Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

HOLTER MONITOR SCAN, RPT, SET

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	74115012
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SETUP

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	74115011
Hospital Revenue Code	731
Min. Negotiated Rate	$150.16
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,404.00
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

HOLTER MONITOR SETUP

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	5300041
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SETUP

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	74115011
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SETUP

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	74116011
Hospital Revenue Code	731
Min. Negotiated Rate	$150.16
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,404.00
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

HOLTER MONITOR SETUP

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	74117011
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SETUP

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	74116011
Hospital Revenue Code	731
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$810.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00

HOLTER MONITOR SETUP

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	5300041
Hospital Revenue Code	731
Min. Negotiated Rate	$150.16
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,404.00
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

HOLTER MONITOR SETUP

Facility

$5,400.00

Service Code	HCPCS 93225
Hospital Charge Code	74117011
Hospital Revenue Code	731
Min. Negotiated Rate	$150.16
Max. Negotiated Rate	$2,460.00
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$184.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.36
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,404.00
Rate for Payer: Oxford Commercial	$2,169.00
Rate for Payer: Qualcare PPO/HMO/WC	$810.00
Rate for Payer: UnitedHealthcare Commercial	$2,460.00
Rate for Payer: UnitedHealthcare Community & State	$170.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$153.36

Homatropine 5% oph soln 5ml

Facility

$127.84

Service Code	NDC 59390019205
Hospital Charge Code	6063943293
Hospital Revenue Code	250
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$63.92
Rate for Payer: Aetna Commercial	$48.58
Rate for Payer: Aetna Medicare Advantage	$38.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.60
Rate for Payer: Cigna Commercial	$63.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.24
Rate for Payer: Oxford Commercial	$25.57
Rate for Payer: Qualcare PPO/HMO/WC	$19.18
Rate for Payer: UnitedHealthcare Commercial	$25.57
Rate for Payer: UnitedHealthcare Community & State	$4.04
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

Homatropine 5% oph soln 5ml

Facility

$127.84

Service Code	NDC 59390019205
Hospital Charge Code	6063943293
Hospital Revenue Code	250
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$19.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.18

HOME SLEEP TEST/TYPE 3 PORATAB

Facility

$30,000.00

Service Code	HCPCS G0399
Hospital Charge Code	90000055
Hospital Revenue Code	920
Min. Negotiated Rate	$243.69
Max. Negotiated Rate	$13,534.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,800.00
Rate for Payer: Oxford Commercial	$11,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00
Rate for Payer: UnitedHealthcare Commercial	$13,534.00
Rate for Payer: UnitedHealthcare Community & State	$948.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$852.00

HOME SLEEP TEST/TYPE 3 PORATAB

Facility

$30,000.00

Service Code	HCPCS G0399
Hospital Charge Code	90000055
Hospital Revenue Code	920
Min. Negotiated Rate	$4,500.00
Max. Negotiated Rate	$4,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,500.00

HOMOCYSTEINE

Facility

$986.00

Service Code	HCPCS 82131
Hospital Charge Code	38472013
Hospital Revenue Code	301
Min. Negotiated Rate	$147.90
Max. Negotiated Rate	$147.90
Rate for Payer: Qualcare PPO/HMO/WC	$147.90

HOMOCYSTEINE

Facility

$1,243.00

Service Code	HCPCS 82131
Hospital Charge Code	38473072
Hospital Revenue Code	301
Min. Negotiated Rate	$18.38
Max. Negotiated Rate	$621.50
Rate for Payer: Aetna Commercial	$62.51
Rate for Payer: Aetna Medicare Advantage	$74.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.36
Rate for Payer: Cigna Commercial	$621.50
Rate for Payer: Cigna Medicare Advantage	$22.98
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.18
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Medicare Advantage	$22.98
Rate for Payer: Wellpoint Medicaid Managed Care	$35.30

HOMOCYSTEINE

Facility

$1,243.00

Service Code	HCPCS 82131
Hospital Charge Code	38473072
Hospital Revenue Code	301
Min. Negotiated Rate	$186.45
Max. Negotiated Rate	$186.45
Rate for Payer: Qualcare PPO/HMO/WC	$186.45

