Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DESOXIMETASONE 15 GM

Facility

$261.05

Hospital Charge Code	60628376W
Hospital Revenue Code	250
Min. Negotiated Rate	$6.29
Max. Negotiated Rate	$130.53
Rate for Payer: Aetna Commercial	$99.20
Rate for Payer: Aetna Medicare Advantage	$78.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.57
Rate for Payer: Cigna Commercial	$130.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.31
Rate for Payer: Oxford Commercial	$52.21
Rate for Payer: Qualcare PPO/HMO/WC	$39.16
Rate for Payer: UnitedHealthcare Commercial	$52.21
Rate for Payer: UnitedHealthcare Community & State	$6.29
Rate for Payer: Wellpoint Medicaid Managed Care	$6.92

DESOXIMETASONE 15 GM

Facility

$261.05

Hospital Charge Code	60628376W
Hospital Revenue Code	250
Min. Negotiated Rate	$39.16
Max. Negotiated Rate	$39.16
Rate for Payer: Qualcare PPO/HMO/WC	$39.16

DESOXIMETASONE CRM 15GM

Facility

$122.25

Hospital Charge Code	6001663
Hospital Revenue Code	252
Min. Negotiated Rate	$2.95
Max. Negotiated Rate	$61.12
Rate for Payer: Aetna Commercial	$46.45
Rate for Payer: Aetna Medicare Advantage	$36.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.17
Rate for Payer: Cigna Commercial	$61.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.67
Rate for Payer: Oxford Commercial	$24.45
Rate for Payer: Qualcare PPO/HMO/WC	$18.34
Rate for Payer: UnitedHealthcare Commercial	$24.45
Rate for Payer: UnitedHealthcare Community & State	$2.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.24

DESOXIMETASONE CRM 15GM

Facility

$122.25

Hospital Charge Code	6001663
Hospital Revenue Code	252
Min. Negotiated Rate	$18.34
Max. Negotiated Rate	$18.34
Rate for Payer: Qualcare PPO/HMO/WC	$18.34

DESOXIMETASONE CRM 60GM

Facility

$274.60

Hospital Charge Code	6001689
Hospital Revenue Code	252
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$137.30
Rate for Payer: Aetna Commercial	$104.35
Rate for Payer: Aetna Medicare Advantage	$82.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.02
Rate for Payer: Cigna Commercial	$137.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.38
Rate for Payer: Oxford Commercial	$54.92
Rate for Payer: Qualcare PPO/HMO/WC	$41.19
Rate for Payer: UnitedHealthcare Commercial	$54.92
Rate for Payer: UnitedHealthcare Community & State	$6.62
Rate for Payer: Wellpoint Medicaid Managed Care	$7.28

DESOXIMETASONE CRM 60GM

Facility

$274.60

Hospital Charge Code	6001689
Hospital Revenue Code	252
Min. Negotiated Rate	$41.19
Max. Negotiated Rate	$41.19
Rate for Payer: Qualcare PPO/HMO/WC	$41.19

DESOXIMETASONE OINT 15GM

Facility

$12.80

Hospital Charge Code	6001671
Hospital Revenue Code	252
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$1.92
Rate for Payer: Qualcare PPO/HMO/WC	$1.92

DESOXIMETASONE OINT 15GM

Facility

$12.80

Hospital Charge Code	6001671
Hospital Revenue Code	252
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.40
Rate for Payer: Aetna Commercial	$4.86
Rate for Payer: Aetna Medicare Advantage	$3.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.26
Rate for Payer: Cigna Commercial	$6.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.84
Rate for Payer: Oxford Commercial	$2.56
Rate for Payer: Qualcare PPO/HMO/WC	$1.92
Rate for Payer: UnitedHealthcare Commercial	$2.56
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

DESOXIMETASONE OINT 60GM

Facility

$274.60

Hospital Charge Code	6001697
Hospital Revenue Code	252
Min. Negotiated Rate	$41.19
Max. Negotiated Rate	$41.19
Rate for Payer: Qualcare PPO/HMO/WC	$41.19

