Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CH AMINO ACIDS

Facility

$105.00

Service Code	HCPCS 82139
Hospital Charge Code	397073251
Hospital Revenue Code	301
Min. Negotiated Rate	$2.78
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.89
Rate for Payer: Aetna Medicare Advantage	$54.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.90
Rate for Payer: Cigna Commercial	$52.50
Rate for Payer: Cigna Medicare Advantage	$16.87
Rate for Payer: Clover Medicare Advantage	$16.03
Rate for Payer: EmblemHealth Commercial	$50.61
Rate for Payer: Humana Medicare Advantage	$17.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.87
Rate for Payer: Wellcare Medicare Advantage	$16.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.78

CH AMINO ACID URINE SCR

Facility

$180.00

Service Code	HCPCS 82128
Hospital Charge Code	397071238
Hospital Revenue Code	301
Min. Negotiated Rate	$4.77
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$37.73
Rate for Payer: Aetna Medicare Advantage	$44.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$28.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.07
Rate for Payer: Cigna Commercial	$90.00
Rate for Payer: Cigna Medicare Advantage	$13.87
Rate for Payer: Clover Medicare Advantage	$13.18
Rate for Payer: EmblemHealth Commercial	$41.61
Rate for Payer: Humana Medicare Advantage	$14.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.87
Rate for Payer: Wellcare Medicare Advantage	$13.87
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

CH AMINO ACID URINE SCR

Facility

$180.00

Service Code	HCPCS 82128
Hospital Charge Code	397071238
Hospital Revenue Code	301
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

CH AMINODARONE

Facility

$89.00

Service Code	HCPCS 80299
Hospital Charge Code	397072027
Hospital Revenue Code	301
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.28
Rate for Payer: Cigna Commercial	$44.50
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

CH AMINODARONE

Facility

$89.00

Service Code	HCPCS 80299
Hospital Charge Code	397072027
Hospital Revenue Code	301
Min. Negotiated Rate	$13.35
Max. Negotiated Rate	$13.35
Rate for Payer: Qualcare PPO/HMO/WC	$13.35

CH AMINOLEVULINIC ACID 24HR

Facility

$278.00

Service Code	HCPCS 82135
Hospital Charge Code	397071330
Hospital Revenue Code	301
Min. Negotiated Rate	$7.37
Max. Negotiated Rate	$139.00
Rate for Payer: Aetna Commercial	$44.74
Rate for Payer: Aetna Medicare Advantage	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.38
Rate for Payer: Cigna Commercial	$139.00
Rate for Payer: Cigna Medicare Advantage	$16.45
Rate for Payer: Clover Medicare Advantage	$15.63
Rate for Payer: EmblemHealth Commercial	$49.35
Rate for Payer: Humana Medicare Advantage	$16.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$41.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.45
Rate for Payer: Wellcare Medicare Advantage	$16.45
Rate for Payer: Wellpoint Medicaid Managed Care	$7.37

CH AMINOLEVULINIC ACID 24HR

Facility

$278.00

Service Code	HCPCS 82135
Hospital Charge Code	397071330
Hospital Revenue Code	301
Min. Negotiated Rate	$41.70
Max. Negotiated Rate	$41.70
Rate for Payer: Qualcare PPO/HMO/WC	$41.70

CH AMINOLEVULINIC ACID RANDM

Facility

$229.00

Service Code	HCPCS 82135
Hospital Charge Code	397073165
Hospital Revenue Code	301
Min. Negotiated Rate	$6.07
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$44.74
Rate for Payer: Aetna Medicare Advantage	$53.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.38
Rate for Payer: Cigna Commercial	$114.50
Rate for Payer: Cigna Medicare Advantage	$16.45
Rate for Payer: Clover Medicare Advantage	$15.63
Rate for Payer: EmblemHealth Commercial	$49.35
Rate for Payer: Humana Medicare Advantage	$16.94
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.16
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.45
Rate for Payer: Wellcare Medicare Advantage	$16.45
Rate for Payer: Wellpoint Medicaid Managed Care	$6.07

CH AMINOLEVULINIC ACID RANDM

Facility

$229.00

Service Code	HCPCS 82135
Hospital Charge Code	397073165
Hospital Revenue Code	301
Min. Negotiated Rate	$34.35
Max. Negotiated Rate	$34.35
Rate for Payer: Qualcare PPO/HMO/WC	$34.35

CH AMITRIP/NORTRIP

Facility

$150.00

Service Code	HCPCS 80335
Hospital Charge Code	397071234
Hospital Revenue Code	301
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

