Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MYOCRD PERF IMG (SPECT) MULT

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	94053005
Hospital Revenue Code	341
Min. Negotiated Rate	$1,598.21
Max. Negotiated Rate	$1,598.21
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21

MYOCRD PERF IMG (SPECT) MULT

Facility

$10,654.71

Service Code	HCPCS 78452
Hospital Charge Code	94053005
Hospital Revenue Code	341
Min. Negotiated Rate	$277.20
Max. Negotiated Rate	$5,579.39
Rate for Payer: Aetna Commercial	$4,183.58
Rate for Payer: Aetna Medicare Advantage	$4,983.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,579.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,579.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,538.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,579.39
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: Cigna Medicare Advantage	$1,076.66
Rate for Payer: Clover Medicare Advantage	$1,461.18
Rate for Payer: EmblemHealth Commercial	$4,614.24
Rate for Payer: Humana Medicare Advantage	$1,584.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,538.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,770.22
Rate for Payer: Oxford Commercial	$4,820.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,598.21
Rate for Payer: UnitedHealthcare Commercial	$4,748.00
Rate for Payer: UnitedHealthcare Community & State	$336.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,538.08
Rate for Payer: Wellcare Medicare Advantage	$1,538.08
Rate for Payer: Wellpoint Medicaid Managed Care	$302.59

MYOCRD PERF IMG (SPECT) SINGLE

Facility

$6,315.40

Service Code	HCPCS 78451
Hospital Charge Code	5305016
Hospital Revenue Code	341
Min. Negotiated Rate	$947.31
Max. Negotiated Rate	$947.31
Rate for Payer: Qualcare PPO/HMO/WC	$947.31

MYOCRD PERF IMG (SPECT) SINGLE

Facility

$6,315.40

Service Code	HCPCS 78451
Hospital Charge Code	5305016
Hospital Revenue Code	341
Min. Negotiated Rate	$179.36
Max. Negotiated Rate	$5,579.39
Rate for Payer: Aetna Commercial	$4,183.58
Rate for Payer: Aetna Medicare Advantage	$4,983.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,579.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,579.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,538.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,579.39
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: Cigna Medicare Advantage	$1,076.66
Rate for Payer: Clover Medicare Advantage	$1,461.18
Rate for Payer: EmblemHealth Commercial	$4,614.24
Rate for Payer: Humana Medicare Advantage	$1,584.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,538.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,642.00
Rate for Payer: Oxford Commercial	$4,820.00
Rate for Payer: Qualcare PPO/HMO/WC	$947.31
Rate for Payer: UnitedHealthcare Commercial	$4,748.00
Rate for Payer: UnitedHealthcare Community & State	$199.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,538.08
Rate for Payer: Wellcare Medicare Advantage	$1,538.08
Rate for Payer: Wellpoint Medicaid Managed Care	$179.36

MYOCRD PERF IMG (SPECT)SINGLE

Facility

$6,851.00

Service Code	HCPCS 78451
Hospital Charge Code	74117001
Hospital Revenue Code	341
Min. Negotiated Rate	$1,027.65
Max. Negotiated Rate	$1,027.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.65

MYOCRD PERF IMG (SPECT)SINGLE

Facility

$6,851.00

Service Code	HCPCS 78451
Hospital Charge Code	74117001
Hospital Revenue Code	341
Min. Negotiated Rate	$194.57
Max. Negotiated Rate	$5,579.39
Rate for Payer: Aetna Commercial	$4,183.58
Rate for Payer: Aetna Medicare Advantage	$4,983.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,579.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,579.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,538.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,579.39
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: Cigna Medicare Advantage	$1,076.66
Rate for Payer: Clover Medicare Advantage	$1,461.18
Rate for Payer: EmblemHealth Commercial	$4,614.24
Rate for Payer: Humana Medicare Advantage	$1,584.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,538.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,781.26
Rate for Payer: Oxford Commercial	$4,820.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.65
Rate for Payer: UnitedHealthcare Commercial	$4,748.00
Rate for Payer: UnitedHealthcare Community & State	$216.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,538.08
Rate for Payer: Wellcare Medicare Advantage	$1,538.08
Rate for Payer: Wellpoint Medicaid Managed Care	$194.57

