Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CH ATB PCR

Facility

$846.00

Service Code	HCPCS 87556
Hospital Charge Code	397073664
Hospital Revenue Code	306
Min. Negotiated Rate	$126.90
Max. Negotiated Rate	$126.90
Rate for Payer: Qualcare PPO/HMO/WC	$126.90

CH ATB PCR

Facility

$846.00

Service Code	HCPCS 87556
Hospital Charge Code	397073664
Hospital Revenue Code	306
Min. Negotiated Rate	$22.42
Max. Negotiated Rate	$423.00
Rate for Payer: Aetna Commercial	$113.37
Rate for Payer: Aetna Medicare Advantage	$135.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$150.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$150.45
Rate for Payer: Cigna Commercial	$423.00
Rate for Payer: Cigna Medicare Advantage	$41.68
Rate for Payer: Clover Medicare Advantage	$39.60
Rate for Payer: EmblemHealth Commercial	$125.04
Rate for Payer: Humana Medicare Advantage	$42.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$41.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$253.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$126.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$33.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.68
Rate for Payer: Wellcare Medicare Advantage	$41.68
Rate for Payer: Wellpoint Medicaid Managed Care	$22.42

CH AUST PARROT FEATHERS IGE

Facility

$114.00

Service Code	HCPCS 86003
Hospital Charge Code	397073633
Hospital Revenue Code	305
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

CH AUST PARROT FEATHERS IGE

Facility

$114.00

Service Code	HCPCS 86003
Hospital Charge Code	397073633
Hospital Revenue Code	305
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
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	$18.84
Rate for Payer: Cigna Commercial	$57.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

CH AUTOCONTROL (AHG TEST)

Facility

$81.00

Service Code	HCPCS 86880
Hospital Charge Code	397031058
Hospital Revenue Code	300
Min. Negotiated Rate	$12.15
Max. Negotiated Rate	$12.15
Rate for Payer: Qualcare PPO/HMO/WC	$12.15

CH AUTOCONTROL (AHG TEST)

Facility

$81.00

Service Code	HCPCS 86880
Hospital Charge Code	397031058
Hospital Revenue Code	300
Min. Negotiated Rate	$2.15
Max. Negotiated Rate	$140.48
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	$9.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.46
Rate for Payer: Cigna Commercial	$140.48
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	$24.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.15
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	$2.15

CH BACTERIAL ANTIGENS

Facility

$390.00

Service Code	HCPCS 86403
Hospital Charge Code	397041120
Hospital Revenue Code	302
Min. Negotiated Rate	$9.23
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$31.39
Rate for Payer: Aetna Medicare Advantage	$37.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.66
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.54
Rate for Payer: Clover Medicare Advantage	$10.96
Rate for Payer: EmblemHealth Commercial	$34.62
Rate for Payer: Humana Medicare Advantage	$11.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.54
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	$9.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.54
Rate for Payer: Wellcare Medicare Advantage	$11.54
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CH BACTERIAL ANTIGENS

Facility

$390.00

Service Code	HCPCS 86403
Hospital Charge Code	397041120
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH BACTERIAL CULTURE SPECIAL

Facility

$390.00

Service Code	HCPCS 87070
Hospital Charge Code	397072161
Hospital Revenue Code	306
Min. Negotiated Rate	$6.90
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$23.45
Rate for Payer: Aetna Medicare Advantage	$27.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.12
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.62
Rate for Payer: Clover Medicare Advantage	$8.19
Rate for Payer: EmblemHealth Commercial	$25.86
Rate for Payer: Humana Medicare Advantage	$8.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.62
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	$6.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.62
Rate for Payer: Wellcare Medicare Advantage	$8.62
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CH BACTERIAL CULTURE SPECIAL

Facility

$390.00

Service Code	HCPCS 87070
Hospital Charge Code	397072161
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH BARBITUATE CONF

Facility

$318.00

Service Code	HCPCS 80345
Hospital Charge Code	397073060
Hospital Revenue Code	301
Min. Negotiated Rate	$47.70
Max. Negotiated Rate	$47.70
Rate for Payer: Qualcare PPO/HMO/WC	$47.70

