Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EXCERCISE MONTHLY INITIAL III

Facility

$40.00

Hospital Charge Code	5200051
Hospital Revenue Code	999
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

EXCERCISE MONTHLY INITIAL III

Facility

$40.00

Hospital Charge Code	5200051
Hospital Revenue Code	999
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

EXC EXT EAR,PARTIAL SPL REPAIR

Facility

$13,615.50

Service Code	HCPCS 69110
Hospital Charge Code	16000345
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

EXC EXT EAR,PARTIAL SPL REPAIR

Facility

$13,615.50

Service Code	HCPCS 69110
Hospital Charge Code	16000345
Hospital Revenue Code	360
Min. Negotiated Rate	$386.68
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,540.03
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$430.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$386.68

EXC EYLID LSN WO CLOSE/SML RPR

Facility

$7,645.60

Service Code	HCPCS 67840
Hospital Charge Code	16000774
Hospital Revenue Code	360
Min. Negotiated Rate	$217.14
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$3,221.35
Rate for Payer: Aetna Medicare Advantage	$3,837.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,296.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,296.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,184.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,296.12
Rate for Payer: Cigna Commercial	$2,373.97
Rate for Payer: Cigna Medicare Advantage	$1,184.32
Rate for Payer: Clover Medicare Advantage	$1,125.10
Rate for Payer: EmblemHealth Commercial	$3,552.96
Rate for Payer: Humana Medicare Advantage	$1,219.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,184.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,987.86
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,146.84
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$241.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,184.32
Rate for Payer: Wellcare Medicare Advantage	$1,184.32
Rate for Payer: Wellpoint Medicaid Managed Care	$217.14

EXC EYLID LSN WO CLOSE/SML RPR

Facility

$7,645.60

Service Code	HCPCS 67840
Hospital Charge Code	16000774
Hospital Revenue Code	360
Min. Negotiated Rate	$1,146.84
Max. Negotiated Rate	$1,146.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,146.84

EXC FACE LES SBQ 2+ CM

Facility

$7,918.25

Service Code	HCPCS 21012
Hospital Charge Code	16000233
Hospital Revenue Code	360
Min. Negotiated Rate	$1,187.74
Max. Negotiated Rate	$1,187.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.74

EXC FACE LES SBQ 2+ CM

Facility

$7,918.25

Service Code	HCPCS 21012
Hospital Charge Code	16000233
Hospital Revenue Code	360
Min. Negotiated Rate	$224.88
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,058.74
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.74
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$250.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$224.88

EXC FACE LES SC < 2 CM

Facility

$11,110.30

Service Code	HCPCS 21011
Hospital Charge Code	16000440
Hospital Revenue Code	360
Min. Negotiated Rate	$315.53
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,888.68
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.55
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$351.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$315.53

EXC FACE LES SC < 2 CM

Facility

$11,110.30

Service Code	HCPCS 21011
Hospital Charge Code	16000440
Hospital Revenue Code	360
Min. Negotiated Rate	$1,666.55
Max. Negotiated Rate	$1,666.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.55

EXC FACE LES SC <2CM

Facility

$8,662.30

Service Code	HCPCS 21011
Hospital Charge Code	323021011
Hospital Revenue Code	450
Min. Negotiated Rate	$1,299.35
Max. Negotiated Rate	$1,299.35
Rate for Payer: Qualcare PPO/HMO/WC	$1,299.35

EXC FACE LES SC <2CM

Facility

$8,662.30

Service Code	HCPCS 21011
Hospital Charge Code	323021011
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,252.20
Rate for Payer: Qualcare PPO/HMO/WC	$1,299.35
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$246.01

EXC FACE MM B9MARG 0.5CM

Facility

$4,994.00

Service Code	HCPCS 11440
Hospital Charge Code	1600000700
Hospital Revenue Code	360
Min. Negotiated Rate	$749.10
Max. Negotiated Rate	$749.10
Rate for Payer: Qualcare PPO/HMO/WC	$749.10

EXC FACE MM B9MARG 0.5CM

Facility

$4,994.00

Service Code	HCPCS 11440
Hospital Charge Code	1600000700
Hospital Revenue Code	360
Min. Negotiated Rate	$141.83
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,298.44
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$749.10
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$157.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$141.83

