Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CH NOREPINEPHRINE

Facility

$390.00

Service Code	HCPCS 82542
Hospital Charge Code	397073630
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH NOROVIRUS STOOL

Facility

$1,058.00

Service Code	HCPCS 87449
Hospital Charge Code	397072167
Hospital Revenue Code	306
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$529.00
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	$12.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.24
Rate for Payer: Cigna Commercial	$529.00
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	$317.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$158.70
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	$28.04

CH NOROVIRUS STOOL

Facility

$1,058.00

Service Code	HCPCS 87449
Hospital Charge Code	397072167
Hospital Revenue Code	306
Min. Negotiated Rate	$158.70
Max. Negotiated Rate	$158.70
Rate for Payer: Qualcare PPO/HMO/WC	$158.70

CH NORTRIPTYLINE

Facility

$84.00

Service Code	HCPCS 80335
Hospital Charge Code	397072117
Hospital Revenue Code	301
Min. Negotiated Rate	$2.23
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$31.92
Rate for Payer: Aetna Medicare Advantage	$25.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.42
Rate for Payer: Cigna Commercial	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$2.23

CH NORTRIPTYLINE

Facility

$84.00

Service Code	HCPCS 80335
Hospital Charge Code	397072117
Hospital Revenue Code	301
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.60

CH NTX

Facility

$171.00

Service Code	HCPCS 82523
Hospital Charge Code	397073556
Hospital Revenue Code	301
Min. Negotiated Rate	$4.53
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.81
Rate for Payer: Aetna Medicare Advantage	$60.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.43
Rate for Payer: Cigna Commercial	$85.50
Rate for Payer: Cigna Medicare Advantage	$18.68
Rate for Payer: Clover Medicare Advantage	$17.75
Rate for Payer: EmblemHealth Commercial	$56.04
Rate for Payer: Humana Medicare Advantage	$19.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.68
Rate for Payer: Wellcare Medicare Advantage	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$4.53

CH NTX

Facility

$171.00

Service Code	HCPCS 82523
Hospital Charge Code	397073556
Hospital Revenue Code	301
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

CH NUCLEI ACID, SIGNAL AMPLI

Facility

$113.00

Service Code	HCPCS 83908
Hospital Charge Code	397071200
Hospital Revenue Code	301
Min. Negotiated Rate	$16.95
Max. Negotiated Rate	$16.95
Rate for Payer: Qualcare PPO/HMO/WC	$16.95

CH NUCLEI ACID, SIGNAL AMPLI

Facility

$113.00

Service Code	HCPCS 83908
Hospital Charge Code	397071200
Hospital Revenue Code	301
Min. Negotiated Rate	$2.72
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$42.94
Rate for Payer: Aetna Medicare Advantage	$33.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.82
Rate for Payer: Cigna Commercial	$56.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.72
Rate for Payer: Wellpoint Medicaid Managed Care	$2.99

CH NUCLEIC ACID AMLICAT X3

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073291
Hospital Revenue Code	301
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

CH NUCLEIC ACID AMLICAT X3

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073291
Hospital Revenue Code	301
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

CH NUCLEIC ACID AMPLIFICAT

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073285
Hospital Revenue Code	301
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

CH NUCLEIC ACID AMPLIFICAT

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073285
Hospital Revenue Code	301
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

CH NUCLEIC ACID AMPLIFICATX4

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073298
Hospital Revenue Code	301
Min. Negotiated Rate	$2.51
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.52
Rate for Payer: Aetna Medicare Advantage	$31.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.52
Rate for Payer: Cigna Commercial	$52.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.76

CH NUCLEIC ACID AMPLIFICATX4

Facility

$104.00

Service Code	HCPCS 83898
Hospital Charge Code	397073298
Hospital Revenue Code	301
Min. Negotiated Rate	$15.60
Max. Negotiated Rate	$15.60
Rate for Payer: Qualcare PPO/HMO/WC	$15.60

CH NUCLEIC ACID HIGH RESOLUT

Facility

$101.00

Service Code	HCPCS 81240
Hospital Charge Code	397071417
Hospital Revenue Code	310
Min. Negotiated Rate	$2.68
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	$50.50
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	$30.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.15
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	$2.68

CH NUCLEIC ACID HIGH RESOLUT

Facility

$101.00

Service Code	HCPCS 81240
Hospital Charge Code	397071417
Hospital Revenue Code	310
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$15.15
Rate for Payer: Qualcare PPO/HMO/WC	$15.15

CH NUCLEIC ACID PROBE

Facility

$390.00

Service Code	HCPCS 81479
Hospital Charge Code	397073284
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CH NUCLEIC ACID PROBE

Facility

$390.00

Service Code	HCPCS 81479
Hospital Charge Code	397073284
Hospital Revenue Code	306
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CH NUCLEIC ACID PROBE X2

Facility

$65.00

Service Code	HCPCS 83896
Hospital Charge Code	397073290
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

CH NUCLEIC ACID PROBE X2

Facility

$65.00

Service Code	HCPCS 83896
Hospital Charge Code	397073290
Hospital Revenue Code	301
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

CH NUCLEIC ACID PROBE X3

Facility

$65.00

Service Code	HCPCS 83896
Hospital Charge Code	397073297
Hospital Revenue Code	301
Min. Negotiated Rate	$9.75
Max. Negotiated Rate	$9.75
Rate for Payer: Qualcare PPO/HMO/WC	$9.75

CH NUCLEIC ACID PROBE X3

Facility

$65.00

Service Code	HCPCS 83896
Hospital Charge Code	397073297
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

CH NUCLEIC ACID TRANSFER X2

Facility

$40.00

Service Code	HCPCS 83897
Hospital Charge Code	397073283
Hospital Revenue Code	301
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

CH NUCLEIC ACID TRANSFER X2

Facility

$40.00

Service Code	HCPCS 83897
Hospital Charge Code	397073283
Hospital Revenue Code	301
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

Know your out-of-pocket cost for care.

All Charges