CH AMITRIP/NORTRIP

Facility

$150.00

Service Code	HCPCS 80335
Hospital Charge Code	397071234
Hospital Revenue Code	301
Min. Negotiated Rate	$3.98
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

CH AMITRIPTYLINE & METABOLTE

Facility

$67.00

Service Code	HCPCS 88152
Hospital Charge Code	397071394
Hospital Revenue Code	311
Min. Negotiated Rate	$10.05
Max. Negotiated Rate	$10.05
Rate for Payer: Qualcare PPO/HMO/WC	$10.05

CH AMITRIPTYLINE & METABOLTE

Facility

$67.00

Service Code	HCPCS 88152
Hospital Charge Code	397071394
Hospital Revenue Code	311
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$75.18
Rate for Payer: Aetna Medicare Advantage	$89.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.77
Rate for Payer: Cigna Commercial	$33.50
Rate for Payer: Cigna Medicare Advantage	$27.64
Rate for Payer: Clover Medicare Advantage	$26.26
Rate for Payer: EmblemHealth Commercial	$82.92
Rate for Payer: Humana Medicare Advantage	$28.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.05
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$22.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.64
Rate for Payer: Wellcare Medicare Advantage	$27.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

CH AMMONIA

Facility

$90.00

Service Code	HCPCS 82140
Hospital Charge Code	397071137
Hospital Revenue Code	301
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.63
Rate for Payer: Aetna Medicare Advantage	$47.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.57
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	$52.59
Rate for Payer: Cigna Commercial	$45.00
Rate for Payer: Cigna Medicare Advantage	$14.57
Rate for Payer: Clover Medicare Advantage	$13.84
Rate for Payer: EmblemHealth Commercial	$43.71
Rate for Payer: Humana Medicare Advantage	$15.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.57
Rate for Payer: Wellcare Medicare Advantage	$14.57
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

CH AMMONIA

Facility

$90.00

Service Code	HCPCS 82140
Hospital Charge Code	397071137
Hospital Revenue Code	301
Min. Negotiated Rate	$13.50
Max. Negotiated Rate	$13.50
Rate for Payer: Qualcare PPO/HMO/WC	$13.50

CH AMPHETAMINE CONF

Facility

$695.00

Service Code	HCPCS 80300
Hospital Charge Code	397073155
Hospital Revenue Code	301
Min. Negotiated Rate	$16.75
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$264.10
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$208.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.75
Rate for Payer: Wellpoint Medicaid Managed Care	$18.42

CH AMPHETAMINE CONF

Facility

$695.00

Service Code	HCPCS 80300
Hospital Charge Code	397073155
Hospital Revenue Code	301
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$104.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

CH AMPHETAMINE DAU

Facility

$44.00

Service Code	HCPCS 80324
Hospital Charge Code	397071271
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

CH AMPHETAMINE DAU

Facility

$44.00

Service Code	HCPCS 80324
Hospital Charge Code	397071271
Hospital Revenue Code	301
Min. Negotiated Rate	$1.17
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$16.72
Rate for Payer: Aetna Medicare Advantage	$13.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.22
Rate for Payer: Cigna Commercial	$22.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

CH AMPLIFICATION

Facility

$162.00

Service Code	HCPCS 83901
Hospital Charge Code	397073563
Hospital Revenue Code	301
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$61.56
Rate for Payer: Aetna Medicare Advantage	$48.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.31
Rate for Payer: Cigna Commercial	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.29

CH AMPLIFICATION

Facility

$162.00

Service Code	HCPCS 83901
Hospital Charge Code	397073563
Hospital Revenue Code	301
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$24.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

CH AMPLIFICATION X5

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073573
Hospital Revenue Code	301
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

CH AMPLIFICATION X5

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073573
Hospital Revenue Code	301
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

CH AMYLASE

Facility

$137.00

Service Code	HCPCS 82150
Hospital Charge Code	397071045
Hospital Revenue Code	301
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$17.63
Rate for Payer: Aetna Medicare Advantage	$21.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.39
Rate for Payer: Cigna Commercial	$68.50
Rate for Payer: Cigna Medicare Advantage	$6.48
Rate for Payer: Clover Medicare Advantage	$6.16
Rate for Payer: EmblemHealth Commercial	$19.44
Rate for Payer: Humana Medicare Advantage	$6.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.48
Rate for Payer: Wellcare Medicare Advantage	$6.48
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

CH AMYLASE

Facility

$137.00

Service Code	HCPCS 82150
Hospital Charge Code	397071045
Hospital Revenue Code	301
Min. Negotiated Rate	$20.55
Max. Negotiated Rate	$20.55
Rate for Payer: Qualcare PPO/HMO/WC	$20.55

Know your out-of-pocket cost for care.

All Charges