Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR-MYELOGRAM INJECTION

Facility

$678.00

Service Code	HCPCS 62284
Hospital Charge Code	7411652
Hospital Revenue Code	361
Min. Negotiated Rate	$21.42
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$257.64
Rate for Payer: Aetna Medicare Advantage	$203.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.89
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	$172.89
Rate for Payer: Cigna Commercial	$339.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.28
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$101.70
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$21.42

IR-MYELOGRAM INJECTION

Facility

$678.00

Service Code	HCPCS 62284
Hospital Charge Code	2670220
Hospital Revenue Code	361
Min. Negotiated Rate	$101.70
Max. Negotiated Rate	$101.70
Rate for Payer: Qualcare PPO/HMO/WC	$101.70

IR MYELOGRAM LUMBAR

Facility

$3,939.00

Service Code	HCPCS 62304
Hospital Charge Code	7411656
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM LUMBAR

Facility

$3,939.00

Service Code	HCPCS 62304
Hospital Charge Code	7411656
Hospital Revenue Code	361
Min. Negotiated Rate	$111.87
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,533.19
Rate for Payer: Aetna Medicare Advantage	$3,017.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$931.32
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	$3,378.36
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: Cigna Medicare Advantage	$931.32
Rate for Payer: Clover Medicare Advantage	$884.75
Rate for Payer: EmblemHealth Commercial	$2,793.96
Rate for Payer: Humana Medicare Advantage	$959.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$931.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.14
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$124.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$931.32
Rate for Payer: Wellcare Medicare Advantage	$931.32
Rate for Payer: Wellpoint Medicaid Managed Care	$111.87

IR MYELOGRAM LUMBAR

Facility

$3,939.00

Hospital Charge Code	2692124
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM LUMBAR

Facility

$3,939.00

Hospital Charge Code	2692124
Hospital Revenue Code	361
Min. Negotiated Rate	$111.87
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,496.82
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,969.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.14
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Community & State	$124.47
Rate for Payer: Wellpoint Medicaid Managed Care	$111.87

IR MYELOGRAM THORACIC

Facility

$3,939.00

Service Code	HCPCS 62303
Hospital Charge Code	7411655
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM THORACIC

Facility

$3,939.00

Service Code	HCPCS 62303
Hospital Charge Code	7411655
Hospital Revenue Code	361
Min. Negotiated Rate	$111.87
Max. Negotiated Rate	$3,629.00
Rate for Payer: Aetna Commercial	$2,533.19
Rate for Payer: Aetna Medicare Advantage	$3,017.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,378.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$931.32
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	$3,378.36
Rate for Payer: Cigna Commercial	$1,866.82
Rate for Payer: Cigna Medicare Advantage	$931.32
Rate for Payer: Clover Medicare Advantage	$884.75
Rate for Payer: EmblemHealth Commercial	$2,793.96
Rate for Payer: Humana Medicare Advantage	$959.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$931.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.14
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$124.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$931.32
Rate for Payer: Wellcare Medicare Advantage	$931.32
Rate for Payer: Wellpoint Medicaid Managed Care	$111.87

IR MYELOGRAM THORACIC

Facility

$3,939.00

Hospital Charge Code	2692123
Hospital Revenue Code	361
Min. Negotiated Rate	$590.85
Max. Negotiated Rate	$590.85
Rate for Payer: Qualcare PPO/HMO/WC	$590.85

IR MYELOGRAM THORACIC

Facility

$3,939.00

Hospital Charge Code	2692123
Hospital Revenue Code	361
Min. Negotiated Rate	$111.87
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,496.82
Rate for Payer: Aetna Medicare Advantage	$1,181.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,004.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,004.45
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	$1,004.45
Rate for Payer: Cigna Commercial	$1,969.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,024.14
Rate for Payer: Qualcare PPO/HMO/WC	$590.85
Rate for Payer: UnitedHealthcare Community & State	$124.47
Rate for Payer: Wellpoint Medicaid Managed Care	$111.87

