Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

C. PSITTACI IGM TITER

Facility

$153.65

Service Code	HCPCS 86632
Hospital Charge Code	3000940F
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. PSITTACI IGM TITER

Facility

$153.65

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

CPTR-ASST DIR MS PX

Facility

$1,772.70

Service Code	HCPCS 20985
Hospital Charge Code	16000670
Hospital Revenue Code	360
Min. Negotiated Rate	$265.90
Max. Negotiated Rate	$265.90
Rate for Payer: Qualcare PPO/HMO/WC	$265.90

CPTR-ASST DIR MS PX

Facility

$1,772.70

Service Code	HCPCS 20985
Hospital Charge Code	16000670
Hospital Revenue Code	360
Min. Negotiated Rate	$42.72
Max. Negotiated Rate	$2,220.00
Rate for Payer: Aetna Commercial	$673.63
Rate for Payer: Aetna Medicare Advantage	$531.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$452.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$452.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,626.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$452.04
Rate for Payer: Cigna Commercial	$886.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$531.81
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$265.90
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$42.72
Rate for Payer: Wellpoint Medicaid Managed Care	$46.98

C-QUR V-PATCH MED RND 6.4CM

Facility

$2,211.15

Hospital Charge Code	270653390
Hospital Revenue Code	278
Min. Negotiated Rate	$53.29
Max. Negotiated Rate	$1,105.58
Rate for Payer: Aetna Commercial	$840.24
Rate for Payer: Aetna Medicare Advantage	$663.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$563.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$563.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$442.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$563.84
Rate for Payer: Cigna Commercial	$1,105.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$535.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$486.45
Rate for Payer: Qualcare PPO/HMO/WC	$331.67
Rate for Payer: UnitedHealthcare Community & State	$53.29
Rate for Payer: Wellpoint Medicaid Managed Care	$58.60

C-QUR V-PATCH MED RND 6.4CM

Facility

$2,211.15

Hospital Charge Code	270653390
Hospital Revenue Code	278
Min. Negotiated Rate	$331.67
Max. Negotiated Rate	$535.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$442.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$535.10
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$486.45
Rate for Payer: Qualcare PPO/HMO/WC	$331.67

C-QUR V-PATCH SML RND 4.3CM

Facility

$1,757.50

Hospital Charge Code	270653389
Hospital Revenue Code	278
Min. Negotiated Rate	$42.36
Max. Negotiated Rate	$878.75
Rate for Payer: Aetna Commercial	$667.85
Rate for Payer: Aetna Medicare Advantage	$527.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.16
Rate for Payer: Cigna Commercial	$878.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$386.65
Rate for Payer: Qualcare PPO/HMO/WC	$263.62
Rate for Payer: UnitedHealthcare Community & State	$42.36
Rate for Payer: Wellpoint Medicaid Managed Care	$46.57

C-QUR V-PATCH SML RND 4.3CM

Facility

$1,757.50

Hospital Charge Code	270653389
Hospital Revenue Code	278
Min. Negotiated Rate	$263.62
Max. Negotiated Rate	$425.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$351.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$425.31
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$386.65
Rate for Payer: Qualcare PPO/HMO/WC	$263.62

CRAB IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003D
Hospital Revenue Code	302
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
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	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CRAB IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	401186003D
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CRADLE BOOT ********

Facility

$135.75

Hospital Charge Code	8002826
Hospital Revenue Code	279
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$67.88
Rate for Payer: Aetna Commercial	$51.59
Rate for Payer: Aetna Medicare Advantage	$40.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.62
Rate for Payer: Cigna Commercial	$67.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.73
Rate for Payer: Oxford Commercial	$27.15
Rate for Payer: Qualcare PPO/HMO/WC	$20.36
Rate for Payer: UnitedHealthcare Commercial	$27.15
Rate for Payer: UnitedHealthcare Community & State	$3.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.60

