Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CHEMO, IV PUSH, SNGL DRUG

Facility

$584.75

Service Code	HCPCS 96409
Hospital Charge Code	3401090
Hospital Revenue Code	331
Min. Negotiated Rate	$14.09
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,067.36
Rate for Payer: Aetna Medicare Advantage	$1,271.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,416.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,416.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$392.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,416.48
Rate for Payer: Cigna Commercial	$786.58
Rate for Payer: Cigna Medicare Advantage	$274.69
Rate for Payer: Clover Medicare Advantage	$372.79
Rate for Payer: EmblemHealth Commercial	$1,177.23
Rate for Payer: Humana Medicare Advantage	$404.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$392.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.43
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.71
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$14.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$392.41
Rate for Payer: Wellcare Medicare Advantage	$392.41
Rate for Payer: Wellpoint Medicaid Managed Care	$15.50

CHEMO MULTI PREMIX****

Facility

$194.40

Service Code	HCPCS Q0083
Hospital Charge Code	3400157
Hospital Revenue Code	289
Min. Negotiated Rate	$4.69
Max. Negotiated Rate	$2,789.00
Rate for Payer: Aetna Commercial	$73.87
Rate for Payer: Aetna Medicare Advantage	$58.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.57
Rate for Payer: Cigna Commercial	$97.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.32
Rate for Payer: Oxford Commercial	$1,591.00
Rate for Payer: Qualcare PPO/HMO/WC	$29.16
Rate for Payer: UnitedHealthcare Commercial	$2,789.00
Rate for Payer: UnitedHealthcare Community & State	$4.69
Rate for Payer: Wellpoint Medicaid Managed Care	$5.15

CHEMO MULTI PREMIX****

Facility

$194.40

Service Code	HCPCS Q0083
Hospital Charge Code	3400157
Hospital Revenue Code	289
Min. Negotiated Rate	$29.16
Max. Negotiated Rate	$29.16
Rate for Payer: Qualcare PPO/HMO/WC	$29.16

CHEMO NEW PATIENT VISIT

Facility

$428.58

Service Code	HCPCS 99202
Hospital Charge Code	3408035
Hospital Revenue Code	510
Min. Negotiated Rate	$64.29
Max. Negotiated Rate	$64.29
Rate for Payer: Qualcare PPO/HMO/WC	$64.29

CHEMO NEW PATIENT VISIT

Facility

$428.58

Service Code	HCPCS 99202
Hospital Charge Code	3408035
Hospital Revenue Code	510
Min. Negotiated Rate	$10.33
Max. Negotiated Rate	$214.29
Rate for Payer: Aetna Commercial	$162.86
Rate for Payer: Aetna Medicare Advantage	$128.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$109.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$109.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$109.29
Rate for Payer: Cigna Commercial	$214.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$128.57
Rate for Payer: Qualcare PPO/HMO/WC	$64.29
Rate for Payer: UnitedHealthcare Community & State	$10.33
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

CHEMOTHERAPY FOR ACUTE LEUKEMIA

Facility

$7,453.45

Service Code	APR-DRG 6951
Min. Negotiated Rate	$7,307.30
Max. Negotiated Rate	$7,453.45
Rate for Payer: UnitedHealthcare Community & State	$7,307.30
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,453.45
Rate for Payer: Wellpoint Medicaid Managed Care	$7,307.30

CHEMOTHERAPY FOR ACUTE LEUKEMIA

Facility

$9,637.86

Service Code	APR-DRG 6952
Min. Negotiated Rate	$9,448.88
Max. Negotiated Rate	$9,637.86
Rate for Payer: UnitedHealthcare Community & State	$9,448.88
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,637.86
Rate for Payer: Wellpoint Medicaid Managed Care	$9,448.88

CHEMOTHERAPY FOR ACUTE LEUKEMIA

Facility

$18,683.36

Service Code	APR-DRG 6953
Min. Negotiated Rate	$18,317.02
Max. Negotiated Rate	$18,683.36
Rate for Payer: UnitedHealthcare Community & State	$18,317.02
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,683.36
Rate for Payer: Wellpoint Medicaid Managed Care	$18,317.02

CHEMOTHERAPY FOR ACUTE LEUKEMIA

Facility

$59,185.72

Service Code	APR-DRG 6954
Min. Negotiated Rate	$58,025.22
Max. Negotiated Rate	$59,185.72
Rate for Payer: UnitedHealthcare Community & State	$58,025.22
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$59,185.72
Rate for Payer: Wellpoint Medicaid Managed Care	$58,025.22

