Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

16X65MM HEADLESS SCREW

Facility

$3,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704037
Hospital Revenue Code	278
Min. Negotiated Rate	$83.14
Max. Negotiated Rate	$1,725.00
Rate for Payer: Aetna Commercial	$1,311.00
Rate for Payer: Aetna Medicare Advantage	$1,035.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$879.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$690.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$879.75
Rate for Payer: Cigna Commercial	$1,725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$517.50
Rate for Payer: UnitedHealthcare Community & State	$83.14
Rate for Payer: Wellpoint Medicaid Managed Care	$91.42

16X65MM HEADLESS SCREW

Facility

$3,450.00

Service Code	HCPCS C1713
Hospital Charge Code	270704037
Hospital Revenue Code	278
Min. Negotiated Rate	$517.50
Max. Negotiated Rate	$834.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$690.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$834.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$759.00
Rate for Payer: Qualcare PPO/HMO/WC	$517.50

17 ALPHA HYDROXYPROGESTERONE

Facility

$201.65

Service Code	HCPCS 83498
Hospital Charge Code	3000545
Hospital Revenue Code	301
Min. Negotiated Rate	$5.34
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$73.90
Rate for Payer: Aetna Medicare Advantage	$88.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.08
Rate for Payer: Cigna Commercial	$100.83
Rate for Payer: Cigna Medicare Advantage	$27.17
Rate for Payer: Clover Medicare Advantage	$25.81
Rate for Payer: EmblemHealth Commercial	$81.51
Rate for Payer: Humana Medicare Advantage	$27.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.17
Rate for Payer: Wellcare Medicare Advantage	$27.17
Rate for Payer: Wellpoint Medicaid Managed Care	$5.34

17 ALPHA HYDROXYPROGESTERONE

Facility

$201.65

Service Code	HCPCS 83498
Hospital Charge Code	3000545
Hospital Revenue Code	301
Min. Negotiated Rate	$30.25
Max. Negotiated Rate	$30.25
Rate for Payer: Qualcare PPO/HMO/WC	$30.25

1.7 DRILL BIT

Facility

$395.00

Hospital Charge Code	270656153
Hospital Revenue Code	272
Min. Negotiated Rate	$59.25
Max. Negotiated Rate	$59.25
Rate for Payer: Qualcare PPO/HMO/WC	$59.25

1.7 DRILL BIT

Facility

$395.00

Hospital Charge Code	270656153
Hospital Revenue Code	272
Min. Negotiated Rate	$9.52
Max. Negotiated Rate	$197.50
Rate for Payer: Aetna Commercial	$150.10
Rate for Payer: Aetna Medicare Advantage	$118.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.72
Rate for Payer: Cigna Commercial	$197.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$118.50
Rate for Payer: Oxford Commercial	$79.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.25
Rate for Payer: UnitedHealthcare Commercial	$79.00
Rate for Payer: UnitedHealthcare Community & State	$9.52
Rate for Payer: Wellpoint Medicaid Managed Care	$10.47

17 HYDROXYCORTICOSTEROIDS

Facility

$404.00

Service Code	HCPCS 83491
Hospital Charge Code	38472380
Hospital Revenue Code	301
Min. Negotiated Rate	$10.71
Max. Negotiated Rate	$202.00
Rate for Payer: Aetna Commercial	$48.69
Rate for Payer: Aetna Medicare Advantage	$58.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.61
Rate for Payer: Cigna Commercial	$202.00
Rate for Payer: Cigna Medicare Advantage	$17.90
Rate for Payer: Clover Medicare Advantage	$17.00
Rate for Payer: EmblemHealth Commercial	$53.70
Rate for Payer: Humana Medicare Advantage	$18.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$121.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.90
Rate for Payer: Wellcare Medicare Advantage	$17.90
Rate for Payer: Wellpoint Medicaid Managed Care	$10.71

17 HYDROXYCORTICOSTEROIDS

Facility

$404.00

Service Code	HCPCS 83491
Hospital Charge Code	38472380
Hospital Revenue Code	301
Min. Negotiated Rate	$60.60
Max. Negotiated Rate	$60.60
Rate for Payer: Qualcare PPO/HMO/WC	$60.60

