Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

COXSACKIE B1-B6 AB VI

Facility

$390.00

Service Code	HCPCS 8665891
Hospital Charge Code	39990040F
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

COXSACKIE B ANTIBODIES

Facility

$225.00

Service Code	HCPCS 86658
Hospital Charge Code	38476091
Hospital Revenue Code	302
Min. Negotiated Rate	$5.96
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$35.44
Rate for Payer: Aetna Medicare Advantage	$42.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.03
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: Cigna Medicare Advantage	$13.03
Rate for Payer: Clover Medicare Advantage	$12.38
Rate for Payer: EmblemHealth Commercial	$39.09
Rate for Payer: Humana Medicare Advantage	$13.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.03
Rate for Payer: Wellcare Medicare Advantage	$13.03
Rate for Payer: Wellpoint Medicaid Managed Care	$5.96

COXSACKIE B ANTIBODIES

Facility

$225.00

Service Code	HCPCS 86658
Hospital Charge Code	38476091
Hospital Revenue Code	302
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

COZAAR, 100MG TAB

Facility

$20.64

Service Code	NDC 65862020330
Hospital Charge Code	60635415
Hospital Revenue Code	250
Min. Negotiated Rate	$3.10
Max. Negotiated Rate	$3.10
Rate for Payer: Qualcare PPO/HMO/WC	$3.10

COZAAR, 100MG TAB

Facility

$20.64

Service Code	NDC 65862020330
Hospital Charge Code	60635415
Hospital Revenue Code	250
Min. Negotiated Rate	$0.50
Max. Negotiated Rate	$10.32
Rate for Payer: Aetna Commercial	$7.84
Rate for Payer: Aetna Medicare Advantage	$6.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.26
Rate for Payer: Cigna Commercial	$10.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.19
Rate for Payer: Oxford Commercial	$4.13
Rate for Payer: Qualcare PPO/HMO/WC	$3.10
Rate for Payer: UnitedHealthcare Commercial	$4.13
Rate for Payer: UnitedHealthcare Community & State	$0.50
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

CPAP/BIPAP CIRCUIT

Facility

$33.24

Hospital Charge Code	270600621
Hospital Revenue Code	272
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$16.62
Rate for Payer: Aetna Commercial	$12.63
Rate for Payer: Aetna Medicare Advantage	$9.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.48
Rate for Payer: Cigna Commercial	$16.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.97
Rate for Payer: Oxford Commercial	$6.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.99
Rate for Payer: UnitedHealthcare Commercial	$6.65
Rate for Payer: UnitedHealthcare Community & State	$0.80
Rate for Payer: Wellpoint Medicaid Managed Care	$0.88

CPAP/BIPAP CIRCUIT

Facility

$33.24

Hospital Charge Code	270600621
Hospital Revenue Code	272
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$4.99
Rate for Payer: Qualcare PPO/HMO/WC	$4.99

CPAP PROCEDURE

Facility

$1,205.70

Service Code	HCPCS 94660
Hospital Charge Code	9500431
Hospital Revenue Code	410
Min. Negotiated Rate	$29.06
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$361.71
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.85
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$29.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$31.95

CPAP PROCEDURE

Facility

$1,205.70

Service Code	HCPCS 94660
Hospital Charge Code	9500431
Hospital Revenue Code	410
Min. Negotiated Rate	$180.85
Max. Negotiated Rate	$180.85
Rate for Payer: Qualcare PPO/HMO/WC	$180.85

CPAP PROCEDURE***

Facility

$264.00

Service Code	HCPCS 94660
Hospital Charge Code	9500430
Hospital Revenue Code	419
Min. Negotiated Rate	$6.36
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.20
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.60
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$6.36
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$7.00

CPAP PROCEDURE***

Facility

$264.00

Service Code	HCPCS 94660
Hospital Charge Code	9500430
Hospital Revenue Code	419
Min. Negotiated Rate	$39.60
Max. Negotiated Rate	$39.60
Rate for Payer: Qualcare PPO/HMO/WC	$39.60

CPAP PROCEDURE W/CIRCUIT****

Facility

$564.00

Service Code	HCPCS 94660
Hospital Charge Code	9500431P
Hospital Revenue Code	419
Min. Negotiated Rate	$84.60
Max. Negotiated Rate	$84.60
Rate for Payer: Qualcare PPO/HMO/WC	$84.60

CPAP PROCEDURE W/CIRCUIT****

Facility

$564.00

Service Code	HCPCS 94660
Hospital Charge Code	9500431P
Hospital Revenue Code	419
Min. Negotiated Rate	$13.59
Max. Negotiated Rate	$1,550.00
Rate for Payer: Aetna Commercial	$707.61
Rate for Payer: Aetna Medicare Advantage	$842.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$939.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$260.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$939.06
Rate for Payer: Cigna Commercial	$521.47
Rate for Payer: Cigna Medicare Advantage	$260.15
Rate for Payer: Clover Medicare Advantage	$247.14
Rate for Payer: EmblemHealth Commercial	$780.45
Rate for Payer: Humana Medicare Advantage	$267.95
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$260.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.20
Rate for Payer: Oxford Commercial	$885.00
Rate for Payer: Qualcare PPO/HMO/WC	$84.60
Rate for Payer: UnitedHealthcare Commercial	$1,550.00
Rate for Payer: UnitedHealthcare Community & State	$13.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$260.15
Rate for Payer: Wellcare Medicare Advantage	$260.15
Rate for Payer: Wellpoint Medicaid Managed Care	$14.95

