Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SKIN ULCERS WITH CC

Facility

$56,944.09

Service Code	MSDRG 593
Min. Negotiated Rate	$17,338.74
Max. Negotiated Rate	$56,944.09
Rate for Payer: Aetna Commercial	$42,414.75
Rate for Payer: Aetna Medicare Advantage	$56,944.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,523.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,523.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,251.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,523.05
Rate for Payer: Cigna Commercial	$26,446.19
Rate for Payer: Cigna Medicare Advantage	$18,251.31
Rate for Payer: Clover Medicare Advantage	$17,338.74
Rate for Payer: EmblemHealth Commercial	$54,753.93
Rate for Payer: Humana Medicare Advantage	$18,798.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,251.31
Rate for Payer: Oxford Commercial	$20,902.61
Rate for Payer: UnitedHealthcare Commercial	$27,978.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,251.31
Rate for Payer: Wellcare Medicare Advantage	$18,251.31

SKIN ULCERS WITH MCC

Facility

$80,607.73

Service Code	MSDRG 592
Min. Negotiated Rate	$24,544.02
Max. Negotiated Rate	$80,607.73
Rate for Payer: Aetna Commercial	$59,268.26
Rate for Payer: Aetna Medicare Advantage	$80,607.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57,903.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57,903.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$25,835.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57,903.45
Rate for Payer: Cigna Commercial	$43,143.64
Rate for Payer: Cigna Medicare Advantage	$25,835.81
Rate for Payer: Clover Medicare Advantage	$24,544.02
Rate for Payer: EmblemHealth Commercial	$77,507.43
Rate for Payer: Humana Medicare Advantage	$26,610.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$25,835.81
Rate for Payer: Oxford Commercial	$34,099.99
Rate for Payer: UnitedHealthcare Commercial	$45,644.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$25,835.81
Rate for Payer: Wellcare Medicare Advantage	$25,835.81

SKIN ULCERS WITHOUT CC/MCC

Facility

$46,850.01

Service Code	MSDRG 594
Min. Negotiated Rate	$14,265.23
Max. Negotiated Rate	$46,850.01
Rate for Payer: Aetna Commercial	$35,225.59
Rate for Payer: Aetna Medicare Advantage	$46,850.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21,886.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21,886.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,016.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21,886.95
Rate for Payer: Cigna Commercial	$19,323.57
Rate for Payer: Cigna Medicare Advantage	$15,016.03
Rate for Payer: Clover Medicare Advantage	$14,265.23
Rate for Payer: EmblemHealth Commercial	$45,048.09
Rate for Payer: Humana Medicare Advantage	$15,466.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,016.03
Rate for Payer: Oxford Commercial	$15,273.02
Rate for Payer: UnitedHealthcare Commercial	$20,443.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,016.03
Rate for Payer: Wellcare Medicare Advantage	$15,016.03

SKN FL GRFT FCE/GNT/HF=<20SQCM

Facility

$17,100.51

Service Code	HCPCS 15240
Hospital Charge Code	1600000799
Hospital Revenue Code	360
Min. Negotiated Rate	$2,565.08
Max. Negotiated Rate	$2,565.08
Rate for Payer: Qualcare PPO/HMO/WC	$2,565.08

SKN FL GRFT FCE/GNT/HF=<20SQCM

Facility

$17,100.51

Service Code	HCPCS 15240
Hospital Charge Code	1600000799
Hospital Revenue Code	360
Min. Negotiated Rate	$485.65
Max. Negotiated Rate	$8,891.84
Rate for Payer: Aetna Commercial	$6,667.35
Rate for Payer: Aetna Medicare Advantage	$7,941.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,891.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,451.23
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	$8,891.84
Rate for Payer: Cigna Commercial	$4,913.48
Rate for Payer: Cigna Medicare Advantage	$2,451.23
Rate for Payer: Clover Medicare Advantage	$2,328.67
Rate for Payer: EmblemHealth Commercial	$7,353.69
Rate for Payer: Humana Medicare Advantage	$2,524.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,451.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,446.13
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,565.08
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$540.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,451.23
Rate for Payer: Wellcare Medicare Advantage	$2,451.23
Rate for Payer: Wellpoint Medicaid Managed Care	$485.65

