Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EEG ROUTINE

Facility

$1,491.00

Service Code	HCPCS 95816
Hospital Charge Code	36540014
Hospital Revenue Code	740
Min. Negotiated Rate	$42.34
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$281.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.66
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$223.65
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$47.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$42.34

EEG ROUTINE

Facility

$1,491.00

Service Code	HCPCS 95816
Hospital Charge Code	36540014
Hospital Revenue Code	740
Min. Negotiated Rate	$223.65
Max. Negotiated Rate	$223.65
Rate for Payer: Qualcare PPO/HMO/WC	$223.65

EEG ROUTINE > 1 HR

Facility

$1,477.50

Service Code	HCPCS 95813
Hospital Charge Code	5500030
Hospital Revenue Code	740
Min. Negotiated Rate	$41.96
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$118.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.15
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.62
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$46.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$41.96

EEG ROUTINE > 1 HR

Facility

$1,477.50

Service Code	HCPCS 95813
Hospital Charge Code	5500030
Hospital Revenue Code	740
Min. Negotiated Rate	$221.62
Max. Negotiated Rate	$221.62
Rate for Payer: Qualcare PPO/HMO/WC	$221.62

EEG ROUTINE UP TO 1 HR

Facility

$1,078.50

Service Code	HCPCS 95812
Hospital Charge Code	5500032
Hospital Revenue Code	740
Min. Negotiated Rate	$30.63
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$273.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$280.41
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$161.78
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$34.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$30.63

EEG ROUTINE UP TO 1 HR

Facility

$1,078.50

Service Code	HCPCS 95812
Hospital Charge Code	5500032
Hospital Revenue Code	740
Min. Negotiated Rate	$161.78
Max. Negotiated Rate	$161.78
Rate for Payer: Qualcare PPO/HMO/WC	$161.78

EEG SLEEP DEPRIVED

Facility

$2,804.90

Service Code	HCPCS 95819
Hospital Charge Code	36540016
Hospital Revenue Code	740
Min. Negotiated Rate	$420.74
Max. Negotiated Rate	$420.74
Rate for Payer: Qualcare PPO/HMO/WC	$420.74

EEG SLEEP DEPRIVED

Facility

$2,804.90

Service Code	HCPCS 95819
Hospital Charge Code	36540016
Hospital Revenue Code	740
Min. Negotiated Rate	$79.66
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$265.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$729.27
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$420.74
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$88.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$79.66

EEG/VIDEO MON/RECORD </= 12 HR

Facility

$2,647.00

Service Code	HCPCS 9595152
Hospital Charge Code	403395951P
Hospital Revenue Code	740
Min. Negotiated Rate	$397.05
Max. Negotiated Rate	$397.05
Rate for Payer: Qualcare PPO/HMO/WC	$397.05

EEG/VIDEO MON/RECORD </= 12 HR

Facility

$2,647.00

Service Code	HCPCS 9595152
Hospital Charge Code	403395951P
Hospital Revenue Code	740
Min. Negotiated Rate	$75.17
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$1,005.86
Rate for Payer: Aetna Medicare Advantage	$794.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$674.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$674.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$674.99
Rate for Payer: Cigna Commercial	$1,323.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$688.22
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$397.05
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$83.65
Rate for Payer: Wellpoint Medicaid Managed Care	$75.17

EEG/VIDEO MON/RECORD PER 24 HR

Facility

$5,294.00

Service Code	HCPCS 95951
Hospital Charge Code	403395951
Hospital Revenue Code	740
Min. Negotiated Rate	$794.10
Max. Negotiated Rate	$794.10
Rate for Payer: Qualcare PPO/HMO/WC	$794.10

EEG/VIDEO MON/RECORD PER 24 HR

Facility

$5,294.00

Service Code	HCPCS 95951
Hospital Charge Code	403395951
Hospital Revenue Code	740
Min. Negotiated Rate	$150.35
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$2,011.72
Rate for Payer: Aetna Medicare Advantage	$1,588.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,349.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,349.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,349.97
Rate for Payer: Cigna Commercial	$2,647.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,376.44
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$794.10
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$167.29
Rate for Payer: Wellpoint Medicaid Managed Care	$150.35

EEG WO VID 12-26HRS CONT MON

Facility

$2,843.33

Service Code	HCPCS 95710
Hospital Charge Code	403395710
Hospital Revenue Code	740
Min. Negotiated Rate	$426.50
Max. Negotiated Rate	$426.50
Rate for Payer: Qualcare PPO/HMO/WC	$426.50

