Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CHIPS CANC BONE 1.7-10M 100150

Facility

$2,280.00

Service Code	HCPCS C1713
Hospital Charge Code	270618744
Hospital Revenue Code	278
Min. Negotiated Rate	$342.00
Max. Negotiated Rate	$551.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$551.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.60
Rate for Payer: Qualcare PPO/HMO/WC	$342.00

CHIPS CANC BONE 1.7-10M 100150

Facility

$2,280.00

Service Code	HCPCS C1713
Hospital Charge Code	270618744
Hospital Revenue Code	278
Min. Negotiated Rate	$54.95
Max. Negotiated Rate	$1,140.00
Rate for Payer: Aetna Commercial	$866.40
Rate for Payer: Aetna Medicare Advantage	$684.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$581.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$581.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$456.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$581.40
Rate for Payer: Cigna Commercial	$1,140.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$551.76
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$501.60
Rate for Payer: Qualcare PPO/HMO/WC	$342.00
Rate for Payer: UnitedHealthcare Community & State	$54.95
Rate for Payer: Wellpoint Medicaid Managed Care	$60.42

CHIPS CANC BONE 1.7-10M 800150

Facility

$1,974.15

Hospital Charge Code	270622373
Hospital Revenue Code	278
Min. Negotiated Rate	$47.58
Max. Negotiated Rate	$987.08
Rate for Payer: Aetna Commercial	$750.18
Rate for Payer: Aetna Medicare Advantage	$592.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$503.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$503.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$394.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$503.41
Rate for Payer: Cigna Commercial	$987.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$434.31
Rate for Payer: Qualcare PPO/HMO/WC	$296.12
Rate for Payer: UnitedHealthcare Community & State	$47.58
Rate for Payer: Wellpoint Medicaid Managed Care	$52.31

CHIPS CANC BONE 1.7-10M 800150

Facility

$1,974.15

Hospital Charge Code	270622373
Hospital Revenue Code	278
Min. Negotiated Rate	$296.12
Max. Negotiated Rate	$477.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$394.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$477.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$434.31
Rate for Payer: Qualcare PPO/HMO/WC	$296.12

CHIPS CANC BONE 4-10MM 500150

Facility

$2,647.25

Hospital Charge Code	270605437
Hospital Revenue Code	278
Min. Negotiated Rate	$63.80
Max. Negotiated Rate	$1,323.62
Rate for Payer: Aetna Commercial	$1,005.96
Rate for Payer: Aetna Medicare Advantage	$794.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$675.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$675.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$529.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$675.05
Rate for Payer: Cigna Commercial	$1,323.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$640.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$582.39
Rate for Payer: Qualcare PPO/HMO/WC	$397.09
Rate for Payer: UnitedHealthcare Community & State	$63.80
Rate for Payer: Wellpoint Medicaid Managed Care	$70.15

CHIPS CANC BONE 4-10MM 500150

Facility

$2,647.25

Hospital Charge Code	270605437
Hospital Revenue Code	278
Min. Negotiated Rate	$397.09
Max. Negotiated Rate	$640.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$529.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$640.63
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$582.39
Rate for Payer: Qualcare PPO/HMO/WC	$397.09

CHIPS CRT BONE 1.7-10MM 100045

Facility

$2,916.00

Hospital Charge Code	270608952
Hospital Revenue Code	278
Min. Negotiated Rate	$437.40
Max. Negotiated Rate	$705.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$583.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$705.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$641.52
Rate for Payer: Qualcare PPO/HMO/WC	$437.40

CHIPS CRT BONE 1.7-10MM 100045

Facility

$2,916.00

Hospital Charge Code	270608952
Hospital Revenue Code	278
Min. Negotiated Rate	$70.28
Max. Negotiated Rate	$1,458.00
Rate for Payer: Aetna Commercial	$1,108.08
Rate for Payer: Aetna Medicare Advantage	$874.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$743.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$743.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$583.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$743.58
Rate for Payer: Cigna Commercial	$1,458.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$705.67
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$641.52
Rate for Payer: Qualcare PPO/HMO/WC	$437.40
Rate for Payer: UnitedHealthcare Community & State	$70.28
Rate for Payer: Wellpoint Medicaid Managed Care	$77.27

