Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FASTGRAFTER AUTOGRAFT HARVESTI

Facility

$4,975.00

Hospital Charge Code	270704034
Hospital Revenue Code	272
Min. Negotiated Rate	$746.25
Max. Negotiated Rate	$746.25
Rate for Payer: Qualcare PPO/HMO/WC	$746.25

FASTGRAFTER AUTOGRAFT HARVESTI

Facility

$4,975.00

Hospital Charge Code	270704034
Hospital Revenue Code	272
Min. Negotiated Rate	$119.90
Max. Negotiated Rate	$2,487.50
Rate for Payer: Aetna Commercial	$1,890.50
Rate for Payer: Aetna Medicare Advantage	$1,492.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,268.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,268.62
Rate for Payer: Cigna Commercial	$2,487.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,492.50
Rate for Payer: Oxford Commercial	$995.00
Rate for Payer: Qualcare PPO/HMO/WC	$746.25
Rate for Payer: UnitedHealthcare Commercial	$995.00
Rate for Payer: UnitedHealthcare Community & State	$119.90
Rate for Payer: Wellpoint Medicaid Managed Care	$131.84

FASTIN 5.0MM RC W/ORTHOCORD

Facility

$1,450.00

Hospital Charge Code	270639527
Hospital Revenue Code	278
Min. Negotiated Rate	$34.95
Max. Negotiated Rate	$725.00
Rate for Payer: Aetna Commercial	$551.00
Rate for Payer: Aetna Medicare Advantage	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.75
Rate for Payer: Cigna Commercial	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.50
Rate for Payer: UnitedHealthcare Community & State	$34.95
Rate for Payer: Wellpoint Medicaid Managed Care	$38.42

FASTIN 5.0MM RC W/ORTHOCORD

Facility

$1,450.00

Hospital Charge Code	270639527
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

FASTIN 5.0 RC W/ORTHOCD 222989

Facility

$1,304.50

Hospital Charge Code	270635309
Hospital Revenue Code	272
Min. Negotiated Rate	$195.68
Max. Negotiated Rate	$195.68
Rate for Payer: Qualcare PPO/HMO/WC	$195.68

FASTIN 5.0 RC W/ORTHOCD 222989

Facility

$1,304.50

Hospital Charge Code	270635309
Hospital Revenue Code	272
Min. Negotiated Rate	$31.44
Max. Negotiated Rate	$652.25
Rate for Payer: Aetna Commercial	$495.71
Rate for Payer: Aetna Medicare Advantage	$391.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$332.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$332.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$332.65
Rate for Payer: Cigna Commercial	$652.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$391.35
Rate for Payer: Oxford Commercial	$260.90
Rate for Payer: Qualcare PPO/HMO/WC	$195.68
Rate for Payer: UnitedHealthcare Commercial	$260.90
Rate for Payer: UnitedHealthcare Community & State	$31.44
Rate for Payer: Wellpoint Medicaid Managed Care	$34.57

FASTIN 6.5mm RC W/ORTHO 222992

Facility

$1,450.00

Hospital Charge Code	270640470
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

FASTIN 6.5mm RC W/ORTHO 222992

Facility

$1,450.00

Hospital Charge Code	270640470
Hospital Revenue Code	278
Min. Negotiated Rate	$34.95
Max. Negotiated Rate	$725.00
Rate for Payer: Aetna Commercial	$551.00
Rate for Payer: Aetna Medicare Advantage	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.75
Rate for Payer: Cigna Commercial	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$319.00
Rate for Payer: Qualcare PPO/HMO/WC	$217.50
Rate for Payer: UnitedHealthcare Community & State	$34.95
Rate for Payer: Wellpoint Medicaid Managed Care	$38.42

FASTING GLUCOSE TOL

Facility

$650.00

Hospital Charge Code	38479021
Hospital Revenue Code	301
Min. Negotiated Rate	$15.66
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$195.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$15.66
Rate for Payer: Wellpoint Medicaid Managed Care	$17.23

FASTING GLUCOSE TOL

Facility

$650.00

Hospital Charge Code	38479021
Hospital Revenue Code	301
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

FAT DROPLETS, URINE

Facility

$120.00

Service Code	HCPCS 81099
Hospital Charge Code	38477032
Hospital Revenue Code	307
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

FAT DROPLETS, URINE

Facility

$120.00

Service Code	HCPCS 81099
Hospital Charge Code	38477032
Hospital Revenue Code	307
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$2.89
Rate for Payer: Wellpoint Medicaid Managed Care	$3.18

FAT EMULSION 10% INJ

Facility

$460.85

Hospital Charge Code	60628618
Hospital Revenue Code	250
Min. Negotiated Rate	$11.11
Max. Negotiated Rate	$230.43
Rate for Payer: Aetna Commercial	$175.12
Rate for Payer: Aetna Medicare Advantage	$138.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$117.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$117.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$117.52
Rate for Payer: Cigna Commercial	$230.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.25
Rate for Payer: Oxford Commercial	$92.17
Rate for Payer: Qualcare PPO/HMO/WC	$69.13
Rate for Payer: UnitedHealthcare Commercial	$92.17
Rate for Payer: UnitedHealthcare Community & State	$11.11
Rate for Payer: Wellpoint Medicaid Managed Care	$12.21

