Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CRYOBALLON BOA C2

Facility

$425.00

Hospital Charge Code	270679448
Hospital Revenue Code	272
Min. Negotiated Rate	$10.24
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$127.50
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$85.00
Rate for Payer: UnitedHealthcare Community & State	$10.24
Rate for Payer: Wellpoint Medicaid Managed Care	$11.26

CRYOBALLON FOCAL CONTROLLER

Facility

$3,250.00

Hospital Charge Code	270679446
Hospital Revenue Code	272
Min. Negotiated Rate	$78.33
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$975.00
Rate for Payer: Oxford Commercial	$650.00
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Commercial	$650.00
Rate for Payer: UnitedHealthcare Community & State	$78.33
Rate for Payer: Wellpoint Medicaid Managed Care	$86.12

CRYOBALLON FOCAL CONTROLLER

Facility

$3,250.00

Hospital Charge Code	270679446
Hospital Revenue Code	272
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$487.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

CRYOCUFF KNEE LG W/COOLER 11B

Facility

$571.25

Hospital Charge Code	270610603
Hospital Revenue Code	272
Min. Negotiated Rate	$85.69
Max. Negotiated Rate	$85.69
Rate for Payer: Qualcare PPO/HMO/WC	$85.69

CRYOCUFF KNEE LG W/COOLER 11B

Facility

$571.25

Hospital Charge Code	270610603
Hospital Revenue Code	272
Min. Negotiated Rate	$13.77
Max. Negotiated Rate	$285.62
Rate for Payer: Aetna Commercial	$217.07
Rate for Payer: Aetna Medicare Advantage	$171.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$145.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$145.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$145.67
Rate for Payer: Cigna Commercial	$285.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.38
Rate for Payer: Oxford Commercial	$114.25
Rate for Payer: Qualcare PPO/HMO/WC	$85.69
Rate for Payer: UnitedHealthcare Commercial	$114.25
Rate for Payer: UnitedHealthcare Community & State	$13.77
Rate for Payer: Wellpoint Medicaid Managed Care	$15.14

CRYOCUFF KNEE MEDIUM 11A01

Facility

$197.25

Hospital Charge Code	270634687
Hospital Revenue Code	272
Min. Negotiated Rate	$4.75
Max. Negotiated Rate	$98.62
Rate for Payer: Aetna Commercial	$74.95
Rate for Payer: Aetna Medicare Advantage	$59.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.30
Rate for Payer: Cigna Commercial	$98.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.17
Rate for Payer: Oxford Commercial	$39.45
Rate for Payer: Qualcare PPO/HMO/WC	$29.59
Rate for Payer: UnitedHealthcare Commercial	$39.45
Rate for Payer: UnitedHealthcare Community & State	$4.75
Rate for Payer: Wellpoint Medicaid Managed Care	$5.23

CRYOCUFF KNEE MEDIUM 11A01

Facility

$197.25

Hospital Charge Code	270634687
Hospital Revenue Code	272
Min. Negotiated Rate	$29.59
Max. Negotiated Rate	$29.59
Rate for Payer: Qualcare PPO/HMO/WC	$29.59

CRYOCUFF SHOULDER W/COOLER 12A

Facility

$392.00

Hospital Charge Code	270633785
Hospital Revenue Code	272
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$196.00
Rate for Payer: Aetna Commercial	$148.96
Rate for Payer: Aetna Medicare Advantage	$117.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.96
Rate for Payer: Cigna Commercial	$196.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.60
Rate for Payer: Oxford Commercial	$78.40
Rate for Payer: Qualcare PPO/HMO/WC	$58.80
Rate for Payer: UnitedHealthcare Commercial	$78.40
Rate for Payer: UnitedHealthcare Community & State	$9.45
Rate for Payer: Wellpoint Medicaid Managed Care	$10.39

CRYOCUFF SHOULDER W/COOLER 12A

Facility

$392.00

Hospital Charge Code	270633785
Hospital Revenue Code	272
Min. Negotiated Rate	$58.80
Max. Negotiated Rate	$58.80
Rate for Payer: Qualcare PPO/HMO/WC	$58.80

CRYOFIBRINOGEN

Facility

$65.65

Service Code	HCPCS 82585
Hospital Charge Code	3008448
Hospital Revenue Code	301
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$38.46
Rate for Payer: Aetna Medicare Advantage	$45.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$51.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$51.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$51.04
Rate for Payer: Cigna Commercial	$32.83
Rate for Payer: Cigna Medicare Advantage	$14.14
Rate for Payer: Clover Medicare Advantage	$13.43
Rate for Payer: EmblemHealth Commercial	$42.42
Rate for Payer: Humana Medicare Advantage	$14.56
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.85
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.14
Rate for Payer: Wellcare Medicare Advantage	$14.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.74

CRYOFIBRINOGEN

Facility

$65.65

Service Code	HCPCS 82585
Hospital Charge Code	3008448
Hospital Revenue Code	301
Min. Negotiated Rate	$9.85
Max. Negotiated Rate	$9.85
Rate for Payer: Qualcare PPO/HMO/WC	$9.85

CRYOGLOBULIN

Facility

$390.00

Service Code	HCPCS 82595
Hospital Charge Code	39900479
Hospital Revenue Code	301
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.35
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
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	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CRYOGLOBULIN

