Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ALCOHOL ETHYL SOL 95% GAL

Facility

$37.80

Hospital Charge Code	6009369
Hospital Revenue Code	250
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

ALCOHOL ETHYL URINE QUANT***

Facility

$146.00

Service Code	HCPCS 80320
Hospital Charge Code	3009891
Hospital Revenue Code	301
Min. Negotiated Rate	$21.90
Max. Negotiated Rate	$21.90
Rate for Payer: Qualcare PPO/HMO/WC	$21.90

ALCOHOL ETHYL URINE QUANT***

Facility

$146.00

Service Code	HCPCS 80320
Hospital Charge Code	3009891
Hospital Revenue Code	301
Min. Negotiated Rate	$3.87
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$55.48
Rate for Payer: Aetna Medicare Advantage	$43.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.23
Rate for Payer: Cigna Commercial	$73.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.66
Rate for Payer: Wellpoint Medicaid Managed Care	$3.87

ALCOHOL GASTRIC

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000412
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

ALCOHOL GASTRIC

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000412
Hospital Revenue Code	301
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.76
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

ALCOHOLIC LIVER DISEASE

Facility

$26,462.34

Service Code	APR-DRG 2804
Min. Negotiated Rate	$25,943.47
Max. Negotiated Rate	$26,462.34
Rate for Payer: UnitedHealthcare Community & State	$25,943.47
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$26,462.34
Rate for Payer: Wellpoint Medicaid Managed Care	$25,943.47

ALCOHOLIC LIVER DISEASE

Facility

$12,650.89

Service Code	APR-DRG 2803
Min. Negotiated Rate	$12,402.83
Max. Negotiated Rate	$12,650.89
Rate for Payer: UnitedHealthcare Community & State	$12,402.83
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,650.89
Rate for Payer: Wellpoint Medicaid Managed Care	$12,402.83

ALCOHOLIC LIVER DISEASE

Facility

$6,432.06

Service Code	APR-DRG 2801
Min. Negotiated Rate	$6,305.94
Max. Negotiated Rate	$6,432.06
Rate for Payer: UnitedHealthcare Community & State	$6,305.94
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,432.06
Rate for Payer: Wellpoint Medicaid Managed Care	$6,305.94

ALCOHOLIC LIVER DISEASE

Facility

$8,306.29

Service Code	APR-DRG 2802
Min. Negotiated Rate	$8,143.42
Max. Negotiated Rate	$8,306.29
Rate for Payer: UnitedHealthcare Community & State	$8,143.42
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,306.29
Rate for Payer: Wellpoint Medicaid Managed Care	$8,143.42

ALCOHOL ISOPROPYL

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000413
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

ALCOHOL ISOPROPYL

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000413
Hospital Revenue Code	301
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.76
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

ALCOHOL,ISOPROPYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473088
Hospital Revenue Code	301
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$286.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.76
Rate for Payer: Cigna Commercial	$286.00
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$15.16

ALCOHOL,ISOPROPYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473088
Hospital Revenue Code	301
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

ALCOHOL LEVEL***

Facility

$71.00

Hospital Charge Code	3010410
Hospital Revenue Code	309
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$10.65

ALCOHOL LEVEL***

Facility

$71.00

Hospital Charge Code	3010410
Hospital Revenue Code	309
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$26.98
Rate for Payer: Aetna Medicare Advantage	$21.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.11
Rate for Payer: Cigna Commercial	$35.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.71
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

ALCOHOL METHYL

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000414
Hospital Revenue Code	301
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.76
Rate for Payer: Cigna Commercial	$55.62
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.38
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.69
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.95

ALCOHOL METHYL

Facility

$111.25

Service Code	HCPCS 84600
Hospital Charge Code	3000414
Hospital Revenue Code	301
Min. Negotiated Rate	$16.69
Max. Negotiated Rate	$16.69
Rate for Payer: Qualcare PPO/HMO/WC	$16.69

ALCOHOL,METHYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473089
Hospital Revenue Code	301
Min. Negotiated Rate	$13.69
Max. Negotiated Rate	$286.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.76
Rate for Payer: Cigna Commercial	$286.00
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$171.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$85.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$15.16

ALCOHOL,METHYL

Facility

$572.00

Service Code	HCPCS 84600
Hospital Charge Code	38473089
Hospital Revenue Code	301
Min. Negotiated Rate	$85.80
Max. Negotiated Rate	$85.80
Rate for Payer: Qualcare PPO/HMO/WC	$85.80

ALCOHOL,METHYL,BLOOD

Facility

$110.50

Service Code	HCPCS 84600
Hospital Charge Code	39900152
Hospital Revenue Code	301
Min. Negotiated Rate	$16.57
Max. Negotiated Rate	$16.57
Rate for Payer: Qualcare PPO/HMO/WC	$16.57

ALCOHOL,METHYL,BLOOD

Facility

$110.50

Service Code	HCPCS 84600
Hospital Charge Code	39900152
Hospital Revenue Code	301
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$46.54
Rate for Payer: Aetna Medicare Advantage	$55.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$61.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$61.76
Rate for Payer: Cigna Commercial	$55.25
Rate for Payer: Cigna Medicare Advantage	$17.11
Rate for Payer: Clover Medicare Advantage	$16.25
Rate for Payer: EmblemHealth Commercial	$51.33
Rate for Payer: Humana Medicare Advantage	$17.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.15
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.11
Rate for Payer: Wellcare Medicare Advantage	$17.11
Rate for Payer: Wellpoint Medicaid Managed Care	$2.93

ALCOHOL PREP PAD STERILE 2-PLY

Facility

$0.03

Hospital Charge Code	270300045
Hospital Revenue Code	272
Max. Negotiated Rate	$0.02
Rate for Payer: Aetna Commercial	$0.01
Rate for Payer: Aetna Medicare Advantage	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.01
Rate for Payer: Cigna Commercial	$0.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.01
Rate for Payer: Oxford Commercial	$0.01
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$0.01
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

ALCOHOL PREP PAD STERILE 2-PLY

Facility

$0.03

Hospital Charge Code	270300045
Hospital Revenue Code	272
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

ALCOHOL PREP PAD WEBCOL 2 PLY

Facility

$0.03

Hospital Charge Code	270624065
Hospital Revenue Code	272
Rate for Payer: Qualcare PPO/HMO/WC	$0.00

ALCOHOL PREP PAD WEBCOL 2 PLY

Facility

$0.03

Hospital Charge Code	270624065
Hospital Revenue Code	272
Max. Negotiated Rate	$0.02
Rate for Payer: Aetna Commercial	$0.01
Rate for Payer: Aetna Medicare Advantage	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.01
Rate for Payer: Cigna Commercial	$0.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.01
Rate for Payer: Oxford Commercial	$0.01
Rate for Payer: Qualcare PPO/HMO/WC	$0.00
Rate for Payer: UnitedHealthcare Commercial	$0.01
Rate for Payer: UnitedHealthcare Community & State	$0.00
Rate for Payer: Wellpoint Medicaid Managed Care	$0.00

Know your out-of-pocket cost for care.

All Charges