17 HYDROXY CORTICOSTEROIDS, U

Facility

$170.45

Service Code	HCPCS 83491
Hospital Charge Code	3001591
Hospital Revenue Code	301
Min. Negotiated Rate	$25.57
Max. Negotiated Rate	$25.57
Rate for Payer: Qualcare PPO/HMO/WC	$25.57

17 HYDROXY CORTICOSTEROIDS, U

Facility

$170.45

Service Code	HCPCS 83491
Hospital Charge Code	3001591
Hospital Revenue Code	301
Min. Negotiated Rate	$4.52
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.69
Rate for Payer: Aetna Medicare Advantage	$58.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$24.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.61
Rate for Payer: Cigna Commercial	$85.22
Rate for Payer: Cigna Medicare Advantage	$17.90
Rate for Payer: Clover Medicare Advantage	$17.00
Rate for Payer: EmblemHealth Commercial	$53.70
Rate for Payer: Humana Medicare Advantage	$18.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.32
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.90
Rate for Payer: Wellcare Medicare Advantage	$17.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.52

17 HYDROXY PREGNENOLONE

Facility

$205.65

Service Code	HCPCS 84143
Hospital Charge Code	3000544
Hospital Revenue Code	301
Min. Negotiated Rate	$30.85
Max. Negotiated Rate	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$30.85

17 HYDROXY PREGNENOLONE

Facility

$205.65

Service Code	HCPCS 84143
Hospital Charge Code	3000544
Hospital Revenue Code	301
Min. Negotiated Rate	$5.45
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$62.04
Rate for Payer: Aetna Medicare Advantage	$73.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.34
Rate for Payer: Cigna Commercial	$102.83
Rate for Payer: Cigna Medicare Advantage	$22.81
Rate for Payer: Clover Medicare Advantage	$21.67
Rate for Payer: EmblemHealth Commercial	$68.43
Rate for Payer: Humana Medicare Advantage	$23.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.81
Rate for Payer: Wellcare Medicare Advantage	$22.81
Rate for Payer: Wellpoint Medicaid Managed Care	$5.45

17 HYDROXYPREGNENOLONE***

Facility

$201.00

Hospital Charge Code	3010543
Hospital Revenue Code	301
Min. Negotiated Rate	$4.84
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$76.38
Rate for Payer: Aetna Medicare Advantage	$60.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.26
Rate for Payer: Cigna Commercial	$100.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$60.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$30.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.84
Rate for Payer: Wellpoint Medicaid Managed Care	$5.33

17 HYDROXYPREGNENOLONE***

Facility

$201.00

Hospital Charge Code	3010543
Hospital Revenue Code	301
Min. Negotiated Rate	$30.15
Max. Negotiated Rate	$30.15
Rate for Payer: Qualcare PPO/HMO/WC	$30.15

17-HYDROXYPREGNENOLONE

Facility

$308.00

Service Code	HCPCS 84143
Hospital Charge Code	38472900
Hospital Revenue Code	301
Min. Negotiated Rate	$8.16
Max. Negotiated Rate	$154.00
Rate for Payer: Aetna Commercial	$62.04
Rate for Payer: Aetna Medicare Advantage	$73.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$22.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$25.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.34
Rate for Payer: Cigna Commercial	$154.00
Rate for Payer: Cigna Medicare Advantage	$22.81
Rate for Payer: Clover Medicare Advantage	$21.67
Rate for Payer: EmblemHealth Commercial	$68.43
Rate for Payer: Humana Medicare Advantage	$23.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$22.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$92.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.20
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$22.81
Rate for Payer: Wellcare Medicare Advantage	$22.81
Rate for Payer: Wellpoint Medicaid Managed Care	$8.16

17-HYDROXYPREGNENOLONE

Facility

$308.00

Service Code	HCPCS 84143
Hospital Charge Code	38472900
Hospital Revenue Code	301
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.20

