Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ALKALINE PHOSPHATASE ISOENZYME

Facility

$451.00

Service Code	HCPCS 84080
Hospital Charge Code	38472053
Hospital Revenue Code	301
Min. Negotiated Rate	$67.65
Max. Negotiated Rate	$67.65
Rate for Payer: Qualcare PPO/HMO/WC	$67.65

ALKALINE PHOSPHATASE SERUM

Facility

$667.59

Service Code	HCPCS 84075
Hospital Charge Code	3000197
Hospital Revenue Code	301
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.70
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$200.28
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

ALKALINE PHOSPHATASE SERUM

Facility

$667.59

Service Code	HCPCS 84075
Hospital Charge Code	3000197
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ALKALOIDS NOS

Facility

$190.45

Service Code	HCPCS 80323
Hospital Charge Code	397043300
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ALKALOIDS NOS

Facility

$190.45

Service Code	HCPCS 80323
Hospital Charge Code	397043300
Hospital Revenue Code	301
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$17.62
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

ALK PHOSPHATASE, BONE

Facility

$54.45

Service Code	HCPCS 84075
Hospital Charge Code	3009995
Hospital Revenue Code	301
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Qualcare PPO/HMO/WC	$8.17

ALK PHOSPHATASE, BONE

Facility

$54.45

Service Code	HCPCS 84075
Hospital Charge Code	3009995
Hospital Revenue Code	301
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.70
Rate for Payer: Cigna Commercial	$27.23
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.34
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.17
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

ALK PHOSPHATASE,BONE

Facility

$35.55

Service Code	HCPCS 84075
Hospital Charge Code	39900119
Hospital Revenue Code	301
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.70
Rate for Payer: Cigna Commercial	$17.77
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.66
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.33
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

ALK PHOSPHATASE,BONE

Facility

$35.55

Service Code	HCPCS 84075
Hospital Charge Code	39900119
Hospital Revenue Code	301
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$5.33
Rate for Payer: Qualcare PPO/HMO/WC	$5.33

ALK PHOSPHATASE ISOENZYME I

Facility

$390.00

Service Code	HCPCS 84075
Hospital Charge Code	39990073A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALK PHOSPHATASE ISOENZYME I

Facility

$390.00

Service Code	HCPCS 84075
Hospital Charge Code	39990073A
Hospital Revenue Code	301
Min. Negotiated Rate	$4.14
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$14.09
Rate for Payer: Aetna Medicare Advantage	$16.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.70
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.18
Rate for Payer: Clover Medicare Advantage	$4.92
Rate for Payer: EmblemHealth Commercial	$15.54
Rate for Payer: Humana Medicare Advantage	$5.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.18
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	$4.14
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.18
Rate for Payer: Wellcare Medicare Advantage	$5.18
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ALK PHOSPHATASE ISOENZYME II

Facility

$390.00

Service Code	HCPCS 84080
Hospital Charge Code	39990073B
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

ALK PHOSPHATASE ISOENZYME II

Facility

$390.00

Service Code	HCPCS 84080
Hospital Charge Code	39990073B
Hospital Revenue Code	301
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$40.20
Rate for Payer: Aetna Medicare Advantage	$47.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.35
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.78
Rate for Payer: Clover Medicare Advantage	$14.04
Rate for Payer: EmblemHealth Commercial	$44.34
Rate for Payer: Humana Medicare Advantage	$15.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.78
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	$11.82
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.78
Rate for Payer: Wellcare Medicare Advantage	$14.78
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

ALLBEE W/ VITAMIN C/TAB

Facility

$3.00

Hospital Charge Code	60634303
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ALLBEE W/ VITAMIN C/TAB

Facility

$3.00

Hospital Charge Code	60634303
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

Allegra

Facility

$16.28

Service Code	NDC 378078205
Hospital Charge Code	6063943300
Hospital Revenue Code	250
Min. Negotiated Rate	$2.44
Max. Negotiated Rate	$2.44
Rate for Payer: Qualcare PPO/HMO/WC	$2.44

Allegra

Facility

$16.28

Service Code	NDC 378078205
Hospital Charge Code	6063943300
Hospital Revenue Code	250
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$8.14
Rate for Payer: Aetna Commercial	$6.19
Rate for Payer: Aetna Medicare Advantage	$4.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.15
Rate for Payer: Cigna Commercial	$8.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.88
Rate for Payer: Oxford Commercial	$3.26
Rate for Payer: Qualcare PPO/HMO/WC	$2.44
Rate for Payer: UnitedHealthcare Commercial	$3.26
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

ALLEN TOTAL KNEE STABILIZER

Facility

$1,565.00

Hospital Charge Code	270656097
Hospital Revenue Code	272
Min. Negotiated Rate	$234.75
Max. Negotiated Rate	$234.75
Rate for Payer: Qualcare PPO/HMO/WC	$234.75

ALLEN TOTAL KNEE STABILIZER

Facility

$1,565.00

Hospital Charge Code	270656097
Hospital Revenue Code	272
Min. Negotiated Rate	$37.72
Max. Negotiated Rate	$782.50
Rate for Payer: Aetna Commercial	$594.70
Rate for Payer: Aetna Medicare Advantage	$469.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$399.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$399.07
Rate for Payer: Cigna Commercial	$782.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.50
Rate for Payer: Oxford Commercial	$313.00
Rate for Payer: Qualcare PPO/HMO/WC	$234.75
Rate for Payer: UnitedHealthcare Commercial	$313.00
Rate for Payer: UnitedHealthcare Community & State	$37.72
Rate for Payer: Wellpoint Medicaid Managed Care	$41.47

ALLERGAN EAR DROPS 15ML

Facility

$9.00

Hospital Charge Code	6016117
Hospital Revenue Code	251
Min. Negotiated Rate	$0.22
Max. Negotiated Rate	$4.50
Rate for Payer: Aetna Commercial	$3.42
Rate for Payer: Aetna Medicare Advantage	$2.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.70
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

ALLERGAN EAR DROPS 15ML

Facility

$9.00

Hospital Charge Code	6016117
Hospital Revenue Code	251
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

ALLERGEN ALMOND

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3031241
Hospital Revenue Code	305
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.20
Rate for Payer: Aetna Medicare Advantage	$16.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$38.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.84
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: Cigna Medicare Advantage	$5.22
Rate for Payer: Clover Medicare Advantage	$4.96
Rate for Payer: EmblemHealth Commercial	$15.66
Rate for Payer: Humana Medicare Advantage	$5.38
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.18
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.22
Rate for Payer: Wellcare Medicare Advantage	$5.22
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

ALLERGEN ALMOND

Facility

$52.00

Service Code	HCPCS 86003
Hospital Charge Code	3031241
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

ALLERGEN AMERICAN ELM

Facility

$52.00

Service Code	HCPCS 8600391
Hospital Charge Code	3031298
Hospital Revenue Code	305
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

ALLERGEN AMERICAN ELM

Facility

$52.00

Service Code	HCPCS 8600391
Hospital Charge Code	3031298
Hospital Revenue Code	305
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

Know your out-of-pocket cost for care.

All Charges