Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

POST EX-FIX LG 30DEG OUTR 11MM

Facility

$582.40

Hospital Charge Code	270642898
Hospital Revenue Code	272
Min. Negotiated Rate	$16.54
Max. Negotiated Rate	$291.20
Rate for Payer: Aetna Commercial	$221.31
Rate for Payer: Aetna Medicare Advantage	$174.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.51
Rate for Payer: Cigna Commercial	$291.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.42
Rate for Payer: Oxford Commercial	$116.48
Rate for Payer: Qualcare PPO/HMO/WC	$87.36
Rate for Payer: UnitedHealthcare Commercial	$116.48
Rate for Payer: UnitedHealthcare Community & State	$18.40
Rate for Payer: Wellpoint Medicaid Managed Care	$16.54

POST EX-FIX LG OUTRIGGER 11MM

Facility

$582.40

Hospital Charge Code	270646019
Hospital Revenue Code	272
Min. Negotiated Rate	$87.36
Max. Negotiated Rate	$87.36
Rate for Payer: Qualcare PPO/HMO/WC	$87.36

POST EX-FIX LG OUTRIGGER 11MM

Facility

$582.40

Hospital Charge Code	270646019
Hospital Revenue Code	272
Min. Negotiated Rate	$16.54
Max. Negotiated Rate	$291.20
Rate for Payer: Aetna Commercial	$221.31
Rate for Payer: Aetna Medicare Advantage	$174.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$148.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$148.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$148.51
Rate for Payer: Cigna Commercial	$291.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.42
Rate for Payer: Oxford Commercial	$116.48
Rate for Payer: Qualcare PPO/HMO/WC	$87.36
Rate for Payer: UnitedHealthcare Commercial	$116.48
Rate for Payer: UnitedHealthcare Community & State	$18.40
Rate for Payer: Wellpoint Medicaid Managed Care	$16.54

POST FEMORAL ATTUNE SZ5N

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686416
Hospital Revenue Code	278
Min. Negotiated Rate	$326.60
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$4,370.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00
Rate for Payer: UnitedHealthcare Community & State	$363.40
Rate for Payer: Wellpoint Medicaid Managed Care	$326.60

POST FEMORAL ATTUNE SZ5N

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686416
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

POST FREE DISTRACTION

Facility

$7,500.00

Hospital Charge Code	270691820
Hospital Revenue Code	272
Min. Negotiated Rate	$213.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,950.00
Rate for Payer: Oxford Commercial	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Commercial	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$237.00
Rate for Payer: Wellpoint Medicaid Managed Care	$213.00

POST FREE DISTRACTION

Facility

$7,500.00

Hospital Charge Code	270691820
Hospital Revenue Code	272
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

POST FREEDOM X 3.5X20MM

Facility

$10,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270698537
Hospital Revenue Code	278
Min. Negotiated Rate	$1,533.75
Max. Negotiated Rate	$2,474.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,045.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,474.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.75

POST FREEDOM X 3.5X20MM

Facility

$10,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270698537
Hospital Revenue Code	278
Min. Negotiated Rate	$290.39
Max. Negotiated Rate	$5,112.50
Rate for Payer: Aetna Commercial	$3,885.50
Rate for Payer: Aetna Medicare Advantage	$3,067.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,607.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,607.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,045.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,607.38
Rate for Payer: Cigna Commercial	$5,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,474.45
Rate for Payer: Qualcare PPO/HMO/WC	$1,533.75
Rate for Payer: UnitedHealthcare Community & State	$323.11
Rate for Payer: Wellpoint Medicaid Managed Care	$290.39

POST INCORE 5.9X28MM RT TI

Facility

$17,440.00

Service Code	HCPCS C1713
Hospital Charge Code	270687066
Hospital Revenue Code	278
Min. Negotiated Rate	$2,616.00
Max. Negotiated Rate	$4,220.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,220.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,616.00

POST INCORE 5.9X28MM RT TI

Facility

$17,440.00

Service Code	HCPCS C1713
Hospital Charge Code	270687066
Hospital Revenue Code	278
Min. Negotiated Rate	$495.30
Max. Negotiated Rate	$8,720.00
Rate for Payer: Aetna Commercial	$6,627.20
Rate for Payer: Aetna Medicare Advantage	$5,232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,447.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,447.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,447.20
Rate for Payer: Cigna Commercial	$8,720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,220.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,616.00
Rate for Payer: UnitedHealthcare Community & State	$551.10
Rate for Payer: Wellpoint Medicaid Managed Care	$495.30

