Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

REVERSE BODY SCREW TITAN

Facility

$12,205.55

Service Code	HCPCS C1713
Hospital Charge Code	270691467
Hospital Revenue Code	278
Min. Negotiated Rate	$1,830.83
Max. Negotiated Rate	$2,953.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,441.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,953.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,830.83

REVERSE BODY SCREW TITAN

Facility

$12,205.55

Service Code	HCPCS C1713
Hospital Charge Code	270691467
Hospital Revenue Code	278
Min. Negotiated Rate	$346.64
Max. Negotiated Rate	$6,102.77
Rate for Payer: Aetna Commercial	$4,638.11
Rate for Payer: Aetna Medicare Advantage	$3,661.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,112.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,441.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,112.42
Rate for Payer: Cigna Commercial	$6,102.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,953.74
Rate for Payer: Qualcare PPO/HMO/WC	$1,830.83
Rate for Payer: UnitedHealthcare Community & State	$385.70
Rate for Payer: Wellpoint Medicaid Managed Care	$346.64

REVERSE BODY SMALL & SCREW

Facility

$14,852.50

Service Code	HCPCS C1776
Hospital Charge Code	270688777
Hospital Revenue Code	278
Min. Negotiated Rate	$421.81
Max. Negotiated Rate	$7,426.25
Rate for Payer: Aetna Commercial	$5,643.95
Rate for Payer: Aetna Medicare Advantage	$4,455.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,787.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,787.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,787.39
Rate for Payer: Cigna Commercial	$7,426.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,594.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.88
Rate for Payer: UnitedHealthcare Community & State	$469.34
Rate for Payer: Wellpoint Medicaid Managed Care	$421.81

REVERSE BODY SMALL & SCREW

Facility

$14,852.50

Service Code	HCPCS C1776
Hospital Charge Code	270688777
Hospital Revenue Code	278
Min. Negotiated Rate	$2,227.88
Max. Negotiated Rate	$3,594.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,970.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,594.30
Rate for Payer: Qualcare PPO/HMO/WC	$2,227.88

REVERSE SHOULDER SYSTEM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270704899
Hospital Revenue Code	278
Min. Negotiated Rate	$750.00
Max. Negotiated Rate	$1,210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00

REVERSE SHOULDER SYSTEM

Facility

$5,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270704899
Hospital Revenue Code	278
Min. Negotiated Rate	$142.00
Max. Negotiated Rate	$2,500.00
Rate for Payer: Aetna Commercial	$1,900.00
Rate for Payer: Aetna Medicare Advantage	$1,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,275.00
Rate for Payer: Cigna Commercial	$2,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,210.00
Rate for Payer: Qualcare PPO/HMO/WC	$750.00
Rate for Payer: UnitedHealthcare Community & State	$158.00
Rate for Payer: Wellpoint Medicaid Managed Care	$142.00

REV GJ ANASTOM WO VAGOT

Facility

$8,727.00

Service Code	HCPCS 43860
Hospital Charge Code	16000968
Hospital Revenue Code	360
Min. Negotiated Rate	$247.85
Max. Negotiated Rate	$10,269.00
Rate for Payer: Aetna Commercial	$3,316.26
Rate for Payer: Aetna Medicare Advantage	$2,618.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,225.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,225.39
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	$2,225.39
Rate for Payer: Cigna Commercial	$4,363.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,269.02
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,309.05
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$275.77
Rate for Payer: Wellpoint Medicaid Managed Care	$247.85

REV GJ ANASTOM WO VAGOT

Facility

$8,727.00

Service Code	HCPCS 43860
Hospital Charge Code	16000968
Hospital Revenue Code	360
Min. Negotiated Rate	$1,309.05
Max. Negotiated Rate	$1,309.05
Rate for Payer: Qualcare PPO/HMO/WC	$1,309.05

REV HIP/ANCA TIBA W SCRW H70MM

Facility

$26,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270678329
Hospital Revenue Code	278
Min. Negotiated Rate	$3,937.50
Max. Negotiated Rate	$6,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,352.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,937.50

