Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

Cat RX

Facility

$9,700.00

Hospital Charge Code	270685892
Hospital Revenue Code	272
Min. Negotiated Rate	$1,455.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,455.00

Cat RX

Facility

$9,700.00

Hospital Charge Code	270685892N
Hospital Revenue Code	272
Min. Negotiated Rate	$233.77
Max. Negotiated Rate	$4,850.00
Rate for Payer: Aetna Commercial	$3,686.00
Rate for Payer: Aetna Medicare Advantage	$2,910.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,473.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,473.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,473.50
Rate for Payer: Cigna Commercial	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,910.00
Rate for Payer: Oxford Commercial	$1,940.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,455.00
Rate for Payer: UnitedHealthcare Commercial	$1,940.00
Rate for Payer: UnitedHealthcare Community & State	$233.77
Rate for Payer: Wellpoint Medicaid Managed Care	$257.05

CAT RX

Facility

$9,700.00

Hospital Charge Code	270685892S
Hospital Revenue Code	272
Min. Negotiated Rate	$1,455.00
Max. Negotiated Rate	$1,455.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,455.00

CAT RX

Facility

$9,700.00

Hospital Charge Code	270685892S
Hospital Revenue Code	272
Min. Negotiated Rate	$233.77
Max. Negotiated Rate	$4,850.00
Rate for Payer: Aetna Commercial	$3,686.00
Rate for Payer: Aetna Medicare Advantage	$2,910.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,473.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,473.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,473.50
Rate for Payer: Cigna Commercial	$4,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,910.00
Rate for Payer: Oxford Commercial	$1,940.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,455.00
Rate for Payer: UnitedHealthcare Commercial	$1,940.00
Rate for Payer: UnitedHealthcare Community & State	$233.77
Rate for Payer: Wellpoint Medicaid Managed Care	$257.05

CAT SCRATCH DISEASE AB PA I

Facility

$82.85

Service Code	HCPCS 8625591
Hospital Charge Code	39990028A
Hospital Revenue Code	302
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.48
Rate for Payer: Aetna Medicare Advantage	$24.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.13
Rate for Payer: Cigna Commercial	$41.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.43
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.20

CAT SCRATCH DISEASE AB PA I

Facility

$82.85

Service Code	HCPCS 8625591
Hospital Charge Code	39990028A
Hospital Revenue Code	302
Min. Negotiated Rate	$12.43
Max. Negotiated Rate	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$12.43

CAT SCRATCH DISEASE AB PA II

Facility

$82.85

Service Code	HCPCS 8625591
Hospital Charge Code	39990028B
Hospital Revenue Code	302
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.48
Rate for Payer: Aetna Medicare Advantage	$24.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.13
Rate for Payer: Cigna Commercial	$41.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.43
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.20

CAT SCRATCH DISEASE AB PA II

Facility

$82.85

Service Code	HCPCS 8625591
Hospital Charge Code	39990028B
Hospital Revenue Code	302
Min. Negotiated Rate	$12.43
Max. Negotiated Rate	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$12.43

CAT SCRATCH DISEASE AB PA III

Facility

$82.85

Service Code	HCPCS 8625591
Hospital Charge Code	39990028C
Hospital Revenue Code	302
Min. Negotiated Rate	$12.43
Max. Negotiated Rate	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$12.43

CAT SCRATCH DISEASE AB PA III

Facility

$82.85

Service Code	HCPCS 8625591
Hospital Charge Code	39990028C
Hospital Revenue Code	302
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.48
Rate for Payer: Aetna Medicare Advantage	$24.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.13
Rate for Payer: Cigna Commercial	$41.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.43
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.20

CAT SCRATCH DISEASE AB PA IV

Facility

$82.85

Service Code	HCPCS 8625591
Hospital Charge Code	39990028D
Hospital Revenue Code	302
Min. Negotiated Rate	$12.43
Max. Negotiated Rate	$12.43
Rate for Payer: Qualcare PPO/HMO/WC	$12.43

CAT SCRATCH DISEASE AB PA IV

Facility

$82.85

Service Code	HCPCS 8625591
Hospital Charge Code	39990028D
Hospital Revenue Code	302
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.48
Rate for Payer: Aetna Medicare Advantage	$24.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.13
Rate for Payer: Cigna Commercial	$41.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.86
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.43
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.20

