Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ACID CITRIC 900GM

Facility

$76.85

Hospital Charge Code	270605263
Hospital Revenue Code	250
Min. Negotiated Rate	$1.85
Max. Negotiated Rate	$38.42
Rate for Payer: Aetna Commercial	$29.20
Rate for Payer: Aetna Medicare Advantage	$23.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.60
Rate for Payer: Cigna Commercial	$38.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.05
Rate for Payer: Oxford Commercial	$15.37
Rate for Payer: Qualcare PPO/HMO/WC	$11.53
Rate for Payer: UnitedHealthcare Commercial	$15.37
Rate for Payer: UnitedHealthcare Community & State	$1.85
Rate for Payer: Wellpoint Medicaid Managed Care	$2.04

ACID FAST BACILLI STAIN

Facility

$324.85

Service Code	HCPCS 88312
Hospital Charge Code	3005410
Hospital Revenue Code	310
Min. Negotiated Rate	$8.61
Max. Negotiated Rate	$223.48
Rate for Payer: Aetna Commercial	$168.40
Rate for Payer: Aetna Medicare Advantage	$200.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.48
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$61.91
Rate for Payer: Clover Medicare Advantage	$58.81
Rate for Payer: EmblemHealth Commercial	$185.73
Rate for Payer: Humana Medicare Advantage	$63.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.73
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$92.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$8.61

ACID FAST BACILLI STAIN

Facility

$390.00

Service Code	HCPCS 87206
Hospital Charge Code	3000072
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ACID FAST BACILLI STAIN

Facility

$390.00

Service Code	HCPCS 87206
Hospital Charge Code	3000072
Hospital Revenue Code	306
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.66
Rate for Payer: Aetna Medicare Advantage	$17.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.46
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.39
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Medicare Advantage	$5.39
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ACID FAST BACILLI STAIN

Facility

$324.85

Service Code	HCPCS 88312
Hospital Charge Code	3005410
Hospital Revenue Code	310
Min. Negotiated Rate	$48.73
Max. Negotiated Rate	$48.73
Rate for Payer: Qualcare PPO/HMO/WC	$48.73

Acid-fast (Mycobacteria) Smear

Facility

$390.00

Service Code	HCPCS 87116
Hospital Charge Code	39880004A
Hospital Revenue Code	309
Min. Negotiated Rate	$8.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$29.38
Rate for Payer: Aetna Medicare Advantage	$34.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.98
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$10.80
Rate for Payer: Clover Medicare Advantage	$10.26
Rate for Payer: EmblemHealth Commercial	$32.40
Rate for Payer: Humana Medicare Advantage	$11.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$8.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$10.80
Rate for Payer: Wellcare Medicare Advantage	$10.80
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

Acid-fast (Mycobacteria) Smear

Facility

$390.00

Service Code	HCPCS 87206
Hospital Charge Code	39880004B
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Acid-fast (Mycobacteria) Smear

Facility

$390.00

Service Code	HCPCS 87116
Hospital Charge Code	39880004A
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Acid-fast (Mycobacteria) Smear

Facility

$390.00

Service Code	HCPCS 87206
Hospital Charge Code	39880004B
Hospital Revenue Code	309
Min. Negotiated Rate	$4.31
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.66
Rate for Payer: Aetna Medicare Advantage	$17.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.46
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.39
Rate for Payer: Clover Medicare Advantage	$5.12
Rate for Payer: EmblemHealth Commercial	$16.17
Rate for Payer: Humana Medicare Advantage	$5.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.39
Rate for Payer: Wellcare Medicare Advantage	$5.39
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ACID FAST SMEAR****

Facility

$21.00

Hospital Charge Code	3010071
Hospital Revenue Code	309
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$7.98
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

ACID FAST SMEAR****

Facility

$21.00

Hospital Charge Code	3010071
Hospital Revenue Code	309
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

ACID HEMOLYSIN (HAMS)

Facility

$159.00

Service Code	HCPCS 85475
Hospital Charge Code	38476041
Hospital Revenue Code	305
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$24.13
Rate for Payer: Aetna Medicare Advantage	$28.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.02
Rate for Payer: Cigna Commercial	$79.50
Rate for Payer: Cigna Medicare Advantage	$8.87
Rate for Payer: Clover Medicare Advantage	$8.43
Rate for Payer: EmblemHealth Commercial	$26.61
Rate for Payer: Humana Medicare Advantage	$9.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.87
Rate for Payer: Wellcare Medicare Advantage	$8.87
Rate for Payer: Wellpoint Medicaid Managed Care	$4.21

ACID HEMOLYSIN (HAMS)

