Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CHECK POINT KIT

Facility

$503.75

Hospital Charge Code	270691180
Hospital Revenue Code	272
Min. Negotiated Rate	$14.31
Max. Negotiated Rate	$251.88
Rate for Payer: Aetna Commercial	$191.43
Rate for Payer: Aetna Medicare Advantage	$151.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.46
Rate for Payer: Cigna Commercial	$251.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.97
Rate for Payer: Oxford Commercial	$100.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.56
Rate for Payer: UnitedHealthcare Commercial	$100.75
Rate for Payer: UnitedHealthcare Community & State	$15.92
Rate for Payer: Wellpoint Medicaid Managed Care	$14.31

CHECK POINT KIT

Facility

$503.75

Hospital Charge Code	270691180
Hospital Revenue Code	272
Min. Negotiated Rate	$75.56
Max. Negotiated Rate	$75.56
Rate for Payer: Qualcare PPO/HMO/WC	$75.56

CHECKPOINT KIT

Facility

$503.75

Hospital Charge Code	270668847
Hospital Revenue Code	272
Min. Negotiated Rate	$75.56
Max. Negotiated Rate	$75.56
Rate for Payer: Qualcare PPO/HMO/WC	$75.56

CHECKPOINT KIT

Facility

$503.75

Hospital Charge Code	270690852
Hospital Revenue Code	272
Min. Negotiated Rate	$14.31
Max. Negotiated Rate	$251.88
Rate for Payer: Aetna Commercial	$191.43
Rate for Payer: Aetna Medicare Advantage	$151.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.46
Rate for Payer: Cigna Commercial	$251.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.97
Rate for Payer: Oxford Commercial	$100.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.56
Rate for Payer: UnitedHealthcare Commercial	$100.75
Rate for Payer: UnitedHealthcare Community & State	$15.92
Rate for Payer: Wellpoint Medicaid Managed Care	$14.31

CHECKPOINT KIT

Facility

$503.75

Hospital Charge Code	270668847
Hospital Revenue Code	272
Min. Negotiated Rate	$14.31
Max. Negotiated Rate	$251.88
Rate for Payer: Aetna Commercial	$191.43
Rate for Payer: Aetna Medicare Advantage	$151.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.46
Rate for Payer: Cigna Commercial	$251.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$130.97
Rate for Payer: Oxford Commercial	$100.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.56
Rate for Payer: UnitedHealthcare Commercial	$100.75
Rate for Payer: UnitedHealthcare Community & State	$15.92
Rate for Payer: Wellpoint Medicaid Managed Care	$14.31

CHECKPOINT KIT

Facility

$503.75

Hospital Charge Code	270690852
Hospital Revenue Code	272
Min. Negotiated Rate	$75.56
Max. Negotiated Rate	$75.56
Rate for Payer: Qualcare PPO/HMO/WC	$75.56

CHEM CAUTERY GRANULATION TIS

Facility

$990.50

Service Code	HCPCS 17250
Hospital Charge Code	412317250
Hospital Revenue Code	361
Min. Negotiated Rate	$148.57
Max. Negotiated Rate	$148.57
Rate for Payer: Qualcare PPO/HMO/WC	$148.57

CHEM CAUTERY GRANULATION TIS

Facility

$990.50

Service Code	HCPCS 17250
Hospital Charge Code	412317250
Hospital Revenue Code	361
Min. Negotiated Rate	$28.13
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	$257.53
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$148.57
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$31.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$28.13

CHEMICAL CAUTERIZATION OF GRAN

Facility

$990.50

Service Code	HCPCS 17250
Hospital Charge Code	9800550
Hospital Revenue Code	510
Min. Negotiated Rate	$148.57
Max. Negotiated Rate	$148.57
Rate for Payer: Qualcare PPO/HMO/WC	$148.57