DESOXIMETASONE OINT 60GM

Facility

$274.60

Hospital Charge Code	6001697
Hospital Revenue Code	252
Min. Negotiated Rate	$6.62
Max. Negotiated Rate	$137.30
Rate for Payer: Aetna Commercial	$104.35
Rate for Payer: Aetna Medicare Advantage	$82.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.02
Rate for Payer: Cigna Commercial	$137.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$82.38
Rate for Payer: Oxford Commercial	$54.92
Rate for Payer: Qualcare PPO/HMO/WC	$41.19
Rate for Payer: UnitedHealthcare Commercial	$54.92
Rate for Payer: UnitedHealthcare Community & State	$6.62
Rate for Payer: Wellpoint Medicaid Managed Care	$7.28

DESTROY ANAL LESN SMP,SURG EXC

Facility

$17,947.70

Service Code	HCPCS 46922
Hospital Charge Code	1600000537
Hospital Revenue Code	360
Min. Negotiated Rate	$432.54
Max. Negotiated Rate	$11,903.20
Rate for Payer: Aetna Commercial	$8,969.36
Rate for Payer: Aetna Medicare Advantage	$10,684.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11,903.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11,903.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,297.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11,903.20
Rate for Payer: Cigna Commercial	$6,609.93
Rate for Payer: Cigna Medicare Advantage	$3,297.56
Rate for Payer: Clover Medicare Advantage	$3,132.68
Rate for Payer: EmblemHealth Commercial	$9,892.68
Rate for Payer: Humana Medicare Advantage	$3,396.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,297.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,384.31
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,692.16
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$432.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,297.56
Rate for Payer: Wellcare Medicare Advantage	$3,297.56
Rate for Payer: Wellpoint Medicaid Managed Care	$475.61

DESTROY ANAL LESN SMP,SURG EXC

Facility

$17,947.70

Service Code	HCPCS 46922
Hospital Charge Code	1600000537
Hospital Revenue Code	360
Min. Negotiated Rate	$2,692.16
Max. Negotiated Rate	$2,692.16
Rate for Payer: Qualcare PPO/HMO/WC	$2,692.16

DESTROY CERV/THOR FACET JNT

Facility

$10,782.78

Service Code	HCPCS 64633
Hospital Charge Code	321564633
Hospital Revenue Code	361
Min. Negotiated Rate	$1,617.42
Max. Negotiated Rate	$1,617.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,617.42

DESTROY CERV/THOR FACET JNT

Facility

$10,782.78

Service Code	HCPCS 64633
Hospital Charge Code	321564633
Hospital Revenue Code	361
Min. Negotiated Rate	$259.86
Max. Negotiated Rate	$8,374.11
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,374.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
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	$8,374.11
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$2,319.89
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,234.83
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,617.42
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$259.86
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellpoint Medicaid Managed Care	$285.74

DESTROY C/TH FACET JNT ADDL

Facility

$10,782.78

Service Code	HCPCS 64634
Hospital Charge Code	321564634
Hospital Revenue Code	361
Min. Negotiated Rate	$1,617.42
Max. Negotiated Rate	$1,617.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,617.42

DESTROY C/TH FACET JNT ADDL

Facility

$10,782.78

Service Code	HCPCS 64634
Hospital Charge Code	321564634
Hospital Revenue Code	361
Min. Negotiated Rate	$259.86
Max. Negotiated Rate	$5,391.39
Rate for Payer: Aetna Commercial	$4,097.46
Rate for Payer: Aetna Medicare Advantage	$3,234.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,749.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,749.61
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	$2,749.61
Rate for Payer: Cigna Commercial	$5,391.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,234.83
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,617.42
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$259.86
Rate for Payer: Wellpoint Medicaid Managed Care	$285.74

DESTROY C/TH FACET JNT ADDL

Facility

$18,351.40

Service Code	HCPCS 64634
Hospital Charge Code	160000250
Hospital Revenue Code	360
Min. Negotiated Rate	$2,752.71
Max. Negotiated Rate	$2,752.71
Rate for Payer: Qualcare PPO/HMO/WC	$2,752.71

DESTROY C/TH FACET JNT ADDL

Facility

$18,351.40

Service Code	HCPCS 64634
Hospital Charge Code	160000250
Hospital Revenue Code	360
Min. Negotiated Rate	$442.27
Max. Negotiated Rate	$9,175.70
Rate for Payer: Aetna Commercial	$6,973.53
Rate for Payer: Aetna Medicare Advantage	$5,505.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,679.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,679.61
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	$4,679.61
Rate for Payer: Cigna Commercial	$9,175.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,505.42
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,752.71
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$442.27
Rate for Payer: Wellpoint Medicaid Managed Care	$486.31

