Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

EDMS III BECKER

Facility

$981.00

Hospital Charge Code	270670474
Hospital Revenue Code	272
Min. Negotiated Rate	$147.15
Max. Negotiated Rate	$147.15
Rate for Payer: Qualcare PPO/HMO/WC	$147.15

EDMS III BECKER

Facility

$981.00

Hospital Charge Code	270670474
Hospital Revenue Code	272
Min. Negotiated Rate	$23.64
Max. Negotiated Rate	$490.50
Rate for Payer: Aetna Commercial	$372.78
Rate for Payer: Aetna Medicare Advantage	$294.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$250.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$250.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$250.16
Rate for Payer: Cigna Commercial	$490.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.30
Rate for Payer: Oxford Commercial	$196.20
Rate for Payer: Qualcare PPO/HMO/WC	$147.15
Rate for Payer: UnitedHealthcare Commercial	$196.20
Rate for Payer: UnitedHealthcare Community & State	$23.64
Rate for Payer: Wellpoint Medicaid Managed Care	$26.00

EDM VENTRICULAR CATHETER

Facility

$249.00

Hospital Charge Code	270335578
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$124.50
Rate for Payer: Aetna Commercial	$94.62
Rate for Payer: Aetna Medicare Advantage	$74.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.49
Rate for Payer: Cigna Commercial	$124.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$74.70
Rate for Payer: Oxford Commercial	$49.80
Rate for Payer: Qualcare PPO/HMO/WC	$37.35
Rate for Payer: UnitedHealthcare Commercial	$49.80
Rate for Payer: UnitedHealthcare Community & State	$6.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.60

EDM VENTRICULAR CATHETER

Facility

$249.00

Hospital Charge Code	270335578
Hospital Revenue Code	272
Min. Negotiated Rate	$37.35
Max. Negotiated Rate	$37.35
Rate for Payer: Qualcare PPO/HMO/WC	$37.35

EDROPH CHLOR INJ 10MG/ML 15ML

Facility

$154.25

Hospital Charge Code	6002158
Hospital Revenue Code	250
Min. Negotiated Rate	$23.14
Max. Negotiated Rate	$23.14
Rate for Payer: Qualcare PPO/HMO/WC	$23.14

EDROPH CHLOR INJ 10MG/ML 15ML

Facility

$154.25

Hospital Charge Code	6002158
Hospital Revenue Code	250
Min. Negotiated Rate	$3.72
Max. Negotiated Rate	$77.12
Rate for Payer: Aetna Commercial	$58.62
Rate for Payer: Aetna Medicare Advantage	$46.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.33
Rate for Payer: Cigna Commercial	$77.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.27
Rate for Payer: Oxford Commercial	$30.85
Rate for Payer: Qualcare PPO/HMO/WC	$23.14
Rate for Payer: UnitedHealthcare Commercial	$30.85
Rate for Payer: UnitedHealthcare Community & State	$3.72
Rate for Payer: Wellpoint Medicaid Managed Care	$4.09

EDROPH CHLOR INJ 10MG/ML 1ML

Facility

$37.80

Hospital Charge Code	6002141
Hospital Revenue Code	250
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$18.90
Rate for Payer: Aetna Commercial	$14.36
Rate for Payer: Aetna Medicare Advantage	$11.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.64
Rate for Payer: Cigna Commercial	$18.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.34
Rate for Payer: Oxford Commercial	$7.56
Rate for Payer: Qualcare PPO/HMO/WC	$5.67
Rate for Payer: UnitedHealthcare Commercial	$7.56
Rate for Payer: UnitedHealthcare Community & State	$0.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.00

EDROPH CHLOR INJ 10MG/ML 1ML

Facility

$37.80

Hospital Charge Code	6002141
Hospital Revenue Code	250
Min. Negotiated Rate	$5.67
Max. Negotiated Rate	$5.67
Rate for Payer: Qualcare PPO/HMO/WC	$5.67

EDROPHONIUM 10 MG/ML INJ

Facility

$44.85

Hospital Charge Code	60627876
Hospital Revenue Code	250
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

