Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COPPER SERUM

Facility

$158.45

Service Code	HCPCS 82525
Hospital Charge Code	3000882
Hospital Revenue Code	301
Min. Negotiated Rate	$23.77
Max. Negotiated Rate	$23.77
Rate for Payer: Qualcare PPO/HMO/WC	$23.77

COPPER,SERUM

Facility

$667.59

Service Code	HCPCS 82525
Hospital Charge Code	39900064
Hospital Revenue Code	301
Min. Negotiated Rate	$9.93
Max. Negotiated Rate	$333.80
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	$333.80
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	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
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	$17.69

COPPER,SERUM

Facility

$667.59

Service Code	HCPCS 82525
Hospital Charge Code	39900064
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

COPPER URINE

Facility

$158.45

Service Code	HCPCS 82525
Hospital Charge Code	3003662
Hospital Revenue Code	301
Min. Negotiated Rate	$23.77
Max. Negotiated Rate	$23.77
Rate for Payer: Qualcare PPO/HMO/WC	$23.77

COPPER URINE

Facility

$158.45

Service Code	HCPCS 82525
Hospital Charge Code	3003662
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

COPPER, URINE

Facility

$85.30

Service Code	HCPCS 82525
Hospital Charge Code	39900063
Hospital Revenue Code	301
Min. Negotiated Rate	$2.26
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	$42.65
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	$25.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.79
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	$2.26

COPPER, URINE

Facility

$85.30

Service Code	HCPCS 82525
Hospital Charge Code	39900063
Hospital Revenue Code	301
Min. Negotiated Rate	$12.79
Max. Negotiated Rate	$12.79
Rate for Payer: Qualcare PPO/HMO/WC	$12.79

COPROPORHYRIN (UR) AUDI 24HR**

Facility

$43.00

Hospital Charge Code	3010899
Hospital Revenue Code	309
Min. Negotiated Rate	$6.45
Max. Negotiated Rate	$6.45
Rate for Payer: Qualcare PPO/HMO/WC	$6.45

COPROPORHYRIN (UR) AUDI 24HR**

Facility

$43.00

Hospital Charge Code	3010899
Hospital Revenue Code	309
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$16.34
Rate for Payer: Aetna Medicare Advantage	$12.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.96
Rate for Payer: Cigna Commercial	$21.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.04
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

CORAIL KS11

Facility

$42,030.00

Hospital Charge Code	270649221
Hospital Revenue Code	278
Min. Negotiated Rate	$1,012.92
Max. Negotiated Rate	$21,015.00
Rate for Payer: Aetna Commercial	$15,971.40
Rate for Payer: Aetna Medicare Advantage	$12,609.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,717.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,406.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,717.65
Rate for Payer: Cigna Commercial	$21,015.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,171.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,246.60
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50
Rate for Payer: UnitedHealthcare Community & State	$1,012.92
Rate for Payer: Wellpoint Medicaid Managed Care	$1,113.80

CORAIL KS11

Facility

$42,030.00

Hospital Charge Code	270649221
Hospital Revenue Code	278
Min. Negotiated Rate	$6,304.50
Max. Negotiated Rate	$10,171.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,406.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,171.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$9,246.60
Rate for Payer: Qualcare PPO/HMO/WC	$6,304.50

CORCORDE BUL LOR 9x11x23

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677191
Hospital Revenue Code	278
Min. Negotiated Rate	$2,887.50
Max. Negotiated Rate	$4,658.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50

CORCORDE BUL LOR 9x11x23

Facility

$19,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270677191
Hospital Revenue Code	278
Min. Negotiated Rate	$463.93
Max. Negotiated Rate	$9,625.00
Rate for Payer: Aetna Commercial	$7,315.00
Rate for Payer: Aetna Medicare Advantage	$5,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,908.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,850.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,908.75
Rate for Payer: Cigna Commercial	$9,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,658.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,887.50
Rate for Payer: UnitedHealthcare Community & State	$463.93
Rate for Payer: Wellpoint Medicaid Managed Care	$510.12

