Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ALTEPLASE INJ 100MG

Facility

$18,581.80

Hospital Charge Code	6007041
Hospital Revenue Code	636
Min. Negotiated Rate	$447.82
Max. Negotiated Rate	$9,290.90
Rate for Payer: Aetna Commercial	$7,061.08
Rate for Payer: Aetna Medicare Advantage	$5,574.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,738.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,738.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,738.36
Rate for Payer: Cigna Commercial	$9,290.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,496.80
Rate for Payer: Qualcare PPO/HMO/WC	$2,787.27
Rate for Payer: UnitedHealthcare Community & State	$447.82
Rate for Payer: Wellpoint Medicaid Managed Care	$492.42

ALTEPLASE INJ 10MG OP

Facility

$1,686.40

Hospital Charge Code	60628991
Hospital Revenue Code	636
Min. Negotiated Rate	$252.96
Max. Negotiated Rate	$408.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$408.11
Rate for Payer: Qualcare PPO/HMO/WC	$252.96

ALTEPLASE INJ 10MG OP

Facility

$1,686.40

Hospital Charge Code	60628991
Hospital Revenue Code	636
Min. Negotiated Rate	$40.64
Max. Negotiated Rate	$843.20
Rate for Payer: Aetna Commercial	$640.83
Rate for Payer: Aetna Medicare Advantage	$505.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$430.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$430.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$430.03
Rate for Payer: Cigna Commercial	$843.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$408.11
Rate for Payer: Qualcare PPO/HMO/WC	$252.96
Rate for Payer: UnitedHealthcare Community & State	$40.64
Rate for Payer: Wellpoint Medicaid Managed Care	$44.69

ALTEPLASE INJ 50MG

Facility

$12,325.80

Hospital Charge Code	6007371
Hospital Revenue Code	636
Min. Negotiated Rate	$297.05
Max. Negotiated Rate	$6,162.90
Rate for Payer: Aetna Commercial	$4,683.80
Rate for Payer: Aetna Medicare Advantage	$3,697.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,143.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,143.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,143.08
Rate for Payer: Cigna Commercial	$6,162.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,982.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,848.87
Rate for Payer: UnitedHealthcare Community & State	$297.05
Rate for Payer: Wellpoint Medicaid Managed Care	$326.63

ALTEPLASE INJ 50MG

Facility

$12,325.80

Hospital Charge Code	6007371
Hospital Revenue Code	636
Min. Negotiated Rate	$1,848.87
Max. Negotiated Rate	$2,982.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,982.84
Rate for Payer: Qualcare PPO/HMO/WC	$1,848.87

ALTERATION IN CONSCIOUSNESS

Facility

$23,118.69

Service Code	APR-DRG 0524
Min. Negotiated Rate	$22,665.38
Max. Negotiated Rate	$23,118.69
Rate for Payer: UnitedHealthcare Community & State	$22,665.38
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,118.69
Rate for Payer: Wellpoint Medicaid Managed Care	$22,665.38

ALTERATION IN CONSCIOUSNESS

Facility

$11,224.81

Service Code	APR-DRG 0523
Min. Negotiated Rate	$11,004.72
Max. Negotiated Rate	$11,224.81
Rate for Payer: UnitedHealthcare Community & State	$11,004.72
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$11,224.81
Rate for Payer: Wellpoint Medicaid Managed Care	$11,004.72

ALTERATION IN CONSCIOUSNESS

Facility

$7,103.64

Service Code	APR-DRG 0521
Min. Negotiated Rate	$6,964.35
Max. Negotiated Rate	$7,103.64
Rate for Payer: UnitedHealthcare Community & State	$6,964.35
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$7,103.64
Rate for Payer: Wellpoint Medicaid Managed Care	$6,964.35

ALTERATION IN CONSCIOUSNESS

Facility

$8,382.85

Service Code	APR-DRG 0522
Min. Negotiated Rate	$8,218.48
Max. Negotiated Rate	$8,382.85
Rate for Payer: UnitedHealthcare Community & State	$8,218.48
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$8,382.85
Rate for Payer: Wellpoint Medicaid Managed Care	$8,218.48

ALTERNAGEL/30ML

Facility

$3.00

Hospital Charge Code	60634606
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

ALTERNAGEL/30ML

Facility

$3.00

Hospital Charge Code	60634606
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

ALTIPLY LYOPH AMNIO MEM 2X4CM

Facility

$9,987.50

Service Code	HCPCS C1762
Hospital Charge Code	270703810
Hospital Revenue Code	278
Min. Negotiated Rate	$240.70
Max. Negotiated Rate	$4,993.75
Rate for Payer: Aetna Commercial	$3,795.25
Rate for Payer: Aetna Medicare Advantage	$2,996.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,546.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,546.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,997.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,546.81
Rate for Payer: Cigna Commercial	$4,993.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,197.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.12
Rate for Payer: UnitedHealthcare Community & State	$240.70
Rate for Payer: Wellpoint Medicaid Managed Care	$264.67

