Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DHT/0.4MG/TAB

Facility

$6.00

Hospital Charge Code	60632815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

DIABETES

Facility

$5,530.71

Service Code	APR-DRG 4201
Min. Negotiated Rate	$5,422.26
Max. Negotiated Rate	$5,530.71
Rate for Payer: UnitedHealthcare Community & State	$5,422.26
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,530.71
Rate for Payer: Wellpoint Medicaid Managed Care	$5,422.26

DIABETES

Facility

$6,974.65

Service Code	APR-DRG 4202
Min. Negotiated Rate	$6,837.89
Max. Negotiated Rate	$6,974.65
Rate for Payer: UnitedHealthcare Community & State	$6,837.89
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$6,974.65
Rate for Payer: Wellpoint Medicaid Managed Care	$6,837.89

DIABETES

Facility

$21,202.29

Service Code	APR-DRG 4204
Min. Negotiated Rate	$20,786.56
Max. Negotiated Rate	$21,202.29
Rate for Payer: UnitedHealthcare Community & State	$20,786.56
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$21,202.29
Rate for Payer: Wellpoint Medicaid Managed Care	$20,786.56

DIABETES

Facility

$10,369.46

Service Code	APR-DRG 4203
Min. Negotiated Rate	$10,166.14
Max. Negotiated Rate	$10,369.46
Rate for Payer: UnitedHealthcare Community & State	$10,166.14
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$10,369.46
Rate for Payer: Wellpoint Medicaid Managed Care	$10,166.14

DIABETES INPATIENT SERVICE

Facility

$112.00

Hospital Charge Code	9200051
Hospital Revenue Code	942
Min. Negotiated Rate	$16.80
Max. Negotiated Rate	$16.80
Rate for Payer: Qualcare PPO/HMO/WC	$16.80

DIABETES INPATIENT SERVICE

Facility

$112.00

Hospital Charge Code	9200051
Hospital Revenue Code	942
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$1,202.00
Rate for Payer: Aetna Commercial	$42.56
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.60
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$2.70
Rate for Payer: Wellpoint Medicaid Managed Care	$2.97

DIABETES WITH CC

Facility

$31,100.75

Service Code	MSDRG 638
Min. Negotiated Rate	$9,469.78
Max. Negotiated Rate	$31,100.75
Rate for Payer: Aetna Commercial	$21,627.09
Rate for Payer: Aetna Medicare Advantage	$31,100.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20,934.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20,934.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,968.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20,934.90
Rate for Payer: Cigna Commercial	$16,771.49
Rate for Payer: Cigna Medicare Advantage	$9,968.19
Rate for Payer: Clover Medicare Advantage	$9,469.78
Rate for Payer: EmblemHealth Commercial	$29,904.57
Rate for Payer: Humana Medicare Advantage	$10,267.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,968.19
Rate for Payer: Oxford Commercial	$12,053.89
Rate for Payer: UnitedHealthcare Commercial	$21,136.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,968.19
Rate for Payer: Wellcare Medicare Advantage	$9,968.19

DIABETES WITH MCC

Facility

$48,570.60

Service Code	MSDRG 637
Min. Negotiated Rate	$14,789.12
Max. Negotiated Rate	$48,570.60
Rate for Payer: Aetna Commercial	$33,630.89
Rate for Payer: Aetna Medicare Advantage	$48,570.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33,728.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33,728.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15,567.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33,728.45
Rate for Payer: Cigna Commercial	$26,886.40
Rate for Payer: Cigna Medicare Advantage	$15,567.50
Rate for Payer: Clover Medicare Advantage	$14,789.12
Rate for Payer: EmblemHealth Commercial	$46,702.50
Rate for Payer: Humana Medicare Advantage	$16,034.52
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15,567.50
Rate for Payer: Oxford Commercial	$19,323.62
Rate for Payer: UnitedHealthcare Commercial	$33,884.57
Rate for Payer: UnitedHealthcare Medicare Advantage	$15,567.50
Rate for Payer: Wellcare Medicare Advantage	$15,567.50

DIABETES WITHOUT CC/MCC

Facility

$22,212.34

Service Code	MSDRG 639
Min. Negotiated Rate	$6,763.37
Max. Negotiated Rate	$22,212.34
Rate for Payer: Aetna Commercial	$15,519.75
Rate for Payer: Aetna Medicare Advantage	$22,212.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,421.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,421.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$7,119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,421.82
Rate for Payer: Cigna Commercial	$11,625.14
Rate for Payer: Cigna Medicare Advantage	$7,119.34
Rate for Payer: Clover Medicare Advantage	$6,763.37
Rate for Payer: EmblemHealth Commercial	$21,358.02
Rate for Payer: Humana Medicare Advantage	$7,332.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$7,119.34
Rate for Payer: Oxford Commercial	$8,355.14
Rate for Payer: UnitedHealthcare Commercial	$14,651.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$7,119.34
Rate for Payer: Wellcare Medicare Advantage	$7,119.34

