Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

CRYST NONBRAID HIPRSS CONN L72

Facility

$32.50

Hospital Charge Code	2709003716
Hospital Revenue Code	272
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$4.88
Rate for Payer: Qualcare PPO/HMO/WC	$4.88

CRYSTODIGIN/0.1MG/TAB

Facility

$3.00

Hospital Charge Code	60635872
Hospital Revenue Code	259
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

CRYSTODIGIN/0.1MG/TAB

Facility

$3.00

Hospital Charge Code	60635872
Hospital Revenue Code	259
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

CS40G

Facility

$6,802.90

Hospital Charge Code	270657202
Hospital Revenue Code	278
Min. Negotiated Rate	$1,020.43
Max. Negotiated Rate	$1,646.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,496.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.43

CS40G

Facility

$6,802.90

Hospital Charge Code	270657202
Hospital Revenue Code	278
Min. Negotiated Rate	$163.95
Max. Negotiated Rate	$3,401.45
Rate for Payer: Aetna Commercial	$2,585.10
Rate for Payer: Aetna Medicare Advantage	$2,040.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,734.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,734.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,360.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,734.74
Rate for Payer: Cigna Commercial	$3,401.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,646.30
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,496.64
Rate for Payer: Qualcare PPO/HMO/WC	$1,020.43
Rate for Payer: UnitedHealthcare Community & State	$163.95
Rate for Payer: Wellpoint Medicaid Managed Care	$180.28

C-SECTION

Facility

$10,100.00

Hospital Charge Code	73190162
Hospital Revenue Code	720
Min. Negotiated Rate	$1,515.00
Max. Negotiated Rate	$1,515.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00

C-SECTION

Facility

$10,100.00

Hospital Charge Code	73190162
Hospital Revenue Code	720
Min. Negotiated Rate	$243.41
Max. Negotiated Rate	$5,050.00
Rate for Payer: Aetna Commercial	$3,838.00
Rate for Payer: Aetna Medicare Advantage	$3,030.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,575.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,575.50
Rate for Payer: Cigna Commercial	$5,050.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,030.00
Rate for Payer: Oxford Commercial	$2,624.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,515.00
Rate for Payer: UnitedHealthcare Commercial	$4,601.00
Rate for Payer: UnitedHealthcare Community & State	$243.41
Rate for Payer: Wellpoint Medicaid Managed Care	$267.65

C-SEC W/ PROC

Facility

$10,859.22

Hospital Charge Code	73190163
Hospital Revenue Code	720
Min. Negotiated Rate	$261.71
Max. Negotiated Rate	$5,429.61
Rate for Payer: Aetna Commercial	$4,126.50
Rate for Payer: Aetna Medicare Advantage	$3,257.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,769.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,769.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,769.10
Rate for Payer: Cigna Commercial	$5,429.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,257.77
Rate for Payer: Oxford Commercial	$2,624.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,628.88
Rate for Payer: UnitedHealthcare Commercial	$4,601.00
Rate for Payer: UnitedHealthcare Community & State	$261.71
Rate for Payer: Wellpoint Medicaid Managed Care	$287.77

C-SEC W/ PROC

Facility

$10,859.22

Hospital Charge Code	73190163
Hospital Revenue Code	720
Min. Negotiated Rate	$1,628.88
Max. Negotiated Rate	$1,628.88
Rate for Payer: Qualcare PPO/HMO/WC	$1,628.88

CSF BATTERY

Facility

$156.00

Service Code	HCPCS 82947
Hospital Charge Code	38479007
Hospital Revenue Code	301
Min. Negotiated Rate	$3.14
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$10.69
Rate for Payer: Aetna Medicare Advantage	$12.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.19
Rate for Payer: Cigna Commercial	$78.00
Rate for Payer: Cigna Medicare Advantage	$3.93
Rate for Payer: Clover Medicare Advantage	$3.73
Rate for Payer: EmblemHealth Commercial	$11.79
Rate for Payer: Humana Medicare Advantage	$4.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$3.93
Rate for Payer: Wellcare Medicare Advantage	$3.93
Rate for Payer: Wellpoint Medicaid Managed Care	$4.13

CSF BATTERY

Facility

$156.00

Service Code	HCPCS 82947
Hospital Charge Code	38479007
Hospital Revenue Code	301
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$23.40
Rate for Payer: Qualcare PPO/HMO/WC	$23.40

