Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HEPATITIS C RNA, PCR

Facility

$2,335.00

Service Code	HCPCS 87522
Hospital Charge Code	38475107
Hospital Revenue Code	306
Min. Negotiated Rate	$350.25
Max. Negotiated Rate	$350.25
Rate for Payer: Qualcare PPO/HMO/WC	$350.25

HEPATITIS C,RNA,PCR,QUAL

Facility

$1,853.00

Service Code	HCPCS 87521
Hospital Charge Code	38475111
Hospital Revenue Code	306
Min. Negotiated Rate	$28.07
Max. Negotiated Rate	$926.50
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$926.50
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$481.78
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$52.63

HEPATITIS C,RNA,PCR,QUAL

Facility

$1,853.00

Service Code	HCPCS 87521
Hospital Charge Code	38475111
Hospital Revenue Code	306
Min. Negotiated Rate	$277.95
Max. Negotiated Rate	$277.95
Rate for Payer: Qualcare PPO/HMO/WC	$277.95

HEPATITIS C RNA QUANT WITH REF

Facility

$294.40

Service Code	HCPCS 87522
Hospital Charge Code	39900459
Hospital Revenue Code	306
Min. Negotiated Rate	$44.16
Max. Negotiated Rate	$44.16
Rate for Payer: Qualcare PPO/HMO/WC	$44.16

HEPATITIS C RNA QUANT WITH REF

Facility

$294.40

Service Code	HCPCS 87522
Hospital Charge Code	39900459
Hospital Revenue Code	306
Min. Negotiated Rate	$8.36
Max. Negotiated Rate	$201.30
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$201.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.40
Rate for Payer: Cigna Commercial	$147.20
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.54
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.16
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$8.36

HEPATITIS C VIRAL RNA QUAL TMA

Facility

$390.00

Service Code	HCPCS 87521
Hospital Charge Code	38479740
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEPATITIS C VIRAL RNA QUAL TMA

Facility

$390.00

Service Code	HCPCS 87521
Hospital Charge Code	38479740
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
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	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEPATITIS D AB,TOTAL

Facility

$390.00

Service Code	HCPCS 86692
Hospital Charge Code	39900240
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEPATITIS D AB,TOTAL

Facility

$390.00

Service Code	HCPCS 86692
Hospital Charge Code	39900240
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.68
Rate for Payer: Aetna Medicare Advantage	$55.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.16
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	$62.25
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.16
Rate for Payer: Clover Medicare Advantage	$16.30
Rate for Payer: EmblemHealth Commercial	$51.48
Rate for Payer: Humana Medicare Advantage	$17.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.16
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	$13.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.16
Rate for Payer: Wellcare Medicare Advantage	$17.16
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEPATITIS DELTA ANTIBODY

Facility

$137.00

Service Code	HCPCS 86692
Hospital Charge Code	38472362
Hospital Revenue Code	302
Min. Negotiated Rate	$20.55
Max. Negotiated Rate	$20.55
Rate for Payer: Qualcare PPO/HMO/WC	$20.55

HEPATITIS DELTA ANTIBODY

Facility

$137.00

Service Code	HCPCS 86692
Hospital Charge Code	38472362
Hospital Revenue Code	302
Min. Negotiated Rate	$3.89
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$46.68
Rate for Payer: Aetna Medicare Advantage	$55.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.16
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	$62.25
Rate for Payer: Cigna Commercial	$68.50
Rate for Payer: Cigna Medicare Advantage	$17.16
Rate for Payer: Clover Medicare Advantage	$16.30
Rate for Payer: EmblemHealth Commercial	$51.48
Rate for Payer: Humana Medicare Advantage	$17.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.62
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.55
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.16
Rate for Payer: Wellcare Medicare Advantage	$17.16
Rate for Payer: Wellpoint Medicaid Managed Care	$3.89

HEPATITIS D VIRUS IGM AB EIA

Facility

$268.84

Service Code	HCPCS 86692
Hospital Charge Code	401386692
Hospital Revenue Code	302
Min. Negotiated Rate	$40.33
Max. Negotiated Rate	$40.33
Rate for Payer: Qualcare PPO/HMO/WC	$40.33

HEPATITIS D VIRUS IGM AB EIA

Facility

$390.00

Service Code	HCPCS 86692
Hospital Charge Code	401086692
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEPATITIS D VIRUS IGM AB EIA

