Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COPE NEPHROUETERSTOMY 22 F

Facility

$687.45

Hospital Charge Code	270703091
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$166.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.24
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

COPE NEPHROUETERSTOMY 22 F

Facility

$687.45

Hospital Charge Code	270703091
Hospital Revenue Code	278
Min. Negotiated Rate	$16.57
Max. Negotiated Rate	$343.73
Rate for Payer: Aetna Commercial	$261.23
Rate for Payer: Aetna Medicare Advantage	$206.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.30
Rate for Payer: Cigna Commercial	$343.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.24
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Community & State	$16.57
Rate for Payer: Wellpoint Medicaid Managed Care	$18.22

COPE NEPHTOUERTEROSTOMY 24 F

Facility

$687.45

Hospital Charge Code	270703092
Hospital Revenue Code	278
Min. Negotiated Rate	$103.12
Max. Negotiated Rate	$166.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.24
Rate for Payer: Qualcare PPO/HMO/WC	$103.12

COPE NEPHTOUERTEROSTOMY 24 F

Facility

$687.45

Hospital Charge Code	270703092
Hospital Revenue Code	278
Min. Negotiated Rate	$16.57
Max. Negotiated Rate	$343.73
Rate for Payer: Aetna Commercial	$261.23
Rate for Payer: Aetna Medicare Advantage	$206.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$175.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$175.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$137.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$175.30
Rate for Payer: Cigna Commercial	$343.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$166.36
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$151.24
Rate for Payer: Qualcare PPO/HMO/WC	$103.12
Rate for Payer: UnitedHealthcare Community & State	$16.57
Rate for Payer: Wellpoint Medicaid Managed Care	$18.22

COPEPTIN (SERUM)

Facility

$249.25

Service Code	HCPCS 86255
Hospital Charge Code	401186255Z
Hospital Revenue Code	302
Min. Negotiated Rate	$6.61
Max. Negotiated Rate	$124.62
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	$124.62
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	$74.78
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.39
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	$6.61

COPEPTIN (SERUM)

Facility

$249.25

Service Code	HCPCS 86255
Hospital Charge Code	401186255Z
Hospital Revenue Code	302
Min. Negotiated Rate	$37.39
Max. Negotiated Rate	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$37.39

COPEPTIN SERUM

Facility

$249.25

Service Code	HCPCS 86255
Hospital Charge Code	401186255W
Hospital Revenue Code	302
Min. Negotiated Rate	$6.61
Max. Negotiated Rate	$124.62
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	$124.62
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	$74.78
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.39
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	$6.61

COPEPTIN SERUM

Facility

$249.25

Service Code	HCPCS 86255
Hospital Charge Code	401186255W
Hospital Revenue Code	302
Min. Negotiated Rate	$37.39
Max. Negotiated Rate	$37.39
Rate for Payer: Qualcare PPO/HMO/WC	$37.39

COPE SUTURE ANCH 17X12

Facility

$66.01

Hospital Charge Code	270658336
Hospital Revenue Code	272
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

COPE SUTURE ANCH 17X12

Facility

$66.01

Hospital Charge Code	270658336
Hospital Revenue Code	272
Min. Negotiated Rate	$1.59
Max. Negotiated Rate	$33.01
Rate for Payer: Aetna Commercial	$25.08
Rate for Payer: Aetna Medicare Advantage	$19.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.83
Rate for Payer: Cigna Commercial	$33.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.80
Rate for Payer: Oxford Commercial	$13.20
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$13.20
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

COPILOT BLEEDBACK CONTROL VALV

Facility

$120.00

Hospital Charge Code	2709002253
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

COPILOT BLEEDBACK CONTROL VALV

Facility

$120.00

Hospital Charge Code	2709002253
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.00
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$24.00
Rate for Payer: UnitedHealthcare Community & State	$2.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

COPPER

Facility

$146.00

Service Code	HCPCS 82525
Hospital Charge Code	38472218
Hospital Revenue Code	301
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

COPPER

Facility

$146.00

Service Code	HCPCS 82525
Hospital Charge Code	38472218
Hospital Revenue Code	301
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$33.76
Rate for Payer: Aetna Medicare Advantage	$40.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$44.80
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: Cigna Medicare Advantage	$12.41
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Medicare Advantage	$12.41
Rate for Payer: Wellpoint Medicaid Managed Care	$3.87

