Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

IR FISTLA/SINUS TRCT ABSC STDY

Facility

OP

$724.85

Service Code	HCPCS 76080
Hospital Charge Code	7411750
Hospital Revenue Code	320
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$217.46
Rate for Payer: Aetna Medicare Advantage	$217.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.84
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.23
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.73
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR FISTLA/SINUS TRCT ABSC STDY

Facility

OP

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	411076080
Hospital Revenue Code	320
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR FISTLA/SINUS TRCT ABSC STDY

Facility

IP

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	411076080
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR FISTLA/SINUS TRCT ABSC STDY

Facility

IP

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	321076080
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR FISTLA/SINUS TRCT ABSC STDY

Facility

IP

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	2600086
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR FISTLA/SINUS TRCT ABSC STDY

Facility

OP

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	2600086
Hospital Revenue Code	320
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR FISTLA/SINUS TRCT ABSC STDY

Facility

IP

$724.85

Service Code	HCPCS 76080
Hospital Charge Code	7411750
Hospital Revenue Code	320
Min. Negotiated Rate	$108.73
Max. Negotiated Rate	$108.73
Rate for Payer: Qualcare PPO/HMO/WC	$108.73

IR FISTLA/SINUS TRCT ABSC STDY

Facility

OP

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	321076080
Hospital Revenue Code	320
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR FISTLA/SINUS TRCT ABSC STDY

Facility

IP

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	366876080
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR FISTLA/SINUS TRCT ABSC STDY

Facility

OP

$5,100.00

Service Code	HCPCS 76080
Hospital Charge Code	366876080
Hospital Revenue Code	320
Min. Negotiated Rate	$39.27
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$1,301.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR FLUOR GUID CV ACCESS DEVICE

Facility

OP

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	321077001
Hospital Revenue Code	320
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$2,607.78
Rate for Payer: Aetna Commercial	$2,607.78
Rate for Payer: Aetna Medicare Advantage	$2,607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,216.61
Rate for Payer: Cigna Commercial	$112.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,130.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR FLUOR GUID CV ACCESS DEVICE

Facility

IP

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	7411754
Hospital Revenue Code	320
Min. Negotiated Rate	$1,303.89
Max. Negotiated Rate	$1,303.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89

IR FLUOR GUID CV ACCESS DEVICE

Facility

IP

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	366877001
Hospital Revenue Code	320
Min. Negotiated Rate	$1,303.89
Max. Negotiated Rate	$1,303.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89

IR FLUOR GUID CV ACCESS DEVICE

Facility

IP

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	2004892
Hospital Revenue Code	320
Min. Negotiated Rate	$1,303.89
Max. Negotiated Rate	$1,303.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89

IR FLUOR GUID CV ACCESS DEVICE

Facility

OP

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	7411754
Hospital Revenue Code	320
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$2,607.78
Rate for Payer: Aetna Commercial	$2,607.78
Rate for Payer: Aetna Medicare Advantage	$2,607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,216.61
Rate for Payer: Cigna Commercial	$112.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,130.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR FLUOR GUID CV ACCESS DEVICE

Facility

IP

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	321077001
Hospital Revenue Code	320
Min. Negotiated Rate	$1,303.89
Max. Negotiated Rate	$1,303.89
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89

IR FLUOR GUID CV ACCESS DEVICE

Facility

OP

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	366877001
Hospital Revenue Code	320
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$2,607.78
Rate for Payer: Aetna Commercial	$2,607.78
Rate for Payer: Aetna Medicare Advantage	$2,607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,216.61
Rate for Payer: Cigna Commercial	$112.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,130.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR FLUOR GUID CV ACCESS DEVICE

Facility

OP

$8,692.60

Service Code	HCPCS 77001
Hospital Charge Code	2004892
Hospital Revenue Code	320
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$2,607.78
Rate for Payer: Aetna Commercial	$2,607.78
Rate for Payer: Aetna Medicare Advantage	$2,607.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,216.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,216.61
Rate for Payer: Cigna Commercial	$112.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,130.04
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,303.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR FLUOROGUIDE FOR SPINE INJ

Facility

OP

$1,507.85

Service Code	HCPCS 77003
Hospital Charge Code	2600150
Hospital Revenue Code	320
Min. Negotiated Rate	$37.81
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$452.36
Rate for Payer: Aetna Medicare Advantage	$452.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$384.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$384.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$37.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$384.50
Rate for Payer: Cigna Commercial	$119.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$196.02
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$226.18
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR FLUOROGUIDE FOR SPINE INJ

Facility

IP

$1,507.85

Service Code	HCPCS 77003
Hospital Charge Code	2600150
Hospital Revenue Code	320
Min. Negotiated Rate	$226.18
Max. Negotiated Rate	$226.18
Rate for Payer: Qualcare PPO/HMO/WC	$226.18

IR FLUORO GUID NEEDLE PLCMENT

Facility

OP

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	2004890
Hospital Revenue Code	320
Min. Negotiated Rate	$53.56
Max. Negotiated Rate	$1,530.00
Rate for Payer: Aetna Commercial	$1,530.00
Rate for Payer: Aetna Medicare Advantage	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,300.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$53.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$138.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$663.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

IR FLUORO GUID NEEDLE PLCMENT

Facility

IP

$5,100.00

Service Code	HCPCS 77002
Hospital Charge Code	2004890
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

IR/GASTRO/CECO/COLON TUBE

Facility

IP

$4,459.55

Service Code	HCPCS 49450
Hospital Charge Code	321049450
Hospital Revenue Code	361
Min. Negotiated Rate	$668.93
Max. Negotiated Rate	$668.93
Rate for Payer: Qualcare PPO/HMO/WC	$668.93

IR/GASTRO/CECO/COLON TUBE

Facility

OP

$4,459.55

Service Code	HCPCS 49450
Hospital Charge Code	2690165
Hospital Revenue Code	361
Min. Negotiated Rate	$579.74
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$1,337.87
Rate for Payer: Aetna Medicare Advantage	$1,337.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,137.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,137.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,137.19
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$579.74
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$668.93
Rate for Payer: UnitedHealthcare Commercial	$3,687.00

IR/GASTRO/CECO/COLON TUBE

Facility

OP

$1,891.00

Service Code	HCPCS 49450
Hospital Charge Code	7411597
Hospital Revenue Code	361
Min. Negotiated Rate	$245.83
Max. Negotiated Rate	$3,687.00
Rate for Payer: Aetna Commercial	$567.30
Rate for Payer: Aetna Medicare Advantage	$567.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$482.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$482.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,864.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$482.20
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$245.83
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$283.65
Rate for Payer: UnitedHealthcare Commercial	$3,687.00