EEG WO VID 12-26HRS CONT MON

Facility

$2,843.33

Service Code	HCPCS 95710
Hospital Charge Code	403395710
Hospital Revenue Code	740
Min. Negotiated Rate	$80.75
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,608.14
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$739.27
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$426.50
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$89.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$80.75

EEG WO VID 12-26HRS INT MON

Facility

$2,843.33

Service Code	HCPCS 95709
Hospital Charge Code	403395709
Hospital Revenue Code	740
Min. Negotiated Rate	$80.75
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,608.14
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$739.27
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$426.50
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$89.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$80.75

EEG WO VID 12-26HRS INT MON

Facility

$2,843.33

Service Code	HCPCS 95709
Hospital Charge Code	403395709
Hospital Revenue Code	740
Min. Negotiated Rate	$426.50
Max. Negotiated Rate	$426.50
Rate for Payer: Qualcare PPO/HMO/WC	$426.50

EEG WO VID 12-26HRS UNMON

Facility

$2,843.33

Service Code	HCPCS 95708
Hospital Charge Code	403395708
Hospital Revenue Code	740
Min. Negotiated Rate	$80.75
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,608.14
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$739.27
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$426.50
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$89.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$80.75

EEG WO VID 12-26HRS UNMON

Facility

$2,843.33

Service Code	HCPCS 95708
Hospital Charge Code	403395708
Hospital Revenue Code	740
Min. Negotiated Rate	$426.50
Max. Negotiated Rate	$426.50
Rate for Payer: Qualcare PPO/HMO/WC	$426.50

EEG WO VID 2-12HRS CONT MON

Facility

$1,481.95

Service Code	HCPCS 95707
Hospital Charge Code	403395707
Hospital Revenue Code	740
Min. Negotiated Rate	$42.09
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.31
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.29
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$46.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$42.09

EEG WO VID 2-12HRS CONT MON

Facility

$1,481.95

Service Code	HCPCS 95707
Hospital Charge Code	403395707
Hospital Revenue Code	740
Min. Negotiated Rate	$222.29
Max. Negotiated Rate	$222.29
Rate for Payer: Qualcare PPO/HMO/WC	$222.29

EEG WO VID 2-12HRS INT MON

Facility

$1,481.95

Service Code	HCPCS 95706
Hospital Charge Code	403395706
Hospital Revenue Code	740
Min. Negotiated Rate	$222.29
Max. Negotiated Rate	$222.29
Rate for Payer: Qualcare PPO/HMO/WC	$222.29

EEG WO VID 2-12HRS INT MON

Facility

$1,481.95

Service Code	HCPCS 95706
Hospital Charge Code	403395706
Hospital Revenue Code	740
Min. Negotiated Rate	$42.09
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.31
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.29
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$46.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$42.09

EEG WO VID 2-12HRS UNMON

Facility

$1,481.95

Service Code	HCPCS 95705
Hospital Charge Code	403395705
Hospital Revenue Code	740
Min. Negotiated Rate	$222.29
Max. Negotiated Rate	$222.29
Rate for Payer: Qualcare PPO/HMO/WC	$222.29

EEG WO VID 2-12HRS UNMON

Facility

$1,481.95

Service Code	HCPCS 95705
Hospital Charge Code	403395705
Hospital Revenue Code	740
Min. Negotiated Rate	$42.09
Max. Negotiated Rate	$5,943.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$385.31
Rate for Payer: Oxford Commercial	$5,237.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.29
Rate for Payer: UnitedHealthcare Commercial	$5,943.00
Rate for Payer: UnitedHealthcare Community & State	$46.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$42.09

EENT KIT

Facility

$163.00

Hospital Charge Code	270338739
Hospital Revenue Code	272
Min. Negotiated Rate	$4.63
Max. Negotiated Rate	$81.50
Rate for Payer: Aetna Commercial	$61.94
Rate for Payer: Aetna Medicare Advantage	$48.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.56
Rate for Payer: Cigna Commercial	$81.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.38
Rate for Payer: Oxford Commercial	$32.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.45
Rate for Payer: UnitedHealthcare Commercial	$32.60
Rate for Payer: UnitedHealthcare Community & State	$5.15
Rate for Payer: Wellpoint Medicaid Managed Care	$4.63

Know your out-of-pocket cost for care.

All Charges