Facility

$390.00

Service Code	HCPCS 82595
Hospital Charge Code	39900479
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CRYOGLOBULINS

Facility

$94.00

Service Code	HCPCS 82595
Hospital Charge Code	38472247
Hospital Revenue Code	301
Min. Negotiated Rate	$2.49
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.35
Rate for Payer: Cigna Commercial	$47.00
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.10
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2.49

CRYOGLOBULINS

Facility

$96.60

Service Code	HCPCS 82595
Hospital Charge Code	3000981
Hospital Revenue Code	301
Min. Negotiated Rate	$2.56
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$17.60
Rate for Payer: Aetna Medicare Advantage	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$6.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.35
Rate for Payer: Cigna Commercial	$48.30
Rate for Payer: Cigna Medicare Advantage	$6.47
Rate for Payer: Clover Medicare Advantage	$6.15
Rate for Payer: EmblemHealth Commercial	$19.41
Rate for Payer: Humana Medicare Advantage	$6.66
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$6.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.98
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.49
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$5.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$6.47
Rate for Payer: Wellcare Medicare Advantage	$6.47
Rate for Payer: Wellpoint Medicaid Managed Care	$2.56

CRYOGLOBULINS

Facility

$96.60

Service Code	HCPCS 82595
Hospital Charge Code	3000981
Hospital Revenue Code	301
Min. Negotiated Rate	$14.49
Max. Negotiated Rate	$14.49
Rate for Payer: Qualcare PPO/HMO/WC	$14.49

CRYOGLOBULINS

Facility

$94.00

Service Code	HCPCS 82595
Hospital Charge Code	38472247
Hospital Revenue Code	301
Min. Negotiated Rate	$14.10
Max. Negotiated Rate	$14.10
Rate for Payer: Qualcare PPO/HMO/WC	$14.10

CRYOPRBE SHRPTP OBLONGICE1.7mm

Facility

$1,200.00

Hospital Charge Code	270658731
Hospital Revenue Code	278
Min. Negotiated Rate	$180.00
Max. Negotiated Rate	$290.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00

CRYOPRBE SHRPTP OBLONGICE1.7mm

Facility

$1,200.00

Hospital Charge Code	270658731
Hospital Revenue Code	278
Min. Negotiated Rate	$28.92
Max. Negotiated Rate	$600.00
Rate for Payer: Aetna Commercial	$456.00
Rate for Payer: Aetna Medicare Advantage	$360.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$306.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$240.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$306.00
Rate for Payer: Cigna Commercial	$600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$290.40
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$264.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.92
Rate for Payer: Wellpoint Medicaid Managed Care	$31.80

CRYOPRECIPITATE (1 UNIT)

Facility

$491.45

Hospital Charge Code	38471046
Hospital Revenue Code	390
Min. Negotiated Rate	$11.84
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$186.75
Rate for Payer: Aetna Medicare Advantage	$147.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$125.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$125.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$125.32
Rate for Payer: Cigna Commercial	$245.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$147.44
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$73.72
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$11.84
Rate for Payer: Wellpoint Medicaid Managed Care	$13.02

CRYOPRECIPITATE (1 UNIT)

Facility

$491.45

Hospital Charge Code	38471046
Hospital Revenue Code	390
Min. Negotiated Rate	$73.72
Max. Negotiated Rate	$73.72
Rate for Payer: Qualcare PPO/HMO/WC	$73.72

CRYOPRECIPITATE REDUCED PLASMA

Facility

$585.50

Hospital Charge Code	3101521
Hospital Revenue Code	390
Min. Negotiated Rate	$14.11
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$222.49
Rate for Payer: Aetna Medicare Advantage	$175.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$149.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$149.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$149.30
Rate for Payer: Cigna Commercial	$292.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.65
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$87.83
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$14.11
Rate for Payer: Wellpoint Medicaid Managed Care	$15.52

CRYOPRECIPITATE REDUCED PLASMA

Facility

$585.50

Hospital Charge Code	3101521
Hospital Revenue Code	390
Min. Negotiated Rate	$87.83
Max. Negotiated Rate	$87.83
Rate for Payer: Qualcare PPO/HMO/WC	$87.83

CRYOPRECIPITATE X5

Facility

$1,550.00

Service Code	HCPCS P9012
Hospital Charge Code	397031104
Hospital Revenue Code	390
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$227.58
Rate for Payer: Aetna Medicare Advantage	$271.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$302.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$302.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$83.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$302.02
Rate for Payer: Cigna Commercial	$167.72
Rate for Payer: Cigna Medicare Advantage	$83.67
Rate for Payer: Clover Medicare Advantage	$79.49
Rate for Payer: EmblemHealth Commercial	$251.01
Rate for Payer: Humana Medicare Advantage	$86.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$83.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$465.00
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$232.50
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$37.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$83.67
Rate for Payer: Wellcare Medicare Advantage	$83.67
Rate for Payer: Wellpoint Medicaid Managed Care	$41.08

CRYOPRECIPITATE X5

Facility

$1,550.00

Service Code	HCPCS P9012
Hospital Charge Code	397031104
Hospital Revenue Code	390
Min. Negotiated Rate	$232.50
Max. Negotiated Rate	$232.50
Rate for Payer: Qualcare PPO/HMO/WC	$232.50

Know your out-of-pocket cost for care.

All Charges