Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ACTIVE WOUND 20 CM OR LES

Facility

$411.00

Service Code	HCPCS 97597
Hospital Charge Code	94186085
Hospital Revenue Code	361
Min. Negotiated Rate	$61.65
Max. Negotiated Rate	$61.65
Rate for Payer: Qualcare PPO/HMO/WC	$61.65

ACTIVITY THERAPY

Facility

$165.80

Hospital Charge Code	50010
Hospital Revenue Code	904
Min. Negotiated Rate	$24.87
Max. Negotiated Rate	$24.87
Rate for Payer: Qualcare PPO/HMO/WC	$24.87

ACTIVITY THERAPY

Facility

$165.80

Hospital Charge Code	50010
Hospital Revenue Code	904
Min. Negotiated Rate	$4.00
Max. Negotiated Rate	$82.90
Rate for Payer: Aetna Commercial	$63.00
Rate for Payer: Aetna Medicare Advantage	$49.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.28
Rate for Payer: Cigna Commercial	$82.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.74
Rate for Payer: Qualcare PPO/HMO/WC	$24.87
Rate for Payer: UnitedHealthcare Community & State	$4.00
Rate for Payer: Wellpoint Medicaid Managed Care	$4.39

ACTONEL 35MG

Facility

$27.00

Hospital Charge Code	60635501
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

ACTONEL 35MG

Facility

$27.00

Hospital Charge Code	60635501
Hospital Revenue Code	250
Min. Negotiated Rate	$0.65
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$10.26
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.10
Rate for Payer: Oxford Commercial	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$5.40
Rate for Payer: UnitedHealthcare Community & State	$0.65
Rate for Payer: Wellpoint Medicaid Managed Care	$0.72

ACTONEL 35MG TAB

Facility

$7.00

Hospital Charge Code	60635519
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

ACTONEL 35MG TAB

Facility

$7.00

Hospital Charge Code	60635519
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

ACTONEL 5MG TAB

Facility

$3.00

Hospital Charge Code	60635400
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

ACTONEL 5MG TAB

Facility

$3.00

Hospital Charge Code	60635400
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ACULOC 2 STANDARD LONG PLATE R

Facility

$5,750.00

Hospital Charge Code	270656022
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

ACULOC 2 STANDARD LONG PLATE R

Facility

$5,750.00

Hospital Charge Code	270656022
Hospital Revenue Code	278
Min. Negotiated Rate	$138.57
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,265.00
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Community & State	$138.57
Rate for Payer: Wellpoint Medicaid Managed Care	$152.38

ACULOC2-VNR-NARROW LONG PLT.

Facility

$6,335.00

Hospital Charge Code	270656021
Hospital Revenue Code	278
Min. Negotiated Rate	$950.25
Max. Negotiated Rate	$1,533.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,267.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,533.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,393.70
Rate for Payer: Qualcare PPO/HMO/WC	$950.25

ACULOC2-VNR-NARROW LONG PLT.

Facility

$6,335.00

Hospital Charge Code	270656021
Hospital Revenue Code	278
Min. Negotiated Rate	$152.67
Max. Negotiated Rate	$3,167.50
Rate for Payer: Aetna Commercial	$2,407.30
Rate for Payer: Aetna Medicare Advantage	$1,900.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,615.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,615.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,615.42
Rate for Payer: Cigna Commercial	$3,167.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,533.07
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,393.70
Rate for Payer: Qualcare PPO/HMO/WC	$950.25
Rate for Payer: UnitedHealthcare Community & State	$152.67
Rate for Payer: Wellpoint Medicaid Managed Care	$167.88

ACUMATCH XLE LINER SZ G 32MM

Facility

$19,310.00

Service Code	HCPCS C1776
Hospital Charge Code	270691337
Hospital Revenue Code	278
Min. Negotiated Rate	$465.37
Max. Negotiated Rate	$9,655.00
Rate for Payer: Aetna Commercial	$7,337.80
Rate for Payer: Aetna Medicare Advantage	$5,793.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,924.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,924.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,924.05
Rate for Payer: Cigna Commercial	$9,655.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,673.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,248.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,896.50
Rate for Payer: UnitedHealthcare Community & State	$465.37
Rate for Payer: Wellpoint Medicaid Managed Care	$511.71

ACUMATCH XLE LINER SZ G 32MM

Facility

$19,310.00

Service Code	HCPCS C1776
Hospital Charge Code	270691337
Hospital Revenue Code	278
Min. Negotiated Rate	$2,896.50
Max. Negotiated Rate	$4,673.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,862.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,673.02
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,248.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,896.50

ACUPAC ADVANCED ALLOGRFT 2.5CC

Facility

$10,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270696752
Hospital Revenue Code	278
Min. Negotiated Rate	$256.06
Max. Negotiated Rate	$5,312.50
Rate for Payer: Aetna Commercial	$4,037.50
Rate for Payer: Aetna Medicare Advantage	$3,187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,709.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,709.38
Rate for Payer: Cigna Commercial	$5,312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,337.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75
Rate for Payer: UnitedHealthcare Community & State	$256.06
Rate for Payer: Wellpoint Medicaid Managed Care	$281.56