CH IPTH

Facility

$281.55

Service Code	HCPCS 83970
Hospital Charge Code	394014002
Hospital Revenue Code	301
Min. Negotiated Rate	$42.23
Max. Negotiated Rate	$42.23
Rate for Payer: Qualcare PPO/HMO/WC	$42.23

CH IPTH

Facility

$281.55

Service Code	HCPCS 83970
Hospital Charge Code	394014002
Hospital Revenue Code	301
Min. Negotiated Rate	$7.46
Max. Negotiated Rate	$149.01
Rate for Payer: Aetna Commercial	$112.28
Rate for Payer: Aetna Medicare Advantage	$133.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.01
Rate for Payer: Cigna Commercial	$140.78
Rate for Payer: Cigna Medicare Advantage	$41.28
Rate for Payer: Clover Medicare Advantage	$39.22
Rate for Payer: EmblemHealth Commercial	$123.84
Rate for Payer: Humana Medicare Advantage	$42.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$41.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.47
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.23
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$33.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.28
Rate for Payer: Wellcare Medicare Advantage	$41.28
Rate for Payer: Wellpoint Medicaid Managed Care	$7.46

CH IRON

Facility

$667.59

Service Code	HCPCS 83540
Hospital Charge Code	397073039
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

CH IRON

Facility

$667.59

Service Code	HCPCS 83540
Hospital Charge Code	397073039
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
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	$23.35
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

CH IRON BIDDING CAPACITY

Facility

$296.00

Service Code	HCPCS 83550
Hospital Charge Code	397073003
Hospital Revenue Code	301
Min. Negotiated Rate	$44.40
Max. Negotiated Rate	$44.40
Rate for Payer: Qualcare PPO/HMO/WC	$44.40

CH IRON BIDDING CAPACITY

Facility

$296.00

Service Code	HCPCS 83550
Hospital Charge Code	397073003
Hospital Revenue Code	301
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$148.00
Rate for Payer: Aetna Commercial	$23.77
Rate for Payer: Aetna Medicare Advantage	$28.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.55
Rate for Payer: Cigna Commercial	$148.00
Rate for Payer: Cigna Medicare Advantage	$8.74
Rate for Payer: Clover Medicare Advantage	$8.30
Rate for Payer: EmblemHealth Commercial	$26.22
Rate for Payer: Humana Medicare Advantage	$9.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$44.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.74
Rate for Payer: Wellcare Medicare Advantage	$8.74
Rate for Payer: Wellpoint Medicaid Managed Care	$7.84

CH IRON, RANDOM URINE

Facility

$254.00

Service Code	HCPCS 83540
Hospital Charge Code	397071398
Hospital Revenue Code	301
Min. Negotiated Rate	$38.10
Max. Negotiated Rate	$38.10
Rate for Payer: Qualcare PPO/HMO/WC	$38.10

CH IRON, RANDOM URINE

Facility

$254.00

Service Code	HCPCS 83540
Hospital Charge Code	397071398
Hospital Revenue Code	301
Min. Negotiated Rate	$5.18
Max. Negotiated Rate	$127.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
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	$23.35
Rate for Payer: Cigna Commercial	$127.00
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$6.73

CHISEL TIP MINI EDGE BLADE

Facility

$19.82

Hospital Charge Code	270663412
Hospital Revenue Code	272
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$2.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.97

CHISEL TIP MINI EDGE BLADE

Facility

$19.82

Hospital Charge Code	270663412
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$9.91
Rate for Payer: Aetna Commercial	$7.53
Rate for Payer: Aetna Medicare Advantage	$5.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.05
Rate for Payer: Cigna Commercial	$9.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.95
Rate for Payer: Oxford Commercial	$3.96
Rate for Payer: Qualcare PPO/HMO/WC	$2.97
Rate for Payer: UnitedHealthcare Commercial	$3.96
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

