Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

ARTERIAL DUPLEX SCAN UPPER EXT

Facility

IP

$5,100.00

Service Code	HCPCS 93930
Hospital Charge Code	74116041
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ARTERIAL DUPLEX SCAN UPPER EXT

Facility

IP

$5,100.00

Service Code	HCPCS 93930
Hospital Charge Code	74115041
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ARTERIAL DUPLEX SCAN UPPER EXT

Facility

OP

$1,079.25

Service Code	HCPCS 93930
Hospital Charge Code	94053230
Hospital Revenue Code	920
Min. Negotiated Rate	$140.30
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$323.77
Rate for Payer: Aetna Medicare Advantage	$323.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,189.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.21
Rate for Payer: Cigna Commercial	$568.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.30
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERIAL DUPLEX SCAN UPPER EXT

Facility

IP

$5,100.00

Service Code	HCPCS 93930
Hospital Charge Code	74117041
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ARTERIAL DUPLEX SCAN UPPER EXT

Facility

OP

$5,100.00

Service Code	HCPCS 93930
Hospital Charge Code	74116041
Hospital Revenue Code	920
Min. Negotiated Rate	$568.20
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	$1,189.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$568.20
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

ARTERIAL DUPLEX SCAN UPPER EXT

Facility

IP

$1,079.25

Service Code	HCPCS 93930
Hospital Charge Code	94053230
Hospital Revenue Code	920
Min. Negotiated Rate	$161.89
Max. Negotiated Rate	$161.89
Rate for Payer: Qualcare PPO/HMO/WC	$161.89

ARTERIAL DUPLEX SCAN UPPER EXT

Facility

OP

$5,100.00

Service Code	HCPCS 93930
Hospital Charge Code	74115041
Hospital Revenue Code	920
Min. Negotiated Rate	$568.20
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	$1,189.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$568.20
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

ARTERIAL DUPLEX SCAN UPPER EXT

Facility

IP

$5,100.00

Service Code	HCPCS 93930
Hospital Charge Code	2692130
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ARTERIAL DUPLEX U/L LE

Facility

IP

$1,079.25

Service Code	HCPCS 93926
Hospital Charge Code	94053190
Hospital Revenue Code	920
Min. Negotiated Rate	$161.89
Max. Negotiated Rate	$161.89
Rate for Payer: Qualcare PPO/HMO/WC	$161.89

ARTERIAL DUPLEX U/L LE

Facility

OP

$1,079.25

Service Code	HCPCS 93926
Hospital Charge Code	94053190
Hospital Revenue Code	920
Min. Negotiated Rate	$140.30
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$323.77
Rate for Payer: Aetna Medicare Advantage	$323.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$275.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$275.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$275.21
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.30
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.89
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERIAL DUPLEX U/L LE

Facility

IP

$5,100.00

Service Code	HCPCS 93926
Hospital Charge Code	74116038
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ARTERIAL DUPLEX U/L LE

Facility

OP

$789.00

Service Code	HCPCS 93926
Hospital Charge Code	7411764
Hospital Revenue Code	920
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERIAL DUPLEX U/L LE

Facility

OP

$5,100.00

Service Code	HCPCS 93926
Hospital Charge Code	74117038
Hospital Revenue Code	920
Min. Negotiated Rate	$248.96
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	$251.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
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

ARTERIAL DUPLEX U/L LE

Facility

IP

$5,100.00

Service Code	HCPCS 93926
Hospital Charge Code	74117038
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ARTERIAL DUPLEX U/L LE

Facility

IP

$789.00

Service Code	HCPCS 93926
Hospital Charge Code	7411764
Hospital Revenue Code	920
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

ARTERIAL DUPLEX U/L LE

Facility

OP

$789.00

Service Code	HCPCS 93926
Hospital Charge Code	2692050
Hospital Revenue Code	920
Min. Negotiated Rate	$102.57
Max. Negotiated Rate	$1,489.00
Rate for Payer: Aetna Commercial	$236.70
Rate for Payer: Aetna Medicare Advantage	$236.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$201.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$251.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$201.19
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.57
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$118.35
Rate for Payer: UnitedHealthcare Commercial	$1,489.00

ARTERIAL DUPLEX U/L LE

Facility

IP

$789.00

Service Code	HCPCS 93926
Hospital Charge Code	2692050
Hospital Revenue Code	920
Min. Negotiated Rate	$118.35
Max. Negotiated Rate	$118.35
Rate for Payer: Qualcare PPO/HMO/WC	$118.35

ARTERIAL DUPLEX U/L LE

Facility

OP

$5,100.00

Service Code	HCPCS 93926
Hospital Charge Code	74115038
Hospital Revenue Code	920
Min. Negotiated Rate	$248.96
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	$251.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
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

ARTERIAL DUPLEX U/L LE

Facility

IP

$5,100.00

Service Code	HCPCS 93926
Hospital Charge Code	74115038
Hospital Revenue Code	920
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

ARTERIAL DUPLEX U/L LE

Facility

OP

$5,100.00

Service Code	HCPCS 93926
Hospital Charge Code	74116038
Hospital Revenue Code	920
Min. Negotiated Rate	$248.96
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	$251.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,300.50
Rate for Payer: Cigna Commercial	$248.96
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

ARTERIAL DUPLEX U/L UE

Facility

OP

$608.00

Service Code	HCPCS 93931
Hospital Charge Code	2692060
Hospital Revenue Code	921
Min. Negotiated Rate	$79.04
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$182.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.04
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.04
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.20
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

ARTERIAL DUPLEX U/L UE

Facility

OP

$17,200.00

Service Code	HCPCS 93931
Hospital Charge Code	74115042
Hospital Revenue Code	921
Min. Negotiated Rate	$248.96
Max. Negotiated Rate	$5,160.00
Rate for Payer: Aetna Commercial	$5,160.00
Rate for Payer: Aetna Medicare Advantage	$5,160.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,386.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,386.00
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,236.00
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,580.00
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

ARTERIAL DUPLEX U/L UE

Facility

IP

$608.00

Service Code	HCPCS 93931
Hospital Charge Code	74116042
Hospital Revenue Code	921
Min. Negotiated Rate	$91.20
Max. Negotiated Rate	$91.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.20

ARTERIAL DUPLEX U/L UE

Facility

OP

$608.00

Service Code	HCPCS 93931
Hospital Charge Code	74116042
Hospital Revenue Code	921
Min. Negotiated Rate	$79.04
Max. Negotiated Rate	$5,061.00
Rate for Payer: Aetna Commercial	$182.40
Rate for Payer: Aetna Medicare Advantage	$182.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$289.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.04
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.04
Rate for Payer: Oxford Commercial	$4,459.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.20
Rate for Payer: UnitedHealthcare Commercial	$5,061.00

ARTERIAL DUPLEX U/L UE

Facility

IP

$608.00

Service Code	HCPCS 93931
Hospital Charge Code	7411766
Hospital Revenue Code	921
Min. Negotiated Rate	$91.20
Max. Negotiated Rate	$91.20
Rate for Payer: Qualcare PPO/HMO/WC	$91.20

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