Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

AFIXIS NAIL AR HUMUNIV 7.5 X 2

Facility

$8,765.00

Service Code	HCPCS C1713
Hospital Charge Code	270688146
Hospital Revenue Code	278
Min. Negotiated Rate	$1,314.75
Max. Negotiated Rate	$2,121.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,753.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,121.13
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,928.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,314.75

AFIXIX HUM BALL NOSE GW ST

Facility

$1,885.00

Hospital Charge Code	270688143
Hospital Revenue Code	272
Min. Negotiated Rate	$282.75
Max. Negotiated Rate	$282.75
Rate for Payer: Qualcare PPO/HMO/WC	$282.75

AFIXIX HUM BALL NOSE GW ST

Facility

$1,885.00

Hospital Charge Code	270688143
Hospital Revenue Code	272
Min. Negotiated Rate	$45.43
Max. Negotiated Rate	$942.50
Rate for Payer: Aetna Commercial	$716.30
Rate for Payer: Aetna Medicare Advantage	$565.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$480.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$480.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$480.68
Rate for Payer: Cigna Commercial	$942.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$565.50
Rate for Payer: Oxford Commercial	$377.00
Rate for Payer: Qualcare PPO/HMO/WC	$282.75
Rate for Payer: UnitedHealthcare Commercial	$377.00
Rate for Payer: UnitedHealthcare Community & State	$45.43
Rate for Payer: Wellpoint Medicaid Managed Care	$49.95

AFLURIA TRIVALENT 0.5ML SYRING

Facility

$105.66

Service Code	NDC 33332002403
Hospital Charge Code	6063943391
Hospital Revenue Code	250
Min. Negotiated Rate	$15.85
Max. Negotiated Rate	$15.85
Rate for Payer: Qualcare PPO/HMO/WC	$15.85

AFLURIA TRIVALENT 0.5ML SYRING

Facility

$105.66

Service Code	NDC 33332002403
Hospital Charge Code	6063943391
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$52.83
Rate for Payer: Aetna Commercial	$40.15
Rate for Payer: Aetna Medicare Advantage	$31.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.94
Rate for Payer: Cigna Commercial	$52.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.70
Rate for Payer: Oxford Commercial	$21.13
Rate for Payer: Qualcare PPO/HMO/WC	$15.85
Rate for Payer: UnitedHealthcare Commercial	$21.13
Rate for Payer: UnitedHealthcare Community & State	$2.55
Rate for Payer: Wellpoint Medicaid Managed Care	$2.80

AFO BRACE - OFF THE SHELF

Facility

$1,129.65

Hospital Charge Code	270611605
Hospital Revenue Code	274
Min. Negotiated Rate	$27.22
Max. Negotiated Rate	$564.83
Rate for Payer: Aetna Commercial	$429.27
Rate for Payer: Aetna Medicare Advantage	$338.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$288.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$288.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$288.06
Rate for Payer: Cigna Commercial	$564.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$248.52
Rate for Payer: Qualcare PPO/HMO/WC	$169.45
Rate for Payer: UnitedHealthcare Community & State	$27.22
Rate for Payer: Wellpoint Medicaid Managed Care	$29.94

AFO BRACE - OFF THE SHELF

Facility

$1,129.65

Hospital Charge Code	270611605
Hospital Revenue Code	274
Min. Negotiated Rate	$169.45
Max. Negotiated Rate	$273.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$225.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$273.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$248.52
Rate for Payer: Qualcare PPO/HMO/WC	$169.45

AFP (AMNIOTIC FLUID)

Facility

$150.45

Service Code	HCPCS 82106
Hospital Charge Code	3001252
Hospital Revenue Code	301
Min. Negotiated Rate	$3.99
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.24
Rate for Payer: Aetna Medicare Advantage	$55.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.36
Rate for Payer: Cigna Commercial	$75.22
Rate for Payer: Cigna Medicare Advantage	$17.00
Rate for Payer: Clover Medicare Advantage	$16.15
Rate for Payer: EmblemHealth Commercial	$51.00
Rate for Payer: Humana Medicare Advantage	$17.51
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.00
Rate for Payer: Wellcare Medicare Advantage	$17.00
Rate for Payer: Wellpoint Medicaid Managed Care	$3.99

AFP (AMNIOTIC FLUID)

Facility

$150.45

Service Code	HCPCS 82106
Hospital Charge Code	3001252
Hospital Revenue Code	301
Min. Negotiated Rate	$22.57
Max. Negotiated Rate	$22.57
Rate for Payer: Qualcare PPO/HMO/WC	$22.57

AFP AND AFP-L3

Facility

$399.70

Service Code	HCPCS 82107
Hospital Charge Code	3038544
Hospital Revenue Code	301
Min. Negotiated Rate	$59.95
Max. Negotiated Rate	$59.95
Rate for Payer: Qualcare PPO/HMO/WC	$59.95

AFP AND AFP-L3

Facility

$399.70

Service Code	HCPCS 82107
Hospital Charge Code	3038544
Hospital Revenue Code	301
Min. Negotiated Rate	$10.59
Max. Negotiated Rate	$232.50
Rate for Payer: Aetna Commercial	$175.20
Rate for Payer: Aetna Medicare Advantage	$208.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$64.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$174.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$232.50
Rate for Payer: Cigna Commercial	$199.85
Rate for Payer: Cigna Medicare Advantage	$64.41
Rate for Payer: Clover Medicare Advantage	$61.19
Rate for Payer: EmblemHealth Commercial	$193.23
Rate for Payer: Humana Medicare Advantage	$66.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$64.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$119.91
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$59.95
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$51.53
Rate for Payer: UnitedHealthcare Medicare Advantage	$64.41
Rate for Payer: Wellcare Medicare Advantage	$64.41
Rate for Payer: Wellpoint Medicaid Managed Care	$10.59

