Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

INTREPID I/A TIP 0.3MM BENT

Facility

$1,500.00

Hospital Charge Code	270662665
Hospital Revenue Code	270
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$390.00
Rate for Payer: Oxford Commercial	$300.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Commercial	$300.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

INTREPID I/A TIP 0.3MM BENT

Facility

$1,500.00

Hospital Charge Code	270662665
Hospital Revenue Code	270
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$225.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

INTRFRN ALFA-2B 10MILL IU/VIAL

Facility

$1,620.06

Service Code	HCPCS J9214
Hospital Charge Code	60627390
Hospital Revenue Code	636
Min. Negotiated Rate	$46.01
Max. Negotiated Rate	$810.03
Rate for Payer: Aetna Commercial	$615.62
Rate for Payer: Aetna Medicare Advantage	$486.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$413.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$413.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$413.12
Rate for Payer: Cigna Commercial	$810.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.05
Rate for Payer: Qualcare PPO/HMO/WC	$243.01
Rate for Payer: UnitedHealthcare Community & State	$51.19
Rate for Payer: Wellpoint Medicaid Managed Care	$46.01

INTRFRN ALFA-2B 10MILL IU/VIAL

Facility

$1,620.06

Service Code	HCPCS J9214
Hospital Charge Code	60627390
Hospital Revenue Code	636
Min. Negotiated Rate	$243.01
Max. Negotiated Rate	$392.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$392.05
Rate for Payer: Qualcare PPO/HMO/WC	$243.01

INTRINSIC FACTOR ANTIBODY

Facility

$145.00

Service Code	HCPCS 86340
Hospital Charge Code	38476229
Hospital Revenue Code	302
Min. Negotiated Rate	$4.12
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$41.02
Rate for Payer: Aetna Medicare Advantage	$48.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.70
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: Cigna Medicare Advantage	$15.08
Rate for Payer: Clover Medicare Advantage	$14.33
Rate for Payer: EmblemHealth Commercial	$45.24
Rate for Payer: Humana Medicare Advantage	$15.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.70
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.08
Rate for Payer: Wellcare Medicare Advantage	$15.08
Rate for Payer: Wellpoint Medicaid Managed Care	$4.12

INTRINSIC FACTOR ANTIBODY

Facility

$145.00

Service Code	HCPCS 86340
Hospital Charge Code	38476229
Hospital Revenue Code	302
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

INTRINSIC FACTOR BLOCKING

Facility

$390.00

Service Code	HCPCS 86340
Hospital Charge Code	39900218
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

INTRINSIC FACTOR BLOCKING

Facility

$390.00

Service Code	HCPCS 86340
Hospital Charge Code	39900218
Hospital Revenue Code	302
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$41.02
Rate for Payer: Aetna Medicare Advantage	$48.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.70
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.08
Rate for Payer: Clover Medicare Advantage	$14.33
Rate for Payer: EmblemHealth Commercial	$45.24
Rate for Payer: Humana Medicare Advantage	$15.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.08
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	$12.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.08
Rate for Payer: Wellcare Medicare Advantage	$15.08
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

INTRO CATH DIALYSIS CIRC BALLO

Facility

$20,340.00

Service Code	HCPCS 36902
Hospital Charge Code	16000949
Hospital Revenue Code	360
Min. Negotiated Rate	$577.66
Max. Negotiated Rate	$24,528.18
Rate for Payer: Aetna Commercial	$18,391.91
Rate for Payer: Aetna Medicare Advantage	$21,908.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,528.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,761.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,528.18
Rate for Payer: Cigna Commercial	$13,553.85
Rate for Payer: Cigna Medicare Advantage	$6,761.73
Rate for Payer: Clover Medicare Advantage	$6,423.64
Rate for Payer: EmblemHealth Commercial	$20,285.19
Rate for Payer: Humana Medicare Advantage	$6,964.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,761.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,288.40
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,051.00
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$642.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,761.73
Rate for Payer: Wellcare Medicare Advantage	$6,761.73
Rate for Payer: Wellpoint Medicaid Managed Care	$577.66

INTRO CATH DIALYSIS CIRC BALLO

Facility

$20,340.00

Service Code	HCPCS 36902
Hospital Charge Code	16000949
Hospital Revenue Code	360
Min. Negotiated Rate	$3,051.00
Max. Negotiated Rate	$3,051.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,051.00

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	2709022
Hospital Revenue Code	361
Min. Negotiated Rate	$512.88
Max. Negotiated Rate	$512.88
Rate for Payer: Qualcare PPO/HMO/WC	$512.88