DESTROY INTERNAL HEMORRHOID

Facility

$5,616.30

Service Code	HCPCS 46930
Hospital Charge Code	1600000264
Hospital Revenue Code	360
Min. Negotiated Rate	$842.45
Max. Negotiated Rate	$842.45
Rate for Payer: Qualcare PPO/HMO/WC	$842.45

DESTROY INTERNAL HEMORRHOID

Facility

$5,616.30

Service Code	HCPCS 46930
Hospital Charge Code	1600000264
Hospital Revenue Code	360
Min. Negotiated Rate	$135.35
Max. Negotiated Rate	$5,131.69
Rate for Payer: Aetna Commercial	$3,866.86
Rate for Payer: Aetna Medicare Advantage	$4,606.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,131.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,131.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,421.64
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	$5,131.69
Rate for Payer: Cigna Commercial	$2,849.67
Rate for Payer: Cigna Medicare Advantage	$1,421.64
Rate for Payer: Clover Medicare Advantage	$1,350.56
Rate for Payer: EmblemHealth Commercial	$4,264.92
Rate for Payer: Humana Medicare Advantage	$1,464.29
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,421.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,684.89
Rate for Payer: Oxford Commercial	$2,269.00
Rate for Payer: Qualcare PPO/HMO/WC	$842.45
Rate for Payer: UnitedHealthcare Commercial	$3,593.00
Rate for Payer: UnitedHealthcare Community & State	$135.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,421.64
Rate for Payer: Wellcare Medicare Advantage	$1,421.64
Rate for Payer: Wellpoint Medicaid Managed Care	$148.83

DESTROY L/S FACET JNT ADDL

Facility

$10,782.78

Service Code	HCPCS 64636
Hospital Charge Code	321564636
Hospital Revenue Code	361
Min. Negotiated Rate	$1,617.42
Max. Negotiated Rate	$1,617.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,617.42

DESTROY L/S FACET JNT ADDL

Facility

$2,817.00

Service Code	HCPCS 64536
Hospital Charge Code	1600000397
Hospital Revenue Code	360
Min. Negotiated Rate	$67.89
Max. Negotiated Rate	$1,626.00
Rate for Payer: Aetna Commercial	$1,070.46
Rate for Payer: Aetna Medicare Advantage	$845.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$718.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$718.34
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	$718.34
Rate for Payer: Cigna Commercial	$1,408.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$845.10
Rate for Payer: Qualcare PPO/HMO/WC	$422.55
Rate for Payer: UnitedHealthcare Community & State	$67.89
Rate for Payer: Wellpoint Medicaid Managed Care	$74.65

DESTROY L/S FACET JNT ADDL

Facility

$2,817.00

Service Code	HCPCS 64536
Hospital Charge Code	1600000397
Hospital Revenue Code	360
Min. Negotiated Rate	$422.55
Max. Negotiated Rate	$422.55
Rate for Payer: Qualcare PPO/HMO/WC	$422.55

DESTROY L/S FACET JNT ADDL

Facility

$10,782.78

Service Code	HCPCS 64636
Hospital Charge Code	321564636
Hospital Revenue Code	361
Min. Negotiated Rate	$259.86
Max. Negotiated Rate	$5,391.39
Rate for Payer: Aetna Commercial	$4,097.46
Rate for Payer: Aetna Medicare Advantage	$3,234.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,749.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,749.61
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	$2,749.61
Rate for Payer: Cigna Commercial	$5,391.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,234.83
Rate for Payer: Oxford Commercial	$1,487.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,617.42
Rate for Payer: UnitedHealthcare Commercial	$2,220.00
Rate for Payer: UnitedHealthcare Community & State	$259.86
Rate for Payer: Wellpoint Medicaid Managed Care	$285.74

DESTROY LUMB/SAC FACET JNT

Facility

$10,782.78

Service Code	HCPCS 64635
Hospital Charge Code	321564635
Hospital Revenue Code	361
Min. Negotiated Rate	$1,617.42
Max. Negotiated Rate	$1,617.42
Rate for Payer: Qualcare PPO/HMO/WC	$1,617.42

Know your out-of-pocket cost for care.

All Charges