Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH CADMIUM BLOOD

Facility

$173.00

Service Code	HCPCS 82300
Hospital Charge Code	397073052
Hospital Revenue Code	301
Min. Negotiated Rate	$25.95
Max. Negotiated Rate	$25.95
Rate for Payer: Qualcare PPO/HMO/WC	$25.95

CH CADMIUM BLOOD

Facility

$173.00

Service Code	HCPCS 82300
Hospital Charge Code	397073052
Hospital Revenue Code	301
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$76.59
Rate for Payer: Aetna Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.62
Rate for Payer: Cigna Commercial	$23.64
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$22.46
Rate for Payer: EmblemHealth Commercial	$70.92
Rate for Payer: Humana Medicare Advantage	$24.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.06
Rate for Payer: Wellcare Medicare Advantage	$23.64

CH CADMIUM URINE

Facility

$608.00

Service Code	HCPCS 82300
Hospital Charge Code	397072037
Hospital Revenue Code	301
Min. Negotiated Rate	$11.82
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$76.59
Rate for Payer: Aetna Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$56.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.62
Rate for Payer: Cigna Commercial	$23.64
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$22.46
Rate for Payer: EmblemHealth Commercial	$70.92
Rate for Payer: Humana Medicare Advantage	$24.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.06
Rate for Payer: Wellcare Medicare Advantage	$23.64

CH CADMIUM URINE

Facility

$608.00

Service Code	HCPCS 82300
Hospital Charge Code	397072037
Hospital Revenue Code	301
Min. Negotiated Rate	$91.20
Max. Negotiated Rate	$91.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.20

CH CALCITONIN

Facility

$208.00

Service Code	HCPCS 82308
Hospital Charge Code	397071218
Hospital Revenue Code	301
Min. Negotiated Rate	$13.39
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$86.80
Rate for Payer: Aetna Medicare Advantage	$26.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.16
Rate for Payer: Cigna Commercial	$26.79
Rate for Payer: Cigna Medicare Advantage	$13.39
Rate for Payer: Clover Medicare Advantage	$25.45
Rate for Payer: EmblemHealth Commercial	$80.37
Rate for Payer: Humana Medicare Advantage	$27.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$26.79
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.40
Rate for Payer: Wellcare Medicare Advantage	$26.79

CH CALCITONIN

Facility

$208.00

Service Code	HCPCS 82308
Hospital Charge Code	397071218
Hospital Revenue Code	301
Min. Negotiated Rate	$31.20
Max. Negotiated Rate	$31.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.20

CH CALCIUM

Facility

$32.00

Service Code	HCPCS 82310
Hospital Charge Code	397071090
Hospital Revenue Code	301
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

CH CALCIUM

Facility

$32.00

Service Code	HCPCS 82310
Hospital Charge Code	397071090
Hospital Revenue Code	301
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$5.16
Rate for Payer: Cigna Medicare Advantage	$2.58
Rate for Payer: Clover Medicare Advantage	$4.90
Rate for Payer: EmblemHealth Commercial	$15.48
Rate for Payer: Humana Medicare Advantage	$5.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.16
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.47
Rate for Payer: Wellcare Medicare Advantage	$5.16

CH CALCIUM CHANNEL BLOCKER

Facility

$352.00

Service Code	HCPCS 83519
Hospital Charge Code	397071300
Hospital Revenue Code	301
Min. Negotiated Rate	$52.80
Max. Negotiated Rate	$52.80
Rate for Payer: Qualcare PPO/HMO/WC	$52.80

CH CALCIUM CHANNEL BLOCKER

Facility

$352.00

Service Code	HCPCS 83519
Hospital Charge Code	397071300
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$59.62
Rate for Payer: Aetna Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.42
Rate for Payer: Cigna Commercial	$18.40
Rate for Payer: Cigna Medicare Advantage	$9.20
Rate for Payer: Clover Medicare Advantage	$17.48
Rate for Payer: EmblemHealth Commercial	$55.20
Rate for Payer: Humana Medicare Advantage	$18.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$52.80
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.40
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.50
Rate for Payer: Wellcare Medicare Advantage	$18.40

CH CALCIUM-IONIZED

Facility

$66.00

Service Code	HCPCS 82330
Hospital Charge Code	397071273
Hospital Revenue Code	301
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

CH CALCIUM-IONIZED

Facility

$66.00

Service Code	HCPCS 82330
Hospital Charge Code	397071273
Hospital Revenue Code	301
Min. Negotiated Rate	$6.84
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$44.32
Rate for Payer: Aetna Medicare Advantage	$13.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.12
Rate for Payer: Cigna Commercial	$13.68
Rate for Payer: Cigna Medicare Advantage	$6.84
Rate for Payer: Clover Medicare Advantage	$13.00
Rate for Payer: EmblemHealth Commercial	$41.04
Rate for Payer: Humana Medicare Advantage	$14.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.68
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$14.50
Rate for Payer: Wellcare Medicare Advantage	$13.68

CH CALCIUM (RANDOM)

Facility

$390.00

Service Code	HCPCS 82310
Hospital Charge Code	397073110
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH CALCIUM (RANDOM)

