Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CHICK PEA IGE(rf309)(SERUM)

Facility

$15.17

Service Code	HCPCS 86003
Hospital Charge Code	397080012
Hospital Revenue Code	305
Min. Negotiated Rate	$2.28
Max. Negotiated Rate	$2.28
Rate for Payer: Qualcare PPO/HMO/WC	$2.28

CHICK PEA IGE(rf309)(SERUM)

Facility

$15.17

Service Code	HCPCS 86003
Hospital Charge Code	397080012
Hospital Revenue Code	305
Min. Negotiated Rate	$0.40
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	$7.58
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	$4.55
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.28
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	$0.40

CHIEF ULTRASOUND GEL.25

Facility

$33.00

Hospital Charge Code	270332498
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.50
Rate for Payer: Aetna Commercial	$12.54
Rate for Payer: Aetna Medicare Advantage	$9.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.41
Rate for Payer: Cigna Commercial	$16.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.90
Rate for Payer: Oxford Commercial	$6.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$6.60
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

CHIEF ULTRASOUND GEL.25

Facility

$33.00

Hospital Charge Code	270332498
Hospital Revenue Code	272
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

CHIEF ULTRASOUND GEL .25-LIT

Facility

$37.00

Hospital Charge Code	270331031
Hospital Revenue Code	272
Min. Negotiated Rate	$5.55
Max. Negotiated Rate	$5.55
Rate for Payer: Qualcare PPO/HMO/WC	$5.55

CHIEF ULTRASOUND GEL .25-LIT

Facility

$37.00

Hospital Charge Code	270331031
Hospital Revenue Code	272
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$18.50
Rate for Payer: Aetna Commercial	$14.06
Rate for Payer: Aetna Medicare Advantage	$11.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.44
Rate for Payer: Cigna Commercial	$18.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.10
Rate for Payer: Oxford Commercial	$7.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.55
Rate for Payer: UnitedHealthcare Commercial	$7.40
Rate for Payer: UnitedHealthcare Community & State	$0.89
Rate for Payer: Wellpoint Medicaid Managed Care	$0.98

CH IEP URINE

Facility

$169.00

Service Code	HCPCS 86325
Hospital Charge Code	397073079
Hospital Revenue Code	302
Min. Negotiated Rate	$4.48
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$62.91
Rate for Payer: Aetna Medicare Advantage	$74.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$48.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.49
Rate for Payer: Cigna Commercial	$84.50
Rate for Payer: Cigna Medicare Advantage	$23.13
Rate for Payer: Clover Medicare Advantage	$21.97
Rate for Payer: EmblemHealth Commercial	$69.39
Rate for Payer: Humana Medicare Advantage	$23.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.13
Rate for Payer: Wellcare Medicare Advantage	$23.13
Rate for Payer: Wellpoint Medicaid Managed Care	$4.48

CH IEP URINE

Facility

$169.00

Service Code	HCPCS 86325
Hospital Charge Code	397073079
Hospital Revenue Code	302
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$25.35
Rate for Payer: Qualcare PPO/HMO/WC	$25.35

CH IGA

Facility

$161.00

Service Code	HCPCS 82784
Hospital Charge Code	397071256
Hospital Revenue Code	301
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.57
Rate for Payer: Cigna Commercial	$80.50
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$4.27

CH IGA

Facility

$161.00

Service Code	HCPCS 82784
Hospital Charge Code	397071256
Hospital Revenue Code	301
Min. Negotiated Rate	$24.15
Max. Negotiated Rate	$24.15
Rate for Payer: Qualcare PPO/HMO/WC	$24.15

CH IGA

Facility

$127.00

Service Code	HCPCS 86677
Hospital Charge Code	397073623
Hospital Revenue Code	302
Min. Negotiated Rate	$19.05
Max. Negotiated Rate	$19.05
Rate for Payer: Qualcare PPO/HMO/WC	$19.05

CH IGA

Facility

$127.00

Service Code	HCPCS 86677
Hospital Charge Code	397073623
Hospital Revenue Code	302
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.83
Rate for Payer: Aetna Medicare Advantage	$54.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.85
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	$60.82
Rate for Payer: Cigna Commercial	$63.50
Rate for Payer: Cigna Medicare Advantage	$16.85
Rate for Payer: Clover Medicare Advantage	$16.01
Rate for Payer: EmblemHealth Commercial	$50.55
Rate for Payer: Humana Medicare Advantage	$17.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.85
Rate for Payer: Wellcare Medicare Advantage	$16.85
Rate for Payer: Wellpoint Medicaid Managed Care	$3.37

CH IGA CSF

Facility

$141.00

Service Code	HCPCS 82784
Hospital Charge Code	397073183
Hospital Revenue Code	301
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$21.15
Rate for Payer: Qualcare PPO/HMO/WC	$21.15

CH IGA CSF

Facility

$141.00

Service Code	HCPCS 82784
Hospital Charge Code	397073183
Hospital Revenue Code	301
Min. Negotiated Rate	$3.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.57
Rate for Payer: Cigna Commercial	$70.50
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.74

