Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

BONE MARROW ASPIRATION BL

Facility

$7,612.30

Service Code	HCPCS 38220
Hospital Charge Code	1600000754
Hospital Revenue Code	360
Min. Negotiated Rate	$1,141.85
Max. Negotiated Rate	$1,141.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85

BONE MARROW ASPIRATION BL

Facility

$7,612.30

Service Code	HCPCS 38220
Hospital Charge Code	1600000754
Hospital Revenue Code	360
Min. Negotiated Rate	$183.46
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,283.69
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$183.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$201.73

BONE MARROW ASPIRATION DX

Facility

$8,995.35

Service Code	HCPCS 38220
Hospital Charge Code	404138220
Hospital Revenue Code	361
Min. Negotiated Rate	$216.79
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,698.61
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,349.30
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$216.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$238.38

BONE MARROW ASPIRATION DX

Facility

$8,995.35

Service Code	HCPCS 38220
Hospital Charge Code	404138220
Hospital Revenue Code	361
Min. Negotiated Rate	$1,349.30
Max. Negotiated Rate	$1,349.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,349.30

BONE MARROW ASPIRATION ONLY

Facility

$1,686.65

Service Code	HCPCS 38220
Hospital Charge Code	1001152
Hospital Revenue Code	361
Min. Negotiated Rate	$253.00
Max. Negotiated Rate	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$253.00

BONE MARROW ASPIRATION ONLY

Facility

$1,686.65

Service Code	HCPCS 38220
Hospital Charge Code	3401032
Hospital Revenue Code	361
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$506.00
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$253.00
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$40.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$44.70

BONE MARROW ASPIRATION ONLY

Facility

$1,686.65

Service Code	HCPCS 38220
Hospital Charge Code	3401032
Hospital Revenue Code	361
Min. Negotiated Rate	$253.00
Max. Negotiated Rate	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$253.00

BONE MARROW ASPIRATION ONLY

Facility

$1,686.65

Service Code	HCPCS 38220
Hospital Charge Code	1001152
Hospital Revenue Code	361
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$506.00
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$253.00
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$40.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$44.70

BONE MARROW ASPIRAT-W/MOD

Facility

$746.00

Service Code	HCPCS 38220
Hospital Charge Code	3409010
Hospital Revenue Code	761
Min. Negotiated Rate	$111.90
Max. Negotiated Rate	$111.90
Rate for Payer: Qualcare PPO/HMO/WC	$111.90

BONE MARROW ASPIRAT-W/MOD

Facility

$746.00

Service Code	HCPCS 38220
Hospital Charge Code	3409010
Hospital Revenue Code	761
Min. Negotiated Rate	$17.98
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$348.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.80
Rate for Payer: Oxford Commercial	$149.20
Rate for Payer: Qualcare PPO/HMO/WC	$111.90
Rate for Payer: UnitedHealthcare Commercial	$149.20
Rate for Payer: UnitedHealthcare Community & State	$17.98
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$19.77

BONE MARROW ASPIRAT-W/MOD

Facility

$746.00

Service Code	HCPCS 3822059
Hospital Charge Code	93500103
Hospital Revenue Code	761
Min. Negotiated Rate	$111.90
Max. Negotiated Rate	$111.90
Rate for Payer: Qualcare PPO/HMO/WC	$111.90

BONE MARROW ASPIRAT-W/MOD

Facility

$746.00

Service Code	HCPCS 3822059
Hospital Charge Code	93500103
Hospital Revenue Code	761
Min. Negotiated Rate	$17.98
Max. Negotiated Rate	$373.00
Rate for Payer: Aetna Commercial	$283.48
Rate for Payer: Aetna Medicare Advantage	$223.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$190.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$190.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$190.23
Rate for Payer: Cigna Commercial	$373.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$223.80
Rate for Payer: Oxford Commercial	$149.20
Rate for Payer: Qualcare PPO/HMO/WC	$111.90
Rate for Payer: UnitedHealthcare Commercial	$149.20
Rate for Payer: UnitedHealthcare Community & State	$17.98
Rate for Payer: Wellpoint Medicaid Managed Care	$19.77

Bone marrow aspir bone grfg

Facility

$11,887.22

Service Code	HCPCS 20939
Hospital Charge Code	16000349
Hospital Revenue Code	360
Min. Negotiated Rate	$1,783.08
Max. Negotiated Rate	$1,783.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,783.08