Facility

$390.00

Service Code	HCPCS 86692
Hospital Charge Code	401086692
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$46.68
Rate for Payer: Aetna Medicare Advantage	$55.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.16
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	$62.25
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.16
Rate for Payer: Clover Medicare Advantage	$16.30
Rate for Payer: EmblemHealth Commercial	$51.48
Rate for Payer: Humana Medicare Advantage	$17.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.16
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	$13.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.16
Rate for Payer: Wellcare Medicare Advantage	$17.16
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEPATITIS D VIRUS IGM AB EIA

Facility

$268.84

Service Code	HCPCS 86692
Hospital Charge Code	401386692
Hospital Revenue Code	302
Min. Negotiated Rate	$7.64
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$46.68
Rate for Payer: Aetna Medicare Advantage	$55.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.16
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	$62.25
Rate for Payer: Cigna Commercial	$134.42
Rate for Payer: Cigna Medicare Advantage	$17.16
Rate for Payer: Clover Medicare Advantage	$16.30
Rate for Payer: EmblemHealth Commercial	$51.48
Rate for Payer: Humana Medicare Advantage	$17.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.90
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.33
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.16
Rate for Payer: Wellcare Medicare Advantage	$17.16
Rate for Payer: Wellpoint Medicaid Managed Care	$7.64

HEPATITIS E AB (IGM)

Facility

$390.00

Service Code	HCPCS 86790
Hospital Charge Code	39900390
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEPATITIS E AB (IGM)

Facility

$390.00

Service Code	HCPCS 86790
Hospital Charge Code	39900390
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$391.36
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$391.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.72
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
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	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEPATITIS E,IGE

Facility

$272.00

Service Code	HCPCS 86790
Hospital Charge Code	38476272
Hospital Revenue Code	302
Min. Negotiated Rate	$40.80
Max. Negotiated Rate	$40.80
Rate for Payer: Qualcare PPO/HMO/WC	$40.80

HEPATITIS E,IGE

Facility

$272.00

Service Code	HCPCS 86790
Hospital Charge Code	38476272
Hospital Revenue Code	302
Min. Negotiated Rate	$7.72
Max. Negotiated Rate	$391.36
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$391.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.72
Rate for Payer: Cigna Commercial	$136.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$70.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$7.72

HEPATITIS E IGG

Facility

$390.00

Service Code	HCPCS 86790
Hospital Charge Code	39900389
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HEPATITIS E IGG

Facility

$390.00

Service Code	HCPCS 86790
Hospital Charge Code	39900389
Hospital Revenue Code	302
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$391.36
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$391.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.72
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
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	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HEPATITIS INJ 10MCG/0.05ML

Facility

$171.79

Service Code	HCPCS 90744
Hospital Charge Code	60628287
Hospital Revenue Code	636
Min. Negotiated Rate	$25.77
Max. Negotiated Rate	$41.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.77

HEPATITIS INJ 10MCG/0.05ML

Facility

$171.79

Service Code	HCPCS 90744
Hospital Charge Code	60628287
Hospital Revenue Code	636
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$85.89
Rate for Payer: Aetna Commercial	$65.28
Rate for Payer: Aetna Medicare Advantage	$51.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.81
Rate for Payer: Cigna Commercial	$85.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.77
Rate for Payer: UnitedHealthcare Community & State	$5.43
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

HEPATITIS INJ 20MCG/1ML

Facility

$955.15

Service Code	HCPCS 90371
Hospital Charge Code	60629109
Hospital Revenue Code	636
Min. Negotiated Rate	$143.27
Max. Negotiated Rate	$231.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.15
Rate for Payer: Qualcare PPO/HMO/WC	$143.27

HEPATITIS INJ 20MCG/1ML

Facility

$955.15

Service Code	HCPCS 90371
Hospital Charge Code	60629109
Hospital Revenue Code	636
Min. Negotiated Rate	$27.13
Max. Negotiated Rate	$508.61
Rate for Payer: Aetna Commercial	$381.37
Rate for Payer: Aetna Medicare Advantage	$454.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$508.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$508.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$140.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$508.61
Rate for Payer: Cigna Medicare Advantage	$140.21
Rate for Payer: Clover Medicare Advantage	$133.20
Rate for Payer: EmblemHealth Commercial	$420.63
Rate for Payer: Humana Medicare Advantage	$144.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$140.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$231.15
Rate for Payer: Qualcare PPO/HMO/WC	$143.27
Rate for Payer: UnitedHealthcare Community & State	$30.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$140.21
Rate for Payer: Wellcare Medicare Advantage	$140.21
Rate for Payer: Wellpoint Medicaid Managed Care	$27.13

Know your out-of-pocket cost for care.

All Charges