HOMOCYSTEINE

Facility

$986.00

Service Code	HCPCS 82131
Hospital Charge Code	38472013
Hospital Revenue Code	301
Min. Negotiated Rate	$18.38
Max. Negotiated Rate	$493.00
Rate for Payer: Aetna Commercial	$62.51
Rate for Payer: Aetna Medicare Advantage	$74.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.36
Rate for Payer: Cigna Commercial	$493.00
Rate for Payer: Cigna Medicare Advantage	$22.98
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.36
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$147.90
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Medicare Advantage	$22.98
Rate for Payer: Wellpoint Medicaid Managed Care	$28.00

HOMOCYSTEINE,CARD

Facility

$1,243.00

Service Code	HCPCS 82131
Hospital Charge Code	38479100
Hospital Revenue Code	301
Min. Negotiated Rate	$18.38
Max. Negotiated Rate	$621.50
Rate for Payer: Aetna Commercial	$62.51
Rate for Payer: Aetna Medicare Advantage	$74.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.36
Rate for Payer: Cigna Commercial	$621.50
Rate for Payer: Cigna Medicare Advantage	$22.98
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.18
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Medicare Advantage	$22.98
Rate for Payer: Wellpoint Medicaid Managed Care	$35.30

HOMOCYSTEINE,CARD

Facility

$1,243.00

Service Code	HCPCS 82131
Hospital Charge Code	38479100
Hospital Revenue Code	301
Min. Negotiated Rate	$186.45
Max. Negotiated Rate	$186.45
Rate for Payer: Qualcare PPO/HMO/WC	$186.45

HOMOCYSTEINE (CARDIO),FPI

Facility

$390.00

Service Code	HCPCS 83090
Hospital Charge Code	39990005EX
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HOMOCYSTEINE (CARDIO),FPI

Facility

$390.00

Service Code	HCPCS 83090
Hospital Charge Code	39990005EX
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$48.74
Rate for Payer: Aetna Medicare Advantage	$58.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.00
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.92
Rate for Payer: Clover Medicare Advantage	$17.02
Rate for Payer: EmblemHealth Commercial	$53.76
Rate for Payer: Humana Medicare Advantage	$18.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.92
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	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.92
Rate for Payer: Wellcare Medicare Advantage	$17.92
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

HOMOCYSTEINE (CARDIO),FPI I

Facility

$115.90

Service Code	HCPCS 82131
Hospital Charge Code	39990005A
Hospital Revenue Code	301
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$62.51
Rate for Payer: Aetna Medicare Advantage	$74.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$43.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.36
Rate for Payer: Cigna Commercial	$57.95
Rate for Payer: Cigna Medicare Advantage	$22.98
Rate for Payer: Clover Medicare Advantage	$21.83
Rate for Payer: EmblemHealth Commercial	$68.94
Rate for Payer: Humana Medicare Advantage	$23.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.13
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.39
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.98
Rate for Payer: Wellcare Medicare Advantage	$22.98
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

HOMOCYSTEINE (CARDIO),FPI I

Facility

$115.90

Service Code	HCPCS 82131
Hospital Charge Code	39990005A
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$17.39
Rate for Payer: Qualcare PPO/HMO/WC	$17.39

HOMOCYSTEINE (CARDIO),FPI II

Facility

$115.95

Service Code	HCPCS 83090
Hospital Charge Code	39990005B
Hospital Revenue Code	301
Min. Negotiated Rate	$17.39
Max. Negotiated Rate	$17.39
Rate for Payer: Qualcare PPO/HMO/WC	$17.39

HOMOCYSTEINE (CARDIO),FPI II

Facility

$115.95

Service Code	HCPCS 83090
Hospital Charge Code	39990005B
Hospital Revenue Code	301
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$48.74
Rate for Payer: Aetna Medicare Advantage	$58.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.00
Rate for Payer: Cigna Commercial	$57.98
Rate for Payer: Cigna Medicare Advantage	$17.92
Rate for Payer: Clover Medicare Advantage	$17.02
Rate for Payer: EmblemHealth Commercial	$53.76
Rate for Payer: Humana Medicare Advantage	$18.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.15
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.39
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.92
Rate for Payer: Wellcare Medicare Advantage	$17.92
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

Know your out-of-pocket cost for care.

All Charges