Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CHEMSTRIPS 50/BOX

Facility

$7.70

Hospital Charge Code	6014062
Hospital Revenue Code	259
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

CHEMSTRIPS 50/BOX

Facility

$7.70

Hospital Charge Code	6014062
Hospital Revenue Code	259
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.93
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.31
Rate for Payer: Oxford Commercial	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$1.54
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

CHEMSTRIP UGK

Facility

$38.00

Hospital Charge Code	60634427
Hospital Revenue Code	250
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

CHEMSTRIP UGK

Facility

$38.00

Hospital Charge Code	60634427
Hospital Revenue Code	250
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$14.44
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.40
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$7.60
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

CH ENDOMYSIAL AUTOANTIBODIES

Facility

$148.00

Service Code	HCPCS 86256
Hospital Charge Code	397073340
Hospital Revenue Code	302
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$74.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$3.92

CH ENDOMYSIAL AUTOANTIBODIES

Facility

$148.00

Service Code	HCPCS 86256
Hospital Charge Code	397073340
Hospital Revenue Code	302
Min. Negotiated Rate	$22.20
Max. Negotiated Rate	$22.20
Rate for Payer: Qualcare PPO/HMO/WC	$22.20

CH ENDOMYSIAL SCR (LGA)W/RFL

Facility

$77.00

Service Code	HCPCS 86255
Hospital Charge Code	397071369
Hospital Revenue Code	302
Min. Negotiated Rate	$2.04
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$38.50
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$2.04

CH ENDOMYSIAL SCR (LGA)W/RFL

Facility

$77.00

Service Code	HCPCS 86255
Hospital Charge Code	397071369
Hospital Revenue Code	302
Min. Negotiated Rate	$11.55
Max. Negotiated Rate	$11.55
Rate for Payer: Qualcare PPO/HMO/WC	$11.55

CH ENTAMOEBA STOOL

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397072166
Hospital Revenue Code	310
Min. Negotiated Rate	$17.81
Max. Negotiated Rate	$570.55
Rate for Payer: Aetna Commercial	$429.92
Rate for Payer: Aetna Medicare Advantage	$512.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$570.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$158.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$570.55
Rate for Payer: Cigna Commercial	$316.85
Rate for Payer: Cigna Medicare Advantage	$158.06
Rate for Payer: Clover Medicare Advantage	$150.16
Rate for Payer: EmblemHealth Commercial	$474.18
Rate for Payer: Humana Medicare Advantage	$162.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$158.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$201.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.80
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$68.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$158.06
Rate for Payer: Wellcare Medicare Advantage	$158.06
Rate for Payer: Wellpoint Medicaid Managed Care	$17.81

CH ENTAMOEBA STOOL

Facility

$672.00

Service Code	HCPCS 88313
Hospital Charge Code	397072166
Hospital Revenue Code	310
Min. Negotiated Rate	$100.80
Max. Negotiated Rate	$100.80
Rate for Payer: Qualcare PPO/HMO/WC	$100.80

CH ENTEROVIRUS CULTURE

Facility

$154.00

Service Code	HCPCS 87254
Hospital Charge Code	397071424
Hospital Revenue Code	309
Min. Negotiated Rate	$23.10
Max. Negotiated Rate	$23.10
Rate for Payer: Qualcare PPO/HMO/WC	$23.10

CH ENTEROVIRUS CULTURE

Facility

$154.00

Service Code	HCPCS 87254
Hospital Charge Code	397071424
Hospital Revenue Code	309
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$53.20
Rate for Payer: Aetna Medicare Advantage	$63.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.61
Rate for Payer: Cigna Commercial	$77.00
Rate for Payer: Cigna Medicare Advantage	$19.56
Rate for Payer: Clover Medicare Advantage	$18.58
Rate for Payer: EmblemHealth Commercial	$58.68
Rate for Payer: Humana Medicare Advantage	$20.15
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.56
Rate for Payer: Wellcare Medicare Advantage	$19.56
Rate for Payer: Wellpoint Medicaid Managed Care	$4.08