CRADLE BOOT ********

Facility

$135.75

Hospital Charge Code	8002826
Hospital Revenue Code	279
Min. Negotiated Rate	$20.36
Max. Negotiated Rate	$20.36
Rate for Payer: Qualcare PPO/HMO/WC	$20.36

CRANIAL ACCESS KIT W/O DRUG

Facility

$1,530.00

Hospital Charge Code	270667197
Hospital Revenue Code	272
Min. Negotiated Rate	$229.50
Max. Negotiated Rate	$229.50
Rate for Payer: Qualcare PPO/HMO/WC	$229.50

CRANIAL ACCESS KIT W/O DRUG

Facility

$1,530.00

Hospital Charge Code	270667197
Hospital Revenue Code	272
Min. Negotiated Rate	$36.87
Max. Negotiated Rate	$765.00
Rate for Payer: Aetna Commercial	$581.40
Rate for Payer: Aetna Medicare Advantage	$459.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$390.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$390.15
Rate for Payer: Cigna Commercial	$765.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$459.00
Rate for Payer: Oxford Commercial	$306.00
Rate for Payer: Qualcare PPO/HMO/WC	$229.50
Rate for Payer: UnitedHealthcare Commercial	$306.00
Rate for Payer: UnitedHealthcare Community & State	$36.87
Rate for Payer: Wellpoint Medicaid Managed Care	$40.55

CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC

Facility

$53,987.73

Service Code	MSDRG 073
Min. Negotiated Rate	$16,438.57
Max. Negotiated Rate	$53,987.73
Rate for Payer: Aetna Medicare Advantage	$53,987.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$35,124.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$35,124.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,303.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$35,124.11
Rate for Payer: Cigna Commercial	$30,022.87
Rate for Payer: Cigna Medicare Advantage	$17,303.76
Rate for Payer: Clover Medicare Advantage	$16,438.57
Rate for Payer: EmblemHealth Commercial	$51,911.28
Rate for Payer: Humana Medicare Advantage	$17,822.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,303.76
Rate for Payer: Oxford Commercial	$21,577.83
Rate for Payer: UnitedHealthcare Commercial	$37,837.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,303.76
Rate for Payer: Wellcare Medicare Advantage	$17,303.76

CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC

Facility

$35,451.22

Service Code	MSDRG 074
Min. Negotiated Rate	$10,794.44
Max. Negotiated Rate	$35,451.22
Rate for Payer: Aetna Medicare Advantage	$35,451.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23,958.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23,958.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11,362.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23,958.83
Rate for Payer: Cigna Commercial	$19,290.39
Rate for Payer: Cigna Medicare Advantage	$11,362.57
Rate for Payer: Clover Medicare Advantage	$10,794.44
Rate for Payer: EmblemHealth Commercial	$34,087.71
Rate for Payer: Humana Medicare Advantage	$11,703.45
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11,362.57
Rate for Payer: Oxford Commercial	$13,864.26
Rate for Payer: UnitedHealthcare Commercial	$24,311.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$11,362.57
Rate for Payer: Wellcare Medicare Advantage	$11,362.57

CRANIAL NERVE SUPPD MUSCLES BI

Facility

$285.65

Service Code	HCPCS 95868
Hospital Charge Code	5500046
Hospital Revenue Code	922
Min. Negotiated Rate	$42.85
Max. Negotiated Rate	$42.85
Rate for Payer: Qualcare PPO/HMO/WC	$42.85

CRANIAL NERVE SUPPD MUSCLES BI

Facility

$285.65

Service Code	HCPCS 95868
Hospital Charge Code	5500046
Hospital Revenue Code	922
Min. Negotiated Rate	$6.88
Max. Negotiated Rate	$2,584.00
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	$247.81
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	$85.69
Rate for Payer: Oxford Commercial	$1,474.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.85
Rate for Payer: UnitedHealthcare Commercial	$2,584.00
Rate for Payer: UnitedHealthcare Community & State	$6.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$7.57