17-HYDROXYPROGESTERONE

Facility

$390.00

Service Code	HCPCS 83498
Hospital Charge Code	39900095
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$73.90
Rate for Payer: Aetna Medicare Advantage	$88.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.08
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$27.17
Rate for Payer: Clover Medicare Advantage	$25.81
Rate for Payer: EmblemHealth Commercial	$81.51
Rate for Payer: Humana Medicare Advantage	$27.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.17
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	$21.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.17
Rate for Payer: Wellcare Medicare Advantage	$27.17
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

17-HYDROXYPROGESTERONE

Facility

$390.00

Service Code	HCPCS 83498
Hospital Charge Code	39900095
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

17-HYDROXYPROGESTERONE

Facility

$729.00

Service Code	HCPCS 83498
Hospital Charge Code	38472901
Hospital Revenue Code	301
Min. Negotiated Rate	$109.35
Max. Negotiated Rate	$109.35
Rate for Payer: Qualcare PPO/HMO/WC	$109.35

17-HYDROXYPROGESTERONE

Facility

$729.00

Service Code	HCPCS 83498
Hospital Charge Code	38472901
Hospital Revenue Code	301
Min. Negotiated Rate	$19.32
Max. Negotiated Rate	$364.50
Rate for Payer: Aetna Commercial	$73.90
Rate for Payer: Aetna Medicare Advantage	$88.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$98.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$98.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$27.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$59.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$98.08
Rate for Payer: Cigna Commercial	$364.50
Rate for Payer: Cigna Medicare Advantage	$27.17
Rate for Payer: Clover Medicare Advantage	$25.81
Rate for Payer: EmblemHealth Commercial	$81.51
Rate for Payer: Humana Medicare Advantage	$27.99
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$27.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$218.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$109.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$21.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$27.17
Rate for Payer: Wellcare Medicare Advantage	$27.17
Rate for Payer: Wellpoint Medicaid Managed Care	$19.32

17 KETOGENIC STEROIDS URINE

Facility

$179.25

Service Code	HCPCS 83582
Hospital Charge Code	3001724
Hospital Revenue Code	301
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$42.08
Rate for Payer: Aetna Medicare Advantage	$50.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$55.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.47
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	$55.84
Rate for Payer: Cigna Commercial	$89.62
Rate for Payer: Cigna Medicare Advantage	$15.47
Rate for Payer: Clover Medicare Advantage	$14.70
Rate for Payer: EmblemHealth Commercial	$46.41
Rate for Payer: Humana Medicare Advantage	$15.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.38
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.47
Rate for Payer: Wellcare Medicare Advantage	$15.47
Rate for Payer: Wellpoint Medicaid Managed Care	$4.75

17 KETOGENIC STEROIDS URINE

Facility

$179.25

Service Code	HCPCS 83582
Hospital Charge Code	3001724
Hospital Revenue Code	301
Min. Negotiated Rate	$26.89
Max. Negotiated Rate	$26.89
Rate for Payer: Qualcare PPO/HMO/WC	$26.89

17 KETOSTEROIDS, URINE

Facility

$136.85

Service Code	HCPCS 83586
Hospital Charge Code	3001732
Hospital Revenue Code	301
Min. Negotiated Rate	$20.53
Max. Negotiated Rate	$20.53
Rate for Payer: Qualcare PPO/HMO/WC	$20.53

17 KETOSTEROIDS, URINE

Facility

$136.85

Service Code	HCPCS 83586
Hospital Charge Code	3001732
Hospital Revenue Code	301
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.82
Rate for Payer: Aetna Medicare Advantage	$41.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.20
Rate for Payer: Cigna Commercial	$68.42
Rate for Payer: Cigna Medicare Advantage	$12.80
Rate for Payer: Clover Medicare Advantage	$12.16
Rate for Payer: EmblemHealth Commercial	$38.40
Rate for Payer: Humana Medicare Advantage	$13.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.05
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.53
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.80
Rate for Payer: Wellcare Medicare Advantage	$12.80
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

17 KETOSTEROIDS,URINE

Facility

$390.00

Service Code	HCPCS 83586
Hospital Charge Code	38472383
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges