Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CHIP CANCELLOUS 5cc

Facility

$840.00

Service Code	HCPCS C1713
Hospital Charge Code	270675128
Hospital Revenue Code	278
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$203.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$203.28
Rate for Payer: Qualcare PPO/HMO/WC	$126.00

CHIP CANCELLOUS 5CC

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270682160
Hospital Revenue Code	278
Min. Negotiated Rate	$19.88
Max. Negotiated Rate	$350.00
Rate for Payer: Aetna Commercial	$266.00
Rate for Payer: Aetna Medicare Advantage	$210.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$178.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$178.50
Rate for Payer: Cigna Commercial	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00
Rate for Payer: UnitedHealthcare Community & State	$22.12
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

CHIP CANCELLOUS 5CC

Facility

$700.00

Service Code	HCPCS C1713
Hospital Charge Code	270682160
Hospital Revenue Code	278
Min. Negotiated Rate	$105.00
Max. Negotiated Rate	$169.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.40
Rate for Payer: Qualcare PPO/HMO/WC	$105.00

CHIPS CANC BONE 1.7-10M 100150

Facility

$2,280.00

Service Code	HCPCS C1713
Hospital Charge Code	270618744
Hospital Revenue Code	278
Min. Negotiated Rate	$342.00
Max. Negotiated Rate	$551.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$551.76
Rate for Payer: Qualcare PPO/HMO/WC	$342.00

CHIPS CANC BONE 1.7-10M 100150

Facility

$2,280.00

Service Code	HCPCS C1713
Hospital Charge Code	270618744
Hospital Revenue Code	278
Min. Negotiated Rate	$64.75
Max. Negotiated Rate	$1,140.00
Rate for Payer: Aetna Commercial	$866.40
Rate for Payer: Aetna Medicare Advantage	$684.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.40
Rate for Payer: Cigna Commercial	$1,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$551.76
Rate for Payer: Qualcare PPO/HMO/WC	$342.00
Rate for Payer: UnitedHealthcare Community & State	$72.05
Rate for Payer: Wellpoint Medicaid Managed Care	$64.75

CH IRON

Facility

$667.59

Service Code	HCPCS 83540
Hospital Charge Code	397073039
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.47
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

CH IRON

Facility

$667.59

Service Code	HCPCS 83540
Hospital Charge Code	397073039
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH JC VIRUS DNA, QN RT-PCR

Facility

$1,114.00

Service Code	HCPCS 87799
Hospital Charge Code	397071388
Hospital Revenue Code	306
Min. Negotiated Rate	$31.64
Max. Negotiated Rate	$557.00
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.40
Rate for Payer: Cigna Commercial	$557.00
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$289.64
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$31.64

CH JC VIRUS DNA, QN RT-PCR

Facility

$1,114.00

Service Code	HCPCS 87799
Hospital Charge Code	397071388
Hospital Revenue Code	306
Min. Negotiated Rate	$167.10
Max. Negotiated Rate	$167.10
Rate for Payer: Qualcare PPO/HMO/WC	$167.10

CH KETONES SERUM

Facility

$667.59

Service Code	HCPCS 82009
Hospital Charge Code	397071272
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH KETONES SERUM

Facility

$667.59

Service Code	HCPCS 82009
Hospital Charge Code	397071272
Hospital Revenue Code	301
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$12.29
Rate for Payer: Aetna Medicare Advantage	$14.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.40
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$4.52
Rate for Payer: Clover Medicare Advantage	$4.29
Rate for Payer: EmblemHealth Commercial	$13.56
Rate for Payer: Humana Medicare Advantage	$4.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.52
Rate for Payer: Wellcare Medicare Advantage	$4.52
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

CHLAMYDIA ABCHLAMYDIA AB

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	401386631A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHLAMYDIA ABCHLAMYDIA AB

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	401386631A
Hospital Revenue Code	302
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.15
Rate for Payer: Aetna Medicare Advantage	$38.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.88
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$11.23
Rate for Payer: EmblemHealth Commercial	$35.46
Rate for Payer: Humana Medicare Advantage	$12.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.82
Rate for Payer: Wellcare Medicare Advantage	$11.82
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CHLAMYDIA,AMPLIF PROB TECH

Facility

$247.00

Service Code	HCPCS 87491
Hospital Charge Code	38478109
Hospital Revenue Code	306
Min. Negotiated Rate	$7.01
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$123.50
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.22
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$7.01

CHLAMYDIA,AMPLIF PROB TECH

Facility

$247.00

Service Code	HCPCS 87491
Hospital Charge Code	38478109
Hospital Revenue Code	306
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

CHLAMYDIA ANTIBODIES,IgM

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	38476075
Hospital Revenue Code	302
Min. Negotiated Rate	$10.14
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.49
Rate for Payer: Aetna Medicare Advantage	$41.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.00
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.68
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$10.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.68
Rate for Payer: Wellcare Medicare Advantage	$12.68
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CHLAMYDIA ANTIBODIES,IgM

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	38476075
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHLAMYDIA ANTIBODIES,QUANT

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	38476078
Hospital Revenue Code	302
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.15
Rate for Payer: Aetna Medicare Advantage	$38.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.88
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$11.23
Rate for Payer: EmblemHealth Commercial	$35.46
Rate for Payer: Humana Medicare Advantage	$12.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.82
Rate for Payer: Wellcare Medicare Advantage	$11.82
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

CHLAMYDIA ANTIBODIES,QUANT

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	38476078
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHLAMYDIA ANTIGEN DETECTION

Facility

$354.00

Service Code	HCPCS 87270
Hospital Charge Code	38475050
Hospital Revenue Code	309
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$177.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.46
Rate for Payer: Cigna Commercial	$177.00
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.04
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$10.05

CHLAMYDIA ANTIGEN DETECTION

Facility

$354.00

Service Code	HCPCS 87270
Hospital Charge Code	38475050
Hospital Revenue Code	309
Min. Negotiated Rate	$53.10
Max. Negotiated Rate	$53.10
Rate for Payer: Qualcare PPO/HMO/WC	$53.10

CHLAMYDIA CULTURE

Facility

$290.00

Service Code	HCPCS 87110
Hospital Charge Code	38475012
Hospital Revenue Code	309
Min. Negotiated Rate	$43.50
Max. Negotiated Rate	$43.50
Rate for Payer: Qualcare PPO/HMO/WC	$43.50

CHLAMYDIA CULTURE

Facility

$290.00

Service Code	HCPCS 87110
Hospital Charge Code	38475012
Hospital Revenue Code	309
Min. Negotiated Rate	$8.24
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$53.31
Rate for Payer: Aetna Medicare Advantage	$63.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.10
Rate for Payer: Cigna Commercial	$145.00
Rate for Payer: Cigna Medicare Advantage	$19.60
Rate for Payer: Clover Medicare Advantage	$18.62
Rate for Payer: EmblemHealth Commercial	$58.80
Rate for Payer: Humana Medicare Advantage	$20.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$15.68
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.60
Rate for Payer: Wellcare Medicare Advantage	$19.60
Rate for Payer: Wellpoint Medicaid Managed Care	$8.24

CHLAMYDIA/GC,SDA

Facility

$247.00

Service Code	HCPCS 87491
Hospital Charge Code	38479087
Hospital Revenue Code	306
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

CHLAMYDIA/GC,SDA

Facility

$247.00

Service Code	HCPCS 87491
Hospital Charge Code	38479087
Hospital Revenue Code	306
Min. Negotiated Rate	$7.01
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$32.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$123.50
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.22
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$7.01

Know your out-of-pocket cost for care.

All Charges