Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

IP

$13,614.10

Service Code	APR-DRG 5313
Min. Negotiated Rate	$13,347.16
Max. Negotiated Rate	$13,614.10
Rate for Payer: UnitedHealthcare Community & State	$13,347.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,614.10
Rate for Payer: Wellpoint Medicaid Managed Care	$13,347.16

FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

IP

$6,724.17

Service Code	APR-DRG 5311
Min. Negotiated Rate	$6,592.32
Max. Negotiated Rate	$6,724.17
Rate for Payer: UnitedHealthcare Community & State	$6,592.32
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,724.17
Rate for Payer: Wellpoint Medicaid Managed Care	$6,592.32

FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

IP

$8,806.86

Service Code	APR-DRG 5312
Min. Negotiated Rate	$8,634.18
Max. Negotiated Rate	$8,806.86
Rate for Payer: UnitedHealthcare Community & State	$8,634.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,806.86
Rate for Payer: Wellpoint Medicaid Managed Care	$8,634.18

FEMALE REPRODUCTIVE SYSTEM INFECTIONS

Facility

IP

$23,228.49

Service Code	APR-DRG 5314
Min. Negotiated Rate	$22,773.03
Max. Negotiated Rate	$23,228.49
Rate for Payer: UnitedHealthcare Community & State	$22,773.03
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,228.49
Rate for Payer: Wellpoint Medicaid Managed Care	$22,773.03

FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

IP

$23,388.57

Service Code	APR-DRG 5304
Min. Negotiated Rate	$22,929.97
Max. Negotiated Rate	$23,388.57
Rate for Payer: UnitedHealthcare Community & State	$22,929.97
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,388.57
Rate for Payer: Wellpoint Medicaid Managed Care	$22,929.97

FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

IP

$14,695.41

Service Code	APR-DRG 5303
Min. Negotiated Rate	$14,407.26
Max. Negotiated Rate	$14,695.41
Rate for Payer: UnitedHealthcare Community & State	$14,407.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,695.41
Rate for Payer: Wellpoint Medicaid Managed Care	$14,407.26

FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

IP

$7,460.07

Service Code	APR-DRG 5301
Min. Negotiated Rate	$7,313.79
Max. Negotiated Rate	$7,460.07
Rate for Payer: UnitedHealthcare Community & State	$7,313.79
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,460.07
Rate for Payer: Wellpoint Medicaid Managed Care	$7,313.79

FEMALE REPRODUCTIVE SYSTEM MALIGNANCY

Facility

IP

$9,830.67

Service Code	APR-DRG 5302
Min. Negotiated Rate	$9,637.91
Max. Negotiated Rate	$9,830.67
Rate for Payer: UnitedHealthcare Community & State	$9,637.91
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,830.67
Rate for Payer: Wellpoint Medicaid Managed Care	$9,637.91

FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES

Facility

IP

$10,968.25

Service Code	APR-DRG 5141
Min. Negotiated Rate	$10,753.19
Max. Negotiated Rate	$10,968.25
Rate for Payer: UnitedHealthcare Community & State	$10,753.19
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,968.25
Rate for Payer: Wellpoint Medicaid Managed Care	$10,753.19

FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES

Facility

IP

$27,611.54

Service Code	APR-DRG 5143
Min. Negotiated Rate	$27,070.14
Max. Negotiated Rate	$27,611.54
Rate for Payer: UnitedHealthcare Community & State	$27,070.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,611.54
Rate for Payer: Wellpoint Medicaid Managed Care	$27,070.14

FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES

Facility

IP

$16,368.04

Service Code	APR-DRG 5142
Min. Negotiated Rate	$16,047.10
Max. Negotiated Rate	$16,368.04
Rate for Payer: UnitedHealthcare Community & State	$16,047.10
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,368.04
Rate for Payer: Wellpoint Medicaid Managed Care	$16,047.10

FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES

Facility

IP

$63,294.38

Service Code	MSDRG 748
Min. Negotiated Rate	$19,272.33
Max. Negotiated Rate	$63,294.38
Rate for Payer: Aetna Commercial	$46,937.49
Rate for Payer: Aetna Medicare Advantage	$63,294.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38,787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38,787.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,286.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38,787.00
Rate for Payer: Cigna Commercial	$30,927.08
Rate for Payer: Cigna Medicare Advantage	$20,286.66
Rate for Payer: Clover Medicare Advantage	$19,272.33
Rate for Payer: EmblemHealth Commercial	$60,859.98
Rate for Payer: Humana Medicare Advantage	$20,895.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,286.66
Rate for Payer: Oxford Commercial	$24,444.23
Rate for Payer: UnitedHealthcare Commercial	$32,719.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,286.66
Rate for Payer: Wellcare Medicare Advantage	$20,286.66

FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES

Facility

IP

$56,307.22

Service Code	APR-DRG 5144
Min. Negotiated Rate	$55,203.16
Max. Negotiated Rate	$56,307.22
Rate for Payer: UnitedHealthcare Community & State	$55,203.16
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$56,307.22
Rate for Payer: Wellpoint Medicaid Managed Care	$55,203.16

