Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HEART FAILURE

Facility

$13,042.51

Service Code	APR-DRG 1943
Min. Negotiated Rate	$12,786.77
Max. Negotiated Rate	$13,042.51
Rate for Payer: UnitedHealthcare Community & State	$12,786.77
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,042.51
Rate for Payer: Wellpoint Medicaid Managed Care	$12,786.77

HEART FAILURE

Facility

$7,014.92

Service Code	APR-DRG 1941
Min. Negotiated Rate	$6,877.37
Max. Negotiated Rate	$7,014.92
Rate for Payer: UnitedHealthcare Community & State	$6,877.37
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,014.92
Rate for Payer: Wellpoint Medicaid Managed Care	$6,877.37

HEART FAILURE AND SHOCK WITH CC

Facility

$46,287.57

Service Code	MSDRG 292
Min. Negotiated Rate	$14,093.97
Max. Negotiated Rate	$46,287.57
Rate for Payer: Aetna Commercial	$34,825.06
Rate for Payer: Aetna Medicare Advantage	$46,287.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,826.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,826.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,835.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,826.30
Rate for Payer: Cigna Commercial	$18,926.76
Rate for Payer: Cigna Medicare Advantage	$14,835.76
Rate for Payer: Clover Medicare Advantage	$14,093.97
Rate for Payer: EmblemHealth Commercial	$44,507.28
Rate for Payer: Humana Medicare Advantage	$15,280.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,835.76
Rate for Payer: Oxford Commercial	$14,959.38
Rate for Payer: UnitedHealthcare Commercial	$20,023.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,835.76
Rate for Payer: Wellcare Medicare Advantage	$14,835.76

HEART FAILURE AND SHOCK WITH MCC

Facility

$60,024.46

Service Code	MSDRG 291
Min. Negotiated Rate	$18,276.68
Max. Negotiated Rate	$60,024.46
Rate for Payer: Aetna Commercial	$44,608.64
Rate for Payer: Aetna Medicare Advantage	$60,024.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,462.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,462.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,238.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,462.40
Rate for Payer: Cigna Commercial	$28,619.75
Rate for Payer: Cigna Medicare Advantage	$19,238.61
Rate for Payer: Clover Medicare Advantage	$18,276.68
Rate for Payer: EmblemHealth Commercial	$57,715.83
Rate for Payer: Humana Medicare Advantage	$19,815.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,238.61
Rate for Payer: Oxford Commercial	$22,620.56
Rate for Payer: UnitedHealthcare Commercial	$30,278.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,238.61
Rate for Payer: Wellcare Medicare Advantage	$19,238.61

HEART FAILURE AND SHOCK WITHOUT CC/MCC

Facility

$37,346.59

Service Code	MSDRG 293
Min. Negotiated Rate	$9,972.92
Max. Negotiated Rate	$37,346.59
Rate for Payer: Aetna Commercial	$28,457.18
Rate for Payer: Aetna Medicare Advantage	$37,346.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,514.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,514.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,970.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15,514.80
Rate for Payer: Cigna Commercial	$12,617.84
Rate for Payer: Cigna Medicare Advantage	$11,970.06
Rate for Payer: Clover Medicare Advantage	$11,371.56
Rate for Payer: EmblemHealth Commercial	$35,910.18
Rate for Payer: Humana Medicare Advantage	$12,329.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11,970.06
Rate for Payer: Oxford Commercial	$9,972.92
Rate for Payer: UnitedHealthcare Commercial	$13,349.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,970.06
Rate for Payer: Wellcare Medicare Advantage	$11,970.06

HEART FLOW RESERVE ADDITI VESS

Facility

$400.00

Service Code	HCPCS 93572
Hospital Charge Code	5100817
Hospital Revenue Code	481
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

HEART FLOW RESERVE ADDITI VESS

Facility

$400.00

Service Code	HCPCS 93572
Hospital Charge Code	5100817
Hospital Revenue Code	481
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$4,213.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

HEART FLOW RESERVE INITI VESS

Facility

$500.00

Service Code	HCPCS 93571
Hospital Charge Code	5100816
Hospital Revenue Code	481
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

HEART FLOW RESERVE INITI VESS

Facility

$500.00

Service Code	HCPCS 93571
Hospital Charge Code	5100816
Hospital Revenue Code	481
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$4,213.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

HEART FLOW RESERVE MEASURE

Facility

$500.00

Service Code	HCPCS 93571
Hospital Charge Code	411093571
Hospital Revenue Code	481
Min. Negotiated Rate	$14.20
Max. Negotiated Rate	$4,213.00
Rate for Payer: Aetna Commercial	$190.00
Rate for Payer: Aetna Medicare Advantage	$150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.50
Rate for Payer: Cigna Commercial	$250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.00
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$15.80
Rate for Payer: Wellpoint Medicaid Managed Care	$14.20

HEART FLOW RESERVE MEASURE

Facility

$400.00

Service Code	HCPCS 93572
Hospital Charge Code	411093572
Hospital Revenue Code	481
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$4,213.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,213.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

HEART FLOW RESERVE MEASURE

Facility

$500.00

Service Code	HCPCS 93571
Hospital Charge Code	411093571
Hospital Revenue Code	481
Min. Negotiated Rate	$75.00
Max. Negotiated Rate	$75.00
Rate for Payer: Qualcare PPO/HMO/WC	$75.00

HEART FLOW RESERVE MEASURE

Facility

$400.00

Service Code	HCPCS 93572
Hospital Charge Code	411093572
Hospital Revenue Code	481
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC

Facility

$904,839.47

Service Code	MSDRG 001
Min. Negotiated Rate	$275,512.02
Max. Negotiated Rate	$904,839.47
Rate for Payer: Aetna Medicare Advantage	$904,839.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$750,805.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$750,805.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$290,012.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$750,805.50
Rate for Payer: Cigna Commercial	$624,736.80
Rate for Payer: Cigna Medicare Advantage	$290,012.65
Rate for Payer: Clover Medicare Advantage	$275,512.02
Rate for Payer: EmblemHealth Commercial	$870,037.95
Rate for Payer: Humana Medicare Advantage	$298,713.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$290,012.65
Rate for Payer: Oxford Commercial	$493,781.12
Rate for Payer: UnitedHealthcare Commercial	$660,943.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$290,012.65
Rate for Payer: Wellcare Medicare Advantage	$290,012.65

HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC

Facility

$377,476.57

Service Code	MSDRG 002
Min. Negotiated Rate	$114,936.78
Max. Negotiated Rate	$377,476.57
Rate for Payer: Aetna Medicare Advantage	$377,476.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$339,109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$339,109.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$120,986.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$339,109.20
Rate for Payer: Cigna Commercial	$252,619.82
Rate for Payer: Cigna Medicare Advantage	$120,986.08
Rate for Payer: Clover Medicare Advantage	$114,936.78
Rate for Payer: EmblemHealth Commercial	$362,958.24
Rate for Payer: Humana Medicare Advantage	$124,615.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$120,986.08
Rate for Payer: Oxford Commercial	$199,666.32
Rate for Payer: UnitedHealthcare Commercial	$267,260.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$120,986.08
Rate for Payer: Wellcare Medicare Advantage	$120,986.08

HEAVY METAL QUAL ANY ANALYTES

Facility

$390.00

Service Code	HCPCS 83015
Hospital Charge Code	39990246
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEAVY METAL QUAL ANY ANALYTES

Facility

$390.00

Service Code	HCPCS 83015
Hospital Charge Code	39990246
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$56.96
Rate for Payer: Aetna Medicare Advantage	$67.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.94
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	$75.96
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$20.94
Rate for Payer: Clover Medicare Advantage	$19.89
Rate for Payer: EmblemHealth Commercial	$62.82
Rate for Payer: Humana Medicare Advantage	$21.57
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.94
Rate for Payer: Wellcare Medicare Advantage	$20.94
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEAVY METAL QUANT EA

Facility

$390.00

Service Code	HCPCS 83018
Hospital Charge Code	401083018C
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.66
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEAVY METAL QUANT EA

Facility

$390.00

Service Code	HCPCS 83018
Hospital Charge Code	401083018C
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEAVY METAL QUANT EACH NES

Facility

$390.00

Service Code	HCPCS 83018
Hospital Charge Code	401083018
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEAVY METAL QUANT EACH NES

Facility

$390.00

Service Code	HCPCS 83018
Hospital Charge Code	401083018
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$59.73
Rate for Payer: Aetna Medicare Advantage	$71.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$41.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.66
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$21.96
Rate for Payer: Clover Medicare Advantage	$20.86
Rate for Payer: EmblemHealth Commercial	$65.88
Rate for Payer: Humana Medicare Advantage	$22.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.96
Rate for Payer: Wellcare Medicare Advantage	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEAVY METALS BLOOD I

Facility

$130.40

Service Code	HCPCS 82175
Hospital Charge Code	39990142A
Hospital Revenue Code	301
Min. Negotiated Rate	$3.70
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$51.60
Rate for Payer: Aetna Medicare Advantage	$61.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$68.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$68.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$68.81
Rate for Payer: Cigna Commercial	$65.20
Rate for Payer: Cigna Medicare Advantage	$18.97
Rate for Payer: Clover Medicare Advantage	$18.02
Rate for Payer: EmblemHealth Commercial	$56.91
Rate for Payer: Humana Medicare Advantage	$19.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.90
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.56
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.97
Rate for Payer: Wellcare Medicare Advantage	$18.97
Rate for Payer: Wellpoint Medicaid Managed Care	$3.70

HEAVY METALS BLOOD I

Facility

$130.40

Service Code	HCPCS 82175
Hospital Charge Code	39990142A
Hospital Revenue Code	301
Min. Negotiated Rate	$19.56
Max. Negotiated Rate	$19.56
Rate for Payer: Qualcare PPO/HMO/WC	$19.56

HEAVY METALS BLOOD II

Facility

$83.20

Service Code	HCPCS 83655
Hospital Charge Code	39990142B
Hospital Revenue Code	301
Min. Negotiated Rate	$12.48
Max. Negotiated Rate	$12.48
Rate for Payer: Qualcare PPO/HMO/WC	$12.48

HEAVY METALS BLOOD II

Facility

$83.20

Service Code	HCPCS 83655
Hospital Charge Code	39990142B
Hospital Revenue Code	301
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.94
Rate for Payer: Aetna Medicare Advantage	$39.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.93
Rate for Payer: Cigna Commercial	$41.60
Rate for Payer: Cigna Medicare Advantage	$12.11
Rate for Payer: Clover Medicare Advantage	$11.50
Rate for Payer: EmblemHealth Commercial	$36.33
Rate for Payer: Humana Medicare Advantage	$12.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.63
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.48
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.11
Rate for Payer: Wellcare Medicare Advantage	$12.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

Know your out-of-pocket cost for care.

All Charges