Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

EPTIFIBATIDE 75 MG/100ML INJ

Facility

$2,923.81

Service Code	HCPCS J1327
Hospital Charge Code	60628969
Hospital Revenue Code	636
Min. Negotiated Rate	$438.57
Max. Negotiated Rate	$707.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$707.56
Rate for Payer: Qualcare PPO/HMO/WC	$438.57

EPZICOM 600/300MG

Facility

$316.31

Service Code	NDC 49702020613
Hospital Charge Code	60635561
Hospital Revenue Code	250
Min. Negotiated Rate	$47.45
Max. Negotiated Rate	$47.45
Rate for Payer: Qualcare PPO/HMO/WC	$47.45

EPZICOM 600/300MG

Facility

$316.31

Service Code	NDC 49702020613
Hospital Charge Code	60635561
Hospital Revenue Code	250
Min. Negotiated Rate	$7.62
Max. Negotiated Rate	$158.16
Rate for Payer: Aetna Commercial	$120.20
Rate for Payer: Aetna Medicare Advantage	$94.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.66
Rate for Payer: Cigna Commercial	$158.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$94.89
Rate for Payer: Oxford Commercial	$63.26
Rate for Payer: Qualcare PPO/HMO/WC	$47.45
Rate for Payer: UnitedHealthcare Commercial	$63.26
Rate for Payer: UnitedHealthcare Community & State	$7.62
Rate for Payer: Wellpoint Medicaid Managed Care	$8.38

EQUILIZER ALLEN

Facility

$1,474.85

Hospital Charge Code	270677421
Hospital Revenue Code	272
Min. Negotiated Rate	$35.54
Max. Negotiated Rate	$737.42
Rate for Payer: Aetna Commercial	$560.44
Rate for Payer: Aetna Medicare Advantage	$442.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.09
Rate for Payer: Cigna Commercial	$737.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.45
Rate for Payer: Oxford Commercial	$294.97
Rate for Payer: Qualcare PPO/HMO/WC	$221.23
Rate for Payer: UnitedHealthcare Commercial	$294.97
Rate for Payer: UnitedHealthcare Community & State	$35.54
Rate for Payer: Wellpoint Medicaid Managed Care	$39.08

EQUILIZER ALLEN

Facility

$1,474.85

Hospital Charge Code	270677421
Hospital Revenue Code	272
Min. Negotiated Rate	$221.23
Max. Negotiated Rate	$221.23
Rate for Payer: Qualcare PPO/HMO/WC	$221.23

EQUINOXE REVERSE SHOULDER GLEN

Facility

$6,470.00

Service Code	HCPCS C1776
Hospital Charge Code	270687750
Hospital Revenue Code	278
Min. Negotiated Rate	$155.93
Max. Negotiated Rate	$3,235.00
Rate for Payer: Aetna Commercial	$2,458.60
Rate for Payer: Aetna Medicare Advantage	$1,941.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,649.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,649.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,294.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,649.85
Rate for Payer: Cigna Commercial	$3,235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,565.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,423.40
Rate for Payer: Qualcare PPO/HMO/WC	$970.50
Rate for Payer: UnitedHealthcare Community & State	$155.93
Rate for Payer: Wellpoint Medicaid Managed Care	$171.46

EQUINOXE REVERSE SHOULDER GLEN

Facility

$6,470.00

Service Code	HCPCS C1776
Hospital Charge Code	270687750
Hospital Revenue Code	278
Min. Negotiated Rate	$970.50
Max. Negotiated Rate	$1,565.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,294.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,565.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,423.40
Rate for Payer: Qualcare PPO/HMO/WC	$970.50

EQUINOX PRES HUM STEM PRES FIT

Facility

$9,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270686661
Hospital Revenue Code	278
Min. Negotiated Rate	$221.00
Max. Negotiated Rate	$4,585.00
Rate for Payer: Aetna Commercial	$3,484.60
Rate for Payer: Aetna Medicare Advantage	$2,751.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,338.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,834.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,338.35
Rate for Payer: Cigna Commercial	$4,585.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,017.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50
Rate for Payer: UnitedHealthcare Community & State	$221.00
Rate for Payer: Wellpoint Medicaid Managed Care	$243.00

EQUINOX PRES HUM STEM PRES FIT

Facility

$9,170.00

Service Code	HCPCS C1776
Hospital Charge Code	270686661
Hospital Revenue Code	278
Min. Negotiated Rate	$1,375.50
Max. Negotiated Rate	$2,219.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,834.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,219.14
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,017.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,375.50

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008405
Hospital Revenue Code	429
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008405
Hospital Revenue Code	429
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008420
Hospital Revenue Code	439
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

EQUIPMENT / EVALUATION ADJUST

Facility

$60.00

Hospital Charge Code	1008420
Hospital Revenue Code	439
Min. Negotiated Rate	$1.45
Max. Negotiated Rate	$1,060.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$116.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.00
Rate for Payer: Oxford Commercial	$604.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$1,060.00
Rate for Payer: UnitedHealthcare Community & State	$1.45
Rate for Payer: Wellpoint Medicaid Managed Care	$1.59

EQUIPMENT RENTAL FEE(PER CASE)

Facility

$3,750.00

Hospital Charge Code	2709007300
Hospital Revenue Code	272
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$562.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

EQUIPMENT RENTAL FEE(PER CASE)

Facility

$3,750.00

Hospital Charge Code	2709007300
Hospital Revenue Code	272
Min. Negotiated Rate	$90.38
Max. Negotiated Rate	$1,875.00
Rate for Payer: Aetna Commercial	$1,425.00
Rate for Payer: Aetna Medicare Advantage	$1,125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$956.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$956.25
Rate for Payer: Cigna Commercial	$1,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,125.00
Rate for Payer: Oxford Commercial	$750.00
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Commercial	$750.00
Rate for Payer: UnitedHealthcare Community & State	$90.38
Rate for Payer: Wellpoint Medicaid Managed Care	$99.38

ER-ABDOMEN PROCEDURE

Facility

$5,904.00

Service Code	HCPCS 49999
Hospital Charge Code	5790160
Hospital Revenue Code	450
Min. Negotiated Rate	$140.00
Max. Negotiated Rate	$3,889.52
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,771.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$885.60
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$156.46

ER-ABDOMEN PROCEDURE

Facility

$5,904.00

Service Code	HCPCS 49999
Hospital Charge Code	5790160
Hospital Revenue Code	450
Min. Negotiated Rate	$885.60
Max. Negotiated Rate	$885.60
Rate for Payer: Qualcare PPO/HMO/WC	$885.60

ER ABD PARACENRESIS W/IMAGING

Facility

$2,674.55

Service Code	HCPCS 49083
Hospital Charge Code	5701003
Hospital Revenue Code	450
Min. Negotiated Rate	$70.88
Max. Negotiated Rate	$3,889.52
Rate for Payer: Aetna Commercial	$2,930.85
Rate for Payer: Aetna Medicare Advantage	$3,491.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,889.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,077.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,889.52
Rate for Payer: Cigna Commercial	$2,159.89
Rate for Payer: Cigna Medicare Advantage	$1,077.52
Rate for Payer: Clover Medicare Advantage	$1,023.64
Rate for Payer: EmblemHealth Commercial	$3,232.56
Rate for Payer: Humana Medicare Advantage	$1,109.85
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,077.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$802.37
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$401.18
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,077.52
Rate for Payer: Wellcare Medicare Advantage	$1,077.52
Rate for Payer: Wellpoint Medicaid Managed Care	$70.88

ER ABD PARACENRESIS W/IMAGING

Facility

$2,674.55

Service Code	HCPCS 49083
Hospital Charge Code	5701003
Hospital Revenue Code	450
Min. Negotiated Rate	$401.18
Max. Negotiated Rate	$401.18
Rate for Payer: Qualcare PPO/HMO/WC	$401.18

ER-ACCESSORY SINUSES

Facility

$343.00

Service Code	HCPCS 31299
Hospital Charge Code	5790075
Hospital Revenue Code	450
Min. Negotiated Rate	$9.09
Max. Negotiated Rate	$1,015.70
Rate for Payer: Aetna Commercial	$765.35
Rate for Payer: Aetna Medicare Advantage	$911.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,015.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$281.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,015.70
Rate for Payer: Cigna Commercial	$564.04
Rate for Payer: Cigna Medicare Advantage	$281.38
Rate for Payer: Clover Medicare Advantage	$267.31
Rate for Payer: EmblemHealth Commercial	$844.14
Rate for Payer: Humana Medicare Advantage	$289.82
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$281.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$102.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$51.45
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$281.38
Rate for Payer: Wellcare Medicare Advantage	$281.38
Rate for Payer: Wellpoint Medicaid Managed Care	$9.09

ER-ACCESSORY SINUSES

Facility

$343.00

Service Code	HCPCS 31299
Hospital Charge Code	5790075
Hospital Revenue Code	450
Min. Negotiated Rate	$51.45
Max. Negotiated Rate	$51.45
Rate for Payer: Qualcare PPO/HMO/WC	$51.45

ER-A/C SEPARATN-DISLO-BIL

Facility

$612.00

Hospital Charge Code	5790330
Hospital Revenue Code	450
Min. Negotiated Rate	$16.22
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$232.56
Rate for Payer: Aetna Medicare Advantage	$183.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$156.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$156.06
Rate for Payer: Cigna Commercial	$306.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.60
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.80
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: Wellpoint Medicaid Managed Care	$16.22

ER-A/C SEPARATN-DISLO-BIL

Facility

$612.00

Hospital Charge Code	5790330
Hospital Revenue Code	450
Min. Negotiated Rate	$91.80
Max. Negotiated Rate	$91.80
Rate for Payer: Qualcare PPO/HMO/WC	$91.80

ER ADMIN ANTIBIOTIC INJ IM

Facility

$161.26

Service Code	HCPCS 96372
Hospital Charge Code	5700250
Hospital Revenue Code	450
Min. Negotiated Rate	$4.27
Max. Negotiated Rate	$850.00
Rate for Payer: Aetna Commercial	$232.67
Rate for Payer: Aetna Medicare Advantage	$277.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$308.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$85.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$22.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$308.77
Rate for Payer: Cigna Commercial	$171.47
Rate for Payer: Cigna Medicare Advantage	$85.54
Rate for Payer: Clover Medicare Advantage	$81.26
Rate for Payer: EmblemHealth Commercial	$256.62
Rate for Payer: Humana Medicare Advantage	$88.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$85.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.38
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$24.19
Rate for Payer: UnitedHealthcare Community & State	$140.00
Rate for Payer: UnitedHealthcare Medicare Advantage	$85.54
Rate for Payer: Wellcare Medicare Advantage	$85.54
Rate for Payer: Wellpoint Medicaid Managed Care	$4.27

ER ADMIN ANTIBIOTIC INJ IM

Facility

$161.26

Service Code	HCPCS 96372
Hospital Charge Code	5700250
Hospital Revenue Code	450
Min. Negotiated Rate	$24.19
Max. Negotiated Rate	$24.19
Rate for Payer: Qualcare PPO/HMO/WC	$24.19

Know your out-of-pocket cost for care.

All Charges