ALTIPLY LYOPH AMNIO MEM 2X4CM

Facility

$9,987.50

Service Code	HCPCS C1762
Hospital Charge Code	270703810
Hospital Revenue Code	278
Min. Negotiated Rate	$1,498.12
Max. Negotiated Rate	$2,416.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,997.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,416.97
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,197.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,498.12

ALT - SGPT

Facility

$667.59

Service Code	HCPCS 84460
Hospital Charge Code	3002458
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

ALT - SGPT

Facility

$667.59

Service Code	HCPCS 84460
Hospital Charge Code	3002458
Hospital Revenue Code	301
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$14.42
Rate for Payer: Aetna Medicare Advantage	$17.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.30
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	$19.13
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$5.30
Rate for Payer: Clover Medicare Advantage	$5.04
Rate for Payer: EmblemHealth Commercial	$15.90
Rate for Payer: Humana Medicare Advantage	$5.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.30
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	$4.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.30
Rate for Payer: Wellcare Medicare Advantage	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

ALT/SGPT

Facility

$47.25

Service Code	HCPCS 84460
Hospital Charge Code	8200352RS
Hospital Revenue Code	301
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

ALT/SGPT

Facility

$47.25

Service Code	HCPCS 84460
Hospital Charge Code	8200352RS
Hospital Revenue Code	301
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.42
Rate for Payer: Aetna Medicare Advantage	$17.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.30
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	$19.13
Rate for Payer: Cigna Commercial	$23.62
Rate for Payer: Cigna Medicare Advantage	$5.30
Rate for Payer: Clover Medicare Advantage	$5.04
Rate for Payer: EmblemHealth Commercial	$15.90
Rate for Payer: Humana Medicare Advantage	$5.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.18
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.30
Rate for Payer: Wellcare Medicare Advantage	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.25

ALT - SGPT PANEL***

Facility

$21.00

Service Code	HCPCS 84460
Hospital Charge Code	3002458P
Hospital Revenue Code	301
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$14.42
Rate for Payer: Aetna Medicare Advantage	$17.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.30
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	$19.13
Rate for Payer: Cigna Commercial	$10.50
Rate for Payer: Cigna Medicare Advantage	$5.30
Rate for Payer: Clover Medicare Advantage	$5.04
Rate for Payer: EmblemHealth Commercial	$15.90
Rate for Payer: Humana Medicare Advantage	$5.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.15
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.30
Rate for Payer: Wellcare Medicare Advantage	$5.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

ALT - SGPT PANEL***

Facility

$21.00

Service Code	HCPCS 84460
Hospital Charge Code	3002458P
Hospital Revenue Code	301
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$3.15
Rate for Payer: Qualcare PPO/HMO/WC	$3.15

ALUM

Facility

$63.00

Hospital Charge Code	60635812
Hospital Revenue Code	250
Min. Negotiated Rate	$9.45
Max. Negotiated Rate	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$9.45

ALUM

Facility

$63.00

Hospital Charge Code	60635812
Hospital Revenue Code	250
Min. Negotiated Rate	$1.52
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna Commercial	$23.94
Rate for Payer: Aetna Medicare Advantage	$18.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.07
Rate for Payer: Cigna Commercial	$31.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.90
Rate for Payer: Oxford Commercial	$12.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.45
Rate for Payer: UnitedHealthcare Commercial	$12.60
Rate for Payer: UnitedHealthcare Community & State	$1.52
Rate for Payer: Wellpoint Medicaid Managed Care	$1.67

ALUM 1% IRRIGATION

Facility

$32.00

Hospital Charge Code	60635135
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$16.00
Rate for Payer: Aetna Commercial	$12.16
Rate for Payer: Aetna Medicare Advantage	$9.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.16
Rate for Payer: Cigna Commercial	$16.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$6.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.80
Rate for Payer: UnitedHealthcare Commercial	$6.40
Rate for Payer: UnitedHealthcare Community & State	$0.77
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

ALUM 1% IRRIGATION

Facility

$32.00

Hospital Charge Code	60635135
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.80

ALUM 30 GRAMS

Facility

$2.00

Hospital Charge Code	60635627
Hospital Revenue Code	250
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

ALUM 30 GRAMS

Facility

$2.00

Hospital Charge Code	60635627
Hospital Revenue Code	250
Min. Negotiated Rate	$0.05
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.60
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.05

Know your out-of-pocket cost for care.

All Charges