Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MULTIFIRE TA55-4.8 LOADING

Facility

$234.00

Hospital Charge Code	270334694
Hospital Revenue Code	272
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$117.00
Rate for Payer: Aetna Commercial	$88.92
Rate for Payer: Aetna Medicare Advantage	$70.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.67
Rate for Payer: Cigna Commercial	$117.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.84
Rate for Payer: Oxford Commercial	$46.80
Rate for Payer: Qualcare PPO/HMO/WC	$35.10
Rate for Payer: UnitedHealthcare Commercial	$46.80
Rate for Payer: UnitedHealthcare Community & State	$7.39
Rate for Payer: Wellpoint Medicaid Managed Care	$6.65

MULTIFIRE TA55-4.8 LOADING

Facility

$234.00

Hospital Charge Code	270334694
Hospital Revenue Code	272
Min. Negotiated Rate	$35.10
Max. Negotiated Rate	$35.10
Rate for Payer: Qualcare PPO/HMO/WC	$35.10

MULTIFIRE TA 55-4.8 STAPLER

Facility

$446.00

Hospital Charge Code	270334726
Hospital Revenue Code	272
Min. Negotiated Rate	$66.90
Max. Negotiated Rate	$66.90
Rate for Payer: Qualcare PPO/HMO/WC	$66.90

MULTIFIRE TA 55-4.8 STAPLER

Facility

$446.00

Hospital Charge Code	270334726
Hospital Revenue Code	272
Min. Negotiated Rate	$12.67
Max. Negotiated Rate	$223.00
Rate for Payer: Aetna Commercial	$169.48
Rate for Payer: Aetna Medicare Advantage	$133.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$113.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$113.73
Rate for Payer: Cigna Commercial	$223.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$115.96
Rate for Payer: Oxford Commercial	$89.20
Rate for Payer: Qualcare PPO/HMO/WC	$66.90
Rate for Payer: UnitedHealthcare Commercial	$89.20
Rate for Payer: UnitedHealthcare Community & State	$14.09
Rate for Payer: Wellpoint Medicaid Managed Care	$12.67

MULTI-LENGTH STENT 6FR.X22-32

Facility

$1,059.00

Hospital Charge Code	270332351
Hospital Revenue Code	278
Min. Negotiated Rate	$30.08
Max. Negotiated Rate	$529.50
Rate for Payer: Aetna Commercial	$402.42
Rate for Payer: Aetna Medicare Advantage	$317.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$270.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$270.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$270.05
Rate for Payer: Cigna Commercial	$529.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.28
Rate for Payer: Qualcare PPO/HMO/WC	$158.85
Rate for Payer: UnitedHealthcare Community & State	$33.46
Rate for Payer: Wellpoint Medicaid Managed Care	$30.08

MULTI-LENGTH STENT 6FR.X22-32

Facility

$1,059.00

Hospital Charge Code	270332351
Hospital Revenue Code	278
Min. Negotiated Rate	$158.85
Max. Negotiated Rate	$256.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$211.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$256.28
Rate for Payer: Qualcare PPO/HMO/WC	$158.85

MULTILOC CAP 2MM

Facility

$2,085.00

Hospital Charge Code	270687873
Hospital Revenue Code	272
Min. Negotiated Rate	$312.75
Max. Negotiated Rate	$312.75
Rate for Payer: Qualcare PPO/HMO/WC	$312.75

MULTILOC CAP 2MM

Facility

$2,085.00

Hospital Charge Code	270687873
Hospital Revenue Code	272
Min. Negotiated Rate	$59.21
Max. Negotiated Rate	$1,042.50
Rate for Payer: Aetna Commercial	$792.30
Rate for Payer: Aetna Medicare Advantage	$625.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$531.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$531.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$531.67
Rate for Payer: Cigna Commercial	$1,042.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$542.10
Rate for Payer: Oxford Commercial	$417.00
Rate for Payer: Qualcare PPO/HMO/WC	$312.75
Rate for Payer: UnitedHealthcare Commercial	$417.00
Rate for Payer: UnitedHealthcare Community & State	$65.89
Rate for Payer: Wellpoint Medicaid Managed Care	$59.21

MULTILOC NAIL 7 X 355

Facility

$19,405.00

Service Code	HCPCS C1713
Hospital Charge Code	270687746
Hospital Revenue Code	278
Min. Negotiated Rate	$551.10
Max. Negotiated Rate	$9,702.50
Rate for Payer: Aetna Commercial	$7,373.90
Rate for Payer: Aetna Medicare Advantage	$5,821.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,948.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,948.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,881.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,948.27
Rate for Payer: Cigna Commercial	$9,702.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,696.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,910.75
Rate for Payer: UnitedHealthcare Community & State	$613.20
Rate for Payer: Wellpoint Medicaid Managed Care	$551.10

MULTILOC NAIL 7 X 355

Facility

$19,405.00

Service Code	HCPCS C1713
Hospital Charge Code	270687746
Hospital Revenue Code	278
Min. Negotiated Rate	$2,910.75
Max. Negotiated Rate	$4,696.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,881.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,696.01
Rate for Payer: Qualcare PPO/HMO/WC	$2,910.75

