Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ALLERGEN,MOLD

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38479132
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

ALLERGEN,MOLD

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38479132
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$22.61

ALLERGEN,RESP

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38479129
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$22.61

ALLERGEN,RESP

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38479129
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

ALLERGEN SPEC-ANIMAL

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38479126
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$22.61

ALLERGEN SPEC-ANIMAL

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38479126
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

ALLERGEN SPECIFIC IGE,QANT,E

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476139
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$22.61

ALLERGEN SPECIFIC IGE,QANT,E

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38476139
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

ALLERGEN,TREES

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38479133
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

ALLERGEN,TREES

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38479133
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$22.61

ALLERGEN,WEED

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38479134
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$398.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$398.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$206.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$119.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$22.61

ALLERGEN,WEED

Facility

$796.00

Service Code	HCPCS 86003
Hospital Charge Code	38479134
Hospital Revenue Code	305
Min. Negotiated Rate	$119.40
Max. Negotiated Rate	$119.40
Rate for Payer: Qualcare PPO/HMO/WC	$119.40

ALLERGIC REACTIONS

Facility

$6,486.85

Service Code	APR-DRG 8112
Min. Negotiated Rate	$6,359.66
Max. Negotiated Rate	$6,486.85
Rate for Payer: UnitedHealthcare Community & State	$6,359.66
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,486.85
Rate for Payer: Wellpoint Medicaid Managed Care	$6,359.66

ALLERGIC REACTIONS

Facility

$26,402.39

Service Code	APR-DRG 8114
Min. Negotiated Rate	$25,884.70
Max. Negotiated Rate	$26,402.39
Rate for Payer: UnitedHealthcare Community & State	$25,884.70
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,402.39
Rate for Payer: Wellpoint Medicaid Managed Care	$25,884.70

ALLERGIC REACTIONS

Facility

$4,383.05

Service Code	APR-DRG 8111
Min. Negotiated Rate	$4,297.11
Max. Negotiated Rate	$4,383.05
Rate for Payer: UnitedHealthcare Community & State	$4,297.11
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,383.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4,297.11

ALLERGIC REACTIONS

Facility

$12,984.93

Service Code	APR-DRG 8113
Min. Negotiated Rate	$12,730.32
Max. Negotiated Rate	$12,984.93
Rate for Payer: UnitedHealthcare Community & State	$12,730.32
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,984.93
Rate for Payer: Wellpoint Medicaid Managed Care	$12,730.32

ALLERGIC REACTIONS WITH MCC

Facility

$72,592.42

Service Code	MSDRG 915
Min. Negotiated Rate	$22,103.46
Max. Negotiated Rate	$72,592.42
Rate for Payer: Aetna Commercial	$53,559.65
Rate for Payer: Aetna Medicare Advantage	$72,592.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,037.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,037.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,266.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49,037.85
Rate for Payer: Cigna Commercial	$37,487.91
Rate for Payer: Cigna Medicare Advantage	$23,266.80
Rate for Payer: Clover Medicare Advantage	$22,103.46
Rate for Payer: EmblemHealth Commercial	$69,800.40
Rate for Payer: Humana Medicare Advantage	$23,964.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,266.80
Rate for Payer: Oxford Commercial	$29,629.79
Rate for Payer: UnitedHealthcare Commercial	$39,660.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,266.80
Rate for Payer: Wellcare Medicare Advantage	$23,266.80

ALLERGIC REACTIONS WITHOUT MCC

Facility

$40,515.42

Service Code	MSDRG 916
Min. Negotiated Rate	$11,740.21
Max. Negotiated Rate	$40,515.42
Rate for Payer: Aetna Commercial	$30,714.04
Rate for Payer: Aetna Medicare Advantage	$40,515.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,285.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,285.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,985.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18,285.30
Rate for Payer: Cigna Commercial	$14,853.83
Rate for Payer: Cigna Medicare Advantage	$12,985.71
Rate for Payer: Clover Medicare Advantage	$12,336.42
Rate for Payer: EmblemHealth Commercial	$38,957.13
Rate for Payer: Humana Medicare Advantage	$13,375.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,985.71
Rate for Payer: Oxford Commercial	$11,740.21
Rate for Payer: UnitedHealthcare Commercial	$15,714.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,985.71
Rate for Payer: Wellcare Medicare Advantage	$12,985.71

ALLERGY,CAT DANDER

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479154
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$298.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$298.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$16.93

ALLERGY,CAT DANDER

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479154
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY,CLAM

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479144
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY,CLAM

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479144
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$298.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$298.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$16.93

ALLERGY,CODFISH

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479141
Hospital Revenue Code	305
Min. Negotiated Rate	$89.40
Max. Negotiated Rate	$89.40
Rate for Payer: Qualcare PPO/HMO/WC	$89.40

ALLERGY,CODFISH

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479141
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$298.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$298.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$16.93

ALLERGY,CRAB

Facility

$596.00

Service Code	HCPCS 86003
Hospital Charge Code	38479142
Hospital Revenue Code	305
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$298.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.94
Rate for Payer: Cigna Commercial	$298.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$154.96
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$89.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$16.93

Know your out-of-pocket cost for care.

All Charges