Facility

$159.00

Service Code	HCPCS 85475
Hospital Charge Code	38476041
Hospital Revenue Code	305
Min. Negotiated Rate	$23.85
Max. Negotiated Rate	$23.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.85

ACID HEMOLYSIN TEST

Facility

$85.65

Service Code	HCPCS 85475
Hospital Charge Code	3006939
Hospital Revenue Code	305
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$12.85
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

ACID HEMOLYSIN TEST

Facility

$85.65

Service Code	HCPCS 85475
Hospital Charge Code	3006939
Hospital Revenue Code	305
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$24.13
Rate for Payer: Aetna Medicare Advantage	$28.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.02
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: Cigna Medicare Advantage	$8.87
Rate for Payer: Clover Medicare Advantage	$8.43
Rate for Payer: EmblemHealth Commercial	$26.61
Rate for Payer: Humana Medicare Advantage	$9.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.87
Rate for Payer: Wellcare Medicare Advantage	$8.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

ACIDOPHILUS/BULGASRICUS PACKET

Facility

$13.60

Service Code	NDC 64980014612
Hospital Charge Code	6063943049
Hospital Revenue Code	250
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$2.04
Rate for Payer: Qualcare PPO/HMO/WC	$2.04

ACIDOPHILUS/BULGASRICUS PACKET

Facility

$13.60

Service Code	NDC 64980014612
Hospital Charge Code	6063943049
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.80
Rate for Payer: Aetna Commercial	$5.17
Rate for Payer: Aetna Medicare Advantage	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.47
Rate for Payer: Cigna Commercial	$6.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.08
Rate for Payer: Oxford Commercial	$2.72
Rate for Payer: Qualcare PPO/HMO/WC	$2.04
Rate for Payer: UnitedHealthcare Commercial	$2.72
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

ACID PHOSPATASE***

Facility

$32.00

Hospital Charge Code	3010105
Hospital Revenue Code	309
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

ACID PHOSPATASE***

Facility

$32.00

Hospital Charge Code	3010105
Hospital Revenue Code	309
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

ACID PHOSPHATASE,PROSTATI

Facility

$390.00

Service Code	HCPCS 84066
Hospital Charge Code	39900118
Hospital Revenue Code	301
Min. Negotiated Rate	$7.73
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$26.28
Rate for Payer: Aetna Medicare Advantage	$31.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.87
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$9.66
Rate for Payer: Clover Medicare Advantage	$9.18
Rate for Payer: EmblemHealth Commercial	$28.98
Rate for Payer: Humana Medicare Advantage	$9.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.66
Rate for Payer: Wellcare Medicare Advantage	$9.66
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ACID PHOSPHATASE,PROSTATI

Facility

$390.00

Service Code	HCPCS 84066
Hospital Charge Code	39900118
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ACID PHOSPHATASE, PROSTATIC

Facility

$120.00

Service Code	HCPCS 84066
Hospital Charge Code	3006483
Hospital Revenue Code	301
Min. Negotiated Rate	$3.18
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$26.28
Rate for Payer: Aetna Medicare Advantage	$31.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.87
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: Cigna Medicare Advantage	$9.66
Rate for Payer: Clover Medicare Advantage	$9.18
Rate for Payer: EmblemHealth Commercial	$28.98
Rate for Payer: Humana Medicare Advantage	$9.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.66
Rate for Payer: Wellcare Medicare Advantage	$9.66
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

ACID PHOSPHATASE, PROSTATIC

Facility

$120.00

Service Code	HCPCS 84066
Hospital Charge Code	3006483
Hospital Revenue Code	301
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

ACID PHOSPHATASE,PROSTATIC (PA

Facility

$251.00

Service Code	HCPCS 84066
Hospital Charge Code	38472029
Hospital Revenue Code	301
Min. Negotiated Rate	$37.65
Max. Negotiated Rate	$37.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.65

ACID PHOSPHATASE,PROSTATIC (PA

Facility

$251.00

Service Code	HCPCS 84066
Hospital Charge Code	38472029
Hospital Revenue Code	301
Min. Negotiated Rate	$6.65
Max. Negotiated Rate	$125.50
Rate for Payer: Aetna Commercial	$26.28
Rate for Payer: Aetna Medicare Advantage	$31.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.87
Rate for Payer: Cigna Commercial	$125.50
Rate for Payer: Cigna Medicare Advantage	$9.66
Rate for Payer: Clover Medicare Advantage	$9.18
Rate for Payer: EmblemHealth Commercial	$28.98
Rate for Payer: Humana Medicare Advantage	$9.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.66
Rate for Payer: Wellcare Medicare Advantage	$9.66
Rate for Payer: Wellpoint Medicaid Managed Care	$6.65

Know your out-of-pocket cost for care.

All Charges