Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

IR TRANSCERVICAL CATH FALLOPTU

Facility

$808.00

Service Code	HCPCS 74742
Hospital Charge Code	7411685
Hospital Revenue Code	320
Min. Negotiated Rate	$121.20
Max. Negotiated Rate	$121.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.20

IR TRANSCERVICAL CATH FALLOPTU

Facility

$808.00

Service Code	HCPCS 74742
Hospital Charge Code	2680315
Hospital Revenue Code	320
Min. Negotiated Rate	$121.20
Max. Negotiated Rate	$121.20
Rate for Payer: Qualcare PPO/HMO/WC	$121.20

IR TRANSCERVICAL CATH FALLOPTU

Facility

$808.00

Service Code	HCPCS 74742
Hospital Charge Code	7411685
Hospital Revenue Code	320
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$307.04
Rate for Payer: Aetna Medicare Advantage	$242.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$206.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$206.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$113.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$206.04
Rate for Payer: Cigna Commercial	$404.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$210.08
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$121.20
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$25.53
Rate for Payer: Wellpoint Medicaid Managed Care	$22.95

IR TRANSHEPATIC CHOLANGIO

Facility

$2,417.00

Hospital Charge Code	2001352
Hospital Revenue Code	320
Min. Negotiated Rate	$362.55
Max. Negotiated Rate	$362.55
Rate for Payer: Qualcare PPO/HMO/WC	$362.55

IR TRANSHEPATIC CHOLANGIO

Facility

$2,417.00

Hospital Charge Code	2001352
Hospital Revenue Code	320
Min. Negotiated Rate	$68.64
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$918.46
Rate for Payer: Aetna Medicare Advantage	$725.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$616.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$616.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$616.34
Rate for Payer: Cigna Commercial	$1,208.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$628.42
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$362.55
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$76.38
Rate for Payer: Wellpoint Medicaid Managed Care	$68.64

IR TRANSL PERI ATHERECT PER TI

Facility

$13,876.00

Service Code	HCPCS 35495
Hospital Charge Code	2680165
Hospital Revenue Code	361
Min. Negotiated Rate	$2,081.40
Max. Negotiated Rate	$2,081.40
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.40

IR TRANSL PERI ATHERECT PER TI

Facility

$13,876.00

Service Code	HCPCS 35495
Hospital Charge Code	2680165
Hospital Revenue Code	361
Min. Negotiated Rate	$394.08
Max. Negotiated Rate	$6,938.00
Rate for Payer: Aetna Commercial	$5,272.88
Rate for Payer: Aetna Medicare Advantage	$4,162.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,538.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,538.38
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	$3,538.38
Rate for Payer: Cigna Commercial	$6,938.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,607.76
Rate for Payer: Qualcare PPO/HMO/WC	$2,081.40
Rate for Payer: UnitedHealthcare Community & State	$438.48
Rate for Payer: Wellpoint Medicaid Managed Care	$394.08

IR TRANSL PERIP ATHERECTOMY PE

Facility

$11,101.00

Service Code	HCPCS 35493
Hospital Charge Code	2680160
Hospital Revenue Code	361
Min. Negotiated Rate	$315.27
Max. Negotiated Rate	$5,550.50
Rate for Payer: Aetna Commercial	$4,218.38
Rate for Payer: Aetna Medicare Advantage	$3,330.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,830.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,830.76
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	$2,830.76
Rate for Payer: Cigna Commercial	$5,550.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,886.26
Rate for Payer: Qualcare PPO/HMO/WC	$1,665.15
Rate for Payer: UnitedHealthcare Community & State	$350.79
Rate for Payer: Wellpoint Medicaid Managed Care	$315.27

IR TRANSL PERIP ATHERECTOMY PE

Facility

$11,101.00

Service Code	HCPCS 35493
Hospital Charge Code	2680160
Hospital Revenue Code	361
Min. Negotiated Rate	$1,665.15
Max. Negotiated Rate	$1,665.15
Rate for Payer: Qualcare PPO/HMO/WC	$1,665.15