FAT EMULSION 10% INJ

Facility

$460.85

Hospital Charge Code	60628618
Hospital Revenue Code	250
Min. Negotiated Rate	$69.13
Max. Negotiated Rate	$69.13
Rate for Payer: Qualcare PPO/HMO/WC	$69.13

FAT EMULSION 20% INJ

Facility

$2.45

Hospital Charge Code	60628619
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

FAT EMULSION 20% INJ

Facility

$2.45

Hospital Charge Code	60628619
Hospital Revenue Code	250
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.23
Rate for Payer: Aetna Commercial	$0.93
Rate for Payer: Aetna Medicare Advantage	$0.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.62
Rate for Payer: Cigna Commercial	$1.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.74
Rate for Payer: Oxford Commercial	$0.49
Rate for Payer: Qualcare PPO/HMO/WC	$0.37
Rate for Payer: UnitedHealthcare Commercial	$0.49
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

FAT EMULSIONS 20% 250ML

Facility

$136.76

Hospital Charge Code	60635810
Hospital Revenue Code	250
Min. Negotiated Rate	$20.51
Max. Negotiated Rate	$20.51
Rate for Payer: Qualcare PPO/HMO/WC	$20.51

FAT EMULSIONS 20% 250ML

Facility

$136.76

Hospital Charge Code	60635810
Hospital Revenue Code	250
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$68.38
Rate for Payer: Aetna Commercial	$51.97
Rate for Payer: Aetna Medicare Advantage	$41.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.87
Rate for Payer: Cigna Commercial	$68.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$41.03
Rate for Payer: Oxford Commercial	$27.35
Rate for Payer: Qualcare PPO/HMO/WC	$20.51
Rate for Payer: UnitedHealthcare Commercial	$27.35
Rate for Payer: UnitedHealthcare Community & State	$3.30
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

FAT EMULSIONS 20% 500ML

Facility

$263.56

Hospital Charge Code	60635811
Hospital Revenue Code	250
Min. Negotiated Rate	$39.53
Max. Negotiated Rate	$39.53
Rate for Payer: Qualcare PPO/HMO/WC	$39.53

FAT EMULSIONS 20% 500ML

Facility

$263.56

Hospital Charge Code	60635811
Hospital Revenue Code	250
Min. Negotiated Rate	$6.35
Max. Negotiated Rate	$131.78
Rate for Payer: Aetna Commercial	$100.15
Rate for Payer: Aetna Medicare Advantage	$79.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.21
Rate for Payer: Cigna Commercial	$131.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$79.07
Rate for Payer: Oxford Commercial	$52.71
Rate for Payer: Qualcare PPO/HMO/WC	$39.53
Rate for Payer: UnitedHealthcare Commercial	$52.71
Rate for Payer: UnitedHealthcare Community & State	$6.35
Rate for Payer: Wellpoint Medicaid Managed Care	$6.98

FAT STAIN,FECES,URINE,OR RESP

Facility

$30.55

Service Code	HCPCS 89125
Hospital Charge Code	38477034
Hospital Revenue Code	300
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$15.99
Rate for Payer: Aetna Medicare Advantage	$19.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.23
Rate for Payer: Cigna Commercial	$15.28
Rate for Payer: Cigna Medicare Advantage	$5.88
Rate for Payer: Clover Medicare Advantage	$5.59
Rate for Payer: EmblemHealth Commercial	$17.64
Rate for Payer: Humana Medicare Advantage	$6.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.16
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.58
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.88
Rate for Payer: Wellcare Medicare Advantage	$5.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

FAT STAIN,FECES,URINE,OR RESP

Facility

$30.55

Service Code	HCPCS 89125
Hospital Charge Code	38477034
Hospital Revenue Code	300
Min. Negotiated Rate	$4.58
Max. Negotiated Rate	$4.58
Rate for Payer: Qualcare PPO/HMO/WC	$4.58

FAT, STOOL

Facility

$116.00

Service Code	HCPCS 82705
Hospital Charge Code	3002953
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

FAT, STOOL

Facility

$116.00

Service Code	HCPCS 82705
Hospital Charge Code	3002953
Hospital Revenue Code	301
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$13.87
Rate for Payer: Aetna Medicare Advantage	$16.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.41
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: Cigna Medicare Advantage	$5.10
Rate for Payer: Clover Medicare Advantage	$4.84
Rate for Payer: EmblemHealth Commercial	$15.30
Rate for Payer: Humana Medicare Advantage	$5.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$4.08
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.10
Rate for Payer: Wellcare Medicare Advantage	$5.10
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

FAT,STOOL,QUANT

Facility

$121.00

Service Code	HCPCS 82710
Hospital Charge Code	38475096
Hospital Revenue Code	301
Min. Negotiated Rate	$18.15
Max. Negotiated Rate	$18.15
Rate for Payer: Qualcare PPO/HMO/WC	$18.15

Know your out-of-pocket cost for care.

All Charges