MYOCRD PERF IMG (SPECT)SINGLE

Facility

$6,851.00

Service Code	HCPCS 78451
Hospital Charge Code	74115001
Hospital Revenue Code	341
Min. Negotiated Rate	$194.57
Max. Negotiated Rate	$5,579.39
Rate for Payer: Aetna Commercial	$4,183.58
Rate for Payer: Aetna Medicare Advantage	$4,983.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,579.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,579.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,538.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$198.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,579.39
Rate for Payer: Cigna Commercial	$3,083.08
Rate for Payer: Cigna Medicare Advantage	$1,076.66
Rate for Payer: Clover Medicare Advantage	$1,461.18
Rate for Payer: EmblemHealth Commercial	$4,614.24
Rate for Payer: Humana Medicare Advantage	$1,584.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,538.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,781.26
Rate for Payer: Oxford Commercial	$4,820.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.65
Rate for Payer: UnitedHealthcare Commercial	$4,748.00
Rate for Payer: UnitedHealthcare Community & State	$216.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,538.08
Rate for Payer: Wellcare Medicare Advantage	$1,538.08
Rate for Payer: Wellpoint Medicaid Managed Care	$194.57

MYOCRD PERF IMG (SPECT)SINGLE

Facility

$6,851.00

Service Code	HCPCS 78451
Hospital Charge Code	74115001
Hospital Revenue Code	341
Min. Negotiated Rate	$1,027.65
Max. Negotiated Rate	$1,027.65
Rate for Payer: Qualcare PPO/HMO/WC	$1,027.65

MYOFLEX CREAM

Facility

$25.39

Service Code	NDC 45802035653
Hospital Charge Code	60635110
Hospital Revenue Code	250
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$3.81
Rate for Payer: Qualcare PPO/HMO/WC	$3.81

MYOFLEX CREAM

Facility

$25.39

Service Code	NDC 45802035653
Hospital Charge Code	60635110
Hospital Revenue Code	250
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$12.70
Rate for Payer: Aetna Commercial	$9.65
Rate for Payer: Aetna Medicare Advantage	$7.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.47
Rate for Payer: Cigna Commercial	$12.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.60
Rate for Payer: Oxford Commercial	$5.08
Rate for Payer: Qualcare PPO/HMO/WC	$3.81
Rate for Payer: UnitedHealthcare Commercial	$5.08
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

MYOGLOBIN SERUM

Facility

$390.00

Service Code	HCPCS 83874
Hospital Charge Code	39900342
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$35.14
Rate for Payer: Aetna Medicare Advantage	$41.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.87
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.92
Rate for Payer: Clover Medicare Advantage	$12.27
Rate for Payer: EmblemHealth Commercial	$38.76
Rate for Payer: Humana Medicare Advantage	$13.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.92
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	$10.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.92
Rate for Payer: Wellcare Medicare Advantage	$12.92
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

MYOGLOBIN SERUM

Facility

$390.00

Service Code	HCPCS 83874
Hospital Charge Code	39900342
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MYOGLOBIN,SERUM

Facility

$489.00

Service Code	HCPCS 83874
Hospital Charge Code	38472516
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$244.50
Rate for Payer: Aetna Commercial	$35.14
Rate for Payer: Aetna Medicare Advantage	$41.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.87
Rate for Payer: Cigna Commercial	$244.50
Rate for Payer: Cigna Medicare Advantage	$12.92
Rate for Payer: Clover Medicare Advantage	$12.27
Rate for Payer: EmblemHealth Commercial	$38.76
Rate for Payer: Humana Medicare Advantage	$13.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.14
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.92
Rate for Payer: Wellcare Medicare Advantage	$12.92
Rate for Payer: Wellpoint Medicaid Managed Care	$13.89

MYOGLOBIN,SERUM

Facility

$489.00

Service Code	HCPCS 83874
Hospital Charge Code	38472516
Hospital Revenue Code	301
Min. Negotiated Rate	$73.35
Max. Negotiated Rate	$73.35
Rate for Payer: Qualcare PPO/HMO/WC	$73.35

MYOGLOBIN URINE

Facility

$390.00

Service Code	HCPCS 83874
Hospital Charge Code	39900110
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

MYOGLOBIN URINE

Facility

$390.00

Service Code	HCPCS 83874
Hospital Charge Code	39900110
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$35.14
Rate for Payer: Aetna Medicare Advantage	$41.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.87
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.92
Rate for Payer: Clover Medicare Advantage	$12.27
Rate for Payer: EmblemHealth Commercial	$38.76
Rate for Payer: Humana Medicare Advantage	$13.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.92
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	$10.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.92
Rate for Payer: Wellcare Medicare Advantage	$12.92
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