Bone marrow aspir bone grfg

Facility

$11,887.22

Service Code	HCPCS 20939
Hospital Charge Code	16000349
Hospital Revenue Code	360
Min. Negotiated Rate	$286.48
Max. Negotiated Rate	$5,943.61
Rate for Payer: Aetna Commercial	$4,517.14
Rate for Payer: Aetna Medicare Advantage	$3,566.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,031.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,031.24
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	$3,031.24
Rate for Payer: Cigna Commercial	$5,943.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,566.17
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,783.08
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$286.48
Rate for Payer: Wellpoint Medicaid Managed Care	$315.01

BONE MARROW ASP NEEDLE 11 GAUG

Facility

$278.00

Hospital Charge Code	270339050
Hospital Revenue Code	272
Min. Negotiated Rate	$6.70
Max. Negotiated Rate	$139.00
Rate for Payer: Aetna Commercial	$105.64
Rate for Payer: Aetna Medicare Advantage	$83.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.89
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.40
Rate for Payer: Oxford Commercial	$55.60
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Commercial	$55.60
Rate for Payer: UnitedHealthcare Community & State	$6.70
Rate for Payer: Wellpoint Medicaid Managed Care	$7.37

BONE MARROW ASP NEEDLE 11 GAUG

Facility

$278.00

Hospital Charge Code	270339050
Hospital Revenue Code	272
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$41.70
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

BONE MARROW BIOPSY

Facility

$1,457.45

Service Code	HCPCS 38221
Hospital Charge Code	93500145
Hospital Revenue Code	761
Min. Negotiated Rate	$218.62
Max. Negotiated Rate	$218.62
Rate for Payer: Qualcare PPO/HMO/WC	$218.62

BONE MARROW BIOPSY

Facility

$7,612.30

Service Code	HCPCS 38221
Hospital Charge Code	16000177
Hospital Revenue Code	360
Min. Negotiated Rate	$1,141.85
Max. Negotiated Rate	$1,141.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85

BONE MARROW BIOPSY

Facility

$1,457.45

Service Code	HCPCS 38221
Hospital Charge Code	93500145
Hospital Revenue Code	761
Min. Negotiated Rate	$35.12
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$183.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.24
Rate for Payer: Oxford Commercial	$291.49
Rate for Payer: Qualcare PPO/HMO/WC	$218.62
Rate for Payer: UnitedHealthcare Commercial	$291.49
Rate for Payer: UnitedHealthcare Community & State	$35.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$38.62

BONE MARROW BIOPSY

Facility

$7,612.30

Service Code	HCPCS 38221
Hospital Charge Code	16000177
Hospital Revenue Code	360
Min. Negotiated Rate	$183.46
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,283.69
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$183.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$201.73

BONE MARROW BIOPSY

Facility

$1,686.65

Service Code	HCPCS 38221
Hospital Charge Code	1001155
Hospital Revenue Code	361
Min. Negotiated Rate	$253.00
Max. Negotiated Rate	$253.00
Rate for Payer: Qualcare PPO/HMO/WC	$253.00

BONE MARROW BIOPSY

Facility

$1,686.65

Service Code	HCPCS 38221
Hospital Charge Code	1001155
Hospital Revenue Code	361
Min. Negotiated Rate	$40.65
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$506.00
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$253.00
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$40.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$44.70

BONE MARROW BIOPSY DX

Facility

$8,995.35

Service Code	HCPCS 38221
Hospital Charge Code	404138221
Hospital Revenue Code	361
Min. Negotiated Rate	$1,349.30
Max. Negotiated Rate	$1,349.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,349.30

BONE MARROW BIOPSY DX

Facility

$8,995.35

Service Code	HCPCS 38221
Hospital Charge Code	404138221
Hospital Revenue Code	361
Min. Negotiated Rate	$216.79
Max. Negotiated Rate	$7,082.74
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,082.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,082.74
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,698.61
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,349.30
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$216.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$238.38

BONE MARROW CONC SYSTEM 60ML

Facility

$17,250.00

Hospital Charge Code	270672818
Hospital Revenue Code	272
Min. Negotiated Rate	$2,587.50
Max. Negotiated Rate	$2,587.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,587.50

Know your out-of-pocket cost for care.

All Charges