CP CLOPIDOGREL CYP2C19 GENOTYP

Facility

$1,456.80

Service Code	HCPCS 81225
Hospital Charge Code	401181225
Hospital Revenue Code	310
Min. Negotiated Rate	$218.52
Max. Negotiated Rate	$218.52
Rate for Payer: Qualcare PPO/HMO/WC	$218.52

CP CLOPIDOGREL CYP2C19 GENOTYP

Facility

$1,456.80

Service Code	HCPCS 81225
Hospital Charge Code	401181225
Hospital Revenue Code	310
Min. Negotiated Rate	$38.61
Max. Negotiated Rate	$1,051.72
Rate for Payer: Aetna Commercial	$792.50
Rate for Payer: Aetna Medicare Advantage	$944.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,051.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,051.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$291.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,051.72
Rate for Payer: Cigna Commercial	$728.40
Rate for Payer: Cigna Medicare Advantage	$291.36
Rate for Payer: Clover Medicare Advantage	$276.79
Rate for Payer: EmblemHealth Commercial	$874.08
Rate for Payer: Humana Medicare Advantage	$300.10
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$291.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$437.04
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$218.52
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$233.09
Rate for Payer: UnitedHealthcare Medicare Advantage	$291.36
Rate for Payer: Wellcare Medicare Advantage	$291.36
Rate for Payer: Wellpoint Medicaid Managed Care	$38.61

C-PEPTIDE

Facility

$292.00

Service Code	HCPCS 84681
Hospital Charge Code	38472230
Hospital Revenue Code	301
Min. Negotiated Rate	$43.80
Max. Negotiated Rate	$43.80
Rate for Payer: Qualcare PPO/HMO/WC	$43.80

C-PEPTIDE

Facility

$292.00

Service Code	HCPCS 84681
Hospital Charge Code	38472230
Hospital Revenue Code	301
Min. Negotiated Rate	$7.74
Max. Negotiated Rate	$146.00
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.12
Rate for Payer: Cigna Commercial	$146.00
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$43.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$7.74

C-PEPTIDE

Facility

$667.59

Service Code	HCPCS 84681
Hospital Charge Code	39900154
Hospital Revenue Code	301
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.12
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
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	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

C-PEPTIDE

Facility

$667.59

Service Code	HCPCS 84681
Hospital Charge Code	39900154
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

C PEPTIDE, SERUM

Facility

$192.85

Service Code	HCPCS 84681
Hospital Charge Code	3007341
Hospital Revenue Code	301
Min. Negotiated Rate	$28.93
Max. Negotiated Rate	$28.93
Rate for Payer: Qualcare PPO/HMO/WC	$28.93

C PEPTIDE, SERUM

Facility

$192.85

Service Code	HCPCS 84681
Hospital Charge Code	3007341
Hospital Revenue Code	301
Min. Negotiated Rate	$5.11
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$56.60
Rate for Payer: Aetna Medicare Advantage	$67.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$20.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.12
Rate for Payer: Cigna Commercial	$96.42
Rate for Payer: Cigna Medicare Advantage	$20.81
Rate for Payer: Clover Medicare Advantage	$19.77
Rate for Payer: EmblemHealth Commercial	$62.43
Rate for Payer: Humana Medicare Advantage	$21.43
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$20.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.85
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.93
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$20.81
Rate for Payer: Wellcare Medicare Advantage	$20.81
Rate for Payer: Wellpoint Medicaid Managed Care	$5.11

CPK (CREATINE PHOS)***

Facility

$32.00

Hospital Charge Code	3010915
Hospital Revenue Code	309
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

CPK (CREATINE PHOS)***

Facility

$32.00

Hospital Charge Code	3010915
Hospital Revenue Code	309
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

CPK FRACT (METPATH)***

Facility

$82.00

Service Code	HCPCS 82550
Hospital Charge Code	3030095
Hospital Revenue Code	301
Min. Negotiated Rate	$2.17
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$17.71
Rate for Payer: Aetna Medicare Advantage	$21.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.50
Rate for Payer: Cigna Commercial	$41.00
Rate for Payer: Cigna Medicare Advantage	$6.51
Rate for Payer: Clover Medicare Advantage	$6.18
Rate for Payer: EmblemHealth Commercial	$19.53
Rate for Payer: Humana Medicare Advantage	$6.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.51
Rate for Payer: Wellcare Medicare Advantage	$6.51
Rate for Payer: Wellpoint Medicaid Managed Care	$2.17

CPK FRACT (METPATH)***

Facility

$82.00

Service Code	HCPCS 82550
Hospital Charge Code	3030095
Hospital Revenue Code	301
Min. Negotiated Rate	$12.30
Max. Negotiated Rate	$12.30
Rate for Payer: Qualcare PPO/HMO/WC	$12.30

Know your out-of-pocket cost for care.

All Charges