MYOGLOBIN,URINE

Facility

$411.00

Service Code	HCPCS 83874
Hospital Charge Code	38472517
Hospital Revenue Code	301
Min. Negotiated Rate	$61.65
Max. Negotiated Rate	$61.65
Rate for Payer: Qualcare PPO/HMO/WC	$61.65

MYOGLOBIN,URINE

Facility

$411.00

Service Code	HCPCS 83874
Hospital Charge Code	38472517
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$205.50
Rate for Payer: Aetna Commercial	$35.14
Rate for Payer: Aetna Medicare Advantage	$41.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.87
Rate for Payer: Cigna Commercial	$205.50
Rate for Payer: Cigna Medicare Advantage	$12.92
Rate for Payer: Clover Medicare Advantage	$12.27
Rate for Payer: EmblemHealth Commercial	$38.76
Rate for Payer: Humana Medicare Advantage	$13.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.86
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$61.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.92
Rate for Payer: Wellcare Medicare Advantage	$12.92
Rate for Payer: Wellpoint Medicaid Managed Care	$11.67

MYOMECTMY ABDOM CMPX 5+MYOMAS

Facility

$18,219.48

Service Code	HCPCS 58146
Hospital Charge Code	160000208
Hospital Revenue Code	360
Min. Negotiated Rate	$517.43
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$6,923.40
Rate for Payer: Aetna Medicare Advantage	$5,465.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,645.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,645.97
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	$4,645.97
Rate for Payer: Cigna Commercial	$9,109.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,737.06
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,732.92
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$575.74
Rate for Payer: Wellpoint Medicaid Managed Care	$517.43

MYOMECTMY ABDOM CMPX 5+MYOMAS

Facility

$18,219.48

Service Code	HCPCS 58146
Hospital Charge Code	160000208
Hospital Revenue Code	360
Min. Negotiated Rate	$2,732.92
Max. Negotiated Rate	$2,732.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,732.92

MYOMECTMY ABDOM METHOD 1-4MYMS

Facility

$14,539.99

Service Code	HCPCS 58140
Hospital Charge Code	14539.99
Hospital Revenue Code	360
Min. Negotiated Rate	$412.94
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$5,525.20
Rate for Payer: Aetna Medicare Advantage	$4,362.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,707.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,707.70
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	$3,707.70
Rate for Payer: Cigna Commercial	$7,269.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,780.40
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,181.00
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$459.46
Rate for Payer: Wellpoint Medicaid Managed Care	$412.94

MYOMECTMY ABDOM METHOD 1-4MYMS

Facility

$14,539.99

Service Code	HCPCS 58140
Hospital Charge Code	14539.99
Hospital Revenue Code	360
Min. Negotiated Rate	$2,181.00
Max. Negotiated Rate	$2,181.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,181.00

MYOMECTMY ABDOM METHOD 1-4MYMS

Facility

$14,539.99

Service Code	HCPCS 58140
Hospital Charge Code	16001004
Hospital Revenue Code	360
Min. Negotiated Rate	$2,181.00
Max. Negotiated Rate	$2,181.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,181.00

MYOMECTMY ABDOM METHOD 1-4MYMS

Facility

$14,539.99

Service Code	HCPCS 58140
Hospital Charge Code	16001004
Hospital Revenue Code	360
Min. Negotiated Rate	$412.94
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$5,525.20
Rate for Payer: Aetna Medicare Advantage	$4,362.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,707.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,707.70
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	$3,707.70
Rate for Payer: Cigna Commercial	$7,269.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,780.40
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,181.00
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$459.46
Rate for Payer: Wellpoint Medicaid Managed Care	$412.94

MYOMECTOMY,EXC FIBROIDS-UTER

Facility

$9,489.90

Service Code	HCPCS 58140
Hospital Charge Code	73190009
Hospital Revenue Code	361
Min. Negotiated Rate	$269.51
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$3,606.16
Rate for Payer: Aetna Medicare Advantage	$2,846.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,419.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,419.92
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	$2,419.92
Rate for Payer: Cigna Commercial	$4,744.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,467.37
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,423.48
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$299.88
Rate for Payer: Wellpoint Medicaid Managed Care	$269.51

Know your out-of-pocket cost for care.

All Charges