Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

AG INDIRECT BCNJ

Facility

$88.75

Service Code	HCPCS 86902
Hospital Charge Code	3100527
Hospital Revenue Code	309
Min. Negotiated Rate	$2.35
Max. Negotiated Rate	$853.60
Rate for Payer: Aetna Commercial	$17.27
Rate for Payer: Aetna Medicare Advantage	$20.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.92
Rate for Payer: Cigna Commercial	$853.60
Rate for Payer: Cigna Medicare Advantage	$6.35
Rate for Payer: Clover Medicare Advantage	$6.03
Rate for Payer: EmblemHealth Commercial	$19.05
Rate for Payer: Humana Medicare Advantage	$6.54
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.62
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.31
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.35
Rate for Payer: Wellcare Medicare Advantage	$6.35
Rate for Payer: Wellpoint Medicaid Managed Care	$2.35

AHMED GLAUCOMA VALVE

Facility

$3,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270678561
Hospital Revenue Code	278
Min. Negotiated Rate	$525.00
Max. Negotiated Rate	$847.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00

AHMED GLAUCOMA VALVE

Facility

$3,500.00

Service Code	HCPCS C1889
Hospital Charge Code	270678561
Hospital Revenue Code	278
Min. Negotiated Rate	$84.35
Max. Negotiated Rate	$1,750.00
Rate for Payer: Aetna Commercial	$1,330.00
Rate for Payer: Aetna Medicare Advantage	$1,050.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$892.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$892.50
Rate for Payer: Cigna Commercial	$1,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$847.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$770.00
Rate for Payer: Qualcare PPO/HMO/WC	$525.00
Rate for Payer: UnitedHealthcare Community & State	$84.35
Rate for Payer: Wellpoint Medicaid Managed Care	$92.75

A-HYDROCORT/1000MG

Facility

$210.00

Hospital Charge Code	60632379
Hospital Revenue Code	250
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$31.50
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

A-HYDROCORT/1000MG

Facility

$210.00

Hospital Charge Code	60632379
Hospital Revenue Code	250
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.00
Rate for Payer: Oxford Commercial	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Commercial	$42.00
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

A-HYDROCORT/100MG

Facility

$18.00

Hospital Charge Code	60632380
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$2.70
Rate for Payer: Qualcare PPO/HMO/WC	$2.70

A-HYDROCORT/100MG

Facility

$18.00

Hospital Charge Code	60632380
Hospital Revenue Code	250
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$9.00
Rate for Payer: Aetna Commercial	$6.84
Rate for Payer: Aetna Medicare Advantage	$5.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.59
Rate for Payer: Cigna Commercial	$9.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.40
Rate for Payer: Oxford Commercial	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$2.70
Rate for Payer: UnitedHealthcare Commercial	$3.60
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

A-HYDROCORT INJ/250MG/VIA

Facility

$24.00

Hospital Charge Code	60634281
Hospital Revenue Code	250
Min. Negotiated Rate	$3.60
Max. Negotiated Rate	$3.60
Rate for Payer: Qualcare PPO/HMO/WC	$3.60

A-HYDROCORT INJ/250MG/VIA

Facility

$24.00

Hospital Charge Code	60634281
Hospital Revenue Code	250
Min. Negotiated Rate	$0.58
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.20
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

A-HYDROCORT INJ/500MG/VIA

Facility

$30.00

Hospital Charge Code	60634282
Hospital Revenue Code	250
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

A-HYDROCORT INJ/500MG/VIA

Facility

$30.00

Hospital Charge Code	60634282
Hospital Revenue Code	250
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.00
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.72
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

AICD GENERATOR PROCEDURES

Facility

$149,598.42

Service Code	MSDRG 245
Min. Negotiated Rate	$45,550.80
Max. Negotiated Rate	$149,598.42
Rate for Payer: Aetna Commercial	$103,048.50
Rate for Payer: Aetna Medicare Advantage	$149,598.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105,372.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105,372.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$47,948.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105,372.33
Rate for Payer: Cigna Commercial	$85,380.75
Rate for Payer: Cigna Medicare Advantage	$47,948.21
Rate for Payer: Clover Medicare Advantage	$45,550.80
Rate for Payer: EmblemHealth Commercial	$143,844.63
Rate for Payer: Humana Medicare Advantage	$49,386.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$47,948.21
Rate for Payer: Oxford Commercial	$61,364.28
Rate for Payer: UnitedHealthcare Commercial	$107,604.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$47,948.21
Rate for Payer: Wellcare Medicare Advantage	$47,948.21