EDROPHONIUM 10 MG/ML INJ

Facility

$44.85

Hospital Charge Code	60627876
Hospital Revenue Code	250
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$22.43
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.44
Rate for Payer: Cigna Commercial	$22.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.46
Rate for Payer: Oxford Commercial	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
Rate for Payer: UnitedHealthcare Commercial	$8.97
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

EDROPHONIUM CHLORIDE 10 MG/ML

Facility

$42.88

Service Code	NDC 67457019015
Hospital Charge Code	6063943195
Hospital Revenue Code	250
Min. Negotiated Rate	$6.43
Max. Negotiated Rate	$6.43
Rate for Payer: Qualcare PPO/HMO/WC	$6.43

EDROPHONIUM CHLORIDE 10 MG/ML

Facility

$42.88

Service Code	NDC 67457019015
Hospital Charge Code	6063943195
Hospital Revenue Code	250
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$21.44
Rate for Payer: Aetna Commercial	$16.29
Rate for Payer: Aetna Medicare Advantage	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.93
Rate for Payer: Cigna Commercial	$21.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.86
Rate for Payer: Oxford Commercial	$8.58
Rate for Payer: Qualcare PPO/HMO/WC	$6.43
Rate for Payer: UnitedHealthcare Commercial	$8.58
Rate for Payer: UnitedHealthcare Community & State	$1.03
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

ED URINE PREGNANCY TEST

Facility

$697.62

Service Code	HCPCS 81025
Hospital Charge Code	5700265
Hospital Revenue Code	300
Min. Negotiated Rate	$104.64
Max. Negotiated Rate	$104.64
Rate for Payer: Qualcare PPO/HMO/WC	$104.64

ED URINE PREGNANCY TEST

Facility

$697.62

Service Code	HCPCS 81025
Hospital Charge Code	5700265
Hospital Revenue Code	300
Min. Negotiated Rate	$5.81
Max. Negotiated Rate	$348.81
Rate for Payer: Aetna Commercial	$23.42
Rate for Payer: Aetna Medicare Advantage	$27.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.08
Rate for Payer: Cigna Commercial	$348.81
Rate for Payer: Cigna Medicare Advantage	$8.61
Rate for Payer: Clover Medicare Advantage	$8.18
Rate for Payer: EmblemHealth Commercial	$25.83
Rate for Payer: Humana Medicare Advantage	$8.87
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$209.29
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.64
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$6.89
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.61
Rate for Payer: Wellcare Medicare Advantage	$8.61
Rate for Payer: Wellpoint Medicaid Managed Care	$18.49

EEG *******

Facility

$180.00

Service Code	HCPCS 95816
Hospital Charge Code	5400015
Hospital Revenue Code	740
Min. Negotiated Rate	$27.00
Max. Negotiated Rate	$27.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00

EEG *******

Facility

$180.00

Service Code	HCPCS 95816
Hospital Charge Code	5400015
Hospital Revenue Code	740
Min. Negotiated Rate	$4.34
Max. Negotiated Rate	$5,944.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.00
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.00
Rate for Payer: UnitedHealthcare Commercial	$5,944.00
Rate for Payer: UnitedHealthcare Community & State	$4.34
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$4.77

EEG AWAKE AND ASLEEP

Facility

$1,004.00

Service Code	HCPCS 95819
Hospital Charge Code	90000045
Hospital Revenue Code	740
Min. Negotiated Rate	$24.20
Max. Negotiated Rate	$5,944.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$466.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$301.20
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$150.60
Rate for Payer: UnitedHealthcare Commercial	$5,944.00
Rate for Payer: UnitedHealthcare Community & State	$24.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$26.61

EEG AWAKE AND ASLEEP

Facility

$1,004.00

Service Code	HCPCS 95819
Hospital Charge Code	90000045
Hospital Revenue Code	740
Min. Negotiated Rate	$150.60
Max. Negotiated Rate	$150.60
Rate for Payer: Qualcare PPO/HMO/WC	$150.60