POST INSERT TIBIAL FX STAB SZ4

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686447
Hospital Revenue Code	278
Min. Negotiated Rate	$1,725.00
Max. Negotiated Rate	$2,783.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00

POST INSERT TIBIAL FX STAB SZ4

Facility

$11,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270686447
Hospital Revenue Code	278
Min. Negotiated Rate	$326.60
Max. Negotiated Rate	$5,750.00
Rate for Payer: Aetna Commercial	$4,370.00
Rate for Payer: Aetna Medicare Advantage	$3,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,932.50
Rate for Payer: Cigna Commercial	$5,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,783.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,725.00
Rate for Payer: UnitedHealthcare Community & State	$363.40
Rate for Payer: Wellpoint Medicaid Managed Care	$326.60

POST LEFT LAPIDUS 5.9MMX28MM

Facility

$17,440.00

Service Code	HCPCS C1713
Hospital Charge Code	270688234
Hospital Revenue Code	278
Min. Negotiated Rate	$2,616.00
Max. Negotiated Rate	$4,220.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,220.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,616.00

POST LEFT LAPIDUS 5.9MMX28MM

Facility

$17,440.00

Service Code	HCPCS C1713
Hospital Charge Code	270688234
Hospital Revenue Code	278
Min. Negotiated Rate	$495.30
Max. Negotiated Rate	$8,720.00
Rate for Payer: Aetna Commercial	$6,627.20
Rate for Payer: Aetna Medicare Advantage	$5,232.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,447.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,447.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,488.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,447.20
Rate for Payer: Cigna Commercial	$8,720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,220.48
Rate for Payer: Qualcare PPO/HMO/WC	$2,616.00
Rate for Payer: UnitedHealthcare Community & State	$551.10
Rate for Payer: Wellpoint Medicaid Managed Care	$495.30

POST LUM CAGE 13X23X0-11MMD

Facility

$26,910.00

Service Code	HCPCS 26910
Hospital Charge Code	270704782
Hospital Revenue Code	278
Min. Negotiated Rate	$764.24
Max. Negotiated Rate	$14,100.89
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,382.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,100.89
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,512.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.50
Rate for Payer: UnitedHealthcare Community & State	$850.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$764.24

POST LUM CAGE 13X23X0-11MMD

Facility

$26,910.00

Service Code	HCPCS 26910
Hospital Charge Code	270704782
Hospital Revenue Code	278
Min. Negotiated Rate	$4,036.50
Max. Negotiated Rate	$6,512.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,382.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,512.22
Rate for Payer: Qualcare PPO/HMO/WC	$4,036.50

POST LUM CAGE 7X23X9MM 6DEG

Facility

$2,660.00

Service Code	HCPCS C1713
Hospital Charge Code	270705424
Hospital Revenue Code	278
Min. Negotiated Rate	$399.00
Max. Negotiated Rate	$643.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$532.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$643.72
Rate for Payer: Qualcare PPO/HMO/WC	$399.00

POST LUM CAGE 7X23X9MM 6DEG

Facility

$2,660.00

Service Code	HCPCS C1713
Hospital Charge Code	270705424
Hospital Revenue Code	278
Min. Negotiated Rate	$75.54
Max. Negotiated Rate	$1,330.00
Rate for Payer: Aetna Commercial	$1,010.80
Rate for Payer: Aetna Medicare Advantage	$798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$678.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$678.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$532.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$678.30
Rate for Payer: Cigna Commercial	$1,330.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$643.72
Rate for Payer: Qualcare PPO/HMO/WC	$399.00
Rate for Payer: UnitedHealthcare Community & State	$84.06
Rate for Payer: Wellpoint Medicaid Managed Care	$75.54

POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC

Facility

$77,081.82

Service Code	MSDRG 862
Min. Negotiated Rate	$23,470.42
Max. Negotiated Rate	$77,081.82
Rate for Payer: Aetna Commercial	$56,757.05
Rate for Payer: Aetna Medicare Advantage	$77,081.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50,977.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50,977.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,705.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50,977.20
Rate for Payer: Cigna Commercial	$40,655.74
Rate for Payer: Cigna Medicare Advantage	$24,705.71
Rate for Payer: Clover Medicare Advantage	$23,470.42
Rate for Payer: EmblemHealth Commercial	$74,117.13
Rate for Payer: Humana Medicare Advantage	$25,446.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,705.71
Rate for Payer: Oxford Commercial	$32,133.59
Rate for Payer: UnitedHealthcare Commercial	$43,011.96
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,705.71
Rate for Payer: Wellcare Medicare Advantage	$24,705.71

POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC

Facility

$50,991.88

Service Code	MSDRG 863
Min. Negotiated Rate	$15,526.37
Max. Negotiated Rate	$50,991.88
Rate for Payer: Aetna Commercial	$38,175.51
Rate for Payer: Aetna Medicare Advantage	$50,991.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27,982.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27,982.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16,343.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27,982.05
Rate for Payer: Cigna Commercial	$22,246.18
Rate for Payer: Cigna Medicare Advantage	$16,343.55
Rate for Payer: Clover Medicare Advantage	$15,526.37
Rate for Payer: EmblemHealth Commercial	$49,030.65
Rate for Payer: Humana Medicare Advantage	$16,833.86
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16,343.55
Rate for Payer: Oxford Commercial	$17,583.00
Rate for Payer: UnitedHealthcare Commercial	$23,535.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$16,343.55
Rate for Payer: Wellcare Medicare Advantage	$16,343.55

POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC

Facility

$87,122.22

Service Code	MSDRG 857
Min. Negotiated Rate	$26,527.60
Max. Negotiated Rate	$87,122.22
Rate for Payer: Aetna Commercial	$63,907.96
Rate for Payer: Aetna Medicare Advantage	$87,122.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59,288.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59,288.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,923.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59,288.70
Rate for Payer: Cigna Commercial	$47,740.46
Rate for Payer: Cigna Medicare Advantage	$27,923.79
Rate for Payer: Clover Medicare Advantage	$26,527.60
Rate for Payer: EmblemHealth Commercial	$83,771.37
Rate for Payer: Humana Medicare Advantage	$28,761.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,923.79
Rate for Payer: Oxford Commercial	$37,733.23
Rate for Payer: UnitedHealthcare Commercial	$50,507.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,923.79
Rate for Payer: Wellcare Medicare Advantage	$27,923.79

POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC

Facility

$163,174.28

Service Code	MSDRG 856
Min. Negotiated Rate	$49,684.48
Max. Negotiated Rate	$163,174.28
Rate for Payer: Aetna Commercial	$118,073.11
Rate for Payer: Aetna Medicare Advantage	$163,174.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$122,733.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$122,733.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$52,299.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$122,733.15
Rate for Payer: Cigna Commercial	$101,404.17
Rate for Payer: Cigna Medicare Advantage	$52,299.45
Rate for Payer: Clover Medicare Advantage	$49,684.48
Rate for Payer: EmblemHealth Commercial	$156,898.35
Rate for Payer: Humana Medicare Advantage	$53,868.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$52,299.45
Rate for Payer: Oxford Commercial	$80,148.09
Rate for Payer: UnitedHealthcare Commercial	$107,281.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$52,299.45
Rate for Payer: Wellcare Medicare Advantage	$52,299.45

POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC

Facility

$63,471.35

Service Code	MSDRG 858
Min. Negotiated Rate	$19,326.21
Max. Negotiated Rate	$63,471.35
Rate for Payer: Aetna Commercial	$47,063.52
Rate for Payer: Aetna Medicare Advantage	$63,471.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,462.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,462.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,343.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,462.40
Rate for Payer: Cigna Commercial	$31,051.92
Rate for Payer: Cigna Medicare Advantage	$20,343.38
Rate for Payer: Clover Medicare Advantage	$19,326.21
Rate for Payer: EmblemHealth Commercial	$61,030.14
Rate for Payer: Humana Medicare Advantage	$20,953.68
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,343.38
Rate for Payer: Oxford Commercial	$24,542.90
Rate for Payer: UnitedHealthcare Commercial	$32,851.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,343.38
Rate for Payer: Wellcare Medicare Advantage	$20,343.38

POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE

Facility

$30,341.69

Service Code	APR-DRG 7113
Min. Negotiated Rate	$29,746.75
Max. Negotiated Rate	$30,341.69
Rate for Payer: UnitedHealthcare Community & State	$29,746.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,341.69
Rate for Payer: Wellpoint Medicaid Managed Care	$29,746.75

Know your out-of-pocket cost for care.

All Charges