DIABETIC EGGNOG

Facility

$13.00

Hospital Charge Code	60634841
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

DIABETIC EGGNOG

Facility

$13.00

Hospital Charge Code	60634841
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

DIABETIC PUDDING

Facility

$13.00

Hospital Charge Code	60634842
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

DIABETIC PUDDING

Facility

$13.00

Hospital Charge Code	60634842
Hospital Revenue Code	250
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$6.50
Rate for Payer: Aetna Commercial	$4.94
Rate for Payer: Aetna Medicare Advantage	$3.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.31
Rate for Payer: Cigna Commercial	$6.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$2.60
Rate for Payer: Qualcare PPO/HMO/WC	$1.95
Rate for Payer: UnitedHealthcare Commercial	$2.60
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.34

DIABETIC SELF MGMT COUNSEL GRP

Facility

$49.30

Hospital Charge Code	9200023
Hospital Revenue Code	942
Min. Negotiated Rate	$7.39
Max. Negotiated Rate	$7.39
Rate for Payer: Qualcare PPO/HMO/WC	$7.39

DIABETIC SELF MGMT COUNSEL GRP

Facility

$49.30

Hospital Charge Code	9200023
Hospital Revenue Code	942
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$1,202.00
Rate for Payer: Aetna Commercial	$18.73
Rate for Payer: Aetna Medicare Advantage	$14.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.57
Rate for Payer: Cigna Commercial	$24.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.79
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.39
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$1.19
Rate for Payer: Wellpoint Medicaid Managed Care	$1.31

DIABETIC SELF MGMT COUNSEL IND

Facility

$89.60

Hospital Charge Code	9200015
Hospital Revenue Code	942
Min. Negotiated Rate	$2.16
Max. Negotiated Rate	$1,202.00
Rate for Payer: Aetna Commercial	$34.05
Rate for Payer: Aetna Medicare Advantage	$26.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.85
Rate for Payer: Cigna Commercial	$44.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.88
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.44
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$2.16
Rate for Payer: Wellpoint Medicaid Managed Care	$2.37

DIABETIC SELF MGMT COUNSEL IND

Facility

$89.60

Hospital Charge Code	9200015
Hospital Revenue Code	942
Min. Negotiated Rate	$13.44
Max. Negotiated Rate	$13.44
Rate for Payer: Qualcare PPO/HMO/WC	$13.44

DIABINESE/100MG/TAB

Facility

$3.00

Hospital Charge Code	60632817
Hospital Revenue Code	250
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

DIABINESE/100MG/TAB

Facility

$3.00

Hospital Charge Code	60632817
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

DIABINESE/250MG/TAB

Facility

$6.00

Hospital Charge Code	60634219
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

DIABINESE/250MG/TAB

Facility

$6.00

Hospital Charge Code	60634219
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

DIAB MGMT F/U PT

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200017
Hospital Revenue Code	942
Min. Negotiated Rate	$405.00
Max. Negotiated Rate	$405.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00

DIAB MGMT F/U PT

Facility

$2,700.00

Service Code	HCPCS 98960
Hospital Charge Code	9200017
Hospital Revenue Code	942
Min. Negotiated Rate	$31.23
Max. Negotiated Rate	$1,350.00
Rate for Payer: Aetna Commercial	$1,026.00
Rate for Payer: Aetna Medicare Advantage	$810.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$688.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$688.50
Rate for Payer: Cigna Commercial	$1,350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$810.00
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$405.00
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$65.07
Rate for Payer: Wellpoint Medicaid Managed Care	$71.55

DIAB MGMT GESTATIONAL

Facility

$112.00

Service Code	HCPCS 98960
Hospital Charge Code	9200029
Hospital Revenue Code	942
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$1,202.00
Rate for Payer: Aetna Commercial	$42.56
Rate for Payer: Aetna Medicare Advantage	$33.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.56
Rate for Payer: Cigna Commercial	$56.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.60
Rate for Payer: Oxford Commercial	$686.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.80
Rate for Payer: UnitedHealthcare Commercial	$1,202.00
Rate for Payer: UnitedHealthcare Community & State	$2.70
Rate for Payer: Wellpoint Medicaid Managed Care	$2.97

Know your out-of-pocket cost for care.

All Charges