Facility

$390.00

Service Code	HCPCS 82310
Hospital Charge Code	397073110
Hospital Revenue Code	301
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$5.16
Rate for Payer: Cigna Medicare Advantage	$2.58
Rate for Payer: Clover Medicare Advantage	$4.90
Rate for Payer: EmblemHealth Commercial	$15.48
Rate for Payer: Humana Medicare Advantage	$5.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.16
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.47
Rate for Payer: Wellcare Medicare Advantage	$5.16

CH CALCIUM RAND UR (W/CREAT)

Facility

$36.00

Service Code	HCPCS 82310
Hospital Charge Code	397073638
Hospital Revenue Code	301
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

CH CALCIUM RAND UR (W/CREAT)

Facility

$36.00

Service Code	HCPCS 82310
Hospital Charge Code	397073638
Hospital Revenue Code	301
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.91
Rate for Payer: Cigna Commercial	$5.16
Rate for Payer: Cigna Medicare Advantage	$2.58
Rate for Payer: Clover Medicare Advantage	$4.90
Rate for Payer: EmblemHealth Commercial	$15.48
Rate for Payer: Humana Medicare Advantage	$5.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.68
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.16
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.47
Rate for Payer: Wellcare Medicare Advantage	$5.16

CH CALCIUM URINE 24 HR

Facility

$114.00

Service Code	HCPCS 82340
Hospital Charge Code	397071042
Hospital Revenue Code	301
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.54
Rate for Payer: Aetna Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.09
Rate for Payer: Cigna Commercial	$6.03
Rate for Payer: Cigna Medicare Advantage	$3.02
Rate for Payer: Clover Medicare Advantage	$5.73
Rate for Payer: EmblemHealth Commercial	$18.09
Rate for Payer: Humana Medicare Advantage	$6.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.82
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.03
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.39
Rate for Payer: Wellcare Medicare Advantage	$6.03

CH CALCIUM URINE 24 HR

Facility

$114.00

Service Code	HCPCS 82340
Hospital Charge Code	397071042
Hospital Revenue Code	301
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

CH CANNABINOID CONF

Facility

$318.00

Service Code	HCPCS 80349
Hospital Charge Code	397073062
Hospital Revenue Code	301
Min. Negotiated Rate	$47.70
Max. Negotiated Rate	$47.70
Rate for Payer: Qualcare PPO/HMO/WC	$47.70

CH CANNABINOID CONF

Facility

$318.00

Service Code	HCPCS 80349
Hospital Charge Code	397073062
Hospital Revenue Code	301
Min. Negotiated Rate	$41.34
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$95.40
Rate for Payer: Aetna Medicare Advantage	$95.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.09
Rate for Payer: Cigna Commercial	$159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.70
Rate for Payer: UnitedHealthcare Commercial	$114.00

CH CARBAMAZEPINE

Facility

$284.00

Service Code	HCPCS 80156
Hospital Charge Code	397071283
Hospital Revenue Code	301
Min. Negotiated Rate	$7.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.21
Rate for Payer: Aetna Medicare Advantage	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.38
Rate for Payer: Cigna Commercial	$14.57
Rate for Payer: Cigna Medicare Advantage	$7.29
Rate for Payer: Clover Medicare Advantage	$13.84
Rate for Payer: EmblemHealth Commercial	$43.71
Rate for Payer: Humana Medicare Advantage	$15.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.92
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.57
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.44
Rate for Payer: Wellcare Medicare Advantage	$14.57

CH CARBAMAZEPINE

Facility

$284.00

Service Code	HCPCS 80156
Hospital Charge Code	397071283
Hospital Revenue Code	301
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$42.60
Rate for Payer: Qualcare PPO/HMO/WC	$42.60

CH CARBAMAZEPINE-10,11 EPOX

Facility

$187.00

Service Code	HCPCS 83789
Hospital Charge Code	397071535
Hospital Revenue Code	301
Min. Negotiated Rate	$12.05
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$78.12
Rate for Payer: Aetna Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.34
Rate for Payer: Cigna Commercial	$24.11
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$22.90
Rate for Payer: EmblemHealth Commercial	$72.33
Rate for Payer: Humana Medicare Advantage	$24.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.05
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.11
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$25.56
Rate for Payer: Wellcare Medicare Advantage	$24.11

CH CARBAMAZEPINE-10,11 EPOX

Facility

$187.00

Service Code	HCPCS 83789
Hospital Charge Code	397071535
Hospital Revenue Code	301
Min. Negotiated Rate	$28.05
Max. Negotiated Rate	$28.05
Rate for Payer: Qualcare PPO/HMO/WC	$28.05

CH CARBON MONOXIDE

Facility

$311.00

Service Code	HCPCS 82375
Hospital Charge Code	397072040
Hospital Revenue Code	301
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$39.92
Rate for Payer: Aetna Medicare Advantage	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.14
Rate for Payer: Cigna Commercial	$12.32
Rate for Payer: Cigna Medicare Advantage	$6.16
Rate for Payer: Clover Medicare Advantage	$11.70
Rate for Payer: EmblemHealth Commercial	$36.96
Rate for Payer: Humana Medicare Advantage	$12.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.32
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.06
Rate for Payer: Wellcare Medicare Advantage	$12.32

Know your out-of-pocket cost for care.

All Charges