EEG AWAKE/DROWSY

Facility

$576.00

Service Code	HCPCS 95816
Hospital Charge Code	5500028
Hospital Revenue Code	740
Min. Negotiated Rate	$86.40
Max. Negotiated Rate	$86.40
Rate for Payer: Qualcare PPO/HMO/WC	$86.40

EEG AWAKE/DROWSY

Facility

$576.00

Service Code	HCPCS 95816
Hospital Charge Code	5500028
Hospital Revenue Code	740
Min. Negotiated Rate	$13.88
Max. Negotiated Rate	$5,944.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$495.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$172.80
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.40
Rate for Payer: UnitedHealthcare Commercial	$5,944.00
Rate for Payer: UnitedHealthcare Community & State	$13.88
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$15.26

EEG AWAKE/SLEEP

Facility

$2,208.72

Service Code	HCPCS 95819
Hospital Charge Code	5500026
Hospital Revenue Code	740
Min. Negotiated Rate	$53.23
Max. Negotiated Rate	$5,944.00
Rate for Payer: Aetna Commercial	$697.73
Rate for Payer: Aetna Medicare Advantage	$831.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$925.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$256.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$466.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$925.96
Rate for Payer: Cigna Commercial	$514.20
Rate for Payer: Cigna Medicare Advantage	$256.52
Rate for Payer: Clover Medicare Advantage	$243.69
Rate for Payer: EmblemHealth Commercial	$769.56
Rate for Payer: Humana Medicare Advantage	$264.22
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$256.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$662.62
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$331.31
Rate for Payer: UnitedHealthcare Commercial	$5,944.00
Rate for Payer: UnitedHealthcare Community & State	$53.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$256.52
Rate for Payer: Wellcare Medicare Advantage	$256.52
Rate for Payer: Wellpoint Medicaid Managed Care	$58.53

EEG AWAKE/SLEEP

Facility

$2,208.72

Service Code	HCPCS 95819
Hospital Charge Code	5500026
Hospital Revenue Code	740
Min. Negotiated Rate	$331.31
Max. Negotiated Rate	$331.31
Rate for Payer: Qualcare PPO/HMO/WC	$331.31

EEG BRAIN DEATH

Facility

$1,105.00

Service Code	HCPCS 95824
Hospital Charge Code	36540015
Hospital Revenue Code	740
Min. Negotiated Rate	$165.75
Max. Negotiated Rate	$165.75
Rate for Payer: Qualcare PPO/HMO/WC	$165.75

EEG BRAIN DEATH

Facility

$1,105.00

Service Code	HCPCS 95824
Hospital Charge Code	36540015
Hospital Revenue Code	740
Min. Negotiated Rate	$26.63
Max. Negotiated Rate	$5,944.00
Rate for Payer: Aetna Commercial	$1,205.83
Rate for Payer: Aetna Medicare Advantage	$1,436.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,600.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$443.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$39.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,600.25
Rate for Payer: Cigna Commercial	$888.63
Rate for Payer: Cigna Medicare Advantage	$443.32
Rate for Payer: Clover Medicare Advantage	$421.15
Rate for Payer: EmblemHealth Commercial	$1,329.96
Rate for Payer: Humana Medicare Advantage	$456.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$443.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$331.50
Rate for Payer: Oxford Commercial	$3,390.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.75
Rate for Payer: UnitedHealthcare Commercial	$5,944.00
Rate for Payer: UnitedHealthcare Community & State	$26.63
Rate for Payer: UnitedHealthcare Medicare Advantage	$443.32
Rate for Payer: Wellcare Medicare Advantage	$443.32
Rate for Payer: Wellpoint Medicaid Managed Care	$29.28

EEG COMA OR SLEEP ONLY

Facility

$1,004.00

Service Code	HCPCS 95822
Hospital Charge Code	90000050
Hospital Revenue Code	740
Min. Negotiated Rate	$150.60
Max. Negotiated Rate	$150.60
Rate for Payer: Qualcare PPO/HMO/WC	$150.60

Know your out-of-pocket cost for care.

All Charges