FEM AUG VANGARD DIST 65x10 RL/

Facility

IP

$6,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270679832
Hospital Revenue Code	278
Min. Negotiated Rate	$931.50
Max. Negotiated Rate	$1,502.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,502.82
Rate for Payer: Qualcare PPO/HMO/WC	$931.50

FEM AUG VANGARD DIST 65x10 RL/

Facility

OP

$6,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270679832
Hospital Revenue Code	278
Min. Negotiated Rate	$176.36
Max. Negotiated Rate	$3,105.00
Rate for Payer: Aetna Commercial	$2,359.80
Rate for Payer: Aetna Medicare Advantage	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,583.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,583.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,583.55
Rate for Payer: Cigna Commercial	$3,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,502.82
Rate for Payer: Qualcare PPO/HMO/WC	$931.50
Rate for Payer: UnitedHealthcare Community & State	$196.24
Rate for Payer: Wellpoint Medicaid Managed Care	$176.36

FEM AUG VNGRD DIST65X10 RL/LM

Facility

OP

$6,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270679833
Hospital Revenue Code	278
Min. Negotiated Rate	$176.36
Max. Negotiated Rate	$3,105.00
Rate for Payer: Aetna Commercial	$2,359.80
Rate for Payer: Aetna Medicare Advantage	$1,863.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,583.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,583.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,583.55
Rate for Payer: Cigna Commercial	$3,105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,502.82
Rate for Payer: Qualcare PPO/HMO/WC	$931.50
Rate for Payer: UnitedHealthcare Community & State	$196.24
Rate for Payer: Wellpoint Medicaid Managed Care	$176.36

FEM AUG VNGRD DIST65X10 RL/LM

Facility

IP

$6,210.00

Service Code	HCPCS C1776
Hospital Charge Code	270679833
Hospital Revenue Code	278
Min. Negotiated Rate	$931.50
Max. Negotiated Rate	$1,502.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,242.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,502.82
Rate for Payer: Qualcare PPO/HMO/WC	$931.50

FEM AUG VNGRD DIST65X10 RL/RM

Facility

OP

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270672832
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

FEM AUG VNGRD DIST65X10 RL/RM

Facility

IP

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270672832
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

FEM COMP PS TRIATH PS LT SZ5

Facility

IP

$7,971.40

Service Code	HCPCS C1776
Hospital Charge Code	270694177
Hospital Revenue Code	278
Min. Negotiated Rate	$1,195.71
Max. Negotiated Rate	$1,929.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,594.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,195.71

FEM COMP PS TRIATH PS LT SZ5

Facility

OP

$7,971.40

Service Code	HCPCS C1776
Hospital Charge Code	270694177
Hospital Revenue Code	278
Min. Negotiated Rate	$226.39
Max. Negotiated Rate	$3,985.70
Rate for Payer: Aetna Commercial	$3,029.13
Rate for Payer: Aetna Medicare Advantage	$2,391.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,032.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,032.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,594.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,032.71
Rate for Payer: Cigna Commercial	$3,985.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,929.08
Rate for Payer: Qualcare PPO/HMO/WC	$1,195.71
Rate for Payer: UnitedHealthcare Community & State	$251.90
Rate for Payer: Wellpoint Medicaid Managed Care	$226.39

FEM COMP PS TRIATH PS RT SZ5

Facility

OP

$10,774.30

Service Code	HCPCS C1776
Hospital Charge Code	270694176
Hospital Revenue Code	278
Min. Negotiated Rate	$305.99
Max. Negotiated Rate	$5,387.15
Rate for Payer: Aetna Commercial	$4,094.23
Rate for Payer: Aetna Medicare Advantage	$3,232.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,747.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,747.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,154.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,747.45
Rate for Payer: Cigna Commercial	$5,387.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,607.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,616.14
Rate for Payer: UnitedHealthcare Community & State	$340.47
Rate for Payer: Wellpoint Medicaid Managed Care	$305.99

FEM COMP PS TRIATH PS RT SZ5

Facility

IP

$10,774.30

Service Code	HCPCS C1776
Hospital Charge Code	270694176
Hospital Revenue Code	278
Min. Negotiated Rate	$1,616.14
Max. Negotiated Rate	$2,607.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,154.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,607.38
Rate for Payer: Qualcare PPO/HMO/WC	$1,616.14

FEM COMP TRIATHLON PS SZ3 RT

Facility

IP

$11,109.45

Service Code	HCPCS C1776
Hospital Charge Code	270695255
Hospital Revenue Code	278
Min. Negotiated Rate	$1,666.42
Max. Negotiated Rate	$2,688.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,221.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,688.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.42

FEM COMP TRIATHLON PS SZ3 RT

Facility

OP

$11,109.45

Service Code	HCPCS C1776
Hospital Charge Code	270695255
Hospital Revenue Code	278
Min. Negotiated Rate	$315.51
Max. Negotiated Rate	$5,554.73
Rate for Payer: Aetna Commercial	$4,221.59
Rate for Payer: Aetna Medicare Advantage	$3,332.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,832.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,832.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,221.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,832.91
Rate for Payer: Cigna Commercial	$5,554.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,688.49
Rate for Payer: Qualcare PPO/HMO/WC	$1,666.42
Rate for Payer: UnitedHealthcare Community & State	$351.06
Rate for Payer: Wellpoint Medicaid Managed Care	$315.51