IR NDL BIOPSY BONE DEEP PERC

Facility

$8,054.80

Service Code	HCPCS 20225
Hospital Charge Code	321020225
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR NDL BIOPSY BONE DEEP PERC

Facility

$8,054.80

Service Code	HCPCS 20225
Hospital Charge Code	2004596
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR NDL BIOPSY BONE DEEP PERC

Facility

$8,054.80

Service Code	HCPCS 20225
Hospital Charge Code	2004596
Hospital Revenue Code	361
Min. Negotiated Rate	$228.76
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,094.25
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$254.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$228.76

IR NDL BIOPSY BONE DEEP PERC

Facility

$8,054.80

Service Code	HCPCS 20225
Hospital Charge Code	321020225
Hospital Revenue Code	361
Min. Negotiated Rate	$228.76
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,094.25
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$254.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$228.76

IR NDL BIOPSY BONE DEEP PERC

Facility

$7,219.95

Service Code	HCPCS 20225
Hospital Charge Code	7411342
Hospital Revenue Code	361
Min. Negotiated Rate	$205.05
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,877.19
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,082.99
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$228.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$205.05

IR NDL BIOPSY BONE DEEP PERC

Facility

$7,219.95

Service Code	HCPCS 20225
Hospital Charge Code	7411342
Hospital Revenue Code	361
Min. Negotiated Rate	$1,082.99
Max. Negotiated Rate	$1,082.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,082.99

IR NDL BIOPSY BONE SUPERFIC

Facility

$3,473.00

Service Code	HCPCS 20220
Hospital Charge Code	7411341
Hospital Revenue Code	361
Min. Negotiated Rate	$520.95
Max. Negotiated Rate	$520.95
Rate for Payer: Qualcare PPO/HMO/WC	$520.95

IR NDL BIOPSY BONE SUPERFIC

Facility

$8,054.80

Service Code	HCPCS 20220
Hospital Charge Code	321020220
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR NDL BIOPSY BONE SUPERFIC

Facility

$3,473.00

Service Code	HCPCS 20220
Hospital Charge Code	7411341
Hospital Revenue Code	361
Min. Negotiated Rate	$98.63
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$902.98
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$520.95
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$109.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$98.63

IR NDL BIOPSY BONE SUPERFIC

Facility

$8,054.80

Service Code	HCPCS 20220
Hospital Charge Code	321020220
Hospital Revenue Code	361
Min. Negotiated Rate	$228.76
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,094.25
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$254.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$228.76

IR NDL BIOPSY BONE SUPERFIC

Facility

$8,054.80

Service Code	HCPCS 20220
Hospital Charge Code	2004588
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR NDL BIOPSY BONE SUPERFIC

Facility

$8,054.80

Service Code	HCPCS 20220
Hospital Charge Code	2004588
Hospital Revenue Code	361
Min. Negotiated Rate	$228.76
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,094.25
Rate for Payer: Oxford Commercial	$3,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22
Rate for Payer: UnitedHealthcare Commercial	$3,629.00
Rate for Payer: UnitedHealthcare Community & State	$254.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$228.76

IR NEEDLE BIOPSY LIVER PERC

Facility

$4,709.90

Service Code	HCPCS 47000
Hospital Charge Code	7411553
Hospital Revenue Code	361
Min. Negotiated Rate	$133.76
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
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	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,224.57
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$706.49
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$148.83
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$133.76

IR NEEDLE BIOPSY LIVER PERC

Facility

$8,054.80

Service Code	HCPCS 47000
Hospital Charge Code	2004570
Hospital Revenue Code	361
Min. Negotiated Rate	$1,208.22
Max. Negotiated Rate	$1,208.22
Rate for Payer: Qualcare PPO/HMO/WC	$1,208.22

IR NEEDLE BIOPSY LIVER PERC

Facility

$4,709.90

Service Code	HCPCS 47000
Hospital Charge Code	7411553
Hospital Revenue Code	361
Min. Negotiated Rate	$706.49
Max. Negotiated Rate	$706.49
Rate for Payer: Qualcare PPO/HMO/WC	$706.49

Know your out-of-pocket cost for care.

All Charges