CH ISLET CELL AB

Facility

$238.00

Service Code	HCPCS 86341
Hospital Charge Code	397072011
Hospital Revenue Code	302
Min. Negotiated Rate	$35.70
Max. Negotiated Rate	$35.70
Rate for Payer: Qualcare PPO/HMO/WC	$35.70

CH ISLET CELL AB

Facility

$238.00

Service Code	HCPCS 86341
Hospital Charge Code	397072011
Hospital Revenue Code	302
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$64.11
Rate for Payer: Aetna Medicare Advantage	$76.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23.57
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	$85.08
Rate for Payer: Cigna Commercial	$119.00
Rate for Payer: Cigna Medicare Advantage	$23.57
Rate for Payer: Clover Medicare Advantage	$22.39
Rate for Payer: EmblemHealth Commercial	$70.71
Rate for Payer: Humana Medicare Advantage	$24.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$23.57
Rate for Payer: Wellcare Medicare Advantage	$23.57
Rate for Payer: Wellpoint Medicaid Managed Care	$6.31

CH ISOLATION

Facility

$72.00

Service Code	HCPCS 81240
Hospital Charge Code	397073572
Hospital Revenue Code	310
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$237.12
Rate for Payer: Aetna Commercial	$178.68
Rate for Payer: Aetna Medicare Advantage	$212.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$237.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$237.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$65.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$237.12
Rate for Payer: Cigna Commercial	$36.00
Rate for Payer: Cigna Medicare Advantage	$65.69
Rate for Payer: Clover Medicare Advantage	$62.41
Rate for Payer: EmblemHealth Commercial	$197.07
Rate for Payer: Humana Medicare Advantage	$67.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$65.69
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	$175.00
Rate for Payer: UnitedHealthcare Community & State	$52.55
Rate for Payer: UnitedHealthcare Medicare Advantage	$65.69
Rate for Payer: Wellcare Medicare Advantage	$65.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1.91

CH ISOLATION

Facility

$72.00

Service Code	HCPCS 81240
Hospital Charge Code	397073572
Hospital Revenue Code	310
Min. Negotiated Rate	$10.80
Max. Negotiated Rate	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$10.80

CH JC VIRUS DNA, QN RT-PCR

Facility

$1,114.00

Service Code	HCPCS 87799
Hospital Charge Code	397071388
Hospital Revenue Code	306
Min. Negotiated Rate	$29.52
Max. Negotiated Rate	$557.00
Rate for Payer: Aetna Commercial	$116.52
Rate for Payer: Aetna Medicare Advantage	$138.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$154.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$154.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$42.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$46.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$154.64
Rate for Payer: Cigna Commercial	$557.00
Rate for Payer: Cigna Medicare Advantage	$42.84
Rate for Payer: Clover Medicare Advantage	$40.70
Rate for Payer: EmblemHealth Commercial	$128.52
Rate for Payer: Humana Medicare Advantage	$44.13
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$42.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$334.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$167.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$34.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$42.84
Rate for Payer: Wellcare Medicare Advantage	$42.84
Rate for Payer: Wellpoint Medicaid Managed Care	$29.52

CH JC VIRUS DNA, QN RT-PCR

Facility

$1,114.00

Service Code	HCPCS 87799
Hospital Charge Code	397071388
Hospital Revenue Code	306
Min. Negotiated Rate	$167.10
Max. Negotiated Rate	$167.10
Rate for Payer: Qualcare PPO/HMO/WC	$167.10

CH KAPPA LAMBDA W CALC 24H U

Facility

$905.00

Hospital Charge Code	3970731
Hospital Revenue Code	301
Min. Negotiated Rate	$135.75
Max. Negotiated Rate	$135.75
Rate for Payer: Qualcare PPO/HMO/WC	$135.75

Know your out-of-pocket cost for care.

All Charges