EXC FACE-MM B9+MARG 0.6-1 CM

Facility

$3,786.40

Service Code	HCPCS 11441
Hospital Charge Code	16000290
Hospital Revenue Code	360
Min. Negotiated Rate	$107.53
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$984.46
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$567.96
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$119.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$107.53

EXC FACE-MM B9+MARG 0.6-1 CM

Facility

$3,786.40

Service Code	HCPCS 11441
Hospital Charge Code	16000290
Hospital Revenue Code	360
Min. Negotiated Rate	$567.96
Max. Negotiated Rate	$567.96
Rate for Payer: Qualcare PPO/HMO/WC	$567.96

EXC FACE-MM B9+MARG 1.1-2 CM

Facility

$7,917.64

Service Code	HCPCS 11442
Hospital Charge Code	16000268
Hospital Revenue Code	360
Min. Negotiated Rate	$1,187.65
Max. Negotiated Rate	$1,187.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.65

EXC FACE-MM B9+MARG 1.1-2 CM

Facility

$7,917.64

Service Code	HCPCS 11442
Hospital Charge Code	16000268
Hospital Revenue Code	360
Min. Negotiated Rate	$224.86
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,288.28
Rate for Payer: Aetna Medicare Advantage	$2,725.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,051.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$841.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,051.74
Rate for Payer: Cigna Commercial	$1,686.34
Rate for Payer: Cigna Medicare Advantage	$841.28
Rate for Payer: Clover Medicare Advantage	$799.22
Rate for Payer: EmblemHealth Commercial	$2,523.84
Rate for Payer: Humana Medicare Advantage	$866.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$841.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,058.59
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.65
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$250.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$841.28
Rate for Payer: Wellcare Medicare Advantage	$841.28
Rate for Payer: Wellpoint Medicaid Managed Care	$224.86

EXC FACE-MM B9+MARG 2.1-3 CM

Facility

$7,917.30

Service Code	HCPCS 11443
Hospital Charge Code	16000284
Hospital Revenue Code	360
Min. Negotiated Rate	$224.85
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,058.50
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.60
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$250.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$224.85

EXC FACE-MM B9+MARG 2.1-3 CM

Facility

$7,917.30

Service Code	HCPCS 11443
Hospital Charge Code	16000284
Hospital Revenue Code	360
Min. Negotiated Rate	$1,187.60
Max. Negotiated Rate	$1,187.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.60

EXC FACE-MM B9+MARG 3.1-4CM E4

Facility

$7,917.30

Service Code	HCPCS 11444
Hospital Charge Code	16000465
Hospital Revenue Code	360
Min. Negotiated Rate	$224.85
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,058.50
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.60
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$250.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$224.85

EXC FACE-MM B9+MARG 3.1-4CM E4

Facility

$7,917.30

Service Code	HCPCS 11444
Hospital Charge Code	16000465
Hospital Revenue Code	360
Min. Negotiated Rate	$1,187.60
Max. Negotiated Rate	$1,187.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,187.60

EXC FACE-MM B9+MARG > 4 CM

Facility

$22,279.93

Service Code	HCPCS 11446
Hospital Charge Code	16000418
Hospital Revenue Code	360
Min. Negotiated Rate	$632.75
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,792.78
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,341.99
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$704.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$632.75

EXC FACE-MM B9+MARG > 4 CM

Facility

$22,279.93

Service Code	HCPCS 11446
Hospital Charge Code	16000418
Hospital Revenue Code	360
Min. Negotiated Rate	$3,341.99
Max. Negotiated Rate	$3,341.99
Rate for Payer: Qualcare PPO/HMO/WC	$3,341.99

EXC FACE TUM DEEP 2 CM/>

Facility

$7,612.30

Service Code	HCPCS 21014
Hospital Charge Code	16000671
Hospital Revenue Code	360
Min. Negotiated Rate	$1,141.85
Max. Negotiated Rate	$1,141.85
Rate for Payer: Qualcare PPO/HMO/WC	$1,141.85

Know your out-of-pocket cost for care.

All Charges