SKN SP AGRF F/N/H/G100SQ CM/1B

Facility

$26,848.40

Service Code	HCPCS 15120
Hospital Charge Code	1600000474
Hospital Revenue Code	360
Min. Negotiated Rate	$4,027.26
Max. Negotiated Rate	$4,027.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26

SKN SP AGRF F/N/H/G100SQ CM/1B

Facility

$26,848.40

Service Code	HCPCS 15120
Hospital Charge Code	1600000474
Hospital Revenue Code	360
Min. Negotiated Rate	$762.49
Max. Negotiated Rate	$15,271.92
Rate for Payer: Aetna Commercial	$11,451.31
Rate for Payer: Aetna Medicare Advantage	$13,640.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15,271.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15,271.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,210.04
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	$15,271.92
Rate for Payer: Cigna Commercial	$8,439.01
Rate for Payer: Cigna Medicare Advantage	$4,210.04
Rate for Payer: Clover Medicare Advantage	$3,999.54
Rate for Payer: EmblemHealth Commercial	$12,630.12
Rate for Payer: Humana Medicare Advantage	$4,336.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,210.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,980.58
Rate for Payer: Oxford Commercial	$9,354.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,027.26
Rate for Payer: UnitedHealthcare Commercial	$10,269.00
Rate for Payer: UnitedHealthcare Community & State	$848.41
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,210.04
Rate for Payer: Wellcare Medicare Advantage	$4,210.04
Rate for Payer: Wellpoint Medicaid Managed Care	$762.49

SKN SPLT A-GRFT F/N/HF/G ADD

Facility

$7,580.00

Service Code	HCPCS 15121
Hospital Charge Code	1600000378
Hospital Revenue Code	360
Min. Negotiated Rate	$1,137.00
Max. Negotiated Rate	$1,137.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,137.00

SKN SPLT A-GRFT F/N/HF/G ADD

Facility

$7,580.00

Service Code	HCPCS 15121
Hospital Charge Code	1600000378
Hospital Revenue Code	360
Min. Negotiated Rate	$239.53
Max. Negotiated Rate	$3,790.00
Rate for Payer: Aetna Commercial	$2,880.40
Rate for Payer: Aetna Medicare Advantage	$2,274.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,932.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,932.90
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	$1,932.90
Rate for Payer: Cigna Commercial	$3,790.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,970.80
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,137.00
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$239.53

SKULL COMPLETE

Facility

$5,100.00

Service Code	HCPCS 70260
Hospital Charge Code	94061015
Hospital Revenue Code	320
Min. Negotiated Rate	$45.38
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	$45.38
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

SKULL COMPLETE

Facility

$5,100.00

Service Code	HCPCS 70260
Hospital Charge Code	94061015
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

SKULL LESS THAN 4 VWS

Facility

$5,100.00

Service Code	HCPCS 70250
Hospital Charge Code	94061013
Hospital Revenue Code	320
Min. Negotiated Rate	$31.07
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	$31.07
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	$316.08
Rate for Payer: Wellpoint Medicaid Managed Care	$144.84

SKULL LESS THAN 4 VWS

Facility

$5,100.00

Service Code	HCPCS 70250
Hospital Charge Code	94061013
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

SKYLITE BASKET 2.4F

Facility

$850.00

Hospital Charge Code	270682480
Hospital Revenue Code	272
Min. Negotiated Rate	$24.14
Max. Negotiated Rate	$425.00
Rate for Payer: Aetna Commercial	$323.00
Rate for Payer: Aetna Medicare Advantage	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$216.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$216.75
Rate for Payer: Cigna Commercial	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$221.00
Rate for Payer: Oxford Commercial	$170.00
Rate for Payer: Qualcare PPO/HMO/WC	$127.50
Rate for Payer: UnitedHealthcare Commercial	$170.00
Rate for Payer: UnitedHealthcare Community & State	$26.86
Rate for Payer: Wellpoint Medicaid Managed Care	$24.14

SKYLITE BASKET 2.4F

Facility

$850.00

Hospital Charge Code	270682480
Hospital Revenue Code	272
Min. Negotiated Rate	$127.50
Max. Negotiated Rate	$127.50
Rate for Payer: Qualcare PPO/HMO/WC	$127.50

