Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CH IMMUNE COMPLEX SELEC

Facility

$331.00

Service Code	HCPCS 86332
Hospital Charge Code	397071341
Hospital Revenue Code	302
Min. Negotiated Rate	$8.77
Max. Negotiated Rate	$165.50
Rate for Payer: Aetna Commercial	$66.29
Rate for Payer: Aetna Medicare Advantage	$78.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.97
Rate for Payer: Cigna Commercial	$165.50
Rate for Payer: Cigna Medicare Advantage	$24.37
Rate for Payer: Clover Medicare Advantage	$23.15
Rate for Payer: EmblemHealth Commercial	$73.11
Rate for Payer: Humana Medicare Advantage	$25.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.37
Rate for Payer: Wellcare Medicare Advantage	$24.37
Rate for Payer: Wellpoint Medicaid Managed Care	$8.77

CH IMMUNE COMPLEX SELEC

Facility

$331.00

Service Code	HCPCS 86332
Hospital Charge Code	397071341
Hospital Revenue Code	302
Min. Negotiated Rate	$49.65
Max. Negotiated Rate	$49.65
Rate for Payer: Qualcare PPO/HMO/WC	$49.65

CH IMMUNODIFFUSION OUCHTERIO

Facility

$72.00

Service Code	HCPCS 86331
Hospital Charge Code	397071486
Hospital Revenue Code	302
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

CH IMMUNODIFFUSION OUCHTERIO

Facility

$72.00

Service Code	HCPCS 86331
Hospital Charge Code	397071486
Hospital Revenue Code	302
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.24
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
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	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

CH IMMUNOELECTROPHORESIS S

Facility

$207.00

Service Code	HCPCS 86334
Hospital Charge Code	397071067
Hospital Revenue Code	302
Min. Negotiated Rate	$5.49
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$60.76
Rate for Payer: Aetna Medicare Advantage	$72.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.64
Rate for Payer: Cigna Commercial	$103.50
Rate for Payer: Cigna Medicare Advantage	$22.34
Rate for Payer: Clover Medicare Advantage	$21.22
Rate for Payer: EmblemHealth Commercial	$67.02
Rate for Payer: Humana Medicare Advantage	$23.01
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$62.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.87
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.34
Rate for Payer: Wellcare Medicare Advantage	$22.34
Rate for Payer: Wellpoint Medicaid Managed Care	$5.49

CH IMMUNOELECTROPHORESIS S

Facility

$207.00

Service Code	HCPCS 86334
Hospital Charge Code	397071067
Hospital Revenue Code	302
Min. Negotiated Rate	$31.05
Max. Negotiated Rate	$31.05
Rate for Payer: Qualcare PPO/HMO/WC	$31.05

CH IMMUNOGLOBULIN SUBCLASSX4

Facility

$339.00

Service Code	HCPCS 82787
Hospital Charge Code	397073577
Hospital Revenue Code	301
Min. Negotiated Rate	$6.42
Max. Negotiated Rate	$169.50
Rate for Payer: Aetna Commercial	$21.81
Rate for Payer: Aetna Medicare Advantage	$25.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$131.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.95
Rate for Payer: Cigna Commercial	$169.50
Rate for Payer: Cigna Medicare Advantage	$8.02
Rate for Payer: Clover Medicare Advantage	$7.62
Rate for Payer: EmblemHealth Commercial	$24.06
Rate for Payer: Humana Medicare Advantage	$8.26
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.02
Rate for Payer: Wellcare Medicare Advantage	$8.02
Rate for Payer: Wellpoint Medicaid Managed Care	$8.98

CH IMMUNOGLOBULIN SUBCLASSX4

Facility

$339.00

Service Code	HCPCS 82787
Hospital Charge Code	397073577
Hospital Revenue Code	301
Min. Negotiated Rate	$50.85
Max. Negotiated Rate	$50.85
Rate for Payer: Qualcare PPO/HMO/WC	$50.85

