Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

DURASEAL 5ML

Facility

$6,284.00

Hospital Charge Code	270663425
Hospital Revenue Code	272
Min. Negotiated Rate	$151.44
Max. Negotiated Rate	$3,142.00
Rate for Payer: Aetna Commercial	$2,387.92
Rate for Payer: Aetna Medicare Advantage	$1,885.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,602.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,602.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,602.42
Rate for Payer: Cigna Commercial	$3,142.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,885.20
Rate for Payer: Oxford Commercial	$1,256.80
Rate for Payer: Qualcare PPO/HMO/WC	$942.60
Rate for Payer: UnitedHealthcare Commercial	$1,256.80
Rate for Payer: UnitedHealthcare Community & State	$151.44
Rate for Payer: Wellpoint Medicaid Managed Care	$166.53

DURASEAL 5ML

Facility

$6,284.00

Hospital Charge Code	270663425
Hospital Revenue Code	272
Min. Negotiated Rate	$942.60
Max. Negotiated Rate	$942.60
Rate for Payer: Qualcare PPO/HMO/WC	$942.60

DURASENSOR ADULT OXYGEN

Facility

$1,280.85

Hospital Charge Code	270601168
Hospital Revenue Code	270
Min. Negotiated Rate	$192.13
Max. Negotiated Rate	$192.13
Rate for Payer: Qualcare PPO/HMO/WC	$192.13

DURASENSOR ADULT OXYGEN

Facility

$1,280.85

Hospital Charge Code	270601168
Hospital Revenue Code	270
Min. Negotiated Rate	$30.87
Max. Negotiated Rate	$640.42
Rate for Payer: Aetna Commercial	$486.72
Rate for Payer: Aetna Medicare Advantage	$384.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$326.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$326.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$326.62
Rate for Payer: Cigna Commercial	$640.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$384.25
Rate for Payer: Oxford Commercial	$256.17
Rate for Payer: Qualcare PPO/HMO/WC	$192.13
Rate for Payer: UnitedHealthcare Commercial	$256.17
Rate for Payer: UnitedHealthcare Community & State	$30.87
Rate for Payer: Wellpoint Medicaid Managed Care	$33.94

DUREPAIR REG MATRIX 4X5INCH

Facility

$9,865.00

Service Code	HCPCS C1762
Hospital Charge Code	270660490
Hospital Revenue Code	278
Min. Negotiated Rate	$1,479.75
Max. Negotiated Rate	$2,387.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,973.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,387.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,170.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,479.75

DUREPAIR REG MATRIX 4X5INCH

Facility

$9,865.00

Service Code	HCPCS C1762
Hospital Charge Code	270660490
Hospital Revenue Code	278
Min. Negotiated Rate	$237.75
Max. Negotiated Rate	$4,932.50
Rate for Payer: Aetna Commercial	$3,748.70
Rate for Payer: Aetna Medicare Advantage	$2,959.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,515.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,515.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,973.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,515.57
Rate for Payer: Cigna Commercial	$4,932.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,387.33
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,170.30
Rate for Payer: Qualcare PPO/HMO/WC	$1,479.75
Rate for Payer: UnitedHealthcare Community & State	$237.75
Rate for Payer: Wellpoint Medicaid Managed Care	$261.42

DURICEF/1GM/TAB

Facility

$28.00

Hospital Charge Code	60632911
Hospital Revenue Code	250
Min. Negotiated Rate	$4.20
Max. Negotiated Rate	$4.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.20

DURICEF/1GM/TAB

Facility

$28.00

Hospital Charge Code	60632911
Hospital Revenue Code	250
Min. Negotiated Rate	$0.67
Max. Negotiated Rate	$14.00
Rate for Payer: Aetna Commercial	$10.64
Rate for Payer: Aetna Medicare Advantage	$8.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.14
Rate for Payer: Cigna Commercial	$14.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.40
Rate for Payer: Oxford Commercial	$5.60
Rate for Payer: Qualcare PPO/HMO/WC	$4.20
Rate for Payer: UnitedHealthcare Commercial	$5.60
Rate for Payer: UnitedHealthcare Community & State	$0.67
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

DURICEF/500MG/CAP

Facility

$13.00

Hospital Charge Code	60632912
Hospital Revenue Code	250
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.95

DURICEF/500MG/CAP

Facility

$13.00

Hospital Charge Code	60632912
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

DU TEST

Facility

$66.00

Service Code	HCPCS 86885
Hospital Charge Code	38471088
Hospital Revenue Code	302
Min. Negotiated Rate	$9.90
Max. Negotiated Rate	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$9.90

DU TEST

Facility

$66.00

Service Code	HCPCS 86885
Hospital Charge Code	38471088
Hospital Revenue Code	302
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$405.73
Rate for Payer: Aetna Commercial	$15.56
Rate for Payer: Aetna Medicare Advantage	$18.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.65
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$5.72
Rate for Payer: Clover Medicare Advantage	$5.43
Rate for Payer: EmblemHealth Commercial	$17.16
Rate for Payer: Humana Medicare Advantage	$5.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.72
Rate for Payer: Wellcare Medicare Advantage	$5.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.75

DVD STRYKER

Facility

$59.80

Hospital Charge Code	270657647
Hospital Revenue Code	270
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$29.90
Rate for Payer: Aetna Commercial	$22.72
Rate for Payer: Aetna Medicare Advantage	$17.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.25
Rate for Payer: Cigna Commercial	$29.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.94
Rate for Payer: Oxford Commercial	$11.96
Rate for Payer: Qualcare PPO/HMO/WC	$8.97
Rate for Payer: UnitedHealthcare Commercial	$11.96
Rate for Payer: UnitedHealthcare Community & State	$1.44
Rate for Payer: Wellpoint Medicaid Managed Care	$1.58

