Heights University Hospital

All Charges

Charge

Type

Setting

Price

FACTOR II ACTIVITY

Facility

$390.00

Service Code	HCPCS 85210
Hospital Charge Code	39900344
Hospital Revenue Code	305
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.06
Rate for Payer: Aetna Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.56
Rate for Payer: Cigna Commercial	$12.98
Rate for Payer: Cigna Medicare Advantage	$6.49
Rate for Payer: Clover Medicare Advantage	$12.33
Rate for Payer: EmblemHealth Commercial	$38.94
Rate for Payer: Humana Medicare Advantage	$13.37
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	$12.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.76
Rate for Payer: Wellcare Medicare Advantage	$12.98

FACTOR II DNA

Facility

$111.00

Service Code	HCPCS 81240
Hospital Charge Code	3035993
Hospital Revenue Code	310
Min. Negotiated Rate	$14.43
Max. Negotiated Rate	$240.69
Rate for Payer: Aetna Commercial	$212.84
Rate for Payer: Aetna Medicare Advantage	$65.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$240.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$240.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$65.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$240.69
Rate for Payer: Cigna Commercial	$65.69
Rate for Payer: Cigna Medicare Advantage	$32.84
Rate for Payer: Clover Medicare Advantage	$62.41
Rate for Payer: EmblemHealth Commercial	$197.07
Rate for Payer: Humana Medicare Advantage	$67.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.43
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$65.69
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$69.63
Rate for Payer: Wellcare Medicare Advantage	$65.69

FACTOR II DNA

Facility

$111.00

Service Code	HCPCS 81240
Hospital Charge Code	3035993
Hospital Revenue Code	310
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

FACTOR II,FUNCTIONAL

Facility

$89.25

Service Code	HCPCS 85210
Hospital Charge Code	39900155
Hospital Revenue Code	305
Min. Negotiated Rate	$13.39
Max. Negotiated Rate	$13.39
Rate for Payer: Qualcare PPO/HMO/WC	$13.39

FACTOR II,FUNCTIONAL

Facility

$89.25

Service Code	HCPCS 85210
Hospital Charge Code	39900155
Hospital Revenue Code	305
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.06
Rate for Payer: Aetna Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.56
Rate for Payer: Cigna Commercial	$12.98
Rate for Payer: Cigna Medicare Advantage	$6.49
Rate for Payer: Clover Medicare Advantage	$12.33
Rate for Payer: EmblemHealth Commercial	$38.94
Rate for Payer: Humana Medicare Advantage	$13.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.39
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.76
Rate for Payer: Wellcare Medicare Advantage	$12.98

FACTOR III ACTIVITY

Facility

$245.65

Service Code	HCPCS 85240
Hospital Charge Code	3004208
Hospital Revenue Code	305
Min. Negotiated Rate	$36.85
Max. Negotiated Rate	$36.85
Rate for Payer: Qualcare PPO/HMO/WC	$36.85

FACTOR III ACTIVITY

Facility

$245.65

Service Code	HCPCS 85240
Hospital Charge Code	3004208
Hospital Revenue Code	305
Min. Negotiated Rate	$8.95
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$58.00
Rate for Payer: Aetna Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.59
Rate for Payer: Cigna Commercial	$17.90
Rate for Payer: Cigna Medicare Advantage	$8.95
Rate for Payer: Clover Medicare Advantage	$17.00
Rate for Payer: EmblemHealth Commercial	$53.70
Rate for Payer: Humana Medicare Advantage	$18.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.93
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.85
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.97
Rate for Payer: Wellcare Medicare Advantage	$17.90

FACTOR II INHIBITOR I

Facility

$42.00

Service Code	HCPCS 85210
Hospital Charge Code	3038092A
Hospital Revenue Code	305
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

FACTOR II INHIBITOR I

Facility

$42.00

Service Code	HCPCS 85210
Hospital Charge Code	3038092A
Hospital Revenue Code	305
Min. Negotiated Rate	$5.46
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.06
Rate for Payer: Aetna Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.56
Rate for Payer: Cigna Commercial	$12.98
Rate for Payer: Cigna Medicare Advantage	$6.49
Rate for Payer: Clover Medicare Advantage	$12.33
Rate for Payer: EmblemHealth Commercial	$38.94
Rate for Payer: Humana Medicare Advantage	$13.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.46
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.76
Rate for Payer: Wellcare Medicare Advantage	$12.98

FACTOR II INHIBITOR II

Facility

$286.00

Service Code	HCPCS 85335
Hospital Charge Code	3038092B
Hospital Revenue Code	305
Min. Negotiated Rate	$42.90
Max. Negotiated Rate	$42.90
Rate for Payer: Qualcare PPO/HMO/WC	$42.90

FACTOR II INHIBITOR II

Facility

$286.00

Service Code	HCPCS 85335
Hospital Charge Code	3038092B
Hospital Revenue Code	305
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.70
Rate for Payer: Aetna Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.16
Rate for Payer: Cigna Commercial	$12.87
Rate for Payer: Cigna Medicare Advantage	$6.43
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.90
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.64
Rate for Payer: Wellcare Medicare Advantage	$12.87

FACTOR II INHIBITOR III

Facility

$317.94

Service Code	HCPCS 85610
Hospital Charge Code	3038092C
Hospital Revenue Code	305
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$13.90
Rate for Payer: Aetna Medicare Advantage	$4.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.29
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	$15.72
Rate for Payer: Cigna Commercial	$4.29
Rate for Payer: Cigna Medicare Advantage	$2.15
Rate for Payer: Clover Medicare Advantage	$4.08
Rate for Payer: EmblemHealth Commercial	$12.87
Rate for Payer: Humana Medicare Advantage	$4.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.33
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.69
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.29
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.55
Rate for Payer: Wellcare Medicare Advantage	$4.29