CORD ACTIVE ELECTROSURGICAL

Facility

$468.20

Hospital Charge Code	270678684
Hospital Revenue Code	272
Min. Negotiated Rate	$11.28
Max. Negotiated Rate	$234.10
Rate for Payer: Aetna Commercial	$177.92
Rate for Payer: Aetna Medicare Advantage	$140.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.39
Rate for Payer: Cigna Commercial	$234.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$140.46
Rate for Payer: Oxford Commercial	$93.64
Rate for Payer: Qualcare PPO/HMO/WC	$70.23
Rate for Payer: UnitedHealthcare Commercial	$93.64
Rate for Payer: UnitedHealthcare Community & State	$11.28
Rate for Payer: Wellpoint Medicaid Managed Care	$12.41

CORD ACTIVE ELECTROSURGICAL

Facility

$468.20

Hospital Charge Code	270678684
Hospital Revenue Code	272
Min. Negotiated Rate	$70.23
Max. Negotiated Rate	$70.23
Rate for Payer: Qualcare PPO/HMO/WC	$70.23

CORDARONE/200MG/TAB

Facility

$9.00

Hospital Charge Code	60632741
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

CORDARONE/200MG/TAB

Facility

$9.00

Hospital Charge Code	60632741
Hospital Revenue Code	250
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

CORDARONE IV

Facility

$242.00

Hospital Charge Code	60635074
Hospital Revenue Code	250
Min. Negotiated Rate	$36.30
Max. Negotiated Rate	$36.30
Rate for Payer: Qualcare PPO/HMO/WC	$36.30

CORDARONE IV

Facility

$242.00

Hospital Charge Code	60635074
Hospital Revenue Code	250
Min. Negotiated Rate	$5.83
Max. Negotiated Rate	$121.00
Rate for Payer: Aetna Commercial	$91.96
Rate for Payer: Aetna Medicare Advantage	$72.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.71
Rate for Payer: Cigna Commercial	$121.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.60
Rate for Payer: Oxford Commercial	$48.40
Rate for Payer: Qualcare PPO/HMO/WC	$36.30
Rate for Payer: UnitedHealthcare Commercial	$48.40
Rate for Payer: UnitedHealthcare Community & State	$5.83
Rate for Payer: Wellpoint Medicaid Managed Care	$6.41

CORD CONNECTION

Facility

$60.00

Hospital Charge Code	270658447
Hospital Revenue Code	270
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

CORD CONNECTION

Facility

$60.00

Hospital Charge Code	270658447
Hospital Revenue Code	270
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

CORD DISPOSABLE ACTIVE

Facility

$151.43

Hospital Charge Code	270655412
Hospital Revenue Code	271
Min. Negotiated Rate	$22.71
Max. Negotiated Rate	$22.71
Rate for Payer: Qualcare PPO/HMO/WC	$22.71

CORD DISPOSABLE ACTIVE

Facility

$151.43

Hospital Charge Code	270655412
Hospital Revenue Code	271
Min. Negotiated Rate	$3.65
Max. Negotiated Rate	$75.72
Rate for Payer: Aetna Commercial	$57.54
Rate for Payer: Aetna Medicare Advantage	$45.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.61
Rate for Payer: Cigna Commercial	$75.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.43
Rate for Payer: Oxford Commercial	$30.29
Rate for Payer: Qualcare PPO/HMO/WC	$22.71
Rate for Payer: UnitedHealthcare Commercial	$30.29
Rate for Payer: UnitedHealthcare Community & State	$3.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.01

CORD DXD BIPOLAR 920-15R

Facility

$576.85

Hospital Charge Code	270608443
Hospital Revenue Code	272
Min. Negotiated Rate	$13.90
Max. Negotiated Rate	$288.43
Rate for Payer: Aetna Commercial	$219.20
Rate for Payer: Aetna Medicare Advantage	$173.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.10
Rate for Payer: Cigna Commercial	$288.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.06
Rate for Payer: Oxford Commercial	$115.37
Rate for Payer: Qualcare PPO/HMO/WC	$86.53
Rate for Payer: UnitedHealthcare Commercial	$115.37
Rate for Payer: UnitedHealthcare Community & State	$13.90
Rate for Payer: Wellpoint Medicaid Managed Care	$15.29

CORD DXD BIPOLAR 920-15R

Facility

$576.85

Hospital Charge Code	270608443
Hospital Revenue Code	272
Min. Negotiated Rate	$86.53
Max. Negotiated Rate	$86.53
Rate for Payer: Qualcare PPO/HMO/WC	$86.53

Know your out-of-pocket cost for care.

All Charges