CH BARBITUATE CONF

Facility

$318.00

Service Code	HCPCS 80345
Hospital Charge Code	397073060
Hospital Revenue Code	301
Min. Negotiated Rate	$8.43
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$120.84
Rate for Payer: Aetna Medicare Advantage	$95.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$81.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$81.09
Rate for Payer: Cigna Commercial	$159.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$8.43

CH BARBITURATE DAU

Facility

$44.00

Service Code	HCPCS 80345
Hospital Charge Code	397071278
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	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.17

CH BARBITURATE DAU

Facility

$44.00

Service Code	HCPCS 80345
Hospital Charge Code	397071278
Hospital Revenue Code	301
Min. Negotiated Rate	$6.60
Max. Negotiated Rate	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.60

CH BARBITURATES

Facility

$75.00

Service Code	HCPCS 80345
Hospital Charge Code	397073662
Hospital Revenue Code	301
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

CH BARBITURATES

Facility

$75.00

Service Code	HCPCS 80345
Hospital Charge Code	397073662
Hospital Revenue Code	301
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

CH BCL1 (CYCLIN D1) 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	397061377
Hospital Revenue Code	310
Min. Negotiated Rate	$28.68
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$324.69
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$162.34
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$86.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$28.68

CH BCL1 (CYCLIN D1) 1ST

Facility

$1,082.30

Service Code	HCPCS 88342
Hospital Charge Code	397061377
Hospital Revenue Code	310
Min. Negotiated Rate	$162.34
Max. Negotiated Rate	$162.34
Rate for Payer: Qualcare PPO/HMO/WC	$162.34

CH BCR/ABL CHROMOSOME (FISH)

Facility

$778.00

Service Code	HCPCS 88237
Hospital Charge Code	397073604
Hospital Revenue Code	310
Min. Negotiated Rate	$116.70
Max. Negotiated Rate	$116.70
Rate for Payer: Qualcare PPO/HMO/WC	$116.70

CH BCR/ABL CHROMOSOME (FISH)

Facility

$778.00

Service Code	HCPCS 88237
Hospital Charge Code	397073604
Hospital Revenue Code	310
Min. Negotiated Rate	$20.62
Max. Negotiated Rate	$518.89
Rate for Payer: Aetna Commercial	$391.00
Rate for Payer: Aetna Medicare Advantage	$465.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$518.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$518.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$518.89
Rate for Payer: Cigna Commercial	$389.00
Rate for Payer: Cigna Medicare Advantage	$143.75
Rate for Payer: Clover Medicare Advantage	$136.56
Rate for Payer: EmblemHealth Commercial	$431.25
Rate for Payer: Humana Medicare Advantage	$148.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$143.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.70
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$115.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$143.75
Rate for Payer: Wellcare Medicare Advantage	$143.75
Rate for Payer: Wellpoint Medicaid Managed Care	$20.62

CH BENZENE BLOOD

Facility

$300.00

Service Code	HCPCS 84600
Hospital Charge Code	397073677
Hospital Revenue Code	301
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

CH BENZENE BLOOD

Facility

$300.00

Service Code	HCPCS 84600
Hospital Charge Code	397073677
Hospital Revenue Code	301
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.76
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

CH BENZETROPINE

Facility

$492.00

Service Code	HCPCS 80299
Hospital Charge Code	397072033
Hospital Revenue Code	301
Min. Negotiated Rate	$11.64
Max. Negotiated Rate	$246.00
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	$246.00
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	$147.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.80
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	$13.04

CH BENZETROPINE

Facility

$492.00

Service Code	HCPCS 80299
Hospital Charge Code	397072033
Hospital Revenue Code	301
Min. Negotiated Rate	$73.80
Max. Negotiated Rate	$73.80
Rate for Payer: Qualcare PPO/HMO/WC	$73.80

CH BENZODIAZEPINE CONF GC/MS

Facility

$233.00

Service Code	HCPCS 80346
Hospital Charge Code	397073061
Hospital Revenue Code	301
Min. Negotiated Rate	$6.17
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$88.54
Rate for Payer: Aetna Medicare Advantage	$69.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.41
Rate for Payer: Cigna Commercial	$116.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$20.96
Rate for Payer: Wellpoint Medicaid Managed Care	$6.17

Know your out-of-pocket cost for care.

All Charges