Heights University Hospital

All Charges

Charge

Type

Setting

Price

CH POTASSIUM

Facility

$28.00

Service Code	HCPCS 84132
Hospital Charge Code	397071105
Hospital Revenue Code	301
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

CH POTASSIUM

Facility

$28.00

Service Code	HCPCS 84132
Hospital Charge Code	397071105
Hospital Revenue Code	301
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.42
Rate for Payer: Aetna Medicare Advantage	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.44
Rate for Payer: Cigna Commercial	$4.76
Rate for Payer: Cigna Medicare Advantage	$2.38
Rate for Payer: Clover Medicare Advantage	$4.52
Rate for Payer: EmblemHealth Commercial	$14.28
Rate for Payer: Humana Medicare Advantage	$4.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.76
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.05
Rate for Payer: Wellcare Medicare Advantage	$4.76

CH POTASSIUM (RANDOM)

Facility

$57.00

Service Code	HCPCS 84133
Hospital Charge Code	397073113
Hospital Revenue Code	301
Min. Negotiated Rate	$8.55
Max. Negotiated Rate	$8.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.55

CH POTASSIUM (RANDOM)

Facility

$57.00

Service Code	HCPCS 84133
Hospital Charge Code	397073113
Hospital Revenue Code	301
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.33
Rate for Payer: Aetna Medicare Advantage	$4.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.33
Rate for Payer: Cigna Commercial	$4.73
Rate for Payer: Cigna Medicare Advantage	$2.37
Rate for Payer: Clover Medicare Advantage	$4.49
Rate for Payer: EmblemHealth Commercial	$14.19
Rate for Payer: Humana Medicare Advantage	$4.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.41
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.55
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.01
Rate for Payer: Wellcare Medicare Advantage	$4.73

CH POTASSIUM URINE 24 HR

Facility

$40.00

Service Code	HCPCS 84133
Hospital Charge Code	397071287
Hospital Revenue Code	301
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CH POTASSIUM URINE 24 HR

Facility

$40.00

Service Code	HCPCS 84133
Hospital Charge Code	397071287
Hospital Revenue Code	301
Min. Negotiated Rate	$2.37
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$15.33
Rate for Payer: Aetna Medicare Advantage	$4.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.33
Rate for Payer: Cigna Commercial	$4.73
Rate for Payer: Cigna Medicare Advantage	$2.37
Rate for Payer: Clover Medicare Advantage	$4.49
Rate for Payer: EmblemHealth Commercial	$14.19
Rate for Payer: Humana Medicare Advantage	$4.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.73
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$5.01
Rate for Payer: Wellcare Medicare Advantage	$4.73

CH PRAZEPAM

Facility

$198.00

Service Code	HCPCS 80299
Hospital Charge Code	397073120
Hospital Revenue Code	301
Min. Negotiated Rate	$9.32
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$60.39
Rate for Payer: Aetna Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.30
Rate for Payer: Cigna Commercial	$18.64
Rate for Payer: Cigna Medicare Advantage	$9.32
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.70
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$19.76
Rate for Payer: Wellcare Medicare Advantage	$18.64

CH PRAZEPAM

Facility

$198.00

Service Code	HCPCS 80299
Hospital Charge Code	397073120
Hospital Revenue Code	301
Min. Negotiated Rate	$29.70
Max. Negotiated Rate	$29.70
Rate for Payer: Qualcare PPO/HMO/WC	$29.70

CH PRE ALBUMIN

Facility

$114.00

Service Code	HCPCS 84134
Hospital Charge Code	397073170
Hospital Revenue Code	301
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

CH PRE ALBUMIN

Facility

$114.00

Service Code	HCPCS 84134
Hospital Charge Code	397073170
Hospital Revenue Code	301
Min. Negotiated Rate	$7.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$47.27
Rate for Payer: Aetna Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.59
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	$53.46
Rate for Payer: Cigna Commercial	$14.59
Rate for Payer: Cigna Medicare Advantage	$7.29
Rate for Payer: Clover Medicare Advantage	$13.86
Rate for Payer: EmblemHealth Commercial	$43.77
Rate for Payer: Humana Medicare Advantage	$15.03
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	$14.59
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$15.47
Rate for Payer: Wellcare Medicare Advantage	$14.59