CHEMOTHERAPY INTRACAVITARY

Facility

$1,292.25

Service Code	HCPCS 96446
Hospital Charge Code	3401106
Hospital Revenue Code	331
Min. Negotiated Rate	$31.14
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$1,067.36
Rate for Payer: Aetna Medicare Advantage	$1,271.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,416.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,416.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$392.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,416.48
Rate for Payer: Cigna Commercial	$786.58
Rate for Payer: Cigna Medicare Advantage	$274.69
Rate for Payer: Clover Medicare Advantage	$372.79
Rate for Payer: EmblemHealth Commercial	$1,177.23
Rate for Payer: Humana Medicare Advantage	$404.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$392.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$387.68
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$193.84
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$31.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$392.41
Rate for Payer: Wellcare Medicare Advantage	$392.41
Rate for Payer: Wellpoint Medicaid Managed Care	$34.24

CHEMOTHERAPY INTRACAVITARY

Facility

$1,292.25

Service Code	HCPCS 96446
Hospital Charge Code	3401106
Hospital Revenue Code	331
Min. Negotiated Rate	$193.84
Max. Negotiated Rate	$193.84
Rate for Payer: Qualcare PPO/HMO/WC	$193.84

CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC

Facility

$157,416.98

Service Code	MSDRG 837
Min. Negotiated Rate	$47,931.45
Max. Negotiated Rate	$157,416.98
Rate for Payer: Aetna Commercial	$108,420.73
Rate for Payer: Aetna Medicare Advantage	$157,416.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$112,583.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$112,583.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$50,454.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$112,583.24
Rate for Payer: Cigna Commercial	$89,907.67
Rate for Payer: Cigna Medicare Advantage	$50,454.16
Rate for Payer: Clover Medicare Advantage	$47,931.45
Rate for Payer: EmblemHealth Commercial	$151,362.48
Rate for Payer: Humana Medicare Advantage	$51,967.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$50,454.16
Rate for Payer: Oxford Commercial	$64,617.83
Rate for Payer: UnitedHealthcare Commercial	$113,309.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$50,454.16
Rate for Payer: Wellcare Medicare Advantage	$50,454.16

CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT

Facility

$69,602.30

Service Code	MSDRG 838
Min. Negotiated Rate	$21,193.01
Max. Negotiated Rate	$69,602.30
Rate for Payer: Aetna Commercial	$48,082.05
Rate for Payer: Aetna Medicare Advantage	$69,602.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46,522.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46,522.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22,308.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46,522.00
Rate for Payer: Cigna Commercial	$39,063.60
Rate for Payer: Cigna Medicare Advantage	$22,308.43
Rate for Payer: Clover Medicare Advantage	$21,193.01
Rate for Payer: EmblemHealth Commercial	$66,925.29
Rate for Payer: Humana Medicare Advantage	$22,977.68
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22,308.43
Rate for Payer: Oxford Commercial	$28,075.53
Rate for Payer: UnitedHealthcare Commercial	$49,231.33
Rate for Payer: UnitedHealthcare Medicare Advantage	$22,308.43
Rate for Payer: Wellcare Medicare Advantage	$22,308.43

CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC

Facility

$48,803.35

Service Code	MSDRG 839
Min. Negotiated Rate	$14,860.00
Max. Negotiated Rate	$48,803.35
Rate for Payer: Aetna Commercial	$33,790.78
Rate for Payer: Aetna Medicare Advantage	$48,803.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,642.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,239.30
Rate for Payer: Cigna Commercial	$27,021.14
Rate for Payer: Cigna Medicare Advantage	$15,642.10
Rate for Payer: Clover Medicare Advantage	$14,860.00
Rate for Payer: EmblemHealth Commercial	$46,926.30
Rate for Payer: Humana Medicare Advantage	$16,111.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,642.10
Rate for Payer: Oxford Commercial	$19,420.46
Rate for Payer: UnitedHealthcare Commercial	$34,054.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,642.10
Rate for Payer: Wellcare Medicare Advantage	$15,642.10

CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC

Facility

$44,417.29

Service Code	MSDRG 847
Min. Negotiated Rate	$13,524.49
Max. Negotiated Rate	$44,417.29
Rate for Payer: Aetna Commercial	$30,777.06
Rate for Payer: Aetna Medicare Advantage	$44,417.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28,145.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28,145.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,236.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28,145.81
Rate for Payer: Cigna Commercial	$24,481.65
Rate for Payer: Cigna Medicare Advantage	$14,236.31
Rate for Payer: Clover Medicare Advantage	$13,524.49
Rate for Payer: EmblemHealth Commercial	$42,708.93
Rate for Payer: Humana Medicare Advantage	$14,663.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,236.31
Rate for Payer: Oxford Commercial	$17,595.29
Rate for Payer: UnitedHealthcare Commercial	$30,853.90
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,236.31
Rate for Payer: Wellcare Medicare Advantage	$14,236.31

CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC

Facility

$85,927.98

Service Code	MSDRG 846
Min. Negotiated Rate	$26,163.97
Max. Negotiated Rate	$85,927.98
Rate for Payer: Aetna Commercial	$59,299.63
Rate for Payer: Aetna Medicare Advantage	$85,927.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56,756.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56,756.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27,541.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56,756.84
Rate for Payer: Cigna Commercial	$48,516.04
Rate for Payer: Cigna Medicare Advantage	$27,541.02
Rate for Payer: Clover Medicare Advantage	$26,163.97
Rate for Payer: EmblemHealth Commercial	$82,623.06
Rate for Payer: Humana Medicare Advantage	$28,367.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27,541.02
Rate for Payer: Oxford Commercial	$34,869.12
Rate for Payer: UnitedHealthcare Commercial	$61,144.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$27,541.02
Rate for Payer: Wellcare Medicare Advantage	$27,541.02

CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC

Facility

$29,588.11

Service Code	MSDRG 848
Min. Negotiated Rate	$9,009.20
Max. Negotiated Rate	$29,588.11
Rate for Payer: Aetna Commercial	$20,587.72
Rate for Payer: Aetna Medicare Advantage	$29,588.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,539.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,539.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,483.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,539.24
Rate for Payer: Cigna Commercial	$15,895.67
Rate for Payer: Cigna Medicare Advantage	$9,483.37
Rate for Payer: Clover Medicare Advantage	$9,009.20
Rate for Payer: EmblemHealth Commercial	$28,450.11
Rate for Payer: Humana Medicare Advantage	$9,767.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,483.37
Rate for Payer: Oxford Commercial	$11,424.43
Rate for Payer: UnitedHealthcare Commercial	$20,033.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,483.37
Rate for Payer: Wellcare Medicare Advantage	$9,483.37

CHEM SPECIAL***

Facility

$114.00

Hospital Charge Code	3010535
Hospital Revenue Code	301
Min. Negotiated Rate	$2.75
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$43.32
Rate for Payer: Aetna Medicare Advantage	$34.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.07
Rate for Payer: Cigna Commercial	$57.00
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	$2.75
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

CHEM SPECIAL***

Facility

$114.00

Hospital Charge Code	3010535
Hospital Revenue Code	301
Min. Negotiated Rate	$17.10
Max. Negotiated Rate	$17.10
Rate for Payer: Qualcare PPO/HMO/WC	$17.10

CHEMSTRIP 10 W/ SG

Facility

$265.00

Hospital Charge Code	60634428
Hospital Revenue Code	250
Min. Negotiated Rate	$39.75
Max. Negotiated Rate	$39.75
Rate for Payer: Qualcare PPO/HMO/WC	$39.75

CHEMSTRIP 10 W/ SG

Facility

$265.00

Hospital Charge Code	60634428
Hospital Revenue Code	250
Min. Negotiated Rate	$6.39
Max. Negotiated Rate	$132.50
Rate for Payer: Aetna Commercial	$100.70
Rate for Payer: Aetna Medicare Advantage	$79.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.58
Rate for Payer: Cigna Commercial	$132.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.50
Rate for Payer: Oxford Commercial	$53.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.75
Rate for Payer: UnitedHealthcare Commercial	$53.00
Rate for Payer: UnitedHealthcare Community & State	$6.39
Rate for Payer: Wellpoint Medicaid Managed Care	$7.02

CHEMSTRIP 9

Facility

$279.00

Hospital Charge Code	60634429
Hospital Revenue Code	250
Min. Negotiated Rate	$41.85
Max. Negotiated Rate	$41.85
Rate for Payer: Qualcare PPO/HMO/WC	$41.85

CHEMSTRIP 9

Facility

$279.00

Hospital Charge Code	60634429
Hospital Revenue Code	250
Min. Negotiated Rate	$6.72
Max. Negotiated Rate	$139.50
Rate for Payer: Aetna Commercial	$106.02
Rate for Payer: Aetna Medicare Advantage	$83.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.14
Rate for Payer: Cigna Commercial	$139.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$83.70
Rate for Payer: Oxford Commercial	$55.80
Rate for Payer: Qualcare PPO/HMO/WC	$41.85
Rate for Payer: UnitedHealthcare Commercial	$55.80
Rate for Payer: UnitedHealthcare Community & State	$6.72
Rate for Payer: Wellpoint Medicaid Managed Care	$7.39

CHEMSTRIP BG/50EACH

Facility

$43.00

Hospital Charge Code	60632677
Hospital Revenue Code	250
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

CHEMSTRIP BG/50EACH

Facility

$43.00

Hospital Charge Code	60632677
Hospital Revenue Code	250
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$21.50
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$8.60
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$8.60
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

Know your out-of-pocket cost for care.

All Charges