Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR INJ,SHOULDER ARTHROGRPHYCT/

Facility

$1,766.00

Service Code	HCPCS 23350
Hospital Charge Code	2680055
Hospital Revenue Code	361
Min. Negotiated Rate	$264.90
Max. Negotiated Rate	$264.90
Rate for Payer: Qualcare PPO/HMO/WC	$264.90

IR INJ,SHOULDER ARTHROGRPHYCT/

Facility

$1,766.00

Service Code	HCPCS 23350
Hospital Charge Code	2680055
Hospital Revenue Code	361
Min. Negotiated Rate	$50.15
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$671.08
Rate for Payer: Aetna Medicare Advantage	$529.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.33
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	$450.33
Rate for Payer: Cigna Commercial	$883.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.16
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.90
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$55.81
Rate for Payer: Wellpoint Medicaid Managed Care	$50.15

IR INJ,SHOULDER ARTHROGRPHYCT/

Facility

$1,766.00

Service Code	HCPCS 23350
Hospital Charge Code	7411360
Hospital Revenue Code	361
Min. Negotiated Rate	$264.90
Max. Negotiated Rate	$264.90
Rate for Payer: Qualcare PPO/HMO/WC	$264.90

IR INJ,SHOULDER ARTHROGRPHYCT/

Facility

$1,766.00

Service Code	HCPCS 23350
Hospital Charge Code	7411360
Hospital Revenue Code	361
Min. Negotiated Rate	$50.15
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$671.08
Rate for Payer: Aetna Medicare Advantage	$529.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.33
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	$450.33
Rate for Payer: Cigna Commercial	$883.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.16
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$264.90
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$55.81
Rate for Payer: Wellpoint Medicaid Managed Care	$50.15

IR INJ TMJ JOINT ARTHROGRAPHY

Facility

$150.00

Service Code	HCPCS 21116
Hospital Charge Code	7411349
Hospital Revenue Code	361
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

IR INJ TMJ JOINT ARTHROGRAPHY

Facility

$150.00

Service Code	HCPCS 21116
Hospital Charge Code	7411349
Hospital Revenue Code	361
Min. Negotiated Rate	$4.74
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
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	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$4.74

IR INJ TMJ JOINT ARTHROGRAPHY

Facility

$150.00

Service Code	HCPCS 21116
Hospital Charge Code	2680040
Hospital Revenue Code	361
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

IR INJ TMJ JOINT ARTHROGRAPHY

Facility

$150.00

Service Code	HCPCS 21116
Hospital Charge Code	2680040
Hospital Revenue Code	361
Min. Negotiated Rate	$4.74
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
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	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$4.74

IRINOTECAN 20 MG/ML INJ

Facility

$4,625.35

Service Code	HCPCS J9206
Hospital Charge Code	6017073
Hospital Revenue Code	636
Min. Negotiated Rate	$131.36
Max. Negotiated Rate	$2,312.68
Rate for Payer: Aetna Commercial	$1,757.63
Rate for Payer: Aetna Medicare Advantage	$1,387.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,179.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,179.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,179.46
Rate for Payer: Cigna Commercial	$2,312.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.33
Rate for Payer: Qualcare PPO/HMO/WC	$693.80
Rate for Payer: UnitedHealthcare Community & State	$146.16
Rate for Payer: Wellpoint Medicaid Managed Care	$131.36

IRINOTECAN 20 MG/ML INJ

Facility

$4,625.35

Service Code	HCPCS J9206
Hospital Charge Code	6017073
Hospital Revenue Code	636
Min. Negotiated Rate	$693.80
Max. Negotiated Rate	$1,119.33
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,119.33
Rate for Payer: Qualcare PPO/HMO/WC	$693.80

IR INS CATH RENAL ART 1ST UNI

Facility

$15,468.50

Service Code	HCPCS 36251
Hospital Charge Code	321036251
Hospital Revenue Code	361
Min. Negotiated Rate	$488.80
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

IR INS CATH RENAL ART 1ST UNI

Facility

$15,468.50

Service Code	HCPCS 36251
Hospital Charge Code	321036251
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR INS CATH RENAL ART 1ST UNI

Facility

$15,468.50

Service Code	HCPCS 36251
Hospital Charge Code	5700253
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR INS CATH RENAL ART 1ST UNI

Facility

$15,468.50

Service Code	HCPCS 36251
Hospital Charge Code	5700253
Hospital Revenue Code	361
Min. Negotiated Rate	$488.80
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

IR INS CATH REN ART 1st BILAT

Facility

$15,468.50

Service Code	HCPCS 36252
Hospital Charge Code	321036252
Hospital Revenue Code	361
Min. Negotiated Rate	$488.80
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

IR INS CATH REN ART 1st BILAT

Facility

$15,468.50

Service Code	HCPCS 36252
Hospital Charge Code	321036252
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR INS CATH REN ART 1st BILAT

Facility

$15,468.50

Service Code	HCPCS 36252
Hospital Charge Code	5700264
Hospital Revenue Code	361
Min. Negotiated Rate	$488.80
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,216.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7,075.29

IR INS CATH REN ART 1st BILAT

Facility

$15,468.50

Service Code	HCPCS 36252
Hospital Charge Code	5700264
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

IR INS CATH REN ART 2ND UNILAT

Facility

$21,323.35

Service Code	HCPCS 36253
Hospital Charge Code	366836253
Hospital Revenue Code	361
Min. Negotiated Rate	$3,198.50
Max. Negotiated Rate	$3,198.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,198.50

IR INS CATH REN ART 2ND UNILAT

Facility

$25,628.45

Service Code	HCPCS 36253
Hospital Charge Code	321036253
Hospital Revenue Code	361
Min. Negotiated Rate	$727.85
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,663.40
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$809.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$727.85

IR INS CATH REN ART 2ND UNILAT

Facility

$21,323.35

Service Code	HCPCS 36253
Hospital Charge Code	366836253
Hospital Revenue Code	361
Min. Negotiated Rate	$605.58
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,544.07
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,198.50
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$673.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$605.58

IR INS CATH REN ART 2ND UNILAT

Facility

$25,628.45

Service Code	HCPCS 36253
Hospital Charge Code	5700211
Hospital Revenue Code	361
Min. Negotiated Rate	$727.85
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,663.40
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$809.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$727.85

IR INS CATH REN ART 2ND UNILAT

Facility

$10,405.00

Service Code	HCPCS 36253
Hospital Charge Code	7411434
Hospital Revenue Code	361
Min. Negotiated Rate	$1,560.75
Max. Negotiated Rate	$1,560.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,560.75

IR INS CATH REN ART 2ND UNILAT

Facility

$10,405.00

Service Code	HCPCS 36253
Hospital Charge Code	7411434
Hospital Revenue Code	361
Min. Negotiated Rate	$295.50
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,705.30
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,560.75
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$328.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$295.50

IR INS CATH REN ART 2ND UNILAT

Facility

$25,628.45

Service Code	HCPCS 36253
Hospital Charge Code	321036253
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

Know your out-of-pocket cost for care.

All Charges