CH ENTEROVIRUS RNA QL RT PCR

Facility

$865.00

Service Code	HCPCS 87798
Hospital Charge Code	397071537
Hospital Revenue Code	306
Min. Negotiated Rate	$22.92
Max. Negotiated Rate	$432.50
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$153.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.66
Rate for Payer: Cigna Commercial	$432.50
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$259.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$129.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$22.92

CH ENTEROVIRUS RNA QL RT PCR

Facility

$865.00

Service Code	HCPCS 87798
Hospital Charge Code	397071537
Hospital Revenue Code	306
Min. Negotiated Rate	$129.75
Max. Negotiated Rate	$129.75
Rate for Payer: Qualcare PPO/HMO/WC	$129.75

CH ENZYMATIC

Facility

$180.00

Service Code	HCPCS 83892
Hospital Charge Code	397073561
Hospital Revenue Code	301
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

CH ENZYMATIC

Facility

$180.00

Service Code	HCPCS 83892
Hospital Charge Code	397073561
Hospital Revenue Code	301
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$68.40
Rate for Payer: Aetna Medicare Advantage	$54.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.90
Rate for Payer: Cigna Commercial	$90.00
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	$4.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

CH ENZYMATIC DIGESTION X3

Facility

$45.00

Service Code	HCPCS 83892
Hospital Charge Code	397073281
Hospital Revenue Code	301
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$17.10
Rate for Payer: Aetna Medicare Advantage	$13.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.47
Rate for Payer: Cigna Commercial	$22.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

CH ENZYMATIC DIGESTION X3

Facility

$45.00

Service Code	HCPCS 83892
Hospital Charge Code	397073281
Hospital Revenue Code	301
Min. Negotiated Rate	$6.75
Max. Negotiated Rate	$6.75
Rate for Payer: Qualcare PPO/HMO/WC	$6.75

CH EOSINOPHILE COUNT

Facility

$390.00

Service Code	HCPCS 85048
Hospital Charge Code	397021036
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH EOSINOPHILE COUNT

Facility

$390.00

Service Code	HCPCS 85048
Hospital Charge Code	397021036
Hospital Revenue Code	301
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$6.91
Rate for Payer: Aetna Medicare Advantage	$8.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.17
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$2.54
Rate for Payer: Clover Medicare Advantage	$2.41
Rate for Payer: EmblemHealth Commercial	$7.62
Rate for Payer: Humana Medicare Advantage	$2.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.54
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	$2.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.54
Rate for Payer: Wellcare Medicare Advantage	$2.54
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CH EOSINOPHILE SMEAR NASAL

Facility

$390.00

Service Code	HCPCS 89190
Hospital Charge Code	397021077
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH EOSINOPHILE SMEAR NASAL

Facility

$390.00

Service Code	HCPCS 89190
Hospital Charge Code	397021077
Hospital Revenue Code	300
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$15.75
Rate for Payer: Aetna Medicare Advantage	$18.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.90
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.79
Rate for Payer: Clover Medicare Advantage	$5.50
Rate for Payer: EmblemHealth Commercial	$17.37
Rate for Payer: Humana Medicare Advantage	$5.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.79
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	$4.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.79
Rate for Payer: Wellcare Medicare Advantage	$5.79
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CH EOSINOPHILE SMEAR UA/FEL

Facility

$72.00

Service Code	HCPCS 87205
Hospital Charge Code	397021285
Hospital Revenue Code	309
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

CH EOSINOPHILE SMEAR UA/FEL

Facility

$72.00

Service Code	HCPCS 87205
Hospital Charge Code	397021285
Hospital Revenue Code	309
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

CH EPINEPHRINE

Facility

$176.00

Service Code	HCPCS 82542
Hospital Charge Code	397073629
Hospital Revenue Code	301
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$26.40
Rate for Payer: Qualcare PPO/HMO/WC	$26.40

Know your out-of-pocket cost for care.

All Charges