Price Transparency

Know your out-of-pocket cost for care.

All Charges

Charge

Type

Setting

Price

Fetoprotein (AFP), Serum, Tu

Facility

IP

$667.59

Service Code	HCPCS 82105
Hospital Charge Code	39888017
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

Fetoprotein (AFP), Serum, Tu

Facility

OP

$667.59

Service Code	HCPCS 82105
Hospital Charge Code	39888017
Hospital Revenue Code	301
Min. Negotiated Rate	$13.42
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$45.61
Rate for Payer: Aetna Medicare Advantage	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.83
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$16.77
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Medicare Advantage	$16.77
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

FEVER AND INFLAMMATORY CONDITIONS

Facility

IP

$16,244.51

Service Code	APR-DRG 7224
Min. Negotiated Rate	$15,925.99
Max. Negotiated Rate	$16,244.51
Rate for Payer: UnitedHealthcare Community & State	$15,925.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$16,244.51
Rate for Payer: Wellpoint Medicaid Managed Care	$15,925.99

FEVER AND INFLAMMATORY CONDITIONS

Facility

IP

$5,361.94

Service Code	APR-DRG 7221
Min. Negotiated Rate	$5,256.80
Max. Negotiated Rate	$5,361.94
Rate for Payer: UnitedHealthcare Community & State	$5,256.80
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,361.94
Rate for Payer: Wellpoint Medicaid Managed Care	$5,256.80

FEVER AND INFLAMMATORY CONDITIONS

Facility

IP

$10,636.82

Service Code	APR-DRG 7223
Min. Negotiated Rate	$10,428.25
Max. Negotiated Rate	$10,636.82
Rate for Payer: UnitedHealthcare Community & State	$10,428.25
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,636.82
Rate for Payer: Wellpoint Medicaid Managed Care	$10,428.25

FEVER AND INFLAMMATORY CONDITIONS

Facility

IP

$47,510.21

Service Code	MSDRG 864
Min. Negotiated Rate	$14,466.25
Max. Negotiated Rate	$47,510.21
Rate for Payer: Aetna Commercial	$35,695.83
Rate for Payer: Aetna Medicare Advantage	$47,510.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,380.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,380.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,227.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,380.40
Rate for Payer: Cigna Commercial	$19,789.50
Rate for Payer: Cigna Medicare Advantage	$15,227.63
Rate for Payer: Clover Medicare Advantage	$14,466.25
Rate for Payer: EmblemHealth Commercial	$45,682.89
Rate for Payer: Humana Medicare Advantage	$15,684.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,227.63
Rate for Payer: Oxford Commercial	$15,641.27
Rate for Payer: UnitedHealthcare Commercial	$20,936.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,227.63
Rate for Payer: Wellcare Medicare Advantage	$15,227.63

FEVER AND INFLAMMATORY CONDITIONS

Facility

IP

$7,627.20

Service Code	APR-DRG 7222
Min. Negotiated Rate	$7,477.65
Max. Negotiated Rate	$7,627.20
Rate for Payer: UnitedHealthcare Community & State	$7,477.65
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,627.20
Rate for Payer: Wellpoint Medicaid Managed Care	$7,477.65

Fexofenadine 180mg

Facility

IP

$6.50

Service Code	NDC 3633717
Hospital Charge Code	6063943281
Hospital Revenue Code	250
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.98

Fexofenadine 180mg

Facility

OP

$6.50

Service Code	NDC 3633717
Hospital Charge Code	6063943281
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.25
Rate for Payer: Aetna Commercial	$2.47
Rate for Payer: Aetna Medicare Advantage	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.66
Rate for Payer: Cigna Commercial	$3.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.98
Rate for Payer: UnitedHealthcare Commercial	$1.30
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

FF SEMIT & GRACILLIS TENDON

Facility

OP

$13,375.00

Service Code	HCPCS C1762
Hospital Charge Code	270680655
Hospital Revenue Code	278
Min. Negotiated Rate	$379.85
Max. Negotiated Rate	$6,687.50
Rate for Payer: Aetna Commercial	$5,082.50
Rate for Payer: Aetna Medicare Advantage	$4,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,410.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,410.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,410.62
Rate for Payer: Cigna Commercial	$6,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,236.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,006.25
Rate for Payer: UnitedHealthcare Community & State	$422.65
Rate for Payer: Wellpoint Medicaid Managed Care	$379.85

FF SEMIT & GRACILLIS TENDON

Facility

IP

$13,375.00

Service Code	HCPCS C1762
Hospital Charge Code	270680655
Hospital Revenue Code	278
Min. Negotiated Rate	$2,006.25
Max. Negotiated Rate	$3,236.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,236.75
Rate for Payer: Qualcare PPO/HMO/WC	$2,006.25

FHC VENI-CAPILLARY(LEAD SCRN)

Facility

IP

$160.00

Service Code	HCPCS 3641659
Hospital Charge Code	9400088
Hospital Revenue Code	300
Min. Negotiated Rate	$24.00
Max. Negotiated Rate	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00

FHC VENI-CAPILLARY(LEAD SCRN)

Facility

OP

$160.00

Service Code	HCPCS 3641659
Hospital Charge Code	9400088
Hospital Revenue Code	300
Min. Negotiated Rate	$4.54
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$60.80
Rate for Payer: Aetna Medicare Advantage	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$40.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$40.80
Rate for Payer: Cigna Commercial	$80.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.60
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$4.54