SLCTIV CATH VEIN,2ND ORDR FAM

Facility

$1,980.80

Service Code	HCPCS 36012
Hospital Charge Code	16000944
Hospital Revenue Code	360
Min. Negotiated Rate	$297.12
Max. Negotiated Rate	$297.12
Rate for Payer: Qualcare PPO/HMO/WC	$297.12

SLCTIV CATH VEIN,2ND ORDR FAM

Facility

$1,980.80

Service Code	HCPCS 36012
Hospital Charge Code	16000944
Hospital Revenue Code	360
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$752.70
Rate for Payer: Aetna Medicare Advantage	$594.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$505.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$505.10
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	$505.10
Rate for Payer: Cigna Commercial	$990.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$515.01
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$297.12
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$62.59
Rate for Payer: Wellpoint Medicaid Managed Care	$56.25

SLCTV WND DEBRIDEM 20 CM OR <

Facility

$630.15

Service Code	HCPCS 97597
Hospital Charge Code	160000220
Hospital Revenue Code	360
Min. Negotiated Rate	$17.90
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$648.34
Rate for Payer: Aetna Medicare Advantage	$772.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$864.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$238.36
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	$864.65
Rate for Payer: Cigna Commercial	$477.79
Rate for Payer: Cigna Medicare Advantage	$238.36
Rate for Payer: Clover Medicare Advantage	$226.44
Rate for Payer: EmblemHealth Commercial	$715.08
Rate for Payer: Humana Medicare Advantage	$245.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$238.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.84
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.52
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$19.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$17.90

SLCTV WND DEBRIDEM 20 CM OR <

Facility

$630.15

Service Code	HCPCS 97597
Hospital Charge Code	160000220
Hospital Revenue Code	360
Min. Negotiated Rate	$94.52
Max. Negotiated Rate	$94.52
Rate for Payer: Qualcare PPO/HMO/WC	$94.52

SLCTV WND DEBRIDEM ADDL 20C

Facility

$361.65

Service Code	HCPCS 97598
Hospital Charge Code	1600000377
Hospital Revenue Code	360
Min. Negotiated Rate	$54.25
Max. Negotiated Rate	$54.25
Rate for Payer: Qualcare PPO/HMO/WC	$54.25

SLCTV WND DEBRIDEM ADDL 20C

Facility

$361.65

Service Code	HCPCS 97598
Hospital Charge Code	1600000377
Hospital Revenue Code	360
Min. Negotiated Rate	$10.27
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$137.43
Rate for Payer: Aetna Medicare Advantage	$108.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$92.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$92.22
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	$92.22
Rate for Payer: Cigna Commercial	$180.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.03
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$54.25
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$11.43
Rate for Payer: Wellpoint Medicaid Managed Care	$10.27

SLEEP STUDY ATTENDED

Facility

$40,000.00

Service Code	HCPCS 95807
Hospital Charge Code	405295807
Hospital Revenue Code	920
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

SLEEP STUDY ATTENDED

Facility

$40,000.00

Service Code	HCPCS 95807
Hospital Charge Code	405295807
Hospital Revenue Code	920
Min. Negotiated Rate	$269.50
Max. Negotiated Rate	$18,046.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,608.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,608.14
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,400.00
Rate for Payer: Oxford Commercial	$15,900.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Commercial	$18,046.00
Rate for Payer: UnitedHealthcare Community & State	$1,264.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$1,136.00

SLEEP STUDY UNATT & RESP EFFOR

Facility

$40,000.00

Service Code	HCPCS 95806
Hospital Charge Code	90000020
Hospital Revenue Code	920
Min. Negotiated Rate	$231.00
Max. Negotiated Rate	$13,534.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$930.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$231.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$930.53
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,400.00
Rate for Payer: Oxford Commercial	$11,925.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00
Rate for Payer: UnitedHealthcare Commercial	$13,534.00
Rate for Payer: UnitedHealthcare Community & State	$1,264.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1,136.00

SLEEP STUDY UNATT & RESP EFFOR

Facility

$40,000.00

Service Code	HCPCS 95806
Hospital Charge Code	90000020
Hospital Revenue Code	920
Min. Negotiated Rate	$6,000.00
Max. Negotiated Rate	$6,000.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,000.00

Know your out-of-pocket cost for care.

All Charges