COPPER,24 HOUR URINE

Facility

$390.00

Service Code	HCPCS 82525
Hospital Charge Code	3003663A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COPPER,24 HOUR URINE

Facility

$390.00

Service Code	HCPCS 82525
Hospital Charge Code	3003663A
Hospital Revenue Code	301
Min. Negotiated Rate	$9.93
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$33.76
Rate for Payer: Aetna Medicare Advantage	$40.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$44.80
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.41
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.41
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	$9.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Medicare Advantage	$12.41
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

COPPER (PLASMA)***

Facility

$39.00

Hospital Charge Code	3010881
Hospital Revenue Code	309
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.85

COPPER (PLASMA)***

Facility

$39.00

Hospital Charge Code	3010881
Hospital Revenue Code	309
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.82
Rate for Payer: Aetna Medicare Advantage	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.95
Rate for Payer: Cigna Commercial	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$1.03

COPPER PLASMA

Facility

$158.45

Service Code	HCPCS 82525
Hospital Charge Code	3035081
Hospital Revenue Code	300
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$33.76
Rate for Payer: Aetna Medicare Advantage	$40.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$44.80
Rate for Payer: Cigna Commercial	$79.22
Rate for Payer: Cigna Medicare Advantage	$12.41
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.77
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Medicare Advantage	$12.41
Rate for Payer: Wellpoint Medicaid Managed Care	$4.20

COPPER PLASMA

Facility

$158.45

Service Code	HCPCS 82525
Hospital Charge Code	3035081
Hospital Revenue Code	300
Min. Negotiated Rate	$23.77
Max. Negotiated Rate	$23.77
Rate for Payer: Qualcare PPO/HMO/WC	$23.77

COPPER, PLASMA AND RBC I

Facility

$158.45

Service Code	HCPCS 82525
Hospital Charge Code	3035080A
Hospital Revenue Code	300
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$33.76
Rate for Payer: Aetna Medicare Advantage	$40.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$44.80
Rate for Payer: Cigna Commercial	$79.22
Rate for Payer: Cigna Medicare Advantage	$12.41
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.77
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Medicare Advantage	$12.41
Rate for Payer: Wellpoint Medicaid Managed Care	$4.20

COPPER, PLASMA AND RBC I

Facility

$158.45

Service Code	HCPCS 82525
Hospital Charge Code	3035080A
Hospital Revenue Code	300
Min. Negotiated Rate	$23.77
Max. Negotiated Rate	$23.77
Rate for Payer: Qualcare PPO/HMO/WC	$23.77

COPPER, PLASMA AND RBC II

Facility

$158.45

Service Code	HCPCS 82525
Hospital Charge Code	3035080B
Hospital Revenue Code	300
Min. Negotiated Rate	$23.77
Max. Negotiated Rate	$23.77
Rate for Payer: Qualcare PPO/HMO/WC	$23.77

COPPER, PLASMA AND RBC II

Facility

$158.45

Service Code	HCPCS 82525
Hospital Charge Code	3035080B
Hospital Revenue Code	300
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$33.76
Rate for Payer: Aetna Medicare Advantage	$40.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$44.80
Rate for Payer: Cigna Commercial	$79.22
Rate for Payer: Cigna Medicare Advantage	$12.41
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.77
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Medicare Advantage	$12.41
Rate for Payer: Wellpoint Medicaid Managed Care	$4.20

COPPER SERUM

Facility

$158.45

Service Code	HCPCS 82525
Hospital Charge Code	3000882
Hospital Revenue Code	301
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$33.76
Rate for Payer: Aetna Medicare Advantage	$40.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.41
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	$44.80
Rate for Payer: Cigna Commercial	$79.22
Rate for Payer: Cigna Medicare Advantage	$12.41
Rate for Payer: Clover Medicare Advantage	$11.79
Rate for Payer: EmblemHealth Commercial	$37.23
Rate for Payer: Humana Medicare Advantage	$12.78
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$47.53
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.77
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.93
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.41
Rate for Payer: Wellcare Medicare Advantage	$12.41
Rate for Payer: Wellpoint Medicaid Managed Care	$4.20

Know your out-of-pocket cost for care.

All Charges