MULTIPLE-FAM GROUP PSYCHOTHPY

Facility

$303.00

Service Code	HCPCS 90849
Hospital Charge Code	83246190
Hospital Revenue Code	916
Min. Negotiated Rate	$8.61
Max. Negotiated Rate	$764.93
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.93
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.78
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
Rate for Payer: UnitedHealthcare Community & State	$9.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

MULTIPLE-FAM GROUP PSYCHOTHPY

Facility

$303.00

Service Code	HCPCS 90849
Hospital Charge Code	83246190
Hospital Revenue Code	916
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

MULTIPLE FAMILY GROUP THERAPY

Facility

$464.00

Service Code	HCPCS 90849
Hospital Charge Code	84504065
Hospital Revenue Code	915
Min. Negotiated Rate	$69.60
Max. Negotiated Rate	$69.60
Rate for Payer: Qualcare PPO/HMO/WC	$69.60

MULTIPLE FAMILY GROUP THERAPY

Facility

$464.00

Service Code	HCPCS 90849
Hospital Charge Code	87506095
Hospital Revenue Code	915
Min. Negotiated Rate	$69.60
Max. Negotiated Rate	$69.60
Rate for Payer: Qualcare PPO/HMO/WC	$69.60

MULTIPLE FAMILY GROUP THERAPY

Facility

$464.00

Service Code	HCPCS 90849
Hospital Charge Code	84504065
Hospital Revenue Code	915
Min. Negotiated Rate	$13.18
Max. Negotiated Rate	$764.93
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.93
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.64
Rate for Payer: Qualcare PPO/HMO/WC	$69.60
Rate for Payer: UnitedHealthcare Community & State	$14.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellpoint Medicaid Managed Care	$13.18

MULTIPLE FAMILY GROUP THERAPY

Facility

$464.00

Service Code	HCPCS 90849
Hospital Charge Code	87506095
Hospital Revenue Code	915
Min. Negotiated Rate	$13.18
Max. Negotiated Rate	$764.93
Rate for Payer: Aetna Commercial	$573.57
Rate for Payer: Aetna Medicare Advantage	$683.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$764.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$210.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$764.93
Rate for Payer: Cigna Commercial	$422.69
Rate for Payer: Cigna Medicare Advantage	$210.87
Rate for Payer: Clover Medicare Advantage	$200.33
Rate for Payer: EmblemHealth Commercial	$632.61
Rate for Payer: Humana Medicare Advantage	$217.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$210.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$120.64
Rate for Payer: Qualcare PPO/HMO/WC	$69.60
Rate for Payer: UnitedHealthcare Community & State	$14.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$210.87
Rate for Payer: Wellcare Medicare Advantage	$210.87
Rate for Payer: Wellpoint Medicaid Managed Care	$13.18

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC

Facility

$247,525.95

Service Code	MSDRG 427
Min. Negotiated Rate	$75,368.48
Max. Negotiated Rate	$247,525.95
Rate for Payer: Aetna Commercial	$178,149.33
Rate for Payer: Aetna Medicare Advantage	$247,525.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$79,335.24
Rate for Payer: Cigna Commercial	$160,924.25
Rate for Payer: Cigna Medicare Advantage	$79,335.24
Rate for Payer: Clover Medicare Advantage	$75,368.48
Rate for Payer: EmblemHealth Commercial	$238,005.72
Rate for Payer: Humana Medicare Advantage	$81,715.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$79,335.24
Rate for Payer: Oxford Commercial	$127,191.73
Rate for Payer: UnitedHealthcare Commercial	$170,250.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$79,335.24
Rate for Payer: Wellcare Medicare Advantage	$79,335.24

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE

Facility

$367,663.58

Service Code	MSDRG 426
Min. Negotiated Rate	$111,948.85
Max. Negotiated Rate	$367,663.58
Rate for Payer: Aetna Commercial	$263,712.76
Rate for Payer: Aetna Medicare Advantage	$367,663.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$117,840.89
Rate for Payer: Cigna Commercial	$245,695.61
Rate for Payer: Cigna Medicare Advantage	$117,840.89
Rate for Payer: Clover Medicare Advantage	$111,948.85
Rate for Payer: EmblemHealth Commercial	$353,522.67
Rate for Payer: Humana Medicare Advantage	$121,376.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$117,840.89
Rate for Payer: Oxford Commercial	$194,193.54
Rate for Payer: UnitedHealthcare Commercial	$259,935.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$117,840.89
Rate for Payer: Wellcare Medicare Advantage	$117,840.89

MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC

Facility

$197,083.66

Service Code	MSDRG 428
Min. Negotiated Rate	$60,009.45
Max. Negotiated Rate	$197,083.66
Rate for Payer: Aetna Commercial	$142,223.76
Rate for Payer: Aetna Medicare Advantage	$197,083.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$63,167.84
Rate for Payer: Cigna Commercial	$125,331.25
Rate for Payer: Cigna Medicare Advantage	$63,167.84
Rate for Payer: Clover Medicare Advantage	$60,009.45
Rate for Payer: EmblemHealth Commercial	$189,503.52
Rate for Payer: Humana Medicare Advantage	$65,062.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$63,167.84
Rate for Payer: Oxford Commercial	$99,059.64
Rate for Payer: UnitedHealthcare Commercial	$132,594.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$63,167.84
Rate for Payer: Wellcare Medicare Advantage	$63,167.84

MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE

Facility

$230,560.20

Service Code	MSDRG 447
Min. Negotiated Rate	$70,202.62
Max. Negotiated Rate	$230,560.20
Rate for Payer: Aetna Commercial	$166,066.14
Rate for Payer: Aetna Medicare Advantage	$230,560.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$73,897.50
Rate for Payer: Cigna Commercial	$148,952.91
Rate for Payer: Cigna Medicare Advantage	$73,897.50
Rate for Payer: Clover Medicare Advantage	$70,202.62
Rate for Payer: EmblemHealth Commercial	$221,692.50
Rate for Payer: Humana Medicare Advantage	$76,114.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$73,897.50
Rate for Payer: Oxford Commercial	$117,729.79
Rate for Payer: UnitedHealthcare Commercial	$157,585.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$73,897.50
Rate for Payer: Wellcare Medicare Advantage	$73,897.50

MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC

Facility

$153,446.59

Service Code	MSDRG 448
Min. Negotiated Rate	$46,722.52
Max. Negotiated Rate	$153,446.59
Rate for Payer: Aetna Commercial	$111,144.93
Rate for Payer: Aetna Medicare Advantage	$153,446.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$49,181.60
Rate for Payer: Cigna Commercial	$94,540.15
Rate for Payer: Cigna Medicare Advantage	$49,181.60
Rate for Payer: Clover Medicare Advantage	$46,722.52
Rate for Payer: EmblemHealth Commercial	$147,544.80
Rate for Payer: Humana Medicare Advantage	$50,657.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$49,181.60
Rate for Payer: Oxford Commercial	$74,722.90
Rate for Payer: UnitedHealthcare Commercial	$100,019.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$49,181.60
Rate for Payer: Wellcare Medicare Advantage	$49,181.60

MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC

Facility

$58,669.07

Service Code	MSDRG 059
Min. Negotiated Rate	$17,863.98
Max. Negotiated Rate	$58,669.07
Rate for Payer: Aetna Medicare Advantage	$58,669.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32,968.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32,968.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,804.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32,968.95
Rate for Payer: Cigna Commercial	$27,663.38
Rate for Payer: Cigna Medicare Advantage	$18,804.19
Rate for Payer: Clover Medicare Advantage	$17,863.98
Rate for Payer: EmblemHealth Commercial	$56,412.57
Rate for Payer: Humana Medicare Advantage	$19,368.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,804.19
Rate for Payer: Oxford Commercial	$21,864.66
Rate for Payer: UnitedHealthcare Commercial	$29,266.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,804.19
Rate for Payer: Wellcare Medicare Advantage	$18,804.19

MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC

Facility

$73,473.82

Service Code	MSDRG 058
Min. Negotiated Rate	$22,371.83
Max. Negotiated Rate	$73,473.82
Rate for Payer: Aetna Medicare Advantage	$73,473.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47,929.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47,929.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,549.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47,929.65
Rate for Payer: Cigna Commercial	$38,109.88
Rate for Payer: Cigna Medicare Advantage	$23,549.30
Rate for Payer: Clover Medicare Advantage	$22,371.83
Rate for Payer: EmblemHealth Commercial	$70,647.90
Rate for Payer: Humana Medicare Advantage	$24,255.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,549.30
Rate for Payer: Oxford Commercial	$30,121.39
Rate for Payer: UnitedHealthcare Commercial	$40,318.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,549.30
Rate for Payer: Wellcare Medicare Advantage	$23,549.30

MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC

Facility

$48,524.36

Service Code	MSDRG 060
Min. Negotiated Rate	$14,775.05
Max. Negotiated Rate	$48,524.36
Rate for Payer: Aetna Medicare Advantage	$48,524.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24,934.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24,934.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,552.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24,934.50
Rate for Payer: Cigna Commercial	$20,505.10
Rate for Payer: Cigna Medicare Advantage	$15,552.68
Rate for Payer: Clover Medicare Advantage	$14,775.05
Rate for Payer: EmblemHealth Commercial	$46,658.04
Rate for Payer: Humana Medicare Advantage	$16,019.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,552.68
Rate for Payer: Oxford Commercial	$16,206.88
Rate for Payer: UnitedHealthcare Commercial	$21,693.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,552.68
Rate for Payer: Wellcare Medicare Advantage	$15,552.68

MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES

Facility

$11,243.49

Service Code	APR-DRG 0431
Min. Negotiated Rate	$11,023.03
Max. Negotiated Rate	$11,243.49
Rate for Payer: UnitedHealthcare Community & State	$11,023.03
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,243.49
Rate for Payer: Wellpoint Medicaid Managed Care	$11,023.03

Know your out-of-pocket cost for care.

All Charges