CRANIAL TONGS/ST FRAME

Facility

$5,332.00

Service Code	HCPCS 20660
Hospital Charge Code	1600000683
Hospital Revenue Code	360
Min. Negotiated Rate	$799.80
Max. Negotiated Rate	$799.80
Rate for Payer: Qualcare PPO/HMO/WC	$799.80

CRANIAL TONGS/ST FRAME

Facility

$5,332.00

Service Code	HCPCS 20660
Hospital Charge Code	1600000683
Hospital Revenue Code	360
Min. Negotiated Rate	$128.50
Max. Negotiated Rate	$6,895.75
Rate for Payer: Aetna Commercial	$5,196.12
Rate for Payer: Aetna Medicare Advantage	$6,189.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6,895.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,910.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6,895.75
Rate for Payer: Cigna Commercial	$3,829.26
Rate for Payer: Cigna Medicare Advantage	$1,910.34
Rate for Payer: Clover Medicare Advantage	$1,814.82
Rate for Payer: EmblemHealth Commercial	$5,731.02
Rate for Payer: Humana Medicare Advantage	$1,967.65
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,910.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,599.60
Rate for Payer: Oxford Commercial	$3,248.00
Rate for Payer: Qualcare PPO/HMO/WC	$799.80
Rate for Payer: UnitedHealthcare Commercial	$5,311.00
Rate for Payer: UnitedHealthcare Community & State	$128.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare Medicare Advantage	$1,910.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,404.80
Rate for Payer: Wellpoint Medicaid Managed Care	$4,318.43

CRANI-DRAFE INCISION SHEET****

Facility

$54.00

Hospital Charge Code	1608041
Hospital Revenue Code	251
Min. Negotiated Rate	$8.10
Max. Negotiated Rate	$8.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.10

CRANI-DRAFE INCISION SHEET****

Facility

$54.00

Hospital Charge Code	1608041
Hospital Revenue Code	251
Min. Negotiated Rate	$1.30
Max. Negotiated Rate	$27.00
Rate for Payer: Aetna Commercial	$20.52
Rate for Payer: Aetna Medicare Advantage	$16.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.77
Rate for Payer: Cigna Commercial	$27.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.20
Rate for Payer: Oxford Commercial	$10.80
Rate for Payer: Qualcare PPO/HMO/WC	$8.10
Rate for Payer: UnitedHealthcare Commercial	$10.80
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

CRANIOFIX TITANIUM CLAMP 16MM

Facility

$360.48

Hospital Charge Code	270654481
Hospital Revenue Code	272
Min. Negotiated Rate	$54.07
Max. Negotiated Rate	$54.07
Rate for Payer: Qualcare PPO/HMO/WC	$54.07

CRANIOFIX TITANIUM CLAMP 16MM

Facility

$360.48

Hospital Charge Code	270654481
Hospital Revenue Code	272
Min. Negotiated Rate	$8.69
Max. Negotiated Rate	$180.24
Rate for Payer: Aetna Commercial	$136.98
Rate for Payer: Aetna Medicare Advantage	$108.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$91.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$91.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$91.92
Rate for Payer: Cigna Commercial	$180.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$108.14
Rate for Payer: Oxford Commercial	$72.10
Rate for Payer: Qualcare PPO/HMO/WC	$54.07
Rate for Payer: UnitedHealthcare Commercial	$72.10
Rate for Payer: UnitedHealthcare Community & State	$8.69
Rate for Payer: Wellpoint Medicaid Managed Care	$9.55

CRANIO SHEET

Facility

$87.00

Hospital Charge Code	270335604
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$43.50
Rate for Payer: Aetna Commercial	$33.06
Rate for Payer: Aetna Medicare Advantage	$26.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.18
Rate for Payer: Cigna Commercial	$43.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.10
Rate for Payer: Oxford Commercial	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$13.05
Rate for Payer: UnitedHealthcare Commercial	$17.40
Rate for Payer: UnitedHealthcare Community & State	$2.10
Rate for Payer: Wellpoint Medicaid Managed Care	$2.31

Know your out-of-pocket cost for care.

All Charges