IR TRANSRECTAL DRAIN PALVIC AB

Facility

$6,588.00

Service Code	HCPCS 45000
Hospital Charge Code	2670175
Hospital Revenue Code	361
Min. Negotiated Rate	$187.10
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$3,866.86
Rate for Payer: Aetna Medicare Advantage	$4,606.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,421.64
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	$5,157.00
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: Cigna Medicare Advantage	$1,421.64
Rate for Payer: Clover Medicare Advantage	$1,350.56
Rate for Payer: EmblemHealth Commercial	$4,264.92
Rate for Payer: Humana Medicare Advantage	$1,464.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,421.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,712.88
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$988.20
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$208.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,421.64
Rate for Payer: Wellcare Medicare Advantage	$1,421.64
Rate for Payer: Wellpoint Medicaid Managed Care	$187.10

IR TRANSRECTAL DRAIN PALVIC AB

Facility

$6,588.00

Service Code	HCPCS 45000
Hospital Charge Code	2670175
Hospital Revenue Code	361
Min. Negotiated Rate	$988.20
Max. Negotiated Rate	$988.20
Rate for Payer: Qualcare PPO/HMO/WC	$988.20

IR TRANSRECTAL DRAIN PALVIC AB

Facility

$6,588.00

Service Code	HCPCS 45000
Hospital Charge Code	7411552
Hospital Revenue Code	361
Min. Negotiated Rate	$187.10
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$3,866.86
Rate for Payer: Aetna Medicare Advantage	$4,606.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,421.64
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	$5,157.00
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: Cigna Medicare Advantage	$1,421.64
Rate for Payer: Clover Medicare Advantage	$1,350.56
Rate for Payer: EmblemHealth Commercial	$4,264.92
Rate for Payer: Humana Medicare Advantage	$1,464.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,421.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,712.88
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$988.20
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$208.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,421.64
Rate for Payer: Wellcare Medicare Advantage	$1,421.64
Rate for Payer: Wellpoint Medicaid Managed Care	$187.10

IR TRANSRECTAL DRAIN PALVIC AB

Facility

$6,588.00

Service Code	HCPCS 45000
Hospital Charge Code	7411552
Hospital Revenue Code	361
Min. Negotiated Rate	$988.20
Max. Negotiated Rate	$988.20
Rate for Payer: Qualcare PPO/HMO/WC	$988.20

IR TRLUML PERIP ATHRC BRCHIOCP

Facility

$37,614.35

Service Code	HCPCS 0237T
Hospital Charge Code	7411257A
Hospital Revenue Code	361
Min. Negotiated Rate	$5,642.15
Max. Negotiated Rate	$5,642.15
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15

IR TRLUML PERIP ATHRC BRCHIOCP

Facility

$37,614.35

Service Code	HCPCS 0237T
Hospital Charge Code	7411257A
Hospital Revenue Code	361
Min. Negotiated Rate	$1,068.25
Max. Negotiated Rate	$49,750.44
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,750.44
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,779.73
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,642.15
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$1,188.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$1,068.25

IR TRLUML PERIP ATHRC ILIAC AR

Facility

$89,914.40

Service Code	HCPCS 0238T
Hospital Charge Code	5600219
Hospital Revenue Code	361
Min. Negotiated Rate	$2,553.57
Max. Negotiated Rate	$79,001.40
Rate for Payer: Aetna Commercial	$59,237.44
Rate for Payer: Aetna Medicare Advantage	$70,562.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,778.47
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	$79,001.40
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: Cigna Medicare Advantage	$21,778.47
Rate for Payer: Clover Medicare Advantage	$20,689.55
Rate for Payer: EmblemHealth Commercial	$65,335.41
Rate for Payer: Humana Medicare Advantage	$22,431.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,778.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23,377.74
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$2,841.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,778.47
Rate for Payer: Wellcare Medicare Advantage	$21,778.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2,553.57

IR TRLUML PERIP ATHRC ILIAC AR

Facility

$89,914.40

Service Code	HCPCS 0238T
Hospital Charge Code	32100238T
Hospital Revenue Code	361
Min. Negotiated Rate	$2,553.57
Max. Negotiated Rate	$79,001.40
Rate for Payer: Aetna Commercial	$59,237.44
Rate for Payer: Aetna Medicare Advantage	$70,562.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,778.47
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	$79,001.40
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: Cigna Medicare Advantage	$21,778.47
Rate for Payer: Clover Medicare Advantage	$20,689.55
Rate for Payer: EmblemHealth Commercial	$65,335.41
Rate for Payer: Humana Medicare Advantage	$22,431.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,778.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23,377.74
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$2,841.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,778.47
Rate for Payer: Wellcare Medicare Advantage	$21,778.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2,553.57

