Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ADJUSTMENT DISORDERS

Facility

$14,429.36

Service Code	APR-DRG 7554
Min. Negotiated Rate	$14,146.43
Max. Negotiated Rate	$14,429.36
Rate for Payer: UnitedHealthcare Community & State	$14,146.43
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$14,429.36
Rate for Payer: Wellpoint Medicaid Managed Care	$14,146.43

ADMIN INJECT ANTIBIOTIC IM

Facility

$138.65

Service Code	HCPCS 96372
Hospital Charge Code	9400110
Hospital Revenue Code	940
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$2,407.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.59
Rate for Payer: Oxford Commercial	$1,373.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.80
Rate for Payer: UnitedHealthcare Commercial	$2,407.00
Rate for Payer: UnitedHealthcare Community & State	$3.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.67

ADMIN INJECT ANTIBIOTIC IM

Facility

$138.65

Service Code	HCPCS 96372
Hospital Charge Code	9400110
Hospital Revenue Code	940
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$20.80

ADMIN INJECT THERAPEUT SUBQ/IM

Facility

$138.65

Service Code	HCPCS 96372
Hospital Charge Code	9400102
Hospital Revenue Code	940
Min. Negotiated Rate	$20.80
Max. Negotiated Rate	$20.80
Rate for Payer: Qualcare PPO/HMO/WC	$20.80

ADMIN INJECT THERAPEUT SUBQ/IM

Facility

$138.65

Service Code	HCPCS 96372
Hospital Charge Code	9400102
Hospital Revenue Code	940
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$2,407.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.59
Rate for Payer: Oxford Commercial	$1,373.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.80
Rate for Payer: UnitedHealthcare Commercial	$2,407.00
Rate for Payer: UnitedHealthcare Community & State	$3.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$3.67

ADMIN OF NITRIC OXIDE

Facility

$545.00

Hospital Charge Code	31701000
Hospital Revenue Code	410
Min. Negotiated Rate	$13.13
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$207.10
Rate for Payer: Aetna Medicare Advantage	$163.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$138.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$138.97
Rate for Payer: Cigna Commercial	$272.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.50
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$81.75
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$13.13
Rate for Payer: Wellpoint Medicaid Managed Care	$14.44

ADMIN OF NITRIC OXIDE

Facility

$545.00

Hospital Charge Code	31701000
Hospital Revenue Code	410
Min. Negotiated Rate	$81.75
Max. Negotiated Rate	$81.75
Rate for Payer: Qualcare PPO/HMO/WC	$81.75

ADMIN VACCIN EA ADD'L NONMCARE

Facility

$46.25

Service Code	HCPCS 90472
Hospital Charge Code	9400012
Hospital Revenue Code	940
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$2,407.00
Rate for Payer: Aetna Commercial	$17.57
Rate for Payer: Aetna Medicare Advantage	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.79
Rate for Payer: Cigna Commercial	$23.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.88
Rate for Payer: Oxford Commercial	$1,373.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.94
Rate for Payer: UnitedHealthcare Commercial	$2,407.00
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.23

ADMIN VACCIN EA ADD'L NONMCARE

Facility

$46.25

Service Code	HCPCS 90472
Hospital Charge Code	9400012
Hospital Revenue Code	940
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$6.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.94

ADMIN VACCINE FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	260122
Hospital Revenue Code	771
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$308.77
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.25
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$38.12
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$6.13
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$6.73

ADMIN VACCINE FLU

Facility

$254.15

Service Code	HCPCS 90471
Hospital Charge Code	260122
Hospital Revenue Code	771
Min. Negotiated Rate	$38.12
Max. Negotiated Rate	$38.12
Rate for Payer: Qualcare PPO/HMO/WC	$38.12

ADMIN VACCIN FIRST NONMCARE

Facility

$46.25

Service Code	HCPCS 90471
Hospital Charge Code	9400010
Hospital Revenue Code	771
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$6.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.94

ADMIN VACCIN FIRST NONMCARE

Facility

$46.25

Service Code	HCPCS 90471
Hospital Charge Code	9400010
Hospital Revenue Code	771
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$308.77
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.88
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.94
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.23

ADMIN VACCIN HEP B MCARE ONLY

Facility

$29.65

Hospital Charge Code	9400014
Hospital Revenue Code	771
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$11.27
Rate for Payer: Aetna Medicare Advantage	$8.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.56
Rate for Payer: Cigna Commercial	$14.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.89
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.45
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

