Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COLCHICINE/0.6MG/TAB

Facility

$3.00

Hospital Charge Code	60634518
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

COLCHICINE/0.6MG/TAB

Facility

$3.00

Hospital Charge Code	60634518
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

COLCHICINE 1 MG/2ML INJ

Facility

$40.85

Hospital Charge Code	60629244
Hospital Revenue Code	250
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$6.13
Rate for Payer: Qualcare PPO/HMO/WC	$6.13

COLCHICINE 1 MG/2ML INJ

Facility

$40.85

Hospital Charge Code	60629244
Hospital Revenue Code	250
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$20.43
Rate for Payer: Aetna Commercial	$15.52
Rate for Payer: Aetna Medicare Advantage	$12.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.42
Rate for Payer: Cigna Commercial	$20.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.26
Rate for Payer: Oxford Commercial	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$6.13
Rate for Payer: UnitedHealthcare Commercial	$8.17
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

COLCHICINE INJ/AMP

Facility

$122.00

Hospital Charge Code	60634519
Hospital Revenue Code	636
Min. Negotiated Rate	$18.30
Max. Negotiated Rate	$29.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.52
Rate for Payer: Qualcare PPO/HMO/WC	$18.30

COLCHICINE INJ/AMP

Facility

$122.00

Hospital Charge Code	60634519
Hospital Revenue Code	636
Min. Negotiated Rate	$2.94
Max. Negotiated Rate	$61.00
Rate for Payer: Aetna Commercial	$46.36
Rate for Payer: Aetna Medicare Advantage	$36.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.11
Rate for Payer: Cigna Commercial	$61.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.52
Rate for Payer: Qualcare PPO/HMO/WC	$18.30
Rate for Payer: UnitedHealthcare Community & State	$2.94
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

COLCHICINE PROBEN TAB .5-500MG

Facility

$4.20

Hospital Charge Code	60628522
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.10
Rate for Payer: Aetna Commercial	$1.60
Rate for Payer: Aetna Medicare Advantage	$1.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.07
Rate for Payer: Cigna Commercial	$2.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.26
Rate for Payer: Oxford Commercial	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.63
Rate for Payer: UnitedHealthcare Commercial	$0.84
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

COLCHICINE PROBEN TAB .5-500MG

Facility

$4.20

Hospital Charge Code	60628522
Hospital Revenue Code	250
Min. Negotiated Rate	$0.63
Max. Negotiated Rate	$0.63
Rate for Payer: Qualcare PPO/HMO/WC	$0.63

COLCHICINE TAB 0.5MG

Facility

$3.85

Hospital Charge Code	60628520
Hospital Revenue Code	250
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.93
Rate for Payer: Aetna Commercial	$1.46
Rate for Payer: Aetna Medicare Advantage	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.98
Rate for Payer: Cigna Commercial	$1.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.16
Rate for Payer: Oxford Commercial	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.58
Rate for Payer: UnitedHealthcare Commercial	$0.77
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.10

COLCHICINE TAB 0.5MG

Facility

$3.85

Hospital Charge Code	60628520
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$0.58
Rate for Payer: Qualcare PPO/HMO/WC	$0.58

COL CHROMOTOGRAPHY QUAL/QUANT

Facility

$120.45

Service Code	HCPCS 82542
Hospital Charge Code	401382725C
Hospital Revenue Code	306
Min. Negotiated Rate	$3.19
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.96
Rate for Payer: Cigna Commercial	$60.23
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.07
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.19

COL CHROMOTOGRAPHY QUAL/QUANT

Facility

$120.45

Service Code	HCPCS 82542
Hospital Charge Code	401382725C
Hospital Revenue Code	306
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$18.07
Rate for Payer: Qualcare PPO/HMO/WC	$18.07

COLD AGGLUTINATION

Facility

$102.00

Service Code	HCPCS 86157
Hospital Charge Code	38476012
Hospital Revenue Code	302
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$21.92
Rate for Payer: Aetna Medicare Advantage	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.09
Rate for Payer: Cigna Commercial	$51.00
Rate for Payer: Cigna Medicare Advantage	$8.06
Rate for Payer: Clover Medicare Advantage	$7.66
Rate for Payer: EmblemHealth Commercial	$24.18
Rate for Payer: Humana Medicare Advantage	$8.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.06
Rate for Payer: Wellcare Medicare Advantage	$8.06
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