FACTOR II INHIBITOR III

Facility

$317.94

Service Code	HCPCS 85610
Hospital Charge Code	3038092C
Hospital Revenue Code	305
Min. Negotiated Rate	$47.69
Max. Negotiated Rate	$47.69
Rate for Payer: Qualcare PPO/HMO/WC	$47.69

FACTOR II INHIBITOR IV

Facility

$144.00

Service Code	HCPCS 85611
Hospital Charge Code	3038092D
Hospital Revenue Code	305
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

FACTOR II INHIBITOR IV

Facility

$144.00

Service Code	HCPCS 85611
Hospital Charge Code	3038092D
Hospital Revenue Code	305
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.77
Rate for Payer: Aetna Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.44
Rate for Payer: Cigna Commercial	$3.94
Rate for Payer: Cigna Medicare Advantage	$1.97
Rate for Payer: Clover Medicare Advantage	$3.74
Rate for Payer: EmblemHealth Commercial	$11.82
Rate for Payer: Humana Medicare Advantage	$4.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.18
Rate for Payer: Wellcare Medicare Advantage	$3.94

FACTOR II INHIBITOR V

Facility

$144.00

Service Code	HCPCS 85611
Hospital Charge Code	3038092E
Hospital Revenue Code	305
Min. Negotiated Rate	$1.97
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$12.77
Rate for Payer: Aetna Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.44
Rate for Payer: Cigna Commercial	$3.94
Rate for Payer: Cigna Medicare Advantage	$1.97
Rate for Payer: Clover Medicare Advantage	$3.74
Rate for Payer: EmblemHealth Commercial	$11.82
Rate for Payer: Humana Medicare Advantage	$4.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.72
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.60
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.94
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$4.18
Rate for Payer: Wellcare Medicare Advantage	$3.94

FACTOR II INHIBITOR V

Facility

$144.00

Service Code	HCPCS 85611
Hospital Charge Code	3038092E
Hospital Revenue Code	305
Min. Negotiated Rate	$21.60
Max. Negotiated Rate	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$21.60

FACTOR II INHIBITOR VI

Facility

$263.57

Service Code	HCPCS 85730
Hospital Charge Code	3038092F
Hospital Revenue Code	305
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$19.47
Rate for Payer: Aetna Medicare Advantage	$6.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.01
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	$22.02
Rate for Payer: Cigna Commercial	$6.01
Rate for Payer: Cigna Medicare Advantage	$3.00
Rate for Payer: Clover Medicare Advantage	$5.71
Rate for Payer: EmblemHealth Commercial	$18.03
Rate for Payer: Humana Medicare Advantage	$6.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.26
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.54
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.01
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$6.37
Rate for Payer: Wellcare Medicare Advantage	$6.01

FACTOR II INHIBITOR VI

Facility

$263.57

Service Code	HCPCS 85730
Hospital Charge Code	3038092F
Hospital Revenue Code	305
Min. Negotiated Rate	$39.54
Max. Negotiated Rate	$39.54
Rate for Payer: Qualcare PPO/HMO/WC	$39.54

FACTOR II MUTATION, NUCLEIOTID

Facility

$448.00

Hospital Charge Code	3004166
Hospital Revenue Code	301
Min. Negotiated Rate	$58.24
Max. Negotiated Rate	$224.00
Rate for Payer: Aetna Commercial	$134.40
Rate for Payer: Aetna Medicare Advantage	$134.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.24
Rate for Payer: Cigna Commercial	$224.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.24
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.20
Rate for Payer: UnitedHealthcare Commercial	$114.00

FACTOR II MUTATION, NUCLEIOTID

Facility

$448.00

Hospital Charge Code	3004166
Hospital Revenue Code	301
Min. Negotiated Rate	$67.20
Max. Negotiated Rate	$67.20
Rate for Payer: Qualcare PPO/HMO/WC	$67.20

FACTOR II PLASMA

Facility

$283.40

Service Code	HCPCS 85210
Hospital Charge Code	3004165
Hospital Revenue Code	305
Min. Negotiated Rate	$42.51
Max. Negotiated Rate	$42.51
Rate for Payer: Qualcare PPO/HMO/WC	$42.51

FACTOR II PLASMA

Facility

$283.40

Service Code	HCPCS 85210
Hospital Charge Code	3004165
Hospital Revenue Code	305
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$42.06
Rate for Payer: Aetna Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.56
Rate for Payer: Cigna Commercial	$12.98
Rate for Payer: Cigna Medicare Advantage	$6.49
Rate for Payer: Clover Medicare Advantage	$12.33
Rate for Payer: EmblemHealth Commercial	$38.94
Rate for Payer: Humana Medicare Advantage	$13.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.84
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.51
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.98
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.76
Rate for Payer: Wellcare Medicare Advantage	$12.98

FACTOR INHIBITOR TEST

Facility

$390.00

Service Code	HCPCS 85335
Hospital Charge Code	401085335
Hospital Revenue Code	305
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$41.70
Rate for Payer: Aetna Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.16
Rate for Payer: Cigna Commercial	$12.87
Rate for Payer: Cigna Medicare Advantage	$6.43
Rate for Payer: Clover Medicare Advantage	$12.23
Rate for Payer: EmblemHealth Commercial	$38.61
Rate for Payer: Humana Medicare Advantage	$13.26
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	$12.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.64
Rate for Payer: Wellcare Medicare Advantage	$12.87

FACTOR INHIBITOR TEST

Facility

$390.00

Service Code	HCPCS 85335
Hospital Charge Code	401085335
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges