Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CH ECHO VIRUS AB

Facility

$155.00

Service Code	HCPCS 86658
Hospital Charge Code	397071477
Hospital Revenue Code	302
Min. Negotiated Rate	$4.11
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$35.44
Rate for Payer: Aetna Medicare Advantage	$42.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.03
Rate for Payer: Cigna Commercial	$77.50
Rate for Payer: Cigna Medicare Advantage	$13.03
Rate for Payer: Clover Medicare Advantage	$12.38
Rate for Payer: EmblemHealth Commercial	$39.09
Rate for Payer: Humana Medicare Advantage	$13.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.03
Rate for Payer: Wellcare Medicare Advantage	$13.03
Rate for Payer: Wellpoint Medicaid Managed Care	$4.11

CH ECHO VIRUS AB

Facility

$155.00

Service Code	HCPCS 86658
Hospital Charge Code	397071477
Hospital Revenue Code	302
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$23.25
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

CHECK FLO ACCESS ADPTR 606002

Facility

$50.00

Hospital Charge Code	270636700C
Hospital Revenue Code	278
Min. Negotiated Rate	$7.50
Max. Negotiated Rate	$12.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50

CHECK FLO ACCESS ADPTR 606002

Facility

$50.00

Hospital Charge Code	270636700C
Hospital Revenue Code	278
Min. Negotiated Rate	$1.21
Max. Negotiated Rate	$25.00
Rate for Payer: Aetna Commercial	$19.00
Rate for Payer: Aetna Medicare Advantage	$15.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.75
Rate for Payer: Cigna Commercial	$25.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.50
Rate for Payer: UnitedHealthcare Community & State	$1.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.32

CHECK FLO ACCESSORY ADAPTOR

Facility

$66.15

Hospital Charge Code	270636700
Hospital Revenue Code	272
Min. Negotiated Rate	$9.92
Max. Negotiated Rate	$9.92
Rate for Payer: Qualcare PPO/HMO/WC	$9.92

CHECK FLO ACCESSORY ADAPTOR

Facility

$66.15

Hospital Charge Code	270636700
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.08
Rate for Payer: Aetna Commercial	$25.14
Rate for Payer: Aetna Medicare Advantage	$19.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.87
Rate for Payer: Cigna Commercial	$33.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.84
Rate for Payer: Oxford Commercial	$13.23
Rate for Payer: Qualcare PPO/HMO/WC	$9.92
Rate for Payer: UnitedHealthcare Commercial	$13.23
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

CHECKPOINT 3.5MM HEX IMPACTION

Facility

$610.00

Hospital Charge Code	270668099
Hospital Revenue Code	272
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.00
Rate for Payer: Oxford Commercial	$122.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$122.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

CHECKPOINT 3.5MM HEX IMPACTION

Facility

$610.00

Hospital Charge Code	270668099
Hospital Revenue Code	272
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

CHECKPOINT HEX 3.5MMX15MM

Facility

$610.00

Hospital Charge Code	270668613
Hospital Revenue Code	272
Min. Negotiated Rate	$14.70
Max. Negotiated Rate	$305.00
Rate for Payer: Aetna Commercial	$231.80
Rate for Payer: Aetna Medicare Advantage	$183.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$155.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$155.55
Rate for Payer: Cigna Commercial	$305.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.00
Rate for Payer: Oxford Commercial	$122.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.50
Rate for Payer: UnitedHealthcare Commercial	$122.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$16.16

CHECKPOINT HEX 3.5MMX15MM

Facility

$610.00

Hospital Charge Code	270668613
Hospital Revenue Code	272
Min. Negotiated Rate	$91.50
Max. Negotiated Rate	$91.50
Rate for Payer: Qualcare PPO/HMO/WC	$91.50

CHECK POINT KIT

Facility

$503.75

Hospital Charge Code	270691180
Hospital Revenue Code	272
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$251.88
Rate for Payer: Aetna Commercial	$191.43
Rate for Payer: Aetna Medicare Advantage	$151.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.46
Rate for Payer: Cigna Commercial	$251.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.12
Rate for Payer: Oxford Commercial	$100.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.56
Rate for Payer: UnitedHealthcare Commercial	$100.75
Rate for Payer: UnitedHealthcare Community & State	$12.14
Rate for Payer: Wellpoint Medicaid Managed Care	$13.35

CHECK POINT KIT

Facility

$503.75

Hospital Charge Code	270691180
Hospital Revenue Code	272
Min. Negotiated Rate	$75.56
Max. Negotiated Rate	$75.56
Rate for Payer: Qualcare PPO/HMO/WC	$75.56

CHECKPOINT KIT

Facility

$503.75

Hospital Charge Code	270690852
Hospital Revenue Code	272
Min. Negotiated Rate	$75.56
Max. Negotiated Rate	$75.56
Rate for Payer: Qualcare PPO/HMO/WC	$75.56

CHECKPOINT KIT

Facility

$503.75

Hospital Charge Code	270668847
Hospital Revenue Code	272
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$251.88
Rate for Payer: Aetna Commercial	$191.43
Rate for Payer: Aetna Medicare Advantage	$151.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.46
Rate for Payer: Cigna Commercial	$251.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.12
Rate for Payer: Oxford Commercial	$100.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.56
Rate for Payer: UnitedHealthcare Commercial	$100.75
Rate for Payer: UnitedHealthcare Community & State	$12.14
Rate for Payer: Wellpoint Medicaid Managed Care	$13.35

CHECKPOINT KIT

Facility

$503.75

Hospital Charge Code	270668847
Hospital Revenue Code	272
Min. Negotiated Rate	$75.56
Max. Negotiated Rate	$75.56
Rate for Payer: Qualcare PPO/HMO/WC	$75.56