CH INDIA INK PREP

Facility

$43.25

Service Code	HCPCS 87210
Hospital Charge Code	397041044
Hospital Revenue Code	309
Min. Negotiated Rate	$6.49
Max. Negotiated Rate	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$6.49

CH INDIA INK PREP

Facility

$43.25

Service Code	HCPCS 87210
Hospital Charge Code	397041044
Hospital Revenue Code	309
Min. Negotiated Rate	$1.15
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.83
Rate for Payer: Aetna Medicare Advantage	$18.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.01
Rate for Payer: Cigna Commercial	$21.62
Rate for Payer: Cigna Medicare Advantage	$5.82
Rate for Payer: Clover Medicare Advantage	$5.53
Rate for Payer: EmblemHealth Commercial	$17.46
Rate for Payer: Humana Medicare Advantage	$5.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.97
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.66
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.82
Rate for Payer: Wellcare Medicare Advantage	$5.82
Rate for Payer: Wellpoint Medicaid Managed Care	$1.15

CH INFLUENZA A,B RNA,QI,PCR

Facility

$423.00

Hospital Charge Code	3970734
Hospital Revenue Code	301
Min. Negotiated Rate	$10.19
Max. Negotiated Rate	$211.50
Rate for Payer: Aetna Commercial	$160.74
Rate for Payer: Aetna Medicare Advantage	$126.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$107.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$107.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$107.86
Rate for Payer: Cigna Commercial	$211.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$126.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.19
Rate for Payer: Wellpoint Medicaid Managed Care	$11.21

CH INFLUENZA A,B RNA,QI,PCR

Facility

$423.00

Hospital Charge Code	3970734
Hospital Revenue Code	301
Min. Negotiated Rate	$63.45
Max. Negotiated Rate	$63.45
Rate for Payer: Qualcare PPO/HMO/WC	$63.45

CH INHIBIN A

Facility

$97.00

Service Code	HCPCS 86336
Hospital Charge Code	397073632
Hospital Revenue Code	302
Min. Negotiated Rate	$14.55
Max. Negotiated Rate	$14.55
Rate for Payer: Qualcare PPO/HMO/WC	$14.55

CH INHIBIN A

Facility

$97.00

Service Code	HCPCS 86336
Hospital Charge Code	397073632
Hospital Revenue Code	302
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$42.40
Rate for Payer: Aetna Medicare Advantage	$50.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.28
Rate for Payer: Cigna Commercial	$48.50
Rate for Payer: Cigna Medicare Advantage	$15.59
Rate for Payer: Clover Medicare Advantage	$14.81
Rate for Payer: EmblemHealth Commercial	$46.77
Rate for Payer: Humana Medicare Advantage	$16.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.59
Rate for Payer: Wellcare Medicare Advantage	$15.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.57

CH INITIAL MRSA SCREEN

Facility

$358.65

Service Code	HCPCS 87081
Hospital Charge Code	397043276
Hospital Revenue Code	309
Min. Negotiated Rate	$53.80
Max. Negotiated Rate	$53.80
Rate for Payer: Qualcare PPO/HMO/WC	$53.80

CH INITIAL MRSA SCREEN

Facility

$358.65

Service Code	HCPCS 87081
Hospital Charge Code	397043276
Hospital Revenue Code	309
Min. Negotiated Rate	$5.30
Max. Negotiated Rate	$179.32
Rate for Payer: Aetna Commercial	$18.03
Rate for Payer: Aetna Medicare Advantage	$21.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.93
Rate for Payer: Cigna Commercial	$179.32
Rate for Payer: Cigna Medicare Advantage	$6.63
Rate for Payer: Clover Medicare Advantage	$6.30
Rate for Payer: EmblemHealth Commercial	$19.89
Rate for Payer: Humana Medicare Advantage	$6.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$53.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.63
Rate for Payer: Wellcare Medicare Advantage	$6.63
Rate for Payer: Wellpoint Medicaid Managed Care	$9.50

