Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

AFP TETRA MATERNAL SERUM SCRN

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3009988
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 MATERNAL SERUM SCRN

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3009988
Hospital Revenue Code	301
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$18.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.19

AFP TRIPLE SCREEN (SERUM)

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3001287
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 TRIPLE SCREEN (SERUM)

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3001287
Hospital Revenue Code	301
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$18.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.19

AFP TUMOR MARKER

Facility

$115.30

Service Code	HCPCS 82105
Hospital Charge Code	39900422
Hospital Revenue Code	301
Min. Negotiated Rate	$17.30
Max. Negotiated Rate	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$17.30

AFP TUMOR MARKER

Facility

$115.30

Service Code	HCPCS 82105
Hospital Charge Code	39900422
Hospital Revenue Code	301
Min. Negotiated Rate	$3.06
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	$57.65
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	$34.59
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.30
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	$3.06

AFP TUMOR MARKER CSF***

Facility

$26.00

Service Code	HCPCS 82105
Hospital Charge Code	3001286
Hospital Revenue Code	300
Min. Negotiated Rate	$0.69
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	$13.00
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	$7.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.90
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	$0.69

AFP TUMOR MARKER CSF***

Facility

$26.00

Service Code	HCPCS 82105
Hospital Charge Code	3001286
Hospital Revenue Code	300
Min. Negotiated Rate	$3.90
Max. Negotiated Rate	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$3.90

AFP TUMOR MARKER, CSF

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3031755
Hospital Revenue Code	301
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$18.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.19

AFP TUMOR MARKER, CSF

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3031755
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 TUMOR MARKER, SERUM

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3031754
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 TUMOR MARKER, SERUM

Facility

$121.25

Service Code	HCPCS 82105
Hospital Charge Code	3031754
Hospital Revenue Code	301
Min. Negotiated Rate	$18.19
Max. Negotiated Rate	$18.19
Rate for Payer: Qualcare PPO/HMO/WC	$18.19

AFP WITH AFP-L3%

Facility

$442.70

Service Code	HCPCS 82107
Hospital Charge Code	3038102
Hospital Revenue Code	300
Min. Negotiated Rate	$66.41
Max. Negotiated Rate	$66.41
Rate for Payer: Qualcare PPO/HMO/WC	$66.41

AFP WITH AFP-L3%

Facility

$442.70

Service Code	HCPCS 82107
Hospital Charge Code	3038102
Hospital Revenue Code	300
Min. Negotiated Rate	$11.73
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	$221.35
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	$132.81
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$66.41
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	$11.73

AFRIN 0.05% NASAL SPRAY 15ML

Facility

$13.74

Service Code	NDC 904571135
Hospital Charge Code	6063943288
Hospital Revenue Code	250
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$6.87
Rate for Payer: Aetna Commercial	$5.22
Rate for Payer: Aetna Medicare Advantage	$4.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.50
Rate for Payer: Cigna Commercial	$6.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.12
Rate for Payer: Oxford Commercial	$2.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.06
Rate for Payer: UnitedHealthcare Commercial	$2.75
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

AFRIN 0.05% NASAL SPRAY 15ML

Facility

$13.74

Service Code	NDC 904571135
Hospital Charge Code	6063943288
Hospital Revenue Code	250
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$2.06
Rate for Payer: Qualcare PPO/HMO/WC	$2.06

AFRIN NASAL SPRAY 3ML

Facility

$34.60

Hospital Charge Code	6006720
Hospital Revenue Code	251
Min. Negotiated Rate	$5.19
Max. Negotiated Rate	$5.19
Rate for Payer: Qualcare PPO/HMO/WC	$5.19

AFRIN NASAL SPRAY 3ML

Facility

$34.60

Hospital Charge Code	6006720
Hospital Revenue Code	251
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$17.30
Rate for Payer: Aetna Commercial	$13.15
Rate for Payer: Aetna Medicare Advantage	$10.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.82
Rate for Payer: Cigna Commercial	$17.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.38
Rate for Payer: Oxford Commercial	$6.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.19
Rate for Payer: UnitedHealthcare Commercial	$6.92
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

AFRIN PEDIATRIC 0.025% NA

Facility

$17.00

Hospital Charge Code	60632406
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

AFRIN PEDIATRIC 0.025% NA

Facility

$17.00

Hospital Charge Code	60632406
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$6.46
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$3.40
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

AFRIN SPRAY 1%

Facility

$8.00

Hospital Charge Code	60634650
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$1.20

AFRIN SPRAY 1%

Facility

$8.00

Hospital Charge Code	60634650
Hospital Revenue Code	250
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$4.00
Rate for Payer: Aetna Commercial	$3.04
Rate for Payer: Aetna Medicare Advantage	$2.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.04
Rate for Payer: Cigna Commercial	$4.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.20
Rate for Payer: UnitedHealthcare Commercial	$1.60
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

AFRIN SPRAY 1/2%

Facility

$17.00

Hospital Charge Code	60634651
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$8.50
Rate for Payer: Aetna Commercial	$6.46
Rate for Payer: Aetna Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.33
Rate for Payer: Cigna Commercial	$8.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.10
Rate for Payer: Oxford Commercial	$3.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.55
Rate for Payer: UnitedHealthcare Commercial	$3.40
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

AFRIN SPRAY 1/2%

Facility

$17.00

Hospital Charge Code	60634651
Hospital Revenue Code	250
Min. Negotiated Rate	$2.55
Max. Negotiated Rate	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$2.55

AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC

Facility

$38,531.47

Service Code	MSDRG 560
Min. Negotiated Rate	$11,732.34
Max. Negotiated Rate	$38,531.47
Rate for Payer: Aetna Commercial	$26,732.84
Rate for Payer: Aetna Medicare Advantage	$38,531.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26,284.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26,284.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12,349.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26,284.93
Rate for Payer: Cigna Commercial	$21,073.84
Rate for Payer: Cigna Medicare Advantage	$12,349.83
Rate for Payer: Clover Medicare Advantage	$11,732.34
Rate for Payer: EmblemHealth Commercial	$37,049.49
Rate for Payer: Humana Medicare Advantage	$12,720.32
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12,349.83
Rate for Payer: Oxford Commercial	$15,146.05
Rate for Payer: UnitedHealthcare Commercial	$26,559.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$12,349.83
Rate for Payer: Wellcare Medicare Advantage	$12,349.83

Know your out-of-pocket cost for care.

All Charges