
Rate for Payer: Qualcare PPO/HMO/WC	$8,508.96
Rate for Payer: UnitedHealthcare Commercial	$16,605.00
Rate for Payer: UnitedHealthcare Community & State	$1,367.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$24,278.35
Rate for Payer: Wellpoint Medicaid Managed Care	$23,802.30

VASCULAR GRAFT

Facility

$6,130.00

Service Code	HCPCS C1768
Hospital Charge Code	270656772
Hospital Revenue Code	278
Min. Negotiated Rate	$919.50
Max. Negotiated Rate	$1,483.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,226.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,483.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,348.60
Rate for Payer: Qualcare PPO/HMO/WC	$919.50

VASCULAR GRAFT

Facility

$6,130.00

Service Code	HCPCS C1768
Hospital Charge Code	270656772
Hospital Revenue Code	278
Min. Negotiated Rate	$147.73
Max. Negotiated Rate	$3,065.00
Rate for Payer: Aetna Commercial	$2,329.40
Rate for Payer: Aetna Medicare Advantage	$1,839.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,226.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,563.15
Rate for Payer: Cigna Commercial	$3,065.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,483.46
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,348.60
Rate for Payer: Qualcare PPO/HMO/WC	$919.50
Rate for Payer: UnitedHealthcare Community & State	$147.73
Rate for Payer: Wellpoint Medicaid Managed Care	$162.44

VASCULAR GRAFT

Facility

$5,030.00

Service Code	HCPCS C1768
Hospital Charge Code	270658074
Hospital Revenue Code	278
Min. Negotiated Rate	$754.50
Max. Negotiated Rate	$1,217.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,006.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,217.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,106.60
Rate for Payer: Qualcare PPO/HMO/WC	$754.50

VASCULAR GRAFT

Facility

$5,030.00

Service Code	HCPCS C1768
Hospital Charge Code	270658074
Hospital Revenue Code	278
Min. Negotiated Rate	$121.22
Max. Negotiated Rate	$2,515.00
Rate for Payer: Aetna Commercial	$1,911.40
Rate for Payer: Aetna Medicare Advantage	$1,509.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,282.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,282.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,006.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,282.65
Rate for Payer: Cigna Commercial	$2,515.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,217.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,106.60
Rate for Payer: Qualcare PPO/HMO/WC	$754.50
Rate for Payer: UnitedHealthcare Community & State	$121.22
Rate for Payer: Wellpoint Medicaid Managed Care	$133.29

VASCULAR KIT

Facility

$147.00

Hospital Charge Code	270338759
Hospital Revenue Code	272
Min. Negotiated Rate	$3.54
Max. Negotiated Rate	$73.50
Rate for Payer: Aetna Commercial	$55.86
Rate for Payer: Aetna Medicare Advantage	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.48
Rate for Payer: Cigna Commercial	$73.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.10
Rate for Payer: Oxford Commercial	$29.40
Rate for Payer: Qualcare PPO/HMO/WC	$22.05
Rate for Payer: UnitedHealthcare Commercial	$29.40
Rate for Payer: UnitedHealthcare Community & State	$3.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.90

VASCULAR KIT

Facility

$147.00

Hospital Charge Code	270338759
Hospital Revenue Code	272
Min. Negotiated Rate	$22.05
Max. Negotiated Rate	$22.05
Rate for Payer: Qualcare PPO/HMO/WC	$22.05

VASCULAR LINEAR STAPLER 30MM

Facility

$172.00

Hospital Charge Code	270338702
Hospital Revenue Code	272
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$65.36
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.60
Rate for Payer: Oxford Commercial	$34.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$34.40
Rate for Payer: UnitedHealthcare Community & State	$4.15
Rate for Payer: Wellpoint Medicaid Managed Care	$4.56

Know your out-of-pocket cost for care.

All Charges