Heights University Hospital

All Charges

Charge

Type

Setting

Price

FACTOR VII ACTIVITY

Facility

$390.00

Service Code	HCPCS 85230
Hospital Charge Code	39900346
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	$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	$17.90
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$18.97
Rate for Payer: Wellcare Medicare Advantage	$17.90

FACTOR VII-CLOTTING

Facility

$299.00

Service Code	HCPCS 85230
Hospital Charge Code	38478038
Hospital Revenue Code	305
Min. Negotiated Rate	$44.85
Max. Negotiated Rate	$44.85
Rate for Payer: Qualcare PPO/HMO/WC	$44.85

FACTOR VII-CLOTTING

Facility

$299.00

Service Code	HCPCS 85230
Hospital Charge Code	38478038
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	$38.87
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.85
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 VII,FUNCTIONAL

Facility

$123.05

Service Code	HCPCS 85230
Hospital Charge Code	39900157
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	$16.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.46
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 VII,FUNCTIONAL

Facility

$123.05

Service Code	HCPCS 85230
Hospital Charge Code	39900157
Hospital Revenue Code	305
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$18.46
Rate for Payer: Qualcare PPO/HMO/WC	$18.46

FACTOR VIII ACTIVITY

Facility

$245.65

Service Code	HCPCS 85240
Hospital Charge Code	3004209
Hospital Revenue Code	305
Min. Negotiated Rate	$36.85
Max. Negotiated Rate	$36.85
Rate for Payer: Qualcare PPO/HMO/WC	$36.85

FACTOR VIII ACTIVITY

Facility

$245.65

Service Code	HCPCS 85240
Hospital Charge Code	3004209
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 VIII ANTIGEN

Facility

$390.00

Service Code	HCPCS 85244
Hospital Charge Code	397073169
Hospital Revenue Code	305
Min. Negotiated Rate	$10.21
Max. Negotiated Rate	$114.00
Rate for Payer: Aetna Commercial	$66.16
Rate for Payer: Aetna Medicare Advantage	$20.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$74.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$74.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$52.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$74.82
Rate for Payer: Cigna Commercial	$20.42
Rate for Payer: Cigna Medicare Advantage	$10.21
Rate for Payer: Clover Medicare Advantage	$19.40
Rate for Payer: EmblemHealth Commercial	$61.26
Rate for Payer: Humana Medicare Advantage	$21.03
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	$20.42
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$21.65
Rate for Payer: Wellcare Medicare Advantage	$20.42

FACTOR VIII ANTIGEN

Facility

$390.00

Service Code	HCPCS 85244
Hospital Charge Code	397073169
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FACTOR VIII ASSAY

Facility

$245.65

Service Code	HCPCS 85240
Hospital Charge Code	3004207
Hospital Revenue Code	305
Min. Negotiated Rate	$36.85
Max. Negotiated Rate	$36.85
Rate for Payer: Qualcare PPO/HMO/WC	$36.85

FACTOR VIII ASSAY

Facility

$245.65

Service Code	HCPCS 85240
Hospital Charge Code	3004207
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 VIII,FUNCTIONAL

Facility

$123.05

Service Code	HCPCS 85240
Hospital Charge Code	39900158
Hospital Revenue Code	305
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$18.46
Rate for Payer: Qualcare PPO/HMO/WC	$18.46

FACTOR VIII,FUNCTIONAL

Facility

$123.05

Service Code	HCPCS 85240
Hospital Charge Code	39900158
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	$16.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.46
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 VIII,ONE STAGE

Facility

$252.00

Service Code	HCPCS 85240
Hospital Charge Code	38478059
Hospital Revenue Code	305
Min. Negotiated Rate	$37.80
Max. Negotiated Rate	$37.80
Rate for Payer: Qualcare PPO/HMO/WC	$37.80

FACTOR VIII,ONE STAGE

Facility

$252.00

Service Code	HCPCS 85240
Hospital Charge Code	38478059
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	$32.76
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.80
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 VIII,ONE STAGE

Facility

$305.00

Service Code	HCPCS 85240
Hospital Charge Code	38479462
Hospital Revenue Code	305
Min. Negotiated Rate	$45.75
Max. Negotiated Rate	$45.75
Rate for Payer: Qualcare PPO/HMO/WC	$45.75

FACTOR VIII,ONE STAGE

Facility

$305.00

Service Code	HCPCS 85240
Hospital Charge Code	38479462
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	$39.65
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.75
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 VIII PORCINE INHIBITOR

Facility

$89.25

Service Code	HCPCS 85335
Hospital Charge Code	3035065
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	$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	$12.87
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$13.64
Rate for Payer: Wellcare Medicare Advantage	$12.87

FACTOR VIII PORCINE INHIBITOR

Facility

$89.25

Service Code	HCPCS 85335
Hospital Charge Code	3035065
Hospital Revenue Code	305
Min. Negotiated Rate	$13.39
Max. Negotiated Rate	$13.39
Rate for Payer: Qualcare PPO/HMO/WC	$13.39

FACTOR V (LEIDEN) MUTATIO

Facility

$390.00

Service Code	HCPCS 81241
Hospital Charge Code	39900017
Hospital Revenue Code	310
Min. Negotiated Rate	$36.69
Max. Negotiated Rate	$268.83
Rate for Payer: Aetna Commercial	$237.72
Rate for Payer: Aetna Medicare Advantage	$73.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$73.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$268.83
Rate for Payer: Cigna Commercial	$73.37
Rate for Payer: Cigna Medicare Advantage	$36.69
Rate for Payer: Clover Medicare Advantage	$69.70
Rate for Payer: EmblemHealth Commercial	$220.11
Rate for Payer: Humana Medicare Advantage	$75.57
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	$73.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$77.77
Rate for Payer: Wellcare Medicare Advantage	$73.37

FACTOR V (LEIDEN) MUTATIO

Facility

$390.00

Service Code	HCPCS 81241
Hospital Charge Code	39900017
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FACTOR V (LEIDON) MUTATION

Facility

$167.25

Service Code	HCPCS 81241
Hospital Charge Code	3004168
Hospital Revenue Code	310
Min. Negotiated Rate	$21.74
Max. Negotiated Rate	$268.83
Rate for Payer: Aetna Commercial	$237.72
Rate for Payer: Aetna Medicare Advantage	$73.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$268.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$268.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$73.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$268.83
Rate for Payer: Cigna Commercial	$73.37
Rate for Payer: Cigna Medicare Advantage	$36.69
Rate for Payer: Clover Medicare Advantage	$69.70
Rate for Payer: EmblemHealth Commercial	$220.11
Rate for Payer: Humana Medicare Advantage	$75.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.74
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.09
Rate for Payer: UnitedHealthcare Commercial	$114.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$73.37
Rate for Payer: Wellcare Ambetter Commercial-Exchange	$77.77
Rate for Payer: Wellcare Medicare Advantage	$73.37

FACTOR V (LEIDON) MUTATION

Facility

$167.25

Service Code	HCPCS 81241
Hospital Charge Code	3004168
Hospital Revenue Code	310
Min. Negotiated Rate	$25.09
Max. Negotiated Rate	$25.09
Rate for Payer: Qualcare PPO/HMO/WC	$25.09

FACTOR X

Facility

$303.00

Service Code	HCPCS 85260
Hospital Charge Code	38478044
Hospital Revenue Code	305
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

FACTOR X

Facility

$303.00

Service Code	HCPCS 85260
Hospital Charge Code	38478044
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	$50.49
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	$39.39
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
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

Know your out-of-pocket cost for care.

All Charges