Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

C PNEU IGM

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3000941A
Hospital Revenue Code	302
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39990089C
Hospital Revenue Code	302
Min. Negotiated Rate	$10.14
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.49
Rate for Payer: Aetna Medicare Advantage	$41.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.77
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.68
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.68
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	$10.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.68
Rate for Payer: Wellcare Medicare Advantage	$12.68
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39990089C
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089B
Hospital Revenue Code	302
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089A
Hospital Revenue Code	302
Min. Negotiated Rate	$9.40
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$9.40
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

C.PNEUMONIAE AB (IGG,A,M) I

Facility

$390.00

Service Code	HCPCS 8663191
Hospital Charge Code	39990089A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C. PNEUMONIAE IGM TITER

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3000940E
Hospital Revenue Code	302
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.49
Rate for Payer: Aetna Medicare Advantage	$41.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.77
Rate for Payer: Cigna Commercial	$76.83
Rate for Payer: Cigna Medicare Advantage	$12.68
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.09
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.05
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.68
Rate for Payer: Wellcare Medicare Advantage	$12.68
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

C. PNEUMONIAE IGM TITER

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3000940E
Hospital Revenue Code	302
Min. Negotiated Rate	$23.05
Max. Negotiated Rate	$23.05
Rate for Payer: Qualcare PPO/HMO/WC	$23.05

CPN SOFTWARE

Facility

$4,800.00

Hospital Charge Code	270658994
Hospital Revenue Code	272
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$720.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

CPN SOFTWARE

Facility

$4,800.00

Hospital Charge Code	270658994
Hospital Revenue Code	272
Min. Negotiated Rate	$115.68
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,824.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,440.00
Rate for Payer: Oxford Commercial	$960.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00
Rate for Payer: UnitedHealthcare Commercial	$960.00
Rate for Payer: UnitedHealthcare Community & State	$115.68
Rate for Payer: Wellpoint Medicaid Managed Care	$127.20

CPR

Facility

$1,000.00

Service Code	HCPCS 929507474
Hospital Charge Code	7411179
Hospital Revenue Code	480
Min. Negotiated Rate	$150.00
Max. Negotiated Rate	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00

CPR

Facility

$1,000.00

Service Code	HCPCS 929507474
Hospital Charge Code	7411179
Hospital Revenue Code	480
Min. Negotiated Rate	$24.10
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$380.00
Rate for Payer: Aetna Medicare Advantage	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$255.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$255.00
Rate for Payer: Cigna Commercial	$500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$300.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$24.10
Rate for Payer: Wellpoint Medicaid Managed Care	$26.50

CPR

Facility

$1,120.00

Service Code	HCPCS 92950
Hospital Charge Code	9500065
Hospital Revenue Code	480
Min. Negotiated Rate	$168.00
Max. Negotiated Rate	$168.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.00

CPR

Facility

$1,120.00

Service Code	HCPCS 92950
Hospital Charge Code	9500065
Hospital Revenue Code	480
Min. Negotiated Rate	$26.99
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$100.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$336.00
Rate for Payer: Oxford Commercial	$1,580.00
Rate for Payer: Qualcare PPO/HMO/WC	$168.00
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$26.99
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$29.68

CPR VIPER IMPLANT SYSTEM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676107
Hospital Revenue Code	278
Min. Negotiated Rate	$712.50
Max. Negotiated Rate	$1,149.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50

CPR VIPER IMPLANT SYSTEM

Facility

$4,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270676107
Hospital Revenue Code	278
Min. Negotiated Rate	$114.47
Max. Negotiated Rate	$2,375.00
Rate for Payer: Aetna Commercial	$1,805.00
Rate for Payer: Aetna Medicare Advantage	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,211.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$950.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,211.25
Rate for Payer: Cigna Commercial	$2,375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,149.50
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,045.00
Rate for Payer: Qualcare PPO/HMO/WC	$712.50
Rate for Payer: UnitedHealthcare Community & State	$114.47
Rate for Payer: Wellpoint Medicaid Managed Care	$125.88

CPS FIXED BEARING ARTICULAR SU

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704571
Hospital Revenue Code	278
Min. Negotiated Rate	$144.60
Max. Negotiated Rate	$3,000.00
Rate for Payer: Aetna Commercial	$2,280.00
Rate for Payer: Aetna Medicare Advantage	$1,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,530.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,530.00
Rate for Payer: Cigna Commercial	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00
Rate for Payer: UnitedHealthcare Community & State	$144.60
Rate for Payer: Wellpoint Medicaid Managed Care	$159.00

CPS FIXED BEARING ARTICULAR SU

Facility

$6,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270704571
Hospital Revenue Code	278
Min. Negotiated Rate	$900.00
Max. Negotiated Rate	$1,452.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,452.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,320.00
Rate for Payer: Qualcare PPO/HMO/WC	$900.00

C PSITTACI AB

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	39708048A
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C PSITTACI AB

Facility

$390.00

Service Code	HCPCS 86631
Hospital Charge Code	39708048A
Hospital Revenue Code	302
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.15
Rate for Payer: Aetna Medicare Advantage	$38.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.67
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$11.23
Rate for Payer: EmblemHealth Commercial	$35.46
Rate for Payer: Humana Medicare Advantage	$12.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.82
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	$9.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.82
Rate for Payer: Wellcare Medicare Advantage	$11.82
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

C. PSITTACI IGG TITER

Facility

$124.00

Service Code	HCPCS 86631
Hospital Charge Code	3000940C
Hospital Revenue Code	302
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.15
Rate for Payer: Aetna Medicare Advantage	$38.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$19.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.67
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: Cigna Medicare Advantage	$11.82
Rate for Payer: Clover Medicare Advantage	$11.23
Rate for Payer: EmblemHealth Commercial	$35.46
Rate for Payer: Humana Medicare Advantage	$12.17
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.46
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.82
Rate for Payer: Wellcare Medicare Advantage	$11.82
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

C. PSITTACI IGG TITER

Facility

$124.00

Service Code	HCPCS 86631
Hospital Charge Code	3000940C
Hospital Revenue Code	302
Min. Negotiated Rate	$18.60
Max. Negotiated Rate	$18.60
Rate for Payer: Qualcare PPO/HMO/WC	$18.60

C PSITTACI IGM

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39708048B
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

C PSITTACI IGM

Facility

$390.00

Service Code	HCPCS 86632
Hospital Charge Code	39708048B
Hospital Revenue Code	302
Min. Negotiated Rate	$10.14
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.49
Rate for Payer: Aetna Medicare Advantage	$41.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$45.77
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.68
Rate for Payer: Clover Medicare Advantage	$12.05
Rate for Payer: EmblemHealth Commercial	$38.04
Rate for Payer: Humana Medicare Advantage	$13.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.68
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	$10.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.68
Rate for Payer: Wellcare Medicare Advantage	$12.68
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

Know your out-of-pocket cost for care.

All Charges