COLD AGGLUTINATION

Facility

$102.00

Service Code	HCPCS 86157
Hospital Charge Code	38476012
Hospital Revenue Code	302
Min. Negotiated Rate	$15.30
Max. Negotiated Rate	$15.30
Rate for Payer: Qualcare PPO/HMO/WC	$15.30

COLD AGGLUTININ SCREEN

Facility

$34.00

Service Code	HCPCS 86156
Hospital Charge Code	38476256
Hospital Revenue Code	312
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$21.95
Rate for Payer: Aetna Medicare Advantage	$26.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.13
Rate for Payer: Cigna Commercial	$17.00
Rate for Payer: Cigna Medicare Advantage	$8.07
Rate for Payer: Clover Medicare Advantage	$7.67
Rate for Payer: EmblemHealth Commercial	$24.21
Rate for Payer: Humana Medicare Advantage	$8.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.10
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.07
Rate for Payer: Wellcare Medicare Advantage	$8.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.90

COLD AGGLUTININ SCREEN

Facility

$390.00

Service Code	HCPCS 86156
Hospital Charge Code	3100183
Hospital Revenue Code	300
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COLD AGGLUTININ SCREEN

Facility

$390.00

Service Code	HCPCS 86156
Hospital Charge Code	3100183
Hospital Revenue Code	300
Min. Negotiated Rate	$5.81
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$21.95
Rate for Payer: Aetna Medicare Advantage	$26.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.13
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.07
Rate for Payer: Clover Medicare Advantage	$7.67
Rate for Payer: EmblemHealth Commercial	$24.21
Rate for Payer: Humana Medicare Advantage	$8.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.07
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	$6.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.07
Rate for Payer: Wellcare Medicare Advantage	$8.07
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

COLD AGGLUTININ SCREEN

Facility

$34.00

Service Code	HCPCS 86156
Hospital Charge Code	38476256
Hospital Revenue Code	312
Min. Negotiated Rate	$5.10
Max. Negotiated Rate	$5.10
Rate for Payer: Qualcare PPO/HMO/WC	$5.10

COLD AGGLUTININ TITER

Facility

$390.00

Service Code	HCPCS 86157
Hospital Charge Code	3000841
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COLD AGGLUTININ TITER

Facility

$390.00

Service Code	HCPCS 86157
Hospital Charge Code	3000841
Hospital Revenue Code	302
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$21.92
Rate for Payer: Aetna Medicare Advantage	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.09
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.06
Rate for Payer: Clover Medicare Advantage	$7.66
Rate for Payer: EmblemHealth Commercial	$24.18
Rate for Payer: Humana Medicare Advantage	$8.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.06
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	$6.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.06
Rate for Payer: Wellcare Medicare Advantage	$8.06
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

COLD AGGUTININS***

Facility

$42.00

Hospital Charge Code	3010840
Hospital Revenue Code	309
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

COLD AGGUTININS***

Facility

$42.00

Hospital Charge Code	3010840
Hospital Revenue Code	309
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.96
Rate for Payer: Aetna Medicare Advantage	$12.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.71
Rate for Payer: Cigna Commercial	$21.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.01
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

COLD HEMAGGLUTINATION

Facility

$55.45

Service Code	HCPCS 86157
Hospital Charge Code	39900195
Hospital Revenue Code	302
Min. Negotiated Rate	$1.47
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$21.92
Rate for Payer: Aetna Medicare Advantage	$26.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.09
Rate for Payer: Cigna Commercial	$27.73
Rate for Payer: Cigna Medicare Advantage	$8.06
Rate for Payer: Clover Medicare Advantage	$7.66
Rate for Payer: EmblemHealth Commercial	$24.18
Rate for Payer: Humana Medicare Advantage	$8.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.32
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.06
Rate for Payer: Wellcare Medicare Advantage	$8.06
Rate for Payer: Wellpoint Medicaid Managed Care	$1.47

COLD HEMAGGLUTINATION

Facility

$55.45

Service Code	HCPCS 86157
Hospital Charge Code	39900195
Hospital Revenue Code	302
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$8.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.32

COLD HEMAGGLUTINS

Facility

$55.00

Hospital Charge Code	39708012
Hospital Revenue Code	302
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

Know your out-of-pocket cost for care.

All Charges