CHECKPOINT KIT

Facility

$503.75

Hospital Charge Code	270690852
Hospital Revenue Code	272
Min. Negotiated Rate	$12.14
Max. Negotiated Rate	$251.88
Rate for Payer: Aetna Commercial	$191.43
Rate for Payer: Aetna Medicare Advantage	$151.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.46
Rate for Payer: Cigna Commercial	$251.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.12
Rate for Payer: Oxford Commercial	$100.75
Rate for Payer: Qualcare PPO/HMO/WC	$75.56
Rate for Payer: UnitedHealthcare Commercial	$100.75
Rate for Payer: UnitedHealthcare Community & State	$12.14
Rate for Payer: Wellpoint Medicaid Managed Care	$13.35

CH EFFEXOR/VENLATAXINE

Facility

$260.00

Service Code	HCPCS 80299
Hospital Charge Code	397071359
Hospital Revenue Code	301
Min. Negotiated Rate	$6.89
Max. Negotiated Rate	$130.00
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	$130.00
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	$78.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00
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	$6.89

CH EFFEXOR/VENLATAXINE

Facility

$260.00

Service Code	HCPCS 80299
Hospital Charge Code	397071359
Hospital Revenue Code	301
Min. Negotiated Rate	$39.00
Max. Negotiated Rate	$39.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.00

CH ELECTROLYTE PANEL

Facility

$179.00

Service Code	HCPCS 80051
Hospital Charge Code	397071355
Hospital Revenue Code	301
Min. Negotiated Rate	$26.85
Max. Negotiated Rate	$26.85
Rate for Payer: Qualcare PPO/HMO/WC	$26.85

CH ELECTROLYTE PANEL

Facility

$179.00

Service Code	HCPCS 80051
Hospital Charge Code	397071355
Hospital Revenue Code	301
Min. Negotiated Rate	$4.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$19.07
Rate for Payer: Aetna Medicare Advantage	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.30
Rate for Payer: Cigna Commercial	$89.50
Rate for Payer: Cigna Medicare Advantage	$7.01
Rate for Payer: Clover Medicare Advantage	$6.66
Rate for Payer: EmblemHealth Commercial	$21.03
Rate for Payer: Humana Medicare Advantage	$7.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$7.01
Rate for Payer: Wellcare Medicare Advantage	$7.01
Rate for Payer: Wellpoint Medicaid Managed Care	$4.74

CHEM 6 PROFILE

Facility

$483.60

Service Code	HCPCS 80048
Hospital Charge Code	3004868
Hospital Revenue Code	301
Min. Negotiated Rate	$6.77
Max. Negotiated Rate	$241.80
Rate for Payer: Aetna Commercial	$23.01
Rate for Payer: Aetna Medicare Advantage	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.54
Rate for Payer: Cigna Commercial	$241.80
Rate for Payer: Cigna Medicare Advantage	$8.46
Rate for Payer: Clover Medicare Advantage	$8.04
Rate for Payer: EmblemHealth Commercial	$25.38
Rate for Payer: Humana Medicare Advantage	$8.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.54
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.46
Rate for Payer: Wellcare Medicare Advantage	$8.46
Rate for Payer: Wellpoint Medicaid Managed Care	$12.82

CHEM 6 PROFILE

Facility

$483.60

Service Code	HCPCS 80048
Hospital Charge Code	3004868
Hospital Revenue Code	301
Min. Negotiated Rate	$72.54
Max. Negotiated Rate	$72.54
Rate for Payer: Qualcare PPO/HMO/WC	$72.54

CHEM 7 PROFILE

Facility

$483.60

Service Code	HCPCS 80048
Hospital Charge Code	3004876
Hospital Revenue Code	301
Min. Negotiated Rate	$72.54
Max. Negotiated Rate	$72.54
Rate for Payer: Qualcare PPO/HMO/WC	$72.54

CHEM 7 PROFILE

Facility

$483.60

Service Code	HCPCS 80048
Hospital Charge Code	3004876
Hospital Revenue Code	301
Min. Negotiated Rate	$6.77
Max. Negotiated Rate	$241.80
Rate for Payer: Aetna Commercial	$23.01
Rate for Payer: Aetna Medicare Advantage	$27.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.54
Rate for Payer: Cigna Commercial	$241.80
Rate for Payer: Cigna Medicare Advantage	$8.46
Rate for Payer: Clover Medicare Advantage	$8.04
Rate for Payer: EmblemHealth Commercial	$25.38
Rate for Payer: Humana Medicare Advantage	$8.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.08
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$72.54
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.46
Rate for Payer: Wellcare Medicare Advantage	$8.46
Rate for Payer: Wellpoint Medicaid Managed Care	$12.82

CHEM8+ LACTATE

Facility

$113.65

Service Code	HCPCS 83605
Hospital Charge Code	402083605
Hospital Revenue Code	450
Min. Negotiated Rate	$3.01
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$31.47
Rate for Payer: Aetna Medicare Advantage	$37.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.76
Rate for Payer: Cigna Commercial	$56.83
Rate for Payer: Cigna Medicare Advantage	$11.57
Rate for Payer: Clover Medicare Advantage	$10.99
Rate for Payer: EmblemHealth Commercial	$34.71
Rate for Payer: Humana Medicare Advantage	$11.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.09
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.05
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.57
Rate for Payer: Wellcare Medicare Advantage	$11.57
Rate for Payer: Wellpoint Medicaid Managed Care	$3.01

Know your out-of-pocket cost for care.

All Charges