Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CHROMOSOM RFX TO MICROARRAY IV

Facility

$236.70

Service Code	HCPCS 88291
Hospital Charge Code	3038516D
Hospital Revenue Code	310
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$89.95
Rate for Payer: Aetna Medicare Advantage	$71.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.36
Rate for Payer: Cigna Commercial	$118.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.51
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$26.68
Rate for Payer: Wellpoint Medicaid Managed Care	$6.27

CHROMOS RFX TO MICROARRAY III

Facility

$236.70

Service Code	HCPCS 88289
Hospital Charge Code	3038516C
Hospital Revenue Code	310
Min. Negotiated Rate	$35.51
Max. Negotiated Rate	$35.51
Rate for Payer: Qualcare PPO/HMO/WC	$35.51

CHROMOS RFX TO MICROARRAY III

Facility

$236.70

Service Code	HCPCS 88289
Hospital Charge Code	3038516C
Hospital Revenue Code	310
Min. Negotiated Rate	$6.27
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$93.65
Rate for Payer: Aetna Medicare Advantage	$111.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.28
Rate for Payer: Cigna Commercial	$118.35
Rate for Payer: Cigna Medicare Advantage	$34.43
Rate for Payer: Clover Medicare Advantage	$32.71
Rate for Payer: EmblemHealth Commercial	$103.29
Rate for Payer: Humana Medicare Advantage	$35.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$71.01
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$35.51
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$27.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.43
Rate for Payer: Wellcare Medicare Advantage	$34.43
Rate for Payer: Wellpoint Medicaid Managed Care	$6.27

CHRONIC KIDNEY DISEASE

Facility

$4,868.06

Service Code	APR-DRG 4701
Min. Negotiated Rate	$4,772.61
Max. Negotiated Rate	$4,868.06
Rate for Payer: UnitedHealthcare Community & State	$4,772.61
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,868.06
Rate for Payer: Wellpoint Medicaid Managed Care	$4,772.61

CHRONIC KIDNEY DISEASE

Facility

$20,538.39

Service Code	APR-DRG 4704
Min. Negotiated Rate	$20,135.68
Max. Negotiated Rate	$20,538.39
Rate for Payer: UnitedHealthcare Community & State	$20,135.68
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$20,538.39
Rate for Payer: Wellpoint Medicaid Managed Care	$20,135.68

CHRONIC KIDNEY DISEASE

Facility

$6,259.73

Service Code	APR-DRG 4702
Min. Negotiated Rate	$6,136.99
Max. Negotiated Rate	$6,259.73
Rate for Payer: UnitedHealthcare Community & State	$6,136.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,259.73
Rate for Payer: Wellpoint Medicaid Managed Care	$6,136.99

CHRONIC KIDNEY DISEASE

Facility

$10,756.27

Service Code	APR-DRG 4703
Min. Negotiated Rate	$10,545.36
Max. Negotiated Rate	$10,756.27
Rate for Payer: UnitedHealthcare Community & State	$10,545.36
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,756.27
Rate for Payer: Wellpoint Medicaid Managed Care	$10,545.36

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$8,141.57

Service Code	APR-DRG 1402
Min. Negotiated Rate	$7,981.93
Max. Negotiated Rate	$8,141.57
Rate for Payer: UnitedHealthcare Community & State	$7,981.93
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,141.57
Rate for Payer: Wellpoint Medicaid Managed Care	$7,981.93

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$10,101.30

Service Code	APR-DRG 1403
Min. Negotiated Rate	$9,903.24
Max. Negotiated Rate	$10,101.30
Rate for Payer: UnitedHealthcare Community & State	$9,903.24
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,101.30
Rate for Payer: Wellpoint Medicaid Managed Care	$9,903.24

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$18,530.16

Service Code	APR-DRG 1404
Min. Negotiated Rate	$18,166.82
Max. Negotiated Rate	$18,530.16
Rate for Payer: UnitedHealthcare Community & State	$18,166.82
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,530.16
Rate for Payer: Wellpoint Medicaid Managed Care	$18,166.82

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Facility

$6,605.70

Service Code	APR-DRG 1401
Min. Negotiated Rate	$6,476.18
Max. Negotiated Rate	$6,605.70
Rate for Payer: UnitedHealthcare Community & State	$6,476.18
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,605.70
Rate for Payer: Wellpoint Medicaid Managed Care	$6,476.18

CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC

Facility

$29,381.16

Service Code	MSDRG 191
Min. Negotiated Rate	$8,946.19
Max. Negotiated Rate	$29,381.16
Rate for Payer: Aetna Commercial	$20,445.54
Rate for Payer: Aetna Medicare Advantage	$29,381.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19,771.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19,771.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,417.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19,771.85
Rate for Payer: Cigna Commercial	$15,775.90
Rate for Payer: Cigna Medicare Advantage	$9,417.04
Rate for Payer: Clover Medicare Advantage	$8,946.19
Rate for Payer: EmblemHealth Commercial	$28,251.12
Rate for Payer: Humana Medicare Advantage	$9,699.55
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,417.04
Rate for Payer: Oxford Commercial	$11,338.35
Rate for Payer: UnitedHealthcare Commercial	$19,882.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,417.04
Rate for Payer: Wellcare Medicare Advantage	$9,417.04

CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC

Facility

$37,936.77

Service Code	MSDRG 190
Min. Negotiated Rate	$11,551.26
Max. Negotiated Rate	$37,936.77
Rate for Payer: Aetna Commercial	$26,324.22
Rate for Payer: Aetna Medicare Advantage	$37,936.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25,587.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25,587.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,159.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25,587.10
Rate for Payer: Cigna Commercial	$20,729.50
Rate for Payer: Cigna Medicare Advantage	$12,159.22
Rate for Payer: Clover Medicare Advantage	$11,551.26
Rate for Payer: EmblemHealth Commercial	$36,477.66
Rate for Payer: Humana Medicare Advantage	$12,524.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,159.22
Rate for Payer: Oxford Commercial	$14,898.57
Rate for Payer: UnitedHealthcare Commercial	$26,125.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,159.22
Rate for Payer: Wellcare Medicare Advantage	$12,159.22

CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC

Facility

$22,884.54

Service Code	MSDRG 192
Min. Negotiated Rate	$6,968.05
Max. Negotiated Rate	$22,884.54
Rate for Payer: Aetna Commercial	$15,981.61
Rate for Payer: Aetna Medicare Advantage	$22,884.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,887.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,887.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,334.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,887.04
Rate for Payer: Cigna Commercial	$12,014.39
Rate for Payer: Cigna Medicare Advantage	$7,334.79
Rate for Payer: Clover Medicare Advantage	$6,968.05
Rate for Payer: EmblemHealth Commercial	$22,004.37
Rate for Payer: Humana Medicare Advantage	$7,554.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,334.79
Rate for Payer: Oxford Commercial	$8,634.90
Rate for Payer: UnitedHealthcare Commercial	$15,141.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,334.79
Rate for Payer: Wellcare Medicare Advantage	$7,334.79

CHRONIC URTICARIA

Facility

$85.65

Service Code	HCPCS 86343
Hospital Charge Code	3038145
Hospital Revenue Code	302
Min. Negotiated Rate	$12.85
Max. Negotiated Rate	$12.85
Rate for Payer: Qualcare PPO/HMO/WC	$12.85

CHRONIC URTICARIA

Facility

$85.65

Service Code	HCPCS 86343
Hospital Charge Code	3038145
Hospital Revenue Code	302
Min. Negotiated Rate	$2.27
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$33.89
Rate for Payer: Aetna Medicare Advantage	$40.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.98
Rate for Payer: Cigna Commercial	$42.83
Rate for Payer: Cigna Medicare Advantage	$12.46
Rate for Payer: Clover Medicare Advantage	$11.84
Rate for Payer: EmblemHealth Commercial	$37.38
Rate for Payer: Humana Medicare Advantage	$12.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.46
Rate for Payer: Wellcare Medicare Advantage	$12.46
Rate for Payer: Wellpoint Medicaid Managed Care	$2.27

Chronic Uticaria panel A

Facility

$390.00

Service Code	HCPCS 84443
Hospital Charge Code	39708021A
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.70
Rate for Payer: Aetna Medicare Advantage	$54.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.80
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	$60.64
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.80
Rate for Payer: Clover Medicare Advantage	$15.96
Rate for Payer: EmblemHealth Commercial	$50.40
Rate for Payer: Humana Medicare Advantage	$17.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.80
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	$13.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.80
Rate for Payer: Wellcare Medicare Advantage	$16.80
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

Chronic Uticaria panel A

Facility

$390.00

Service Code	HCPCS 84443
Hospital Charge Code	39708021A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Chronic Uticaria panel B

Facility

$390.00

Service Code	HCPCS 86343
Hospital Charge Code	39708021B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Chronic Uticaria panel B

Facility

$390.00

Service Code	HCPCS 86343
Hospital Charge Code	39708021B
Hospital Revenue Code	302
Min. Negotiated Rate	$9.97
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$33.89
Rate for Payer: Aetna Medicare Advantage	$40.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.98
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.46
Rate for Payer: Clover Medicare Advantage	$11.84
Rate for Payer: EmblemHealth Commercial	$37.38
Rate for Payer: Humana Medicare Advantage	$12.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.46
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	$9.97
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.46
Rate for Payer: Wellcare Medicare Advantage	$12.46
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

Chronic Uticaria panel C

Facility

$390.00

Service Code	HCPCS 86376
Hospital Charge Code	39708021C
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.58
Rate for Payer: Aetna Medicare Advantage	$47.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.52
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.55
Rate for Payer: Clover Medicare Advantage	$13.82
Rate for Payer: EmblemHealth Commercial	$43.65
Rate for Payer: Humana Medicare Advantage	$14.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.55
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	$11.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.55
Rate for Payer: Wellcare Medicare Advantage	$14.55
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

Chronic Uticaria panel C

Facility

$390.00

Service Code	HCPCS 86376
Hospital Charge Code	39708021C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Chronic Uticaria panel D

Facility

$390.00

Service Code	HCPCS 86800
Hospital Charge Code	39708021D
Hospital Revenue Code	302
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$43.28
Rate for Payer: Aetna Medicare Advantage	$51.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.43
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.91
Rate for Payer: Clover Medicare Advantage	$15.11
Rate for Payer: EmblemHealth Commercial	$47.73
Rate for Payer: Humana Medicare Advantage	$16.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.91
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	$12.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.91
Rate for Payer: Wellcare Medicare Advantage	$15.91
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

Chronic Uticaria panel D

Facility

$390.00

Service Code	HCPCS 86800
Hospital Charge Code	39708021D
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CHRONOS 10cc

Facility

$2,960.20

Hospital Charge Code	270639428
Hospital Revenue Code	278
Min. Negotiated Rate	$71.34
Max. Negotiated Rate	$1,480.10
Rate for Payer: Aetna Commercial	$1,124.88
Rate for Payer: Aetna Medicare Advantage	$888.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$754.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$754.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$592.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$754.85
Rate for Payer: Cigna Commercial	$1,480.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$716.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$651.24
Rate for Payer: Qualcare PPO/HMO/WC	$444.03
Rate for Payer: UnitedHealthcare Community & State	$71.34
Rate for Payer: Wellpoint Medicaid Managed Care	$78.45

Know your out-of-pocket cost for care.

All Charges