ADMIN VACCIN HEP B MCARE ONLY

Facility

$29.65

Hospital Charge Code	9400014
Hospital Revenue Code	771
Min. Negotiated Rate	$4.45
Max. Negotiated Rate	$4.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.45

ADMIN VACCIN INFLZA MCARE ONLY

Facility

$46.25

Hospital Charge Code	9400016
Hospital Revenue Code	771
Min. Negotiated Rate	$6.94
Max. Negotiated Rate	$6.94
Rate for Payer: Qualcare PPO/HMO/WC	$6.94

ADMIN VACCIN INFLZA MCARE ONLY

Facility

$46.25

Hospital Charge Code	9400016
Hospital Revenue Code	771
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$17.57
Rate for Payer: Aetna Medicare Advantage	$13.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.79
Rate for Payer: Cigna Commercial	$23.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.88
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.94
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.11
Rate for Payer: Wellpoint Medicaid Managed Care	$1.23

ADMIN VACCIN PNEUMC MCARE ONLY

Facility

$68.75

Hospital Charge Code	9400018
Hospital Revenue Code	771
Min. Negotiated Rate	$1.66
Max. Negotiated Rate	$159.00
Rate for Payer: Aetna Commercial	$26.12
Rate for Payer: Aetna Medicare Advantage	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.53
Rate for Payer: Cigna Commercial	$34.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$20.62
Rate for Payer: Oxford Commercial	$91.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.31
Rate for Payer: UnitedHealthcare Commercial	$159.00
Rate for Payer: UnitedHealthcare Community & State	$1.66
Rate for Payer: Wellpoint Medicaid Managed Care	$1.82

ADMIN VACCIN PNEUMC MCARE ONLY

Facility

$68.75

Hospital Charge Code	9400018
Hospital Revenue Code	771
Min. Negotiated Rate	$10.31
Max. Negotiated Rate	$10.31
Rate for Payer: Qualcare PPO/HMO/WC	$10.31

A & D OINTMENT 5 GM

Facility

$5.00

Hospital Charge Code	60628432W
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.50
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.12
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

A & D OINTMENT 5 GM

Facility

$5.00

Hospital Charge Code	60628432W
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

ADRENAL AB W/RFX

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900203
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.50
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
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	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ADRENAL AB W/RFX

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900203
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC

Facility

$72,976.68

Service Code	MSDRG 614
Min. Negotiated Rate	$22,220.46
Max. Negotiated Rate	$72,976.68
Rate for Payer: Aetna Commercial	$50,400.60
Rate for Payer: Aetna Medicare Advantage	$72,976.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52,337.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52,337.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,389.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52,337.25
Rate for Payer: Cigna Commercial	$41,017.35
Rate for Payer: Cigna Medicare Advantage	$23,389.96
Rate for Payer: Clover Medicare Advantage	$22,220.46
Rate for Payer: EmblemHealth Commercial	$70,169.88
Rate for Payer: Humana Medicare Advantage	$24,091.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,389.96
Rate for Payer: Oxford Commercial	$29,479.71
Rate for Payer: UnitedHealthcare Commercial	$51,693.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,389.96
Rate for Payer: Wellcare Medicare Advantage	$23,389.96

ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC

Facility

$47,361.82

Service Code	MSDRG 615
Min. Negotiated Rate	$14,421.07
Max. Negotiated Rate	$47,361.82
Rate for Payer: Aetna Commercial	$32,800.29
Rate for Payer: Aetna Medicare Advantage	$47,361.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34,193.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34,193.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,180.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34,193.67
Rate for Payer: Cigna Commercial	$26,186.50
Rate for Payer: Cigna Medicare Advantage	$15,180.07
Rate for Payer: Clover Medicare Advantage	$14,421.07
Rate for Payer: EmblemHealth Commercial	$45,540.21
Rate for Payer: Humana Medicare Advantage	$15,635.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,180.07
Rate for Payer: Oxford Commercial	$18,820.58
Rate for Payer: UnitedHealthcare Commercial	$33,002.49
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,180.07
Rate for Payer: Wellcare Medicare Advantage	$15,180.07

Know your out-of-pocket cost for care.

All Charges