Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PEG THREADED NL TI 2.7X24MM

Facility

$495.00

Service Code	HCPCS C1713
Hospital Charge Code	270664418
Hospital Revenue Code	278
Min. Negotiated Rate	$14.06
Max. Negotiated Rate	$247.50
Rate for Payer: Aetna Commercial	$188.10
Rate for Payer: Aetna Medicare Advantage	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$99.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.22
Rate for Payer: Cigna Commercial	$247.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.79
Rate for Payer: Qualcare PPO/HMO/WC	$74.25
Rate for Payer: UnitedHealthcare Community & State	$15.64
Rate for Payer: Wellpoint Medicaid Managed Care	$14.06

PEG THREADED NON LOCK 2.7x18MM

Facility

$442.00

Service Code	HCPCS C1713
Hospital Charge Code	270664416
Hospital Revenue Code	278
Min. Negotiated Rate	$66.30
Max. Negotiated Rate	$106.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.96
Rate for Payer: Qualcare PPO/HMO/WC	$66.30

PEG THREADED NON LOCK 2.7x18MM

Facility

$442.00

Service Code	HCPCS C1713
Hospital Charge Code	270664416
Hospital Revenue Code	278
Min. Negotiated Rate	$12.55
Max. Negotiated Rate	$221.00
Rate for Payer: Aetna Commercial	$167.96
Rate for Payer: Aetna Medicare Advantage	$132.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$88.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112.71
Rate for Payer: Cigna Commercial	$221.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$106.96
Rate for Payer: Qualcare PPO/HMO/WC	$66.30
Rate for Payer: UnitedHealthcare Community & State	$13.97
Rate for Payer: Wellpoint Medicaid Managed Care	$12.55

PEG THRED FLUTD LCKNG 2.3X22MM

Facility

$570.00

Service Code	HCPCS C1713
Hospital Charge Code	270686659
Hospital Revenue Code	278
Min. Negotiated Rate	$16.19
Max. Negotiated Rate	$285.00
Rate for Payer: Aetna Commercial	$216.60
Rate for Payer: Aetna Medicare Advantage	$171.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.35
Rate for Payer: Cigna Commercial	$285.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.94
Rate for Payer: Qualcare PPO/HMO/WC	$85.50
Rate for Payer: UnitedHealthcare Community & State	$18.01
Rate for Payer: Wellpoint Medicaid Managed Care	$16.19

PEG THRED FLUTD LCKNG 2.3X22MM

Facility

$570.00

Service Code	HCPCS C1713
Hospital Charge Code	270686659
Hospital Revenue Code	278
Min. Negotiated Rate	$85.50
Max. Negotiated Rate	$137.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$114.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$137.94
Rate for Payer: Qualcare PPO/HMO/WC	$85.50

PEG VARIAX LOCKING T8 2X20MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700619
Hospital Revenue Code	278
Min. Negotiated Rate	$35.28
Max. Negotiated Rate	$621.15
Rate for Payer: Aetna Commercial	$472.07
Rate for Payer: Aetna Medicare Advantage	$372.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$316.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$316.79
Rate for Payer: Cigna Commercial	$621.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34
Rate for Payer: UnitedHealthcare Community & State	$39.26
Rate for Payer: Wellpoint Medicaid Managed Care	$35.28

PEG VARIAX LOCKING T8 2X20MM

Facility

$1,242.30

Service Code	HCPCS C1713
Hospital Charge Code	270700619
Hospital Revenue Code	278
Min. Negotiated Rate	$186.34
Max. Negotiated Rate	$300.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$248.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.64
Rate for Payer: Qualcare PPO/HMO/WC	$186.34

PELVIC

Facility

$6,700.00

Service Code	HCPCS 76856
Hospital Charge Code	94061179
Hospital Revenue Code	402
Min. Negotiated Rate	$108.90
Max. Negotiated Rate	$2,904.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$108.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$124.20
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,742.00
Rate for Payer: Oxford Commercial	$2,697.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00
Rate for Payer: UnitedHealthcare Commercial	$2,904.00
Rate for Payer: UnitedHealthcare Community & State	$211.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$190.28

PELVIC

Facility

$6,700.00

Service Code	HCPCS 76856
Hospital Charge Code	94061179
Hospital Revenue Code	402
Min. Negotiated Rate	$1,005.00
Max. Negotiated Rate	$1,005.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,005.00

PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC

Facility

$86,758.96

Service Code	MSDRG 734
Min. Negotiated Rate	$26,416.99
Max. Negotiated Rate	$86,758.96
Rate for Payer: Aetna Commercial	$63,649.23
Rate for Payer: Aetna Medicare Advantage	$86,758.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60,119.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60,119.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,807.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60,119.85
Rate for Payer: Cigna Commercial	$47,484.09
Rate for Payer: Cigna Medicare Advantage	$27,807.36
Rate for Payer: Clover Medicare Advantage	$26,416.99
Rate for Payer: EmblemHealth Commercial	$83,422.08
Rate for Payer: Humana Medicare Advantage	$28,641.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,807.36
Rate for Payer: Oxford Commercial	$37,530.60
Rate for Payer: UnitedHealthcare Commercial	$50,236.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,807.36
Rate for Payer: Wellcare Medicare Advantage	$27,807.36

PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC

Facility

$61,973.81

Service Code	MSDRG 735
Min. Negotiated Rate	$18,870.23
Max. Negotiated Rate	$61,973.81
Rate for Payer: Aetna Commercial	$45,996.98
Rate for Payer: Aetna Medicare Advantage	$61,973.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,908.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,908.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19,863.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,908.30
Rate for Payer: Cigna Commercial	$29,995.23
Rate for Payer: Cigna Medicare Advantage	$19,863.40
Rate for Payer: Clover Medicare Advantage	$18,870.23
Rate for Payer: EmblemHealth Commercial	$59,590.20
Rate for Payer: Humana Medicare Advantage	$20,459.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19,863.40
Rate for Payer: Oxford Commercial	$23,707.71
Rate for Payer: UnitedHealthcare Commercial	$31,733.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$19,863.40
Rate for Payer: Wellcare Medicare Advantage	$19,863.40

PELVIC EXAM,UNDER ANESTHESIA

Facility

$16,333.80

Service Code	HCPCS 57410
Hospital Charge Code	160000183
Hospital Revenue Code	360
Min. Negotiated Rate	$2,450.07
Max. Negotiated Rate	$2,450.07
Rate for Payer: Qualcare PPO/HMO/WC	$2,450.07

PELVIC EXAM,UNDER ANESTHESIA

Facility

$16,333.80

Service Code	HCPCS 57410
Hospital Charge Code	160000183
Hospital Revenue Code	360
Min. Negotiated Rate	$463.88
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
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	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,246.79
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,450.07
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$516.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$463.88

PELVIC LONG STERILE SCREW

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270681643
Hospital Revenue Code	278
Min. Negotiated Rate	$46.50
Max. Negotiated Rate	$75.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50

PELVIC LONG STERILE SCREW

Facility

$310.00

Service Code	HCPCS C1713
Hospital Charge Code	270681643
Hospital Revenue Code	278
Min. Negotiated Rate	$8.80
Max. Negotiated Rate	$155.00
Rate for Payer: Aetna Commercial	$117.80
Rate for Payer: Aetna Medicare Advantage	$93.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.05
Rate for Payer: Cigna Commercial	$155.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.02
Rate for Payer: Qualcare PPO/HMO/WC	$46.50
Rate for Payer: UnitedHealthcare Community & State	$9.80
Rate for Payer: Wellpoint Medicaid Managed Care	$8.80

PELVIS 1-2 VIEW

Facility

$5,100.00

Service Code	HCPCS 72170
Hospital Charge Code	94061089
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

PELVIS 1-2 VIEW

Facility

$5,100.00

Service Code	HCPCS 72170
Hospital Charge Code	94061089
Hospital Revenue Code	320
Min. Negotiated Rate	$27.23
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

PELVIS COMPLETE

Facility

$5,100.00

Service Code	HCPCS 72190
Hospital Charge Code	94061091
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

PELVIS COMPLETE

Facility

$5,100.00

Service Code	HCPCS 72190
Hospital Charge Code	94061091
Hospital Revenue Code	320
Min. Negotiated Rate	$33.00
Max. Negotiated Rate	$2,231.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,326.00
Rate for Payer: Oxford Commercial	$1,955.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$2,231.00
Rate for Payer: UnitedHealthcare Community & State	$161.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$407.88
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

PELVIS W/PO CONTRAST ONLY

Facility

$9,500.00

Service Code	HCPCS 72192
Hospital Charge Code	2200152
Hospital Revenue Code	352
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

PELVIS W/PO CONTRAST ONLY

Facility

$9,500.00

Service Code	HCPCS 72192
Hospital Charge Code	2200152
Hospital Revenue Code	352
Min. Negotiated Rate	$86.94
Max. Negotiated Rate	$3,916.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$450.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$237.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$450.54
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,470.00
Rate for Payer: Oxford Commercial	$3,774.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$3,916.00
Rate for Payer: UnitedHealthcare Community & State	$300.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$306.90
Rate for Payer: Wellpoint Medicaid Managed Care	$269.80

PEMETREXED 500 MG VIAL

Facility

$24,192.36

Service Code	HCPCS J9305
Hospital Charge Code	60629356
Hospital Revenue Code	636
Min. Negotiated Rate	$3,628.85
Max. Negotiated Rate	$5,854.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,854.55
Rate for Payer: Qualcare PPO/HMO/WC	$3,628.85

PEMETREXED 500 MG VIAL

Facility

$24,192.36

Service Code	HCPCS J9305
Hospital Charge Code	60629356
Hospital Revenue Code	636
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$5,854.55
Rate for Payer: Aetna Commercial	$10.99
Rate for Payer: Aetna Medicare Advantage	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.66
Rate for Payer: Cigna Medicare Advantage	$4.04
Rate for Payer: Clover Medicare Advantage	$3.84
Rate for Payer: EmblemHealth Commercial	$12.12
Rate for Payer: Humana Medicare Advantage	$4.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,854.55
Rate for Payer: Qualcare PPO/HMO/WC	$3,628.85
Rate for Payer: UnitedHealthcare Community & State	$764.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.04
Rate for Payer: Wellcare Medicare Advantage	$4.04
Rate for Payer: Wellpoint Medicaid Managed Care	$687.06

PEMETREXED DISODIUM 100MG INJ

Facility

$20,424.05

Hospital Charge Code	6063943162
Hospital Revenue Code	636
Min. Negotiated Rate	$3,063.61
Max. Negotiated Rate	$4,942.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,942.62
Rate for Payer: Qualcare PPO/HMO/WC	$3,063.61

PEMETREXED DISODIUM 100MG INJ

Facility

$20,424.05

Hospital Charge Code	6063943162
Hospital Revenue Code	636
Min. Negotiated Rate	$580.04
Max. Negotiated Rate	$10,212.02
Rate for Payer: Aetna Commercial	$7,761.14
Rate for Payer: Aetna Medicare Advantage	$6,127.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,208.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,208.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,208.13
Rate for Payer: Cigna Commercial	$10,212.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,942.62
Rate for Payer: Qualcare PPO/HMO/WC	$3,063.61
Rate for Payer: UnitedHealthcare Community & State	$645.40
Rate for Payer: Wellpoint Medicaid Managed Care	$580.04

Know your out-of-pocket cost for care.

All Charges