CSF CELL COUNT***

Facility

$22.00

Hospital Charge Code	3010675
Hospital Revenue Code	309
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$8.36
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.58

CSF CELL COUNT***

Facility

$22.00

Hospital Charge Code	3010675
Hospital Revenue Code	309
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

CSF CL***

Facility

$21.00

Hospital Charge Code	3010766
Hospital Revenue Code	309
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$7.98
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

CSF CL***

Facility

$21.00

Hospital Charge Code	3010766
Hospital Revenue Code	309
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

CSF CYTOLOGY

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005352
Hospital Revenue Code	311
Min. Negotiated Rate	$7.02
Max. Negotiated Rate	$175.00
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.16
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.45
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$39.73
Rate for Payer: UnitedHealthcare Commercial	$175.00
Rate for Payer: UnitedHealthcare Community & State	$61.56
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.02

CSF CYTOLOGY

Facility

$264.85

Service Code	HCPCS 88104
Hospital Charge Code	3005352
Hospital Revenue Code	311
Min. Negotiated Rate	$39.73
Max. Negotiated Rate	$39.73
Rate for Payer: Qualcare PPO/HMO/WC	$39.73

CSF DIFFERENTIAL

Facility

$183.00

Service Code	HCPCS 89051
Hospital Charge Code	38479048
Hospital Revenue Code	309
Min. Negotiated Rate	$27.45
Max. Negotiated Rate	$27.45
Rate for Payer: Qualcare PPO/HMO/WC	$27.45

CSF DIFFERENTIAL

Facility

$183.00

Service Code	HCPCS 89051
Hospital Charge Code	38479048
Hospital Revenue Code	309
Min. Negotiated Rate	$1.74
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.23
Rate for Payer: Aetna Medicare Advantage	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.21
Rate for Payer: Cigna Commercial	$91.50
Rate for Payer: Cigna Medicare Advantage	$5.60
Rate for Payer: Clover Medicare Advantage	$5.32
Rate for Payer: EmblemHealth Commercial	$16.80
Rate for Payer: Humana Medicare Advantage	$5.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.90
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.48
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.60
Rate for Payer: Wellcare Medicare Advantage	$5.60
Rate for Payer: Wellpoint Medicaid Managed Care	$4.85

CSF PROTEIN****

Facility

$21.00

Hospital Charge Code	3012234
Hospital Revenue Code	309
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$7.98
Rate for Payer: Aetna Medicare Advantage	$6.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.36
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

CSF PROTEIN****

Facility

$21.00

Hospital Charge Code	3012234
Hospital Revenue Code	309
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

CSF PROTEIN ELECTROPHORESIS I

Facility

$390.00

Service Code	HCPCS 84157
Hospital Charge Code	3990163A
Hospital Revenue Code	301
Min. Negotiated Rate	$3.20
Max. Negotiated Rate	$15,880.57
Rate for Payer: Aetna Commercial	$10.88
Rate for Payer: Aetna Medicare Advantage	$12.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.44
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.00
Rate for Payer: Clover Medicare Advantage	$3.80
Rate for Payer: EmblemHealth Commercial	$12.00
Rate for Payer: Humana Medicare Advantage	$4.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.00
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	$3.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.00
Rate for Payer: Wellcare Medicare Advantage	$4.00
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$15,880.57
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

CSF PROTEIN ELECTROPHORESIS I

Facility

$390.00

Service Code	HCPCS 84157
Hospital Charge Code	3990163A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CSF PROTEIN ELECTROPHORESIS II

Facility

$390.00

Service Code	HCPCS 84166
Hospital Charge Code	3990163B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

CSF PROTEIN ELECTROPHORESIS II

Facility

$390.00

Service Code	HCPCS 84166
Hospital Charge Code	3990163B
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$48.50
Rate for Payer: Aetna Medicare Advantage	$57.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$36.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.36
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.83
Rate for Payer: Clover Medicare Advantage	$16.94
Rate for Payer: EmblemHealth Commercial	$53.49
Rate for Payer: Humana Medicare Advantage	$18.36
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.83
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	$14.26
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.83
Rate for Payer: Wellcare Medicare Advantage	$17.83
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

Know your out-of-pocket cost for care.

All Charges