AFP,MATERNAL,INITIAL,SERU

Facility

$390.00

Service Code	HCPCS 82105
Hospital Charge Code	39900039
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.61
Rate for Payer: Aetna Medicare Advantage	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.53
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.77
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.77
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	$13.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Medicare Advantage	$16.77
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

AFP,MATERNAL,INITIAL,SERU

Facility

$390.00

Service Code	HCPCS 82105
Hospital Charge Code	39900039
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

AFP MATERNAL SERUM INTI/REP

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3001245
Hospital Revenue Code	301
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.61
Rate for Payer: Aetna Medicare Advantage	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.53
Rate for Payer: Cigna Commercial	$60.62
Rate for Payer: Cigna Medicare Advantage	$16.77
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.19
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Medicare Advantage	$16.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

AFP MATERNAL SERUM INTI/REP

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3001245
Hospital Revenue Code	301
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$18.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.19

AFP MATERNAL SERUM (REPEAT)

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3001377
Hospital Revenue Code	301
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.61
Rate for Payer: Aetna Medicare Advantage	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.53
Rate for Payer: Cigna Commercial	$60.62
Rate for Payer: Cigna Medicare Advantage	$16.77
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.19
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Medicare Advantage	$16.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

AFP MATERNAL SERUM (REPEAT)

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3001377
Hospital Revenue Code	301
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$18.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.19

AFP TETRA

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3037050A
Hospital Revenue Code	301
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.61
Rate for Payer: Aetna Medicare Advantage	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.53
Rate for Payer: Cigna Commercial	$60.62
Rate for Payer: Cigna Medicare Advantage	$16.77
Rate for Payer: Clover Medicare Advantage	$15.93
Rate for Payer: EmblemHealth Commercial	$50.31
Rate for Payer: Humana Medicare Advantage	$17.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.19
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.77
Rate for Payer: Wellcare Medicare Advantage	$16.77
Rate for Payer: Wellpoint Medicaid Managed Care	$3.21

AFP TETRA

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3037050A
Hospital Revenue Code	301
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$18.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.19

AFP TETRA II

Facility

$231.25

Service Code	HCPCS 82677
Hospital Charge Code	3037050B
Hospital Revenue Code	301
Min. Negotiated Rate	$34.69
Max. Negotiated Rate	$34.69
Rate for Payer: Qualcare PPO/HMO/WC	$34.69

AFP TETRA II

Facility

$231.25

Service Code	HCPCS 82677
Hospital Charge Code	3037050B
Hospital Revenue Code	301
Min. Negotiated Rate	$6.13
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$65.77
Rate for Payer: Aetna Medicare Advantage	$78.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.28
Rate for Payer: Cigna Commercial	$115.62
Rate for Payer: Cigna Medicare Advantage	$24.18
Rate for Payer: Clover Medicare Advantage	$22.97
Rate for Payer: EmblemHealth Commercial	$72.54
Rate for Payer: Humana Medicare Advantage	$24.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$34.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$19.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.18
Rate for Payer: Wellcare Medicare Advantage	$24.18
Rate for Payer: Wellpoint Medicaid Managed Care	$6.13

AFP TETRA III

Facility

$164.00

Service Code	HCPCS 84702
Hospital Charge Code	3037050C
Hospital Revenue Code	301
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$40.94
Rate for Payer: Aetna Medicare Advantage	$48.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$54.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$54.33
Rate for Payer: Cigna Commercial	$82.00
Rate for Payer: Cigna Medicare Advantage	$15.05
Rate for Payer: Clover Medicare Advantage	$14.30
Rate for Payer: EmblemHealth Commercial	$45.15
Rate for Payer: Humana Medicare Advantage	$15.50
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.05
Rate for Payer: Wellcare Medicare Advantage	$15.05
Rate for Payer: Wellpoint Medicaid Managed Care	$4.35

AFP TETRA III

Facility

$164.00

Service Code	HCPCS 84702
Hospital Charge Code	3037050C
Hospital Revenue Code	301
Min. Negotiated Rate	$24.60
Max. Negotiated Rate	$24.60
Rate for Payer: Qualcare PPO/HMO/WC	$24.60

AFP TETRA IV

Facility

$110.35

Service Code	HCPCS 86336
Hospital Charge Code	3037050D
Hospital Revenue Code	302
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$42.40
Rate for Payer: Aetna Medicare Advantage	$50.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$17.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.28
Rate for Payer: Cigna Commercial	$55.17
Rate for Payer: Cigna Medicare Advantage	$15.59
Rate for Payer: Clover Medicare Advantage	$14.81
Rate for Payer: EmblemHealth Commercial	$46.77
Rate for Payer: Humana Medicare Advantage	$16.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.10
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.55
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.47
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.59
Rate for Payer: Wellcare Medicare Advantage	$15.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.92

AFP TETRA IV

Facility

$110.35

Service Code	HCPCS 86336
Hospital Charge Code	3037050D
Hospital Revenue Code	302
Min. Negotiated Rate	$16.55
Max. Negotiated Rate	$16.55
Rate for Payer: Qualcare PPO/HMO/WC	$16.55

Know your out-of-pocket cost for care.

All Charges