ACUPAC ADVANCED ALLOGRFT 2.5CC

Facility

$10,625.00

Service Code	HCPCS C1713
Hospital Charge Code	270696752
Hospital Revenue Code	278
Min. Negotiated Rate	$1,593.75
Max. Negotiated Rate	$2,571.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,571.25
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,337.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,593.75

ACUSNARE POLYPECTOMY

Facility

$58.00

Hospital Charge Code	270325601
Hospital Revenue Code	272
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$29.00
Rate for Payer: Aetna Commercial	$22.04
Rate for Payer: Aetna Medicare Advantage	$17.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.79
Rate for Payer: Cigna Commercial	$29.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.40
Rate for Payer: Oxford Commercial	$11.60
Rate for Payer: Qualcare PPO/HMO/WC	$8.70
Rate for Payer: UnitedHealthcare Commercial	$11.60
Rate for Payer: UnitedHealthcare Community & State	$1.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1.54

ACUSNARE POLYPECTOMY

Facility

$58.00

Hospital Charge Code	270325601
Hospital Revenue Code	272
Min. Negotiated Rate	$8.70
Max. Negotiated Rate	$8.70
Rate for Payer: Qualcare PPO/HMO/WC	$8.70

ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION

Facility

$33,169.31

Service Code	MSDRG 880
Min. Negotiated Rate	$3,330.00
Max. Negotiated Rate	$33,169.31
Rate for Payer: Aetna Commercial	$23,048.42
Rate for Payer: Aetna Medicare Advantage	$33,169.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,097.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,606.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,097.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$10,631.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,606.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,097.95
Rate for Payer: Cigna Commercial	$17,969.18
Rate for Payer: Cigna Medicare Advantage	$10,631.19
Rate for Payer: Clover Medicare Advantage	$10,099.63
Rate for Payer: EmblemHealth Commercial	$31,893.57
Rate for Payer: Humana Medicare Advantage	$10,950.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$10,631.19
Rate for Payer: Oxford Commercial	$12,914.69
Rate for Payer: UnitedHealthcare Commercial	$22,646.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$10,631.19
Rate for Payer: Wellcare Medicare Advantage	$10,631.19

ACUTE AND SUBACUTE ENDOCARDITIS

Facility

$9,690.20

Service Code	APR-DRG 1931
Min. Negotiated Rate	$9,500.20
Max. Negotiated Rate	$9,690.20
Rate for Payer: UnitedHealthcare Community & State	$9,500.20
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,690.20
Rate for Payer: Wellpoint Medicaid Managed Care	$9,500.20

ACUTE AND SUBACUTE ENDOCARDITIS

Facility

$27,469.70

Service Code	APR-DRG 1934
Min. Negotiated Rate	$26,931.08
Max. Negotiated Rate	$27,469.70
Rate for Payer: UnitedHealthcare Community & State	$26,931.08
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$27,469.70
Rate for Payer: Wellpoint Medicaid Managed Care	$26,931.08

ACUTE AND SUBACUTE ENDOCARDITIS

Facility

$17,922.44

Service Code	APR-DRG 1933
Min. Negotiated Rate	$17,571.02
Max. Negotiated Rate	$17,922.44
Rate for Payer: UnitedHealthcare Community & State	$17,571.02
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$17,922.44
Rate for Payer: Wellpoint Medicaid Managed Care	$17,571.02

ACUTE AND SUBACUTE ENDOCARDITIS

Facility

$13,414.38

Service Code	APR-DRG 1932
Min. Negotiated Rate	$13,151.35
Max. Negotiated Rate	$13,414.38
Rate for Payer: UnitedHealthcare Community & State	$13,151.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$13,414.38
Rate for Payer: Wellpoint Medicaid Managed Care	$13,151.35

ACUTE AND SUBACUTE ENDOCARDITIS WITH CC

Facility

$57,303.92

Service Code	MSDRG 289
Min. Negotiated Rate	$17,448.31
Max. Negotiated Rate	$57,303.92
Rate for Payer: Aetna Commercial	$39,631.64
Rate for Payer: Aetna Medicare Advantage	$57,303.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,426.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,366.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,426.28
Rate for Payer: Cigna Commercial	$31,942.93
Rate for Payer: Cigna Medicare Advantage	$18,366.64
Rate for Payer: Clover Medicare Advantage	$17,448.31
Rate for Payer: EmblemHealth Commercial	$55,099.92
Rate for Payer: Humana Medicare Advantage	$18,917.64
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,366.64
Rate for Payer: Oxford Commercial	$22,957.81
Rate for Payer: UnitedHealthcare Commercial	$40,257.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,366.64
Rate for Payer: Wellcare Medicare Advantage	$18,366.64

Know your out-of-pocket cost for care.

All Charges