IR TRLUML PERIP ATHRC ILIAC AR

Facility

$89,914.40

Service Code	HCPCS 0238T
Hospital Charge Code	32100238T
Hospital Revenue Code	361
Min. Negotiated Rate	$13,487.16
Max. Negotiated Rate	$13,487.16
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16

IR TRLUML PERIP ATHRC ILIAC AR

Facility

$80,096.45

Service Code	HCPCS 0238T
Hospital Charge Code	36680238T
Hospital Revenue Code	361
Min. Negotiated Rate	$12,014.47
Max. Negotiated Rate	$12,014.47
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47

IR TRLUML PERIP ATHRC ILIAC AR

Facility

$80,096.45

Service Code	HCPCS 0238T
Hospital Charge Code	41100238T
Hospital Revenue Code	361
Min. Negotiated Rate	$2,274.74
Max. Negotiated Rate	$79,001.40
Rate for Payer: Aetna Commercial	$59,237.44
Rate for Payer: Aetna Medicare Advantage	$70,562.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,778.47
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	$79,001.40
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: Cigna Medicare Advantage	$21,778.47
Rate for Payer: Clover Medicare Advantage	$20,689.55
Rate for Payer: EmblemHealth Commercial	$65,335.41
Rate for Payer: Humana Medicare Advantage	$22,431.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,778.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,825.08
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$2,531.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,778.47
Rate for Payer: Wellcare Medicare Advantage	$21,778.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2,274.74

IR TRLUML PERIP ATHRC ILIAC AR

Facility

$89,914.40

Service Code	HCPCS 0238T
Hospital Charge Code	5600219
Hospital Revenue Code	361
Min. Negotiated Rate	$13,487.16
Max. Negotiated Rate	$13,487.16
Rate for Payer: Qualcare PPO/HMO/WC	$13,487.16

IR TRLUML PERIP ATHRC ILIAC AR

Facility

$80,096.45

Service Code	HCPCS 0238T
Hospital Charge Code	36680238T
Hospital Revenue Code	361
Min. Negotiated Rate	$2,274.74
Max. Negotiated Rate	$79,001.40
Rate for Payer: Aetna Commercial	$59,237.44
Rate for Payer: Aetna Medicare Advantage	$70,562.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79,001.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21,778.47
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	$79,001.40
Rate for Payer: Cigna Commercial	$43,654.87
Rate for Payer: Cigna Medicare Advantage	$21,778.47
Rate for Payer: Clover Medicare Advantage	$20,689.55
Rate for Payer: EmblemHealth Commercial	$65,335.41
Rate for Payer: Humana Medicare Advantage	$22,431.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21,778.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20,825.08
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$2,531.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$21,778.47
Rate for Payer: Wellcare Medicare Advantage	$21,778.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2,274.74

IR TRLUML PERIP ATHRC ILIAC AR

Facility

$80,096.45

Service Code	HCPCS 0238T
Hospital Charge Code	41100238T
Hospital Revenue Code	361
Min. Negotiated Rate	$12,014.47
Max. Negotiated Rate	$12,014.47
Rate for Payer: Qualcare PPO/HMO/WC	$12,014.47

IR TRLUML PERIP ATHRC RENAL AR

Facility

$22,749.00

Service Code	HCPCS 0234T
Hospital Charge Code	5600218
Hospital Revenue Code	361
Min. Negotiated Rate	$646.07
Max. Negotiated Rate	$49,750.44
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,750.44
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,914.74
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,412.35
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$718.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$646.07

IR TRLUML PERIP ATHRC RENAL AR

Facility

$22,749.00

Service Code	HCPCS 0234T
Hospital Charge Code	7411848A
Hospital Revenue Code	361
Min. Negotiated Rate	$646.07
Max. Negotiated Rate	$49,750.44
Rate for Payer: Aetna Commercial	$37,304.26
Rate for Payer: Aetna Medicare Advantage	$44,435.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49,750.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,714.80
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	$49,750.44
Rate for Payer: Cigna Commercial	$27,491.26
Rate for Payer: Cigna Medicare Advantage	$13,714.80
Rate for Payer: Clover Medicare Advantage	$13,029.06
Rate for Payer: EmblemHealth Commercial	$41,144.40
Rate for Payer: Humana Medicare Advantage	$14,126.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,714.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,914.74
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,412.35
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$718.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,714.80
Rate for Payer: Wellcare Medicare Advantage	$13,714.80
Rate for Payer: Wellpoint Medicaid Managed Care	$646.07

Know your out-of-pocket cost for care.

All Charges