CHEMICAL CAUTERIZATION OF GRAN

Facility

$990.50

Service Code	HCPCS 17250
Hospital Charge Code	9800550
Hospital Revenue Code	510
Min. Negotiated Rate	$28.13
Max. Negotiated Rate	$864.65
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	$47.97
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	$257.53
Rate for Payer: Qualcare PPO/HMO/WC	$148.57
Rate for Payer: UnitedHealthcare Community & State	$31.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$238.36
Rate for Payer: Wellcare Medicare Advantage	$238.36
Rate for Payer: Wellpoint Medicaid Managed Care	$28.13

CHEMILUMINESCENT ASSAY

Facility

$99.00

Service Code	HCPCS 82397
Hospital Charge Code	38477121
Hospital Revenue Code	301
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$38.41
Rate for Payer: Aetna Medicare Advantage	$45.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.22
Rate for Payer: Cigna Commercial	$49.50
Rate for Payer: Cigna Medicare Advantage	$14.12
Rate for Payer: Clover Medicare Advantage	$13.41
Rate for Payer: EmblemHealth Commercial	$42.36
Rate for Payer: Humana Medicare Advantage	$14.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.74
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.12
Rate for Payer: Wellcare Medicare Advantage	$14.12
Rate for Payer: Wellpoint Medicaid Managed Care	$2.81

CHEMILUMINESCENT ASSAY

Facility

$99.00

Service Code	HCPCS 82397
Hospital Charge Code	38477121
Hospital Revenue Code	301
Min. Negotiated Rate	$14.85
Max. Negotiated Rate	$14.85
Rate for Payer: Qualcare PPO/HMO/WC	$14.85

CHEMO ADMIN INTRATHECAL

Facility

$1,242.40

Service Code	HCPCS 96450
Hospital Charge Code	93500097
Hospital Revenue Code	335
Min. Negotiated Rate	$186.36
Max. Negotiated Rate	$186.36
Rate for Payer: Qualcare PPO/HMO/WC	$186.36

CHEMO ADMIN INTRATHECAL

Facility

$1,242.40

Service Code	HCPCS 96450
Hospital Charge Code	93500097
Hospital Revenue Code	335
Min. Negotiated Rate	$35.28
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,067.36
Rate for Payer: Aetna Medicare Advantage	$1,271.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,423.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,423.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$392.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,423.47
Rate for Payer: Cigna Commercial	$786.58
Rate for Payer: Cigna Medicare Advantage	$274.69
Rate for Payer: Clover Medicare Advantage	$372.79
Rate for Payer: EmblemHealth Commercial	$1,177.23
Rate for Payer: Humana Medicare Advantage	$404.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$392.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.02
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.36
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$39.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$392.41
Rate for Payer: Wellcare Medicare Advantage	$392.41
Rate for Payer: Wellpoint Medicaid Managed Care	$35.28

CHEMO ADMIN IV INFUS UP TO 1HR

Facility

$1,242.40

Service Code	HCPCS 96413
Hospital Charge Code	93500087
Hospital Revenue Code	335
Min. Negotiated Rate	$35.28
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,067.36
Rate for Payer: Aetna Medicare Advantage	$1,271.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,423.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,423.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$392.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,423.47
Rate for Payer: Cigna Commercial	$786.58
Rate for Payer: Cigna Medicare Advantage	$274.69
Rate for Payer: Clover Medicare Advantage	$372.79
Rate for Payer: EmblemHealth Commercial	$1,177.23
Rate for Payer: Humana Medicare Advantage	$404.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$392.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$323.02
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.36
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$39.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$392.41
Rate for Payer: Wellcare Medicare Advantage	$392.41
Rate for Payer: Wellpoint Medicaid Managed Care	$35.28

CHEMO ADMIN IV INFUS UP TO 1HR

Facility

$1,242.40

Service Code	HCPCS 96413
Hospital Charge Code	93500087
Hospital Revenue Code	335
Min. Negotiated Rate	$186.36
Max. Negotiated Rate	$186.36
Rate for Payer: Qualcare PPO/HMO/WC	$186.36