CH PREGNANCY TEST URINE

Facility

$296.00

Service Code	HCPCS 81025
Hospital Charge Code	397071116
Hospital Revenue Code	307
Min. Negotiated Rate	$4.30
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$27.90
Rate for Payer: Aetna Medicare Advantage	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.61
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	$31.55
Rate for Payer: Cigna Commercial	$8.61
Rate for Payer: Cigna Medicare Advantage	$4.30
Rate for Payer: Clover Medicare Advantage	$8.18
Rate for Payer: EmblemHealth Commercial	$25.83
Rate for Payer: Humana Medicare Advantage	$8.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.48
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.40
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.61
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$9.13
Rate for Payer: Wellcare Medicare Advantage	$8.61

CH PREGNANCY TEST URINE

Facility

$296.00

Service Code	HCPCS 81025
Hospital Charge Code	397071116
Hospital Revenue Code	307
Min. Negotiated Rate	$44.40
Max. Negotiated Rate	$44.40
Rate for Payer: Qualcare PPO/HMO/WC	$44.40

CH PREGNENOLONE, LC/MS/MS

Facility

$373.00

Service Code	HCPCS 84140
Hospital Charge Code	397071516
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$66.97
Rate for Payer: Aetna Medicare Advantage	$20.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.73
Rate for Payer: Cigna Commercial	$20.67
Rate for Payer: Cigna Medicare Advantage	$10.34
Rate for Payer: Clover Medicare Advantage	$19.64
Rate for Payer: EmblemHealth Commercial	$62.01
Rate for Payer: Humana Medicare Advantage	$21.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$55.95
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.67
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21.91
Rate for Payer: Wellcare Medicare Advantage	$20.67

CH PREGNENOLONE, LC/MS/MS

Facility

$373.00

Service Code	HCPCS 84140
Hospital Charge Code	397071516
Hospital Revenue Code	301
Min. Negotiated Rate	$55.95
Max. Negotiated Rate	$55.95
Rate for Payer: Qualcare PPO/HMO/WC	$55.95

CH PRIMIDONE

Facility

$310.00

Service Code	HCPCS 80188
Hospital Charge Code	397071023
Hospital Revenue Code	301
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$46.50
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

CH PRIMIDONE

Facility

$310.00

Service Code	HCPCS 80188
Hospital Charge Code	397071023
Hospital Revenue Code	301
Min. Negotiated Rate	$8.29
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$53.75
Rate for Payer: Aetna Medicare Advantage	$16.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.59
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	$60.79
Rate for Payer: Cigna Commercial	$16.59
Rate for Payer: Cigna Medicare Advantage	$8.29
Rate for Payer: Clover Medicare Advantage	$15.76
Rate for Payer: EmblemHealth Commercial	$49.77
Rate for Payer: Humana Medicare Advantage	$17.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.59
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$17.59
Rate for Payer: Wellcare Medicare Advantage	$16.59

CH PROBNP

Facility

$340.75

Service Code	HCPCS 83880
Hospital Charge Code	397073602
Hospital Revenue Code	301
Min. Negotiated Rate	$51.11
Max. Negotiated Rate	$51.11
Rate for Payer: Qualcare PPO/HMO/WC	$51.11

CH PROBNP

Facility

$340.75

Service Code	HCPCS 83880
Hospital Charge Code	397073602
Hospital Revenue Code	301
Min. Negotiated Rate	$19.63
Max. Negotiated Rate	$143.85
Rate for Payer: Aetna Commercial	$127.20
Rate for Payer: Aetna Medicare Advantage	$39.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$143.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$143.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$39.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$143.85
Rate for Payer: Cigna Commercial	$39.26
Rate for Payer: Cigna Medicare Advantage	$19.63
Rate for Payer: Clover Medicare Advantage	$37.30
Rate for Payer: EmblemHealth Commercial	$117.78
Rate for Payer: Humana Medicare Advantage	$40.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.11
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$39.26
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$41.62
Rate for Payer: Wellcare Medicare Advantage	$39.26

