Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IMMUNOFIXATION,URINE

Facility

$390.00

Service Code	HCPCS 86335
Hospital Charge Code	39900215
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$79.83
Rate for Payer: Aetna Medicare Advantage	$95.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.47
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$29.35
Rate for Payer: Clover Medicare Advantage	$27.88
Rate for Payer: EmblemHealth Commercial	$88.05
Rate for Payer: Humana Medicare Advantage	$30.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.35
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	$23.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.35
Rate for Payer: Wellcare Medicare Advantage	$29.35
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

IMMUNOFIXATION (URINE IFE)

Facility

$450.27

Service Code	HCPCS 86335
Hospital Charge Code	3031499
Hospital Revenue Code	302
Min. Negotiated Rate	$67.54
Max. Negotiated Rate	$67.54
Rate for Payer: Qualcare PPO/HMO/WC	$67.54

IMMUNOFIXATION (URINE IFE)

Facility

$450.27

Service Code	HCPCS 86335
Hospital Charge Code	3031499
Hospital Revenue Code	302
Min. Negotiated Rate	$12.79
Max. Negotiated Rate	$225.13
Rate for Payer: Aetna Commercial	$79.83
Rate for Payer: Aetna Medicare Advantage	$95.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.47
Rate for Payer: Cigna Commercial	$225.13
Rate for Payer: Cigna Medicare Advantage	$29.35
Rate for Payer: Clover Medicare Advantage	$27.88
Rate for Payer: EmblemHealth Commercial	$88.05
Rate for Payer: Humana Medicare Advantage	$30.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.07
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.54
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$23.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.35
Rate for Payer: Wellcare Medicare Advantage	$29.35
Rate for Payer: Wellpoint Medicaid Managed Care	$12.79

IMMUNOFIX ELECT-PJORESIS FLUID

Facility

$207.00

Service Code	HCPCS 86335
Hospital Charge Code	38477181
Hospital Revenue Code	302
Min. Negotiated Rate	$5.88
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$79.83
Rate for Payer: Aetna Medicare Advantage	$95.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$106.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$106.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$29.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$106.47
Rate for Payer: Cigna Commercial	$103.50
Rate for Payer: Cigna Medicare Advantage	$29.35
Rate for Payer: Clover Medicare Advantage	$27.88
Rate for Payer: EmblemHealth Commercial	$88.05
Rate for Payer: Humana Medicare Advantage	$30.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$29.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.82
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$23.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$29.35
Rate for Payer: Wellcare Medicare Advantage	$29.35
Rate for Payer: Wellpoint Medicaid Managed Care	$5.88

IMMUNOFIX ELECT-PJORESIS FLUID

Facility

$207.00

Service Code	HCPCS 86335
Hospital Charge Code	38477181
Hospital Revenue Code	302
Min. Negotiated Rate	$31.05
Max. Negotiated Rate	$31.05
Rate for Payer: Qualcare PPO/HMO/WC	$31.05

IMMUNOFLUOR STDY EA ANTIB DIRC

Facility

$217.00

Service Code	HCPCS 88346
Hospital Charge Code	38477185
Hospital Revenue Code	312
Min. Negotiated Rate	$6.16
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$56.42
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.55
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$122.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$6.16

IMMUNOFLUOR STDY EA ANTIB DIRC

Facility

$217.00

Service Code	HCPCS 88346
Hospital Charge Code	38477185
Hospital Revenue Code	312
Min. Negotiated Rate	$32.55
Max. Negotiated Rate	$32.55
Rate for Payer: Qualcare PPO/HMO/WC	$32.55

Immunoglobulin A

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39888026
Hospital Revenue Code	301
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.74
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
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	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Immunoglobulin A

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39888026
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Immunoglobulin E

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39888029
Hospital Revenue Code	301
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.74
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
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	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Immunoglobulin E

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39888029
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

IMMUNOGLOBULIN E (IgE)

Facility

$390.00

Service Code	HCPCS 82785
Hospital Charge Code	401182785
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

IMMUNOGLOBULIN E (IgE)

Facility

$390.00

Service Code	HCPCS 82785
Hospital Charge Code	401182785
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$44.77
Rate for Payer: Aetna Medicare Advantage	$53.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.46
Rate for Payer: Clover Medicare Advantage	$15.64
Rate for Payer: EmblemHealth Commercial	$49.38
Rate for Payer: Humana Medicare Advantage	$16.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.46
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	$13.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.46
Rate for Payer: Wellcare Medicare Advantage	$16.46
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Immunoglobulin G

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39888027
Hospital Revenue Code	301
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.74
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
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	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Immunoglobulin G

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39888027
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Immunoglobulin M

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39888028
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Immunoglobulin M

Facility

$390.00

Service Code	HCPCS 82784
Hospital Charge Code	39888028
Hospital Revenue Code	301
Min. Negotiated Rate	$7.44
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.74
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
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	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

IMMUNOGLOBULINS

Facility

$240.00

Service Code	HCPCS 82784
Hospital Charge Code	38472419
Hospital Revenue Code	301
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.74
Rate for Payer: Cigna Commercial	$120.00
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$6.82

IMMUNOGLOBULINS

Facility

$240.00

Service Code	HCPCS 82784
Hospital Charge Code	38472419
Hospital Revenue Code	301
Min. Negotiated Rate	$36.00
Max. Negotiated Rate	$36.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.00

IMMUNOGLOBULINS(IGG,A,M),I

Facility

$63.90

Service Code	HCPCS 8278491
Hospital Charge Code	39990007A
Hospital Revenue Code	301
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$24.28
Rate for Payer: Aetna Medicare Advantage	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.29
Rate for Payer: Cigna Commercial	$31.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.61
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.59
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$1.81

IMMUNOGLOBULINS(IGG,A,M),I

Facility

$63.90

Service Code	HCPCS 8278491
Hospital Charge Code	39990007A
Hospital Revenue Code	301
Min. Negotiated Rate	$9.59
Max. Negotiated Rate	$9.59
Rate for Payer: Qualcare PPO/HMO/WC	$9.59

IMMUNOGLOBULINS(IGG,A,M),II

Facility

$63.90

Service Code	HCPCS 8278491
Hospital Charge Code	39990007B
Hospital Revenue Code	301
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$24.28
Rate for Payer: Aetna Medicare Advantage	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.29
Rate for Payer: Cigna Commercial	$31.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.61
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.59
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$1.81

IMMUNOGLOBULINS(IGG,A,M),II

Facility

$63.90

Service Code	HCPCS 8278491
Hospital Charge Code	39990007B
Hospital Revenue Code	301
Min. Negotiated Rate	$9.59
Max. Negotiated Rate	$9.59
Rate for Payer: Qualcare PPO/HMO/WC	$9.59

IMMUNOGLOBULINS(IGG,A,M),III

Facility

$63.90

Service Code	HCPCS 8278491
Hospital Charge Code	39990007C
Hospital Revenue Code	301
Min. Negotiated Rate	$9.59
Max. Negotiated Rate	$9.59
Rate for Payer: Qualcare PPO/HMO/WC	$9.59

IMMUNOGLOBULINS(IGG,A,M),III

Facility

$63.90

Service Code	HCPCS 8278491
Hospital Charge Code	39990007C
Hospital Revenue Code	301
Min. Negotiated Rate	$1.81
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$24.28
Rate for Payer: Aetna Medicare Advantage	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.29
Rate for Payer: Cigna Commercial	$31.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.61
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.59
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$1.81

Know your out-of-pocket cost for care.

All Charges