CHEMO ADMIN PERIT CAVITY IMPL

Facility

$1,158.00

Service Code	HCPCS 96446
Hospital Charge Code	93500095
Hospital Revenue Code	335
Min. Negotiated Rate	$32.89
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,067.36
Rate for Payer: Aetna Medicare Advantage	$1,271.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,423.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,423.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$392.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,423.47
Rate for Payer: Cigna Commercial	$786.58
Rate for Payer: Cigna Medicare Advantage	$274.69
Rate for Payer: Clover Medicare Advantage	$372.79
Rate for Payer: EmblemHealth Commercial	$1,177.23
Rate for Payer: Humana Medicare Advantage	$404.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$392.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.08
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$173.70
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$36.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$392.41
Rate for Payer: Wellcare Medicare Advantage	$392.41
Rate for Payer: Wellpoint Medicaid Managed Care	$32.89

CHEMO ADMIN PERIT CAVITY IMPL

Facility

$1,158.00

Service Code	HCPCS 96446
Hospital Charge Code	93500095
Hospital Revenue Code	335
Min. Negotiated Rate	$173.70
Max. Negotiated Rate	$173.70
Rate for Payer: Qualcare PPO/HMO/WC	$173.70

CHEMO ADMN IV ADDT INFS TO 1HR

Facility

$402.60

Service Code	HCPCS 96417
Hospital Charge Code	93500093
Hospital Revenue Code	335
Min. Negotiated Rate	$11.43
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$59.88
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.68
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.39
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$12.72
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$11.43

CHEMO ADMN IV ADDT INFS TO 1HR

Facility

$402.60

Service Code	HCPCS 96417
Hospital Charge Code	93500093
Hospital Revenue Code	335
Min. Negotiated Rate	$60.39
Max. Negotiated Rate	$60.39
Rate for Payer: Qualcare PPO/HMO/WC	$60.39

CHEMO ADMN IV INFS ECH ADD HR

Facility

$210.90

Service Code	HCPCS 96415
Hospital Charge Code	93500091
Hospital Revenue Code	335
Min. Negotiated Rate	$31.64
Max. Negotiated Rate	$31.64
Rate for Payer: Qualcare PPO/HMO/WC	$31.64

CHEMO ADMN IV INFS ECH ADD HR

Facility

$210.90

Service Code	HCPCS 96415
Hospital Charge Code	93500091
Hospital Revenue Code	335
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$59.88
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.83
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.64
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$6.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$5.99

CHEMO, ANTI-NEOPL, SQ/IM

Facility

$671.00

Service Code	HCPCS 96401
Hospital Charge Code	3401080
Hospital Revenue Code	331
Min. Negotiated Rate	$100.65
Max. Negotiated Rate	$100.65
Rate for Payer: Qualcare PPO/HMO/WC	$100.65

CHEMO, ANTI-NEOPL, SQ/IM

Facility

$671.00

Service Code	HCPCS 96401
Hospital Charge Code	3401080
Hospital Revenue Code	331
Min. Negotiated Rate	$19.06
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.30
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$59.88
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$174.46
Rate for Payer: Oxford Commercial	$2,441.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.65
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$21.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$19.06

CHEMODENERVATION ANAL MUSC

Facility

$16,865.10

Service Code	HCPCS 46505
Hospital Charge Code	16000750
Hospital Revenue Code	360
Min. Negotiated Rate	$478.97
Max. Negotiated Rate	$5,347.00
Rate for Payer: Aetna Commercial	$3,866.86
Rate for Payer: Aetna Medicare Advantage	$4,606.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,157.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,421.64
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	$5,157.00
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: Cigna Medicare Advantage	$1,421.64
Rate for Payer: Clover Medicare Advantage	$1,350.56
Rate for Payer: EmblemHealth Commercial	$4,264.92
Rate for Payer: Humana Medicare Advantage	$1,464.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,421.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,384.93
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,529.76
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$532.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,421.64
Rate for Payer: Wellcare Medicare Advantage	$1,421.64
Rate for Payer: Wellpoint Medicaid Managed Care	$478.97

Know your out-of-pocket cost for care.

All Charges