REV HIP/ANCA TIBA W SCRW H70MM

Facility

$26,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270678329
Hospital Revenue Code	278
Min. Negotiated Rate	$745.50
Max. Negotiated Rate	$13,125.00
Rate for Payer: Aetna Commercial	$9,975.00
Rate for Payer: Aetna Medicare Advantage	$7,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,693.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,693.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,693.75
Rate for Payer: Cigna Commercial	$13,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,352.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,937.50
Rate for Payer: UnitedHealthcare Community & State	$829.50
Rate for Payer: Wellpoint Medicaid Managed Care	$745.50

REV HIP/TIBA DIA-18MM L-140MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270678330
Hospital Revenue Code	278
Min. Negotiated Rate	$795.20
Max. Negotiated Rate	$14,000.00
Rate for Payer: Aetna Commercial	$10,640.00
Rate for Payer: Aetna Medicare Advantage	$8,400.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,140.00
Rate for Payer: Cigna Commercial	$14,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00
Rate for Payer: UnitedHealthcare Community & State	$884.80
Rate for Payer: Wellpoint Medicaid Managed Care	$795.20

REV HIP/TIBA DIA-18MM L-140MM

Facility

$28,000.00

Service Code	HCPCS C1776
Hospital Charge Code	270678330
Hospital Revenue Code	278
Min. Negotiated Rate	$4,200.00
Max. Negotiated Rate	$6,776.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,776.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,200.00

REV HIP TIB NCK W SCRW H80MM

Facility

$26,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270678331
Hospital Revenue Code	278
Min. Negotiated Rate	$3,937.50
Max. Negotiated Rate	$6,352.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,352.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,937.50

REV HIP TIB NCK W SCRW H80MM

Facility

$26,250.00

Service Code	HCPCS C1776
Hospital Charge Code	270678331
Hospital Revenue Code	278
Min. Negotiated Rate	$745.50
Max. Negotiated Rate	$13,125.00
Rate for Payer: Aetna Commercial	$9,975.00
Rate for Payer: Aetna Medicare Advantage	$7,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,693.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,693.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,693.75
Rate for Payer: Cigna Commercial	$13,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,352.50
Rate for Payer: Qualcare PPO/HMO/WC	$3,937.50
Rate for Payer: UnitedHealthcare Community & State	$829.50
Rate for Payer: Wellpoint Medicaid Managed Care	$745.50

REVISE AV FISTULA - GRAFT

Facility

$38,857.60

Service Code	HCPCS 36832
Hospital Charge Code	16000948
Hospital Revenue Code	360
Min. Negotiated Rate	$5,828.64
Max. Negotiated Rate	$5,828.64
Rate for Payer: Qualcare PPO/HMO/WC	$5,828.64

REVISE AV FISTULA - GRAFT

Facility

$38,857.60

Service Code	HCPCS 36832
Hospital Charge Code	16000948
Hospital Revenue Code	360
Min. Negotiated Rate	$1,103.56
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	$10,102.98
Rate for Payer: Oxford Commercial	$13,407.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,828.64
Rate for Payer: UnitedHealthcare Commercial	$14,869.00
Rate for Payer: UnitedHealthcare Community & State	$1,227.90
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	$1,103.56

REVISE CERV ARTIFIC DISC

Facility

$44,286.00

Service Code	HCPCS 22861
Hospital Charge Code	160000229
Hospital Revenue Code	360
Min. Negotiated Rate	$1,257.72
Max. Negotiated Rate	$75,563.15
Rate for Payer: Aetna Commercial	$56,659.34
Rate for Payer: Aetna Medicare Advantage	$67,491.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75,563.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20,830.64
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	$75,563.15
Rate for Payer: Cigna Commercial	$41,754.94
Rate for Payer: Cigna Medicare Advantage	$20,830.64
Rate for Payer: Clover Medicare Advantage	$19,789.11
Rate for Payer: EmblemHealth Commercial	$62,491.92
Rate for Payer: Humana Medicare Advantage	$21,455.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20,830.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,514.36
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,642.90
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$1,399.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$20,830.64
Rate for Payer: Wellcare Medicare Advantage	$20,830.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1,257.72