DVD STRYKER

Facility

$59.80

Hospital Charge Code	270657647
Hospital Revenue Code	270
Min. Negotiated Rate	$8.97
Max. Negotiated Rate	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$8.97

D-VI-SOL (VIT D 400IU/ML) LIQ

Facility

$4.00

Service Code	NDC 87086644
Hospital Charge Code	606390294
Hospital Revenue Code	250
Min. Negotiated Rate	$0.10
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.20
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

D-VI-SOL (VIT D 400IU/ML) LIQ

Facility

$4.00

Service Code	NDC 87086644
Hospital Charge Code	606390294
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

DVR ANATOMIC SHORT LEFT

Facility

$5,395.00

Hospital Charge Code	270638001
Hospital Revenue Code	278
Min. Negotiated Rate	$130.02
Max. Negotiated Rate	$2,697.50
Rate for Payer: Aetna Commercial	$2,050.10
Rate for Payer: Aetna Medicare Advantage	$1,618.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,375.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,375.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,079.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,375.72
Rate for Payer: Cigna Commercial	$2,697.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,305.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,186.90
Rate for Payer: Qualcare PPO/HMO/WC	$809.25
Rate for Payer: UnitedHealthcare Community & State	$130.02
Rate for Payer: Wellpoint Medicaid Managed Care	$142.97

DVR ANATOMIC SHORT LEFT

Facility

$5,395.00

Hospital Charge Code	270638001
Hospital Revenue Code	278
Min. Negotiated Rate	$809.25
Max. Negotiated Rate	$1,305.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,079.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,305.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,186.90
Rate for Payer: Qualcare PPO/HMO/WC	$809.25

DVR LOCK NARROW L

Facility

$7,525.00

Hospital Charge Code	270681160
Hospital Revenue Code	272
Min. Negotiated Rate	$181.35
Max. Negotiated Rate	$3,762.50
Rate for Payer: Aetna Commercial	$2,859.50
Rate for Payer: Aetna Medicare Advantage	$2,257.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,918.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,918.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,918.88
Rate for Payer: Cigna Commercial	$3,762.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,257.50
Rate for Payer: Oxford Commercial	$1,505.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,128.75
Rate for Payer: UnitedHealthcare Commercial	$1,505.00
Rate for Payer: UnitedHealthcare Community & State	$181.35
Rate for Payer: Wellpoint Medicaid Managed Care	$199.41

DVR LOCK NARROW L

Facility

$7,525.00

Hospital Charge Code	270681160
Hospital Revenue Code	272
Min. Negotiated Rate	$1,128.75
Max. Negotiated Rate	$1,128.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,128.75

DVR LOCK NARROW MINI R

Facility

$3,905.00

Hospital Charge Code	270688188
Hospital Revenue Code	272
Min. Negotiated Rate	$585.75
Max. Negotiated Rate	$585.75
Rate for Payer: Qualcare PPO/HMO/WC	$585.75

DVR LOCK NARROW MINI R

Facility

$3,905.00

Hospital Charge Code	270688188
Hospital Revenue Code	272
Min. Negotiated Rate	$94.11
Max. Negotiated Rate	$1,952.50
Rate for Payer: Aetna Commercial	$1,483.90
Rate for Payer: Aetna Medicare Advantage	$1,171.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$995.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$995.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$995.77
Rate for Payer: Cigna Commercial	$1,952.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,171.50
Rate for Payer: Oxford Commercial	$781.00
Rate for Payer: Qualcare PPO/HMO/WC	$585.75
Rate for Payer: UnitedHealthcare Commercial	$781.00
Rate for Payer: UnitedHealthcare Community & State	$94.11
Rate for Payer: Wellpoint Medicaid Managed Care	$103.48

DXA CT BONE DENSITY AXIAL-GL

Facility

$5,100.00

Service Code	HCPCS 77080
Hospital Charge Code	85000310
Hospital Revenue Code	320
Min. Negotiated Rate	$86.94
Max. Negotiated Rate	$1,975.00
Rate for Payer: Aetna Commercial	$337.82
Rate for Payer: Aetna Medicare Advantage	$402.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$448.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$124.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$448.32
Rate for Payer: Cigna Commercial	$248.96
Rate for Payer: Cigna Medicare Advantage	$86.94
Rate for Payer: Clover Medicare Advantage	$117.99
Rate for Payer: EmblemHealth Commercial	$372.60
Rate for Payer: Humana Medicare Advantage	$127.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$124.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,530.00
Rate for Payer: Oxford Commercial	$1,311.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00
Rate for Payer: UnitedHealthcare Commercial	$1,975.00
Rate for Payer: UnitedHealthcare Community & State	$122.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$124.20
Rate for Payer: Wellcare Medicare Advantage	$124.20
Rate for Payer: Wellpoint Medicaid Managed Care	$135.15

DXA CT BONE DENSITY AXIAL-GL

Facility

$5,100.00

Service Code	HCPCS 77080
Hospital Charge Code	85000310
Hospital Revenue Code	320
Min. Negotiated Rate	$765.00
Max. Negotiated Rate	$765.00
Rate for Payer: Qualcare PPO/HMO/WC	$765.00

DXA CT BONE DENSITY AXIAL-PC

Facility

$53.45

Service Code	HCPCS 7708026
Hospital Charge Code	85000320
Hospital Revenue Code	320
Min. Negotiated Rate	$8.02
Max. Negotiated Rate	$8.02
Rate for Payer: Qualcare PPO/HMO/WC	$8.02

Know your out-of-pocket cost for care.

All Charges