CAT SCRATCH DISEASE AB PA V

Facility

$69.95

Service Code	HCPCS 8661191
Hospital Charge Code	39990028E
Hospital Revenue Code	302
Min. Negotiated Rate	$10.49
Max. Negotiated Rate	$10.49
Rate for Payer: Qualcare PPO/HMO/WC	$10.49

CAT SCRATCH DISEASE AB PA V

Facility

$69.95

Service Code	HCPCS 8661191
Hospital Charge Code	39990028E
Hospital Revenue Code	302
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$26.58
Rate for Payer: Aetna Medicare Advantage	$20.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.84
Rate for Payer: Cigna Commercial	$34.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

CAT SCRATCH DISEASE AB PA VI

Facility

$69.95

Service Code	HCPCS 8661191
Hospital Charge Code	39990028F
Hospital Revenue Code	302
Min. Negotiated Rate	$10.49
Max. Negotiated Rate	$10.49
Rate for Payer: Qualcare PPO/HMO/WC	$10.49

CAT SCRATCH DISEASE AB PA VI

Facility

$69.95

Service Code	HCPCS 8661191
Hospital Charge Code	39990028F
Hospital Revenue Code	302
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$26.58
Rate for Payer: Aetna Medicare Advantage	$20.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.84
Rate for Payer: Cigna Commercial	$34.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

CAT SCRATCH DISEASE AB PA VII

Facility

$69.95

Service Code	HCPCS 8661191
Hospital Charge Code	39990028G
Hospital Revenue Code	302
Min. Negotiated Rate	$10.49
Max. Negotiated Rate	$10.49
Rate for Payer: Qualcare PPO/HMO/WC	$10.49

CAT SCRATCH DISEASE AB PA VII

Facility

$69.95

Service Code	HCPCS 8661191
Hospital Charge Code	39990028G
Hospital Revenue Code	302
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$26.58
Rate for Payer: Aetna Medicare Advantage	$20.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.84
Rate for Payer: Cigna Commercial	$34.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

CAT SCRATCH DISEASE AB PA VIII

Facility

$69.95

Service Code	HCPCS 8661191
Hospital Charge Code	39990028H
Hospital Revenue Code	302
Min. Negotiated Rate	$10.49
Max. Negotiated Rate	$10.49
Rate for Payer: Qualcare PPO/HMO/WC	$10.49

CAT SCRATCH DISEASE AB PA VIII

Facility

$69.95

Service Code	HCPCS 8661191
Hospital Charge Code	39990028H
Hospital Revenue Code	302
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$26.58
Rate for Payer: Aetna Medicare Advantage	$20.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.84
Rate for Payer: Cigna Commercial	$34.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.85

CAT SCRATCH FEVER ANTIBODY

Facility

$100.00

Service Code	HCPCS 86609
Hospital Charge Code	3009305
Hospital Revenue Code	302
Min. Negotiated Rate	$2.65
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.49
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

CAT SCRATCH FEVER ANTIBODY

Facility

$100.00

Service Code	HCPCS 86609
Hospital Charge Code	3009305
Hospital Revenue Code	302
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

CA URINE QUANT TIMED

Facility

$390.00

Service Code	HCPCS 82340
Hospital Charge Code	39990241B
Hospital Revenue Code	301
Min. Negotiated Rate	$4.82
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$16.40
Rate for Payer: Aetna Medicare Advantage	$19.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.77
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.03
Rate for Payer: Clover Medicare Advantage	$5.73
Rate for Payer: EmblemHealth Commercial	$18.09
Rate for Payer: Humana Medicare Advantage	$6.21
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.03
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	$4.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.03
Rate for Payer: Wellcare Medicare Advantage	$6.03
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CA URINE QUANT TIMED

Facility

$390.00

Service Code	HCPCS 82340
Hospital Charge Code	39990241B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CAUT AC-TEMP FINE TIP 8442000

Facility

$386.95

Hospital Charge Code	270635128
Hospital Revenue Code	272
Min. Negotiated Rate	$58.04
Max. Negotiated Rate	$58.04
Rate for Payer: Qualcare PPO/HMO/WC	$58.04

Know your out-of-pocket cost for care.

All Charges