FIBER BAR GLASS 11MM X 150MM

Facility

OP

$887.75

Hospital Charge Code	270668709
Hospital Revenue Code	278
Min. Negotiated Rate	$25.21
Max. Negotiated Rate	$443.88
Rate for Payer: Aetna Commercial	$337.35
Rate for Payer: Aetna Medicare Advantage	$266.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$226.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$226.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$226.38
Rate for Payer: Cigna Commercial	$443.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.84
Rate for Payer: Qualcare PPO/HMO/WC	$133.16
Rate for Payer: UnitedHealthcare Community & State	$28.05
Rate for Payer: Wellpoint Medicaid Managed Care	$25.21

FIBER BAR GLASS 11MM X 150MM

Facility

IP

$887.75

Hospital Charge Code	270668709
Hospital Revenue Code	278
Min. Negotiated Rate	$133.16
Max. Negotiated Rate	$214.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.84
Rate for Payer: Qualcare PPO/HMO/WC	$133.16

FIBER BAR GLASS 11MM X 350MM

Facility

IP

$1,155.75

Hospital Charge Code	270668710
Hospital Revenue Code	278
Min. Negotiated Rate	$173.36
Max. Negotiated Rate	$279.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.69
Rate for Payer: Qualcare PPO/HMO/WC	$173.36

FIBER BAR GLASS 11MM X 350MM

Facility

OP

$1,155.75

Hospital Charge Code	270668710
Hospital Revenue Code	278
Min. Negotiated Rate	$32.82
Max. Negotiated Rate	$577.88
Rate for Payer: Aetna Commercial	$439.19
Rate for Payer: Aetna Medicare Advantage	$346.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$294.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$294.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$294.72
Rate for Payer: Cigna Commercial	$577.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$279.69
Rate for Payer: Qualcare PPO/HMO/WC	$173.36
Rate for Payer: UnitedHealthcare Community & State	$36.52
Rate for Payer: Wellpoint Medicaid Managed Care	$32.82

FIBER BONE GRAFT STAGRAFT 5CC

Facility

OP

$11,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270700039
Hospital Revenue Code	278
Min. Negotiated Rate	$322.34
Max. Negotiated Rate	$5,675.00
Rate for Payer: Aetna Commercial	$4,313.00
Rate for Payer: Aetna Medicare Advantage	$3,405.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,894.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,894.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,894.25
Rate for Payer: Cigna Commercial	$5,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,746.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,702.50
Rate for Payer: UnitedHealthcare Community & State	$358.66
Rate for Payer: Wellpoint Medicaid Managed Care	$322.34

FIBER BONE GRAFT STAGRAFT 5CC

Facility

IP

$11,350.00

Service Code	HCPCS C1713
Hospital Charge Code	270700039
Hospital Revenue Code	278
Min. Negotiated Rate	$1,702.50
Max. Negotiated Rate	$2,746.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,270.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,746.70
Rate for Payer: Qualcare PPO/HMO/WC	$1,702.50

FIBER DISC

Facility

OP

$10,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270692240
Hospital Revenue Code	278
Min. Negotiated Rate	$295.36
Max. Negotiated Rate	$5,200.00
Rate for Payer: Aetna Commercial	$3,952.00
Rate for Payer: Aetna Medicare Advantage	$3,120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,652.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,652.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,652.00
Rate for Payer: Cigna Commercial	$5,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,516.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,560.00
Rate for Payer: UnitedHealthcare Community & State	$328.64
Rate for Payer: Wellpoint Medicaid Managed Care	$295.36

FIBER DISC

Facility

IP

$10,400.00

Service Code	HCPCS C1713
Hospital Charge Code	270692240
Hospital Revenue Code	278
Min. Negotiated Rate	$1,560.00
Max. Negotiated Rate	$2,516.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,080.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,516.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,560.00

FIBERGLASS ROLL 4X15

Facility

IP

$1,823.00

Hospital Charge Code	270331944
Hospital Revenue Code	272
Min. Negotiated Rate	$273.45
Max. Negotiated Rate	$273.45
Rate for Payer: Qualcare PPO/HMO/WC	$273.45

FIBERGLASS ROLL 4X15

Facility

OP

$1,823.00

Hospital Charge Code	270331944
Hospital Revenue Code	272
Min. Negotiated Rate	$51.77
Max. Negotiated Rate	$911.50
Rate for Payer: Aetna Commercial	$692.74
Rate for Payer: Aetna Medicare Advantage	$546.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$464.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$464.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$464.87
Rate for Payer: Cigna Commercial	$911.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$473.98
Rate for Payer: Oxford Commercial	$364.60
Rate for Payer: Qualcare PPO/HMO/WC	$273.45
Rate for Payer: UnitedHealthcare Commercial	$364.60
Rate for Payer: UnitedHealthcare Community & State	$57.61
Rate for Payer: Wellpoint Medicaid Managed Care	$51.77

FIBER GREENLIGHT

Facility

OP

$5,000.00

Hospital Charge Code	270683514
Hospital Revenue Code	272
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,300.00
Rate for Payer: Oxford Commercial	$1,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Commercial	$1,000.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

FIBER GREENLIGHT

Facility

IP

$5,000.00

Hospital Charge Code	270683514
Hospital Revenue Code	272
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00