Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FECAL GLOBIN IMMUNOASSAY FIT

Facility

$90.25

Service Code	HCPCS 82274
Hospital Charge Code	401182274
Hospital Revenue Code	301
Min. Negotiated Rate	$13.54
Max. Negotiated Rate	$13.54
Rate for Payer: Qualcare PPO/HMO/WC	$13.54

FECAL GLOBIN, IMMUNO CHEM

Facility

$390.00

Service Code	HCPCS 82274
Hospital Charge Code	305086
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FECAL GLOBIN, IMMUNO CHEM

Facility

$390.00

Service Code	HCPCS 82274
Hospital Charge Code	305086
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$43.30
Rate for Payer: Aetna Medicare Advantage	$51.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$21.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.47
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$15.92
Rate for Payer: Clover Medicare Advantage	$15.12
Rate for Payer: EmblemHealth Commercial	$47.76
Rate for Payer: Humana Medicare Advantage	$16.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$12.74
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.92
Rate for Payer: Wellcare Medicare Advantage	$15.92
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

FECAL LEUKOCYTE

Facility

$150.00

Service Code	HCPCS 89055
Hospital Charge Code	38475094
Hospital Revenue Code	309
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$3.98

FECAL LEUKOCYTE

Facility

$150.00

Service Code	HCPCS 89055
Hospital Charge Code	38475094
Hospital Revenue Code	309
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

FECAL LEUKOCYTES

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	3004652
Hospital Revenue Code	309
Min. Negotiated Rate	$3.42
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

FECAL LEUKOCYTES

Facility

$390.00

Service Code	HCPCS 87205
Hospital Charge Code	3004652
Hospital Revenue Code	309
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FECAL LIPIDS,TOTAL

Facility

$390.00

Service Code	HCPCS 82710
Hospital Charge Code	39900078
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FECAL LIPIDS,TOTAL

Facility

$390.00

Service Code	HCPCS 82710
Hospital Charge Code	39900078
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$45.70
Rate for Payer: Aetna Medicare Advantage	$54.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.64
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.80
Rate for Payer: Clover Medicare Advantage	$15.96
Rate for Payer: EmblemHealth Commercial	$50.40
Rate for Payer: Humana Medicare Advantage	$17.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$13.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.80
Rate for Payer: Wellcare Medicare Advantage	$16.80
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

FECAL, STARCH

Facility

$116.00

Service Code	HCPCS 82710
Hospital Charge Code	3004653
Hospital Revenue Code	301
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$45.70
Rate for Payer: Aetna Medicare Advantage	$54.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$15.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.64
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: Cigna Medicare Advantage	$16.80
Rate for Payer: Clover Medicare Advantage	$15.96
Rate for Payer: EmblemHealth Commercial	$50.40
Rate for Payer: Humana Medicare Advantage	$17.30
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.80
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	$13.44
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.80
Rate for Payer: Wellcare Medicare Advantage	$16.80
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

FECAL, STARCH

Facility

$116.00

Service Code	HCPCS 82710
Hospital Charge Code	3004653
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

FEC. PANCREATIC ELASTASE-1

Facility

$951.00

Service Code	HCPCS 82656
Hospital Charge Code	397071379
Hospital Revenue Code	301
Min. Negotiated Rate	$142.65
Max. Negotiated Rate	$142.65
Rate for Payer: Qualcare PPO/HMO/WC	$142.65

FEC. PANCREATIC ELASTASE-1

Facility

$951.00

Service Code	HCPCS 82656
Hospital Charge Code	397071379
Hospital Revenue Code	301
Min. Negotiated Rate	$9.22
Max. Negotiated Rate	$475.50
Rate for Payer: Aetna Commercial	$31.36
Rate for Payer: Aetna Medicare Advantage	$37.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.62
Rate for Payer: Cigna Commercial	$475.50
Rate for Payer: Cigna Medicare Advantage	$11.53
Rate for Payer: Clover Medicare Advantage	$10.95
Rate for Payer: EmblemHealth Commercial	$34.59
Rate for Payer: Humana Medicare Advantage	$11.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$285.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$142.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.22
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.53
Rate for Payer: Wellcare Medicare Advantage	$11.53
Rate for Payer: Wellpoint Medicaid Managed Care	$25.20

FEE CANCEL AT PROCEDURE ATS400

Facility

$1,455.00

Hospital Charge Code	270613407
Hospital Revenue Code	272
Min. Negotiated Rate	$218.25
Max. Negotiated Rate	$218.25
Rate for Payer: Qualcare PPO/HMO/WC	$218.25

FEE CANCEL AT PROCEDURE ATS400

Facility

$1,455.00

Hospital Charge Code	270613407
Hospital Revenue Code	272
Min. Negotiated Rate	$35.07
Max. Negotiated Rate	$727.50
Rate for Payer: Aetna Commercial	$552.90
Rate for Payer: Aetna Medicare Advantage	$436.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$371.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$371.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$371.02
Rate for Payer: Cigna Commercial	$727.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$436.50
Rate for Payer: Oxford Commercial	$291.00
Rate for Payer: Qualcare PPO/HMO/WC	$218.25
Rate for Payer: UnitedHealthcare Commercial	$291.00
Rate for Payer: UnitedHealthcare Community & State	$35.07
Rate for Payer: Wellpoint Medicaid Managed Care	$38.56

FEEDING TUBE CHANGE****

Facility

$225.00

Service Code	HCPCS 43760
Hospital Charge Code	1001120
Hospital Revenue Code	361
Min. Negotiated Rate	$33.75
Max. Negotiated Rate	$33.75
Rate for Payer: Qualcare PPO/HMO/WC	$33.75

FEEDING TUBE CHANGE****

Facility

$225.00

Service Code	HCPCS 43760
Hospital Charge Code	1001120
Hospital Revenue Code	361
Min. Negotiated Rate	$5.42
Max. Negotiated Rate	$862.00
Rate for Payer: Aetna Commercial	$85.50
Rate for Payer: Aetna Medicare Advantage	$67.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$862.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.38
Rate for Payer: Cigna Commercial	$112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$33.75
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$781.67
Rate for Payer: Wellpoint Medicaid Managed Care	$766.34

FEEDING TUBE INFANT 6FR

Facility

$7.70

Hospital Charge Code	270659380
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.85
Rate for Payer: Aetna Commercial	$2.93
Rate for Payer: Aetna Medicare Advantage	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.96
Rate for Payer: Cigna Commercial	$3.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.31
Rate for Payer: Oxford Commercial	$1.54
Rate for Payer: Qualcare PPO/HMO/WC	$1.16
Rate for Payer: UnitedHealthcare Commercial	$1.54
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

FEEDING TUBE INFANT 6FR

Facility

$7.70

Hospital Charge Code	270659380
Hospital Revenue Code	272
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$1.16
Rate for Payer: Qualcare PPO/HMO/WC	$1.16

FEEDING TUBE JUJUNAL

Facility

$195.20

Hospital Charge Code	270687764
Hospital Revenue Code	272
Min. Negotiated Rate	$29.28
Max. Negotiated Rate	$29.28
Rate for Payer: Qualcare PPO/HMO/WC	$29.28

FEEDING TUBE JUJUNAL

Facility

$195.20

Hospital Charge Code	270687764
Hospital Revenue Code	272
Min. Negotiated Rate	$4.70
Max. Negotiated Rate	$97.60
Rate for Payer: Aetna Commercial	$74.18
Rate for Payer: Aetna Medicare Advantage	$58.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.78
Rate for Payer: Cigna Commercial	$97.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.56
Rate for Payer: Oxford Commercial	$39.04
Rate for Payer: Qualcare PPO/HMO/WC	$29.28
Rate for Payer: UnitedHealthcare Commercial	$39.04
Rate for Payer: UnitedHealthcare Community & State	$4.70
Rate for Payer: Wellpoint Medicaid Managed Care	$5.17

FEE SHIPPING/DEVICE PAT CHAR

Facility

$750.00

Hospital Charge Code	270608796
Hospital Revenue Code	272
Min. Negotiated Rate	$112.50
Max. Negotiated Rate	$112.50
Rate for Payer: Qualcare PPO/HMO/WC	$112.50

FEE SHIPPING/DEVICE PAT CHAR

Facility

$750.00

Hospital Charge Code	270608796
Hospital Revenue Code	272
Min. Negotiated Rate	$18.07
Max. Negotiated Rate	$375.00
Rate for Payer: Aetna Commercial	$285.00
Rate for Payer: Aetna Medicare Advantage	$225.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$191.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$191.25
Rate for Payer: Cigna Commercial	$375.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$225.00
Rate for Payer: Oxford Commercial	$150.00
Rate for Payer: Qualcare PPO/HMO/WC	$112.50
Rate for Payer: UnitedHealthcare Commercial	$150.00
Rate for Payer: UnitedHealthcare Community & State	$18.07
Rate for Payer: Wellpoint Medicaid Managed Care	$19.88

FEE SHOULDER BASKET FEE

Facility

$496.00

Hospital Charge Code	270636218
Hospital Revenue Code	272
Min. Negotiated Rate	$74.40
Max. Negotiated Rate	$74.40
Rate for Payer: Qualcare PPO/HMO/WC	$74.40

FEE SHOULDER BASKET FEE

Facility

$496.00

Hospital Charge Code	270636218
Hospital Revenue Code	272
Min. Negotiated Rate	$11.95
Max. Negotiated Rate	$248.00
Rate for Payer: Aetna Commercial	$188.48
Rate for Payer: Aetna Medicare Advantage	$148.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$126.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$126.48
Rate for Payer: Cigna Commercial	$248.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.80
Rate for Payer: Oxford Commercial	$99.20
Rate for Payer: Qualcare PPO/HMO/WC	$74.40
Rate for Payer: UnitedHealthcare Commercial	$99.20
Rate for Payer: UnitedHealthcare Community & State	$11.95
Rate for Payer: Wellpoint Medicaid Managed Care	$13.14

Know your out-of-pocket cost for care.

All Charges