CH PROCAINAMIDE

Facility

$169.00

Service Code	HCPCS 80190
Hospital Charge Code	397071021
Hospital Revenue Code	301
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$25.35
Rate for Payer: Qualcare PPO/HMO/WC	$25.35

CH PROCAINAMIDE

Facility

$169.00

Service Code	HCPCS 80190
Hospital Charge Code	397071021
Hospital Revenue Code	301
Min. Negotiated Rate	$21.97
Max. Negotiated Rate	$219.84
Rate for Payer: Aetna Commercial	$194.40
Rate for Payer: Aetna Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$219.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$219.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$60.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$219.84
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: Cigna Medicare Advantage	$30.00
Rate for Payer: Clover Medicare Advantage	$57.00
Rate for Payer: EmblemHealth Commercial	$180.00
Rate for Payer: Humana Medicare Advantage	$61.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.35
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$60.00
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$63.60
Rate for Payer: Wellcare Medicare Advantage	$60.00

CH PROCALCITONIN SERUM

Facility

$1,249.59

Service Code	HCPCS 84145
Hospital Charge Code	397073679
Hospital Revenue Code	301
Min. Negotiated Rate	$187.44
Max. Negotiated Rate	$187.44
Rate for Payer: Qualcare PPO/HMO/WC	$187.44

CH PROCALCITONIN SERUM

Facility

$1,249.59

Service Code	HCPCS 84145
Hospital Charge Code	397073679
Hospital Revenue Code	301
Min. Negotiated Rate	$13.61
Max. Negotiated Rate	$187.44
Rate for Payer: Aetna Commercial	$88.19
Rate for Payer: Aetna Medicare Advantage	$27.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.73
Rate for Payer: Cigna Commercial	$27.22
Rate for Payer: Cigna Medicare Advantage	$13.61
Rate for Payer: Clover Medicare Advantage	$25.86
Rate for Payer: EmblemHealth Commercial	$81.66
Rate for Payer: Humana Medicare Advantage	$28.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$187.44
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.22
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.85
Rate for Payer: Wellcare Medicare Advantage	$27.22

CH PROGESTERONE

Facility

$390.00

Service Code	HCPCS 84144
Hospital Charge Code	397071019
Hospital Revenue Code	301
Min. Negotiated Rate	$10.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$67.59
Rate for Payer: Aetna Medicare Advantage	$20.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.86
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	$76.43
Rate for Payer: Cigna Commercial	$20.86
Rate for Payer: Cigna Medicare Advantage	$10.43
Rate for Payer: Clover Medicare Advantage	$19.82
Rate for Payer: EmblemHealth Commercial	$62.58
Rate for Payer: Humana Medicare Advantage	$21.49
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	$20.86
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$22.11
Rate for Payer: Wellcare Medicare Advantage	$20.86

CH PROGESTERONE

Facility

$390.00

Service Code	HCPCS 84144
Hospital Charge Code	397071019
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH PROINSULIN

Facility

$390.00

Service Code	HCPCS 84206
Hospital Charge Code	397072120
Hospital Revenue Code	301
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$86.48
Rate for Payer: Aetna Medicare Advantage	$26.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$26.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$35.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.79
Rate for Payer: Cigna Commercial	$26.69
Rate for Payer: Cigna Medicare Advantage	$13.35
Rate for Payer: Clover Medicare Advantage	$25.36
Rate for Payer: EmblemHealth Commercial	$80.07
Rate for Payer: Humana Medicare Advantage	$27.49
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	$26.69
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$28.29
Rate for Payer: Wellcare Medicare Advantage	$26.69

Know your out-of-pocket cost for care.

All Charges