Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

GRAFT PATELLA RT PAR80

Facility

$56,875.50

Service Code	HCPCS C1713
Hospital Charge Code	270694007
Hospital Revenue Code	278
Min. Negotiated Rate	$8,531.33
Max. Negotiated Rate	$13,763.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,375.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,763.87
Rate for Payer: Qualcare PPO/HMO/WC	$8,531.33

GRAFT PATELLA RT PAR80

Facility

$56,875.50

Service Code	HCPCS C1713
Hospital Charge Code	270694007
Hospital Revenue Code	278
Min. Negotiated Rate	$1,615.26
Max. Negotiated Rate	$28,437.75
Rate for Payer: Aetna Commercial	$21,612.69
Rate for Payer: Aetna Medicare Advantage	$17,062.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,503.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,503.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11,375.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,503.25
Rate for Payer: Cigna Commercial	$28,437.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13,763.87
Rate for Payer: Qualcare PPO/HMO/WC	$8,531.33
Rate for Payer: UnitedHealthcare Community & State	$1,797.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1,615.26

GRAFT PLACENTAL TISSUE MATRIX

Facility

$9,500.00

Service Code	HCPCS Q4139
Hospital Charge Code	270673755
Hospital Revenue Code	278
Min. Negotiated Rate	$269.80
Max. Negotiated Rate	$4,750.00
Rate for Payer: Aetna Commercial	$3,610.00
Rate for Payer: Aetna Medicare Advantage	$2,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,422.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,422.50
Rate for Payer: Cigna Commercial	$4,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Community & State	$300.20
Rate for Payer: Wellpoint Medicaid Managed Care	$269.80

GRAFT PLACENTAL TISSUE MATRIX

Facility

$9,500.00

Service Code	HCPCS Q4139
Hospital Charge Code	270673755
Hospital Revenue Code	278
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$2,299.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,299.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

GRAFT PREP STATION BASE

Facility

$3,125.00

Hospital Charge Code	270691451
Hospital Revenue Code	272
Min. Negotiated Rate	$468.75
Max. Negotiated Rate	$468.75
Rate for Payer: Qualcare PPO/HMO/WC	$468.75

GRAFT PREP STATION BASE

Facility

$3,125.00

Hospital Charge Code	270691451
Hospital Revenue Code	272
Min. Negotiated Rate	$88.75
Max. Negotiated Rate	$1,562.50
Rate for Payer: Aetna Commercial	$1,187.50
Rate for Payer: Aetna Medicare Advantage	$937.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$796.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$796.88
Rate for Payer: Cigna Commercial	$1,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$812.50
Rate for Payer: Oxford Commercial	$625.00
Rate for Payer: Qualcare PPO/HMO/WC	$468.75
Rate for Payer: UnitedHealthcare Commercial	$625.00
Rate for Payer: UnitedHealthcare Community & State	$98.75
Rate for Payer: Wellpoint Medicaid Managed Care	$88.75

GRAFT PRIMATRIX 20X25CM

Facility

$44,913.20

Service Code	HCPCS Q4110
Hospital Charge Code	270695270
Hospital Revenue Code	278
Min. Negotiated Rate	$6,736.98
Max. Negotiated Rate	$10,868.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,982.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,868.99
Rate for Payer: Qualcare PPO/HMO/WC	$6,736.98

GRAFT PRIMATRIX 20X25CM

Facility

$44,913.20

Service Code	HCPCS Q4110
Hospital Charge Code	270695270
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$10,868.99
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,982.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,868.99
Rate for Payer: Qualcare PPO/HMO/WC	$6,736.98
Rate for Payer: UnitedHealthcare Community & State	$1,419.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$1,275.53

GRAFT PRIMATRIX 2x2cm

Facility

$2,125.00

Hospital Charge Code	270673683
Hospital Revenue Code	636
Min. Negotiated Rate	$60.35
Max. Negotiated Rate	$1,062.50
Rate for Payer: Aetna Commercial	$807.50
Rate for Payer: Aetna Medicare Advantage	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$541.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$541.88
Rate for Payer: Cigna Commercial	$1,062.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75
Rate for Payer: UnitedHealthcare Community & State	$67.15
Rate for Payer: Wellpoint Medicaid Managed Care	$60.35

GRAFT PRIMATRIX 2x2cm

Facility

$2,125.00

Hospital Charge Code	270673683
Hospital Revenue Code	636
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

GRAFT PRIMATRIX 3x3cm

Facility

$2,480.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673684
Hospital Revenue Code	278
Min. Negotiated Rate	$372.00
Max. Negotiated Rate	$600.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00

GRAFT PRIMATRIX 3x3cm

Facility

$2,480.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673684
Hospital Revenue Code	278
Min. Negotiated Rate	$70.43
Max. Negotiated Rate	$600.16
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$496.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$600.16
Rate for Payer: Qualcare PPO/HMO/WC	$372.00
Rate for Payer: UnitedHealthcare Community & State	$78.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$70.43