CH IGA CSF

Facility

$129.00

Service Code	HCPCS 81784
Hospital Charge Code	397073225
Hospital Revenue Code	301
Min. Negotiated Rate	$3.11
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$49.02
Rate for Payer: Aetna Medicare Advantage	$38.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.90
Rate for Payer: Cigna Commercial	$64.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.11
Rate for Payer: Wellpoint Medicaid Managed Care	$3.42

CH IGA CSF

Facility

$129.00

Service Code	HCPCS 81784
Hospital Charge Code	397073225
Hospital Revenue Code	301
Min. Negotiated Rate	$19.35
Max. Negotiated Rate	$19.35
Rate for Payer: Qualcare PPO/HMO/WC	$19.35

CH IGA SERUM

Facility

$129.00

Service Code	HCPCS 82784
Hospital Charge Code	397073226
Hospital Revenue Code	301
Min. Negotiated Rate	$19.35
Max. Negotiated Rate	$19.35
Rate for Payer: Qualcare PPO/HMO/WC	$19.35

CH IGA SERUM

Facility

$129.00

Service Code	HCPCS 82784
Hospital Charge Code	397073226
Hospital Revenue Code	301
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$25.30
Rate for Payer: Aetna Medicare Advantage	$30.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.57
Rate for Payer: Cigna Commercial	$64.50
Rate for Payer: Cigna Medicare Advantage	$9.30
Rate for Payer: Clover Medicare Advantage	$8.84
Rate for Payer: EmblemHealth Commercial	$27.90
Rate for Payer: Humana Medicare Advantage	$9.58
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$9.30
Rate for Payer: Wellcare Medicare Advantage	$9.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.42

CH IGD

Facility

$222.00

Service Code	HCPCS 86329
Hospital Charge Code	397073074
Hospital Revenue Code	302
Min. Negotiated Rate	$33.30
Max. Negotiated Rate	$33.30
Rate for Payer: Qualcare PPO/HMO/WC	$33.30

CH IGD

Facility

$222.00

Service Code	HCPCS 86329
Hospital Charge Code	397073074
Hospital Revenue Code	302
Min. Negotiated Rate	$5.88
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$38.22
Rate for Payer: Aetna Medicare Advantage	$45.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$47.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.72
Rate for Payer: Cigna Commercial	$111.00
Rate for Payer: Cigna Medicare Advantage	$14.05
Rate for Payer: Clover Medicare Advantage	$13.35
Rate for Payer: EmblemHealth Commercial	$42.15
Rate for Payer: Humana Medicare Advantage	$14.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.05
Rate for Payer: Wellcare Medicare Advantage	$14.05
Rate for Payer: Wellpoint Medicaid Managed Care	$5.88

CH IGE

Facility

$218.00

Service Code	HCPCS 82785
Hospital Charge Code	397071132
Hospital Revenue Code	301
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$44.77
Rate for Payer: Aetna Medicare Advantage	$53.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$30.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59.42
Rate for Payer: Cigna Commercial	$109.00
Rate for Payer: Cigna Medicare Advantage	$16.46
Rate for Payer: Clover Medicare Advantage	$15.64
Rate for Payer: EmblemHealth Commercial	$49.38
Rate for Payer: Humana Medicare Advantage	$16.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.17
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.46
Rate for Payer: Wellcare Medicare Advantage	$16.46
Rate for Payer: Wellpoint Medicaid Managed Care	$5.78

CH IGE

Facility

$218.00

Service Code	HCPCS 82785
Hospital Charge Code	397071132
Hospital Revenue Code	301
Min. Negotiated Rate	$32.70
Max. Negotiated Rate	$32.70
Rate for Payer: Qualcare PPO/HMO/WC	$32.70

CH IGE BINDING PROTEIN 3

Facility

$472.07

Hospital Charge Code	3970732
Hospital Revenue Code	301
Min. Negotiated Rate	$70.81
Max. Negotiated Rate	$70.81
Rate for Payer: Qualcare PPO/HMO/WC	$70.81

CH IGE BINDING PROTEIN 3

Facility

$472.07

Hospital Charge Code	3970732
Hospital Revenue Code	301
Min. Negotiated Rate	$11.38
Max. Negotiated Rate	$236.03
Rate for Payer: Aetna Commercial	$179.39
Rate for Payer: Aetna Medicare Advantage	$141.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.38
Rate for Payer: Cigna Commercial	$236.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$141.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$70.81
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.38
Rate for Payer: Wellpoint Medicaid Managed Care	$12.51

CH IGF-1

Facility

$649.00

Service Code	HCPCS 84305
Hospital Charge Code	397073195
Hospital Revenue Code	301
Min. Negotiated Rate	$97.35
Max. Negotiated Rate	$97.35
Rate for Payer: Qualcare PPO/HMO/WC	$97.35

Know your out-of-pocket cost for care.

All Charges