Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PKU TESTING

Facility

$163.00

Service Code	HCPCS 84030
Hospital Charge Code	83091020
Hospital Revenue Code	301
Min. Negotiated Rate	$24.45
Max. Negotiated Rate	$24.45
Rate for Payer: Qualcare PPO/HMO/WC	$24.45

PKU TESTING

Facility

$153.00

Service Code	HCPCS 84030
Hospital Charge Code	38472544
Hospital Revenue Code	301
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$14.96
Rate for Payer: Aetna Medicare Advantage	$17.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.95
Rate for Payer: Cigna Commercial	$76.50
Rate for Payer: Cigna Medicare Advantage	$5.50
Rate for Payer: Clover Medicare Advantage	$5.22
Rate for Payer: EmblemHealth Commercial	$16.50
Rate for Payer: Humana Medicare Advantage	$5.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.78
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.50
Rate for Payer: Wellcare Medicare Advantage	$5.50
Rate for Payer: Wellpoint Medicaid Managed Care	$4.35

PKU TESTING

Facility

$153.00

Service Code	HCPCS 84030
Hospital Charge Code	38472544
Hospital Revenue Code	301
Min. Negotiated Rate	$22.95
Max. Negotiated Rate	$22.95
Rate for Payer: Qualcare PPO/HMO/WC	$22.95

PLACE CATH CAROTD ART

Facility

$21,387.78

Service Code	HCPCS 36224
Hospital Charge Code	411036224
Hospital Revenue Code	361
Min. Negotiated Rate	$607.41
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,560.82
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,208.17
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$675.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$607.41

PLACE CATH CAROTD ART

Facility

$21,387.78

Service Code	HCPCS 36224
Hospital Charge Code	411036224
Hospital Revenue Code	361
Min. Negotiated Rate	$3,208.17
Max. Negotiated Rate	$3,208.17
Rate for Payer: Qualcare PPO/HMO/WC	$3,208.17

PLACE CATH CAROTD ART

Facility

$21,387.78

Service Code	HCPCS 36224
Hospital Charge Code	366836224
Hospital Revenue Code	361
Min. Negotiated Rate	$3,208.17
Max. Negotiated Rate	$3,208.17
Rate for Payer: Qualcare PPO/HMO/WC	$3,208.17

PLACE CATH CAROTD ART

Facility

$21,387.78

Service Code	HCPCS 36224
Hospital Charge Code	366836224
Hospital Revenue Code	361
Min. Negotiated Rate	$607.41
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,560.82
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,208.17
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$675.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$607.41

PLACE CATH CAROTD ART BI

Facility

$38,442.70

Service Code	HCPCS 3622450
Hospital Charge Code	411036224B
Hospital Revenue Code	361
Min. Negotiated Rate	$5,766.40
Max. Negotiated Rate	$5,766.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,766.40

PLACE CATH CAROTD ART BI

Facility

$38,442.70

Service Code	HCPCS 3622450
Hospital Charge Code	411036224B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,091.77
Max. Negotiated Rate	$19,221.35
Rate for Payer: Aetna Commercial	$14,608.23
Rate for Payer: Aetna Medicare Advantage	$11,532.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,802.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,802.89
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	$9,802.89
Rate for Payer: Cigna Commercial	$19,221.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,995.10
Rate for Payer: Qualcare PPO/HMO/WC	$5,766.40
Rate for Payer: UnitedHealthcare Community & State	$1,214.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1,091.77

PLACE CATH CAROTID ART BI

Facility

$38,442.70

Service Code	HCPCS 3622450
Hospital Charge Code	321036224B
Hospital Revenue Code	361
Min. Negotiated Rate	$1,091.77
Max. Negotiated Rate	$19,221.35
Rate for Payer: Aetna Commercial	$14,608.23
Rate for Payer: Aetna Medicare Advantage	$11,532.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,802.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,802.89
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	$9,802.89
Rate for Payer: Cigna Commercial	$19,221.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,995.10
Rate for Payer: Qualcare PPO/HMO/WC	$5,766.40
Rate for Payer: UnitedHealthcare Community & State	$1,214.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1,091.77

PLACE CATH CAROTID ART BI

Facility

$38,442.70

Service Code	HCPCS 3622450
Hospital Charge Code	321036224B
Hospital Revenue Code	361
Min. Negotiated Rate	$5,766.40
Max. Negotiated Rate	$5,766.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,766.40

PLACE CATH CAROTID ART BI

Facility

$38,442.70

Service Code	HCPCS 3622450
Hospital Charge Code	5600224
Hospital Revenue Code	361
Min. Negotiated Rate	$5,766.40
Max. Negotiated Rate	$5,766.40
Rate for Payer: Qualcare PPO/HMO/WC	$5,766.40

PLACE CATH CAROTID ART BI

Facility

$38,442.70

Service Code	HCPCS 3622450
Hospital Charge Code	5600224
Hospital Revenue Code	361
Min. Negotiated Rate	$1,091.77
Max. Negotiated Rate	$19,221.35
Rate for Payer: Aetna Commercial	$14,608.23
Rate for Payer: Aetna Medicare Advantage	$11,532.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9,802.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9,802.89
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	$9,802.89
Rate for Payer: Cigna Commercial	$19,221.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,995.10
Rate for Payer: Qualcare PPO/HMO/WC	$5,766.40
Rate for Payer: UnitedHealthcare Community & State	$1,214.79
Rate for Payer: Wellpoint Medicaid Managed Care	$1,091.77

PLACE CATH CAROTID/INOM ART

Facility

$15,468.50

Service Code	HCPCS 36222
Hospital Charge Code	5600222
Hospital Revenue Code	361
Min. Negotiated Rate	$439.31
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,021.81
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$488.80
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$439.31

PLACE CATH CAROTID/INOM ART

Facility

$13,077.63

Service Code	HCPCS 36222
Hospital Charge Code	411036222
Hospital Revenue Code	361
Min. Negotiated Rate	$1,961.64
Max. Negotiated Rate	$1,961.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.64

PLACE CATH CAROTID/INOM ART

Facility

$13,077.63

Service Code	HCPCS 36222
Hospital Charge Code	411036222
Hospital Revenue Code	361
Min. Negotiated Rate	$371.40
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,400.18
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.64
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$413.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$371.40

PLACE CATH CAROTID/INOM ART

Facility

$25,628.45

Service Code	HCPCS 36223
Hospital Charge Code	5600223
Hospital Revenue Code	361
Min. Negotiated Rate	$727.85
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,663.40
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$809.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$727.85

PLACE CATH CAROTID/INOM ART

Facility

$25,628.45

Service Code	HCPCS 36223
Hospital Charge Code	5600223
Hospital Revenue Code	361
Min. Negotiated Rate	$3,844.27
Max. Negotiated Rate	$3,844.27
Rate for Payer: Qualcare PPO/HMO/WC	$3,844.27

PLACE CATH CAROTID/INOM ART

Facility

$15,468.50

Service Code	HCPCS 36222
Hospital Charge Code	5600222
Hospital Revenue Code	361
Min. Negotiated Rate	$2,320.28
Max. Negotiated Rate	$2,320.28
Rate for Payer: Qualcare PPO/HMO/WC	$2,320.28

PLACE CATH CAROTID/INOM ART

Facility

$13,077.63

Service Code	HCPCS 36223
Hospital Charge Code	366836223
Hospital Revenue Code	361
Min. Negotiated Rate	$371.40
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,400.18
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.64
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$413.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$371.40

PLACE CATH CAROTID/INOM ART

Facility

$13,077.63

Service Code	HCPCS 36222
Hospital Charge Code	366836222
Hospital Revenue Code	361
Min. Negotiated Rate	$371.40
Max. Negotiated Rate	$13,607.37
Rate for Payer: Aetna Commercial	$10,203.18
Rate for Payer: Aetna Medicare Advantage	$12,153.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,607.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,751.17
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	$13,607.37
Rate for Payer: Cigna Commercial	$7,519.21
Rate for Payer: Cigna Medicare Advantage	$3,751.17
Rate for Payer: Clover Medicare Advantage	$3,563.61
Rate for Payer: EmblemHealth Commercial	$11,253.51
Rate for Payer: Humana Medicare Advantage	$3,863.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,751.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,400.18
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.64
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$413.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,751.17
Rate for Payer: Wellcare Medicare Advantage	$3,751.17
Rate for Payer: Wellpoint Medicaid Managed Care	$371.40

PLACE CATH CAROTID/INOM ART

Facility

$13,077.63

Service Code	HCPCS 36222
Hospital Charge Code	366836222
Hospital Revenue Code	361
Min. Negotiated Rate	$1,961.64
Max. Negotiated Rate	$1,961.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.64

PLACE CATH CAROTID/INOM ART

Facility

$13,077.63

Service Code	HCPCS 36223
Hospital Charge Code	411036223
Hospital Revenue Code	361
Min. Negotiated Rate	$1,961.64
Max. Negotiated Rate	$1,961.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.64

PLACE CATH CAROTID/INOM ART

Facility

$13,077.63

Service Code	HCPCS 36223
Hospital Charge Code	366836223
Hospital Revenue Code	361
Min. Negotiated Rate	$1,961.64
Max. Negotiated Rate	$1,961.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.64

PLACE CATH CAROTID/INOM ART

Facility

$13,077.63

Service Code	HCPCS 36223
Hospital Charge Code	411036223
Hospital Revenue Code	361
Min. Negotiated Rate	$371.40
Max. Negotiated Rate	$23,980.53
Rate for Payer: Aetna Commercial	$17,981.27
Rate for Payer: Aetna Medicare Advantage	$21,418.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,980.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6,610.76
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	$23,980.53
Rate for Payer: Cigna Commercial	$13,251.23
Rate for Payer: Cigna Medicare Advantage	$6,610.76
Rate for Payer: Clover Medicare Advantage	$6,280.22
Rate for Payer: EmblemHealth Commercial	$19,832.28
Rate for Payer: Humana Medicare Advantage	$6,809.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6,610.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,400.18
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,961.64
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$413.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$6,610.76
Rate for Payer: Wellcare Medicare Advantage	$6,610.76
Rate for Payer: Wellpoint Medicaid Managed Care	$371.40

Know your out-of-pocket cost for care.

All Charges