GRAFT PRIMATRIX 4 X 4 CM

Facility

$4,989.40

Service Code	HCPCS Q4110
Hospital Charge Code	270689733
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$1,207.43
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$997.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,207.43
Rate for Payer: Qualcare PPO/HMO/WC	$748.41
Rate for Payer: UnitedHealthcare Community & State	$157.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$141.70

GRAFT PRIMATRIX 4 X 4 CM

Facility

$4,989.40

Service Code	HCPCS Q4110
Hospital Charge Code	270689733
Hospital Revenue Code	278
Min. Negotiated Rate	$748.41
Max. Negotiated Rate	$1,207.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$997.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,207.43
Rate for Payer: Qualcare PPO/HMO/WC	$748.41

GRAFT PRIMATRIX 4X4 CM

Facility

$3,850.00

Service Code	HCPCS Q4110
Hospital Charge Code	270684069
Hospital Revenue Code	278
Min. Negotiated Rate	$109.34
Max. Negotiated Rate	$931.70
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: Qualcare PPO/HMO/WC	$577.50
Rate for Payer: UnitedHealthcare Community & State	$121.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$109.34

GRAFT PRIMATRIX 4X4 CM

Facility

$3,850.00

Service Code	HCPCS Q4110
Hospital Charge Code	270684069
Hospital Revenue Code	278
Min. Negotiated Rate	$577.50
Max. Negotiated Rate	$931.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: Qualcare PPO/HMO/WC	$577.50

GRAFT PRIMATRIX 4x4cm

Facility

$3,850.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673685
Hospital Revenue Code	278
Min. Negotiated Rate	$577.50
Max. Negotiated Rate	$931.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: Qualcare PPO/HMO/WC	$577.50

GRAFT PRIMATRIX 4x4cm

Facility

$3,850.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673685
Hospital Revenue Code	278
Min. Negotiated Rate	$109.34
Max. Negotiated Rate	$931.70
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$770.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$931.70
Rate for Payer: Qualcare PPO/HMO/WC	$577.50
Rate for Payer: UnitedHealthcare Community & State	$121.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$109.34

GRAFT PRIMATRIX 5x5CM/SQ CM

Facility

$4,460.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673686
Hospital Revenue Code	278
Min. Negotiated Rate	$669.00
Max. Negotiated Rate	$1,079.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.32
Rate for Payer: Qualcare PPO/HMO/WC	$669.00

GRAFT PRIMATRIX 5x5CM/SQ CM

Facility

$4,460.00

Service Code	HCPCS Q4110
Hospital Charge Code	270673686
Hospital Revenue Code	278
Min. Negotiated Rate	$126.66
Max. Negotiated Rate	$1,079.32
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$892.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,079.32
Rate for Payer: Qualcare PPO/HMO/WC	$669.00
Rate for Payer: UnitedHealthcare Community & State	$140.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$126.66

GRAFT PRIMATRIX 5x5CM/SQ CM JW

Facility

$319.20

Hospital Charge Code	270673686W
Hospital Revenue Code	636
Min. Negotiated Rate	$47.88
Max. Negotiated Rate	$77.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.25
Rate for Payer: Qualcare PPO/HMO/WC	$47.88

GRAFT PRIMATRIX 5x5CM/SQ CM JW

Facility

$319.20

Hospital Charge Code	270673686W
Hospital Revenue Code	636
Min. Negotiated Rate	$9.07
Max. Negotiated Rate	$159.60
Rate for Payer: Aetna Commercial	$121.30
Rate for Payer: Aetna Medicare Advantage	$95.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.40
Rate for Payer: Cigna Commercial	$159.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$77.25
Rate for Payer: Qualcare PPO/HMO/WC	$47.88
Rate for Payer: UnitedHealthcare Community & State	$10.09
Rate for Payer: Wellpoint Medicaid Managed Care	$9.07

GRAFT PRIMATRIX 6 X 6 CM

Facility

$6,560.00

Service Code	HCPCS Q4110
Hospital Charge Code	270682617
Hospital Revenue Code	278
Min. Negotiated Rate	$984.00
Max. Negotiated Rate	$1,587.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,312.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,587.52
Rate for Payer: Qualcare PPO/HMO/WC	$984.00

GRAFT PRIMATRIX 6 X 6 CM

Facility

$6,560.00

Service Code	HCPCS Q4110
Hospital Charge Code	270682617
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$1,587.52
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,312.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,587.52
Rate for Payer: Qualcare PPO/HMO/WC	$984.00
Rate for Payer: UnitedHealthcare Community & State	$207.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$186.30

GRAFT PRIMATRIX 6X6CM

Facility

$7,695.00

Service Code	HCPCS Q4110
Hospital Charge Code	270675446
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$1,862.19
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,539.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,862.19
Rate for Payer: Qualcare PPO/HMO/WC	$1,154.25
Rate for Payer: UnitedHealthcare Community & State	$243.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$218.54

Know your out-of-pocket cost for care.

All Charges