REVISE CERV ARTIFIC DISC

Facility

$44,286.00

Service Code	HCPCS 22861
Hospital Charge Code	160000229
Hospital Revenue Code	360
Min. Negotiated Rate	$6,642.90
Max. Negotiated Rate	$6,642.90
Rate for Payer: Qualcare PPO/HMO/WC	$6,642.90

REVISED TOTAL HIP ARTHROPL

Facility

$22,885.90

Service Code	HCPCS 27138
Hospital Charge Code	1600000597
Hospital Revenue Code	360
Min. Negotiated Rate	$3,432.89
Max. Negotiated Rate	$3,432.89
Rate for Payer: Qualcare PPO/HMO/WC	$3,432.89

REVISED TOTAL HIP ARTHROPL

Facility

$22,885.90

Service Code	HCPCS 27138
Hospital Charge Code	1600000597
Hospital Revenue Code	360
Min. Negotiated Rate	$649.96
Max. Negotiated Rate	$55,329.13
Rate for Payer: Aetna Commercial	$41,487.32
Rate for Payer: Aetna Medicare Advantage	$49,418.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55,329.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,252.69
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	$55,329.13
Rate for Payer: Cigna Commercial	$30,573.98
Rate for Payer: Cigna Medicare Advantage	$15,252.69
Rate for Payer: Clover Medicare Advantage	$14,490.06
Rate for Payer: EmblemHealth Commercial	$45,758.07
Rate for Payer: Humana Medicare Advantage	$15,710.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,252.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,950.33
Rate for Payer: Oxford Commercial	$14,968.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,432.89
Rate for Payer: UnitedHealthcare Commercial	$16,639.00
Rate for Payer: UnitedHealthcare Community & State	$723.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,252.69
Rate for Payer: Wellcare Medicare Advantage	$15,252.69
Rate for Payer: Wellpoint Medicaid Managed Care	$649.96

REVISE FINGER JOINT EACH

Facility

$10,580.92

Service Code	HCPCS 26135
Hospital Charge Code	16000699
Hospital Revenue Code	360
Min. Negotiated Rate	$300.50
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	$3,536.00
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	$2,751.04
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,587.14
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$334.36
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	$300.50

REVISE FINGER JOINT EACH

Facility

$10,580.92

Service Code	HCPCS 26135
Hospital Charge Code	16000699
Hospital Revenue Code	360
Min. Negotiated Rate	$1,587.14
Max. Negotiated Rate	$1,587.14
Rate for Payer: Qualcare PPO/HMO/WC	$1,587.14

REVISE FINGER/TOE NERVE

Facility

$9,553.80

Service Code	HCPCS 64702
Hospital Charge Code	323064702
Hospital Revenue Code	450
Min. Negotiated Rate	$1,433.07
Max. Negotiated Rate	$1,433.07
Rate for Payer: Qualcare PPO/HMO/WC	$1,433.07

REVISE FINGER/TOE NERVE

Facility

$9,553.80

Service Code	HCPCS 64702
Hospital Charge Code	323064702
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$8,415.40
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,415.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,415.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$159.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,415.40
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$2,319.89
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,483.99
Rate for Payer: Qualcare PPO/HMO/WC	$1,433.07
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellpoint Medicaid Managed Care	$271.33

REVISE FINGER/TOE NERVE-F6

Facility

$16,437.00

Service Code	HCPCS 64702
Hospital Charge Code	16000526
Hospital Revenue Code	360
Min. Negotiated Rate	$466.81
Max. Negotiated Rate	$8,415.40
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,415.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,415.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
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	$8,415.40
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$2,319.89
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,273.62
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,465.55
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$519.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellpoint Medicaid Managed Care	$466.81

Know your out-of-pocket cost for care.

All Charges