AICD LEAD PROCEDURES

Facility

$119,080.26

Service Code	MSDRG 265
Min. Negotiated Rate	$36,258.41
Max. Negotiated Rate	$119,080.26
Rate for Payer: Aetna Commercial	$82,079.05
Rate for Payer: Aetna Medicare Advantage	$119,080.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82,111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82,111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$38,166.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82,111.33
Rate for Payer: Cigna Commercial	$67,710.99
Rate for Payer: Cigna Medicare Advantage	$38,166.75
Rate for Payer: Clover Medicare Advantage	$36,258.41
Rate for Payer: EmblemHealth Commercial	$114,500.25
Rate for Payer: Humana Medicare Advantage	$39,311.75
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$38,166.75
Rate for Payer: Oxford Commercial	$48,664.79
Rate for Payer: UnitedHealthcare Commercial	$85,335.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$38,166.75
Rate for Payer: Wellcare Medicare Advantage	$38,166.75

AID BUTTON/ZIPPER A923-1

Facility

$65.65

Hospital Charge Code	270608453
Hospital Revenue Code	279
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.70
Rate for Payer: Oxford Commercial	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$13.13
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

AID BUTTON/ZIPPER A923-1

Facility

$65.65

Hospital Charge Code	270608453
Hospital Revenue Code	279
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

AID SHOE HORN

Facility

$22.45

Hospital Charge Code	270611383
Hospital Revenue Code	279
Min. Negotiated Rate	$0.54
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$8.53
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.74
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$4.49
Rate for Payer: UnitedHealthcare Community & State	$0.54
Rate for Payer: Wellpoint Medicaid Managed Care	$0.59

AID SHOE HORN

Facility

$22.45

Hospital Charge Code	270611383
Hospital Revenue Code	279
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

AID SHOELACES

Facility

$24.85

Hospital Charge Code	270613433
Hospital Revenue Code	279
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$9.44
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.46
Rate for Payer: Oxford Commercial	$4.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$4.97
Rate for Payer: UnitedHealthcare Community & State	$0.60
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

AID SHOELACES

Facility

$24.85

Hospital Charge Code	270613433
Hospital Revenue Code	279
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

AID SOCK W/HANDLES A754-21

Facility

$65.65

Hospital Charge Code	270612328
Hospital Revenue Code	279
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

AID SOCK W/HANDLES A754-21

Facility

$65.65

Hospital Charge Code	270612328
Hospital Revenue Code	279
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$32.83
Rate for Payer: Aetna Commercial	$24.95
Rate for Payer: Aetna Medicare Advantage	$19.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.74
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.70
Rate for Payer: Oxford Commercial	$13.13
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$13.13
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

AILERON POST FUS SYST SCREW

Facility

$100.00

Service Code	HCPCS C1713
Hospital Charge Code	270697662
Hospital Revenue Code	278
Min. Negotiated Rate	$15.00
Max. Negotiated Rate	$24.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00

AILERON POST FUS SYST SCREW

Facility

$100.00

Service Code	HCPCS C1713
Hospital Charge Code	270697662
Hospital Revenue Code	278
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$50.00
Rate for Payer: Aetna Commercial	$38.00
Rate for Payer: Aetna Medicare Advantage	$30.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.50
Rate for Payer: Cigna Commercial	$50.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$22.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.41
Rate for Payer: Wellpoint Medicaid Managed Care	$2.65

AILERON TRX EXP IMP CORE MED

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697663
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

AILERON TRX EXP IMP CORE MED

Facility

$15,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270697663
Hospital Revenue Code	278
Min. Negotiated Rate	$361.50
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$361.50
Rate for Payer: Wellpoint Medicaid Managed Care	$397.50

Know your out-of-pocket cost for care.

All Charges