CH INSULIN

Facility

$214.00

Service Code	HCPCS 83525
Hospital Charge Code	397071065
Hospital Revenue Code	301
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.09
Rate for Payer: Aetna Medicare Advantage	$37.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.43
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	$41.26
Rate for Payer: Cigna Commercial	$107.00
Rate for Payer: Cigna Medicare Advantage	$11.43
Rate for Payer: Clover Medicare Advantage	$10.86
Rate for Payer: EmblemHealth Commercial	$34.29
Rate for Payer: Humana Medicare Advantage	$11.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.43
Rate for Payer: Wellcare Medicare Advantage	$11.43
Rate for Payer: Wellpoint Medicaid Managed Care	$5.67

CH INSULIN

Facility

$214.00

Service Code	HCPCS 83525
Hospital Charge Code	397071065
Hospital Revenue Code	301
Min. Negotiated Rate	$32.10
Max. Negotiated Rate	$32.10
Rate for Payer: Qualcare PPO/HMO/WC	$32.10

CH INSULIN ANTIBODY

Facility

$303.00

Service Code	HCPCS 86337
Hospital Charge Code	397072010
Hospital Revenue Code	302
Min. Negotiated Rate	$8.03
Max. Negotiated Rate	$151.50
Rate for Payer: Aetna Commercial	$58.24
Rate for Payer: Aetna Medicare Advantage	$69.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.28
Rate for Payer: Cigna Commercial	$151.50
Rate for Payer: Cigna Medicare Advantage	$21.41
Rate for Payer: Clover Medicare Advantage	$20.34
Rate for Payer: EmblemHealth Commercial	$64.23
Rate for Payer: Humana Medicare Advantage	$22.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.41
Rate for Payer: Wellcare Medicare Advantage	$21.41
Rate for Payer: Wellpoint Medicaid Managed Care	$8.03

CH INSULIN ANTIBODY

Facility

$303.00

Service Code	HCPCS 86337
Hospital Charge Code	397072010
Hospital Revenue Code	302
Min. Negotiated Rate	$45.45
Max. Negotiated Rate	$45.45
Rate for Payer: Qualcare PPO/HMO/WC	$45.45

CH INTERLEUKIN-6 (IL-6)

Facility

$573.00

Service Code	HCPCS 83520
Hospital Charge Code	397070014
Hospital Revenue Code	301
Min. Negotiated Rate	$85.95
Max. Negotiated Rate	$85.95
Rate for Payer: Qualcare PPO/HMO/WC	$85.95

CH INTERLEUKIN-6 (IL-6)

Facility

$573.00

Service Code	HCPCS 83520
Hospital Charge Code	397070014
Hospital Revenue Code	301
Min. Negotiated Rate	$13.82
Max. Negotiated Rate	$286.50
Rate for Payer: Aetna Commercial	$46.97
Rate for Payer: Aetna Medicare Advantage	$55.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.34
Rate for Payer: Cigna Commercial	$286.50
Rate for Payer: Cigna Medicare Advantage	$17.27
Rate for Payer: Clover Medicare Advantage	$16.41
Rate for Payer: EmblemHealth Commercial	$51.81
Rate for Payer: Humana Medicare Advantage	$17.79
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.27
Rate for Payer: Wellcare Medicare Advantage	$17.27
Rate for Payer: Wellpoint Medicaid Managed Care	$15.18

CH INTERPRETATION

Facility

$162.00

Service Code	HCPCS 83912
Hospital Charge Code	397073575
Hospital Revenue Code	301
Min. Negotiated Rate	$24.30
Max. Negotiated Rate	$24.30
Rate for Payer: Qualcare PPO/HMO/WC	$24.30

CH INTERPRETATION

Facility

$65.00

Service Code	HCPCS 83912
Hospital Charge Code	397073300
Hospital Revenue Code	301
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

CH INTERPRETATION

Facility

$65.00

Service Code	HCPCS 83912
Hospital Charge Code	397073300
Hospital Revenue Code	301
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$24.70
Rate for Payer: Aetna Medicare Advantage	$19.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.57
Rate for Payer: Cigna Commercial	$32.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

Know your out-of-pocket cost for care.

All Charges