INTRO CATH DIALYSIS CIRCUIT

Facility

$6,404.20

Service Code	HCPCS 36901
Hospital Charge Code	2692127
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

INTRO CATH DIALYSIS CIRCUIT

Facility

$6,404.20

Service Code	HCPCS 36901
Hospital Charge Code	321036901
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$6,783.93
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,783.93
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	2709022
Hospital Revenue Code	361
Min. Negotiated Rate	$97.11
Max. Negotiated Rate	$6,783.93
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,783.93
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$888.99
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$512.88
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$108.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$97.11

INTRO CATH DIALYSIS CIRCUIT

Facility

$6,404.20

Service Code	HCPCS 36901
Hospital Charge Code	321036901
Hospital Revenue Code	361
Min. Negotiated Rate	$960.63
Max. Negotiated Rate	$960.63
Rate for Payer: Qualcare PPO/HMO/WC	$960.63

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	366836901
Hospital Revenue Code	361
Min. Negotiated Rate	$512.88
Max. Negotiated Rate	$512.88
Rate for Payer: Qualcare PPO/HMO/WC	$512.88

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	7412056
Hospital Revenue Code	361
Min. Negotiated Rate	$97.11
Max. Negotiated Rate	$6,783.93
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,783.93
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$888.99
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$512.88
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$108.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$97.11

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	366836901
Hospital Revenue Code	361
Min. Negotiated Rate	$97.11
Max. Negotiated Rate	$6,783.93
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,783.93
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$888.99
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$512.88
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$108.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$97.11

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	5100835
Hospital Revenue Code	361
Min. Negotiated Rate	$512.88
Max. Negotiated Rate	$512.88
Rate for Payer: Qualcare PPO/HMO/WC	$512.88

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	5100835
Hospital Revenue Code	361
Min. Negotiated Rate	$97.11
Max. Negotiated Rate	$6,783.93
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,783.93
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$888.99
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$512.88
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$108.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$97.11

INTRO CATH DIALYSIS CIRCUIT

Facility

$3,419.20

Service Code	HCPCS 36901
Hospital Charge Code	7412056
Hospital Revenue Code	361
Min. Negotiated Rate	$512.88
Max. Negotiated Rate	$512.88
Rate for Payer: Qualcare PPO/HMO/WC	$512.88

INTRO CATH DIALYSIS CIRCUIT

Facility

$6,404.20

Service Code	HCPCS 36901
Hospital Charge Code	2692127
Hospital Revenue Code	361
Min. Negotiated Rate	$181.88
Max. Negotiated Rate	$6,783.93
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,783.93
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,665.09
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$960.63
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$202.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$181.88

INTRO DIALYSIS CIRCUIT

Facility

$2,873.16

Service Code	HCPCS 36901
Hospital Charge Code	16000484
Hospital Revenue Code	360
Min. Negotiated Rate	$430.97
Max. Negotiated Rate	$430.97
Rate for Payer: Qualcare PPO/HMO/WC	$430.97

INTRO DIALYSIS CIRCUIT

Facility

$2,873.16

Service Code	HCPCS 36901
Hospital Charge Code	16000484
Hospital Revenue Code	360
Min. Negotiated Rate	$81.60
Max. Negotiated Rate	$6,783.93
Rate for Payer: Aetna Commercial	$5,086.78
Rate for Payer: Aetna Medicare Advantage	$6,059.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,783.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,870.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,783.93
Rate for Payer: Cigna Commercial	$3,748.67
Rate for Payer: Cigna Medicare Advantage	$1,870.14
Rate for Payer: Clover Medicare Advantage	$1,776.63
Rate for Payer: EmblemHealth Commercial	$5,610.42
Rate for Payer: Humana Medicare Advantage	$1,926.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,870.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$747.02
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$430.97
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$90.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,870.14
Rate for Payer: Wellcare Medicare Advantage	$1,870.14
Rate for Payer: Wellpoint Medicaid Managed Care	$81.60

INTROD RAABE 7FR 70CM G11635

Facility

$220.50

Service Code	HCPCS C1894
Hospital Charge Code	270636699A
Hospital Revenue Code	278
Min. Negotiated Rate	$6.26
Max. Negotiated Rate	$110.25
Rate for Payer: Aetna Commercial	$83.79
Rate for Payer: Aetna Medicare Advantage	$66.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$44.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.23
Rate for Payer: Cigna Commercial	$110.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.36
Rate for Payer: Qualcare PPO/HMO/WC	$33.08
Rate for Payer: UnitedHealthcare Community & State	$6.97
Rate for Payer: Wellpoint Medicaid Managed Care	$6.26

Know your out-of-pocket cost for care.

All Charges