Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

AMBULANCE OTH FACIL W/RETURN

Facility

$896.00

Hospital Charge Code	1000020
Hospital Revenue Code	540
Min. Negotiated Rate	$21.59
Max. Negotiated Rate	$3,643.00
Rate for Payer: Aetna Commercial	$340.48
Rate for Payer: Aetna Medicare Advantage	$268.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$228.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$228.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$228.48
Rate for Payer: Cigna Commercial	$448.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.80
Rate for Payer: Oxford Commercial	$2,078.00
Rate for Payer: Qualcare PPO/HMO/WC	$134.40
Rate for Payer: UnitedHealthcare Commercial	$3,643.00
Rate for Payer: UnitedHealthcare Community & State	$21.59
Rate for Payer: Wellpoint Medicaid Managed Care	$23.74

AMBULANCE OTH FACIL W/RETURN

Facility

$896.00

Hospital Charge Code	1000020
Hospital Revenue Code	540
Min. Negotiated Rate	$134.40
Max. Negotiated Rate	$134.40
Rate for Payer: Qualcare PPO/HMO/WC	$134.40

AMBULATORY INFUSION PUMP***

Facility

$300.00

Service Code	HCPCS 99999
Hospital Charge Code	3400264
Hospital Revenue Code	272
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

AMBULATORY INFUSION PUMP***

Facility

$300.00

Service Code	HCPCS 99999
Hospital Charge Code	3400264
Hospital Revenue Code	272
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$150.00
Rate for Payer: Aetna Commercial	$114.00
Rate for Payer: Aetna Medicare Advantage	$90.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$76.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$76.50
Rate for Payer: Cigna Commercial	$150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$60.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

AMCINONIDE OINT 0.1%

Facility

$195.85

Hospital Charge Code	60628368
Hospital Revenue Code	250
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$97.92
Rate for Payer: Aetna Commercial	$74.42
Rate for Payer: Aetna Medicare Advantage	$58.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.94
Rate for Payer: Cigna Commercial	$97.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.76
Rate for Payer: Oxford Commercial	$39.17
Rate for Payer: Qualcare PPO/HMO/WC	$29.38
Rate for Payer: UnitedHealthcare Commercial	$39.17
Rate for Payer: UnitedHealthcare Community & State	$4.72
Rate for Payer: Wellpoint Medicaid Managed Care	$5.19

AMCINONIDE OINT 0.1%

Facility

$195.85

Hospital Charge Code	60628368
Hospital Revenue Code	250
Min. Negotiated Rate	$29.38
Max. Negotiated Rate	$29.38
Rate for Payer: Qualcare PPO/HMO/WC	$29.38

AMEBIASIS ANTIBODIES

Facility

$336.00

Service Code	HCPCS 86753
Hospital Charge Code	3009992
Hospital Revenue Code	302
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

AMEBIASIS ANTIBODIES

Facility

$336.00

Service Code	HCPCS 86753
Hospital Charge Code	3009992
Hospital Revenue Code	302
Min. Negotiated Rate	$8.90
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$33.70
Rate for Payer: Aetna Medicare Advantage	$40.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.72
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: Cigna Medicare Advantage	$12.39
Rate for Payer: Clover Medicare Advantage	$11.77
Rate for Payer: EmblemHealth Commercial	$37.17
Rate for Payer: Humana Medicare Advantage	$12.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$100.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.39
Rate for Payer: Wellcare Medicare Advantage	$12.39
Rate for Payer: Wellpoint Medicaid Managed Care	$8.90

AMEBIC (E.HISTOLYTICA) ANTIBOD

Facility

$324.00

Service Code	HCPCS 86753
Hospital Charge Code	38476151
Hospital Revenue Code	302
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

AMEBIC (E.HISTOLYTICA) ANTIBOD

Facility

$324.00

Service Code	HCPCS 86753
Hospital Charge Code	38476151
Hospital Revenue Code	302
Min. Negotiated Rate	$8.59
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna Commercial	$33.70
Rate for Payer: Aetna Medicare Advantage	$40.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.72
Rate for Payer: Cigna Commercial	$162.00
Rate for Payer: Cigna Medicare Advantage	$12.39
Rate for Payer: Clover Medicare Advantage	$11.77
Rate for Payer: EmblemHealth Commercial	$37.17
Rate for Payer: Humana Medicare Advantage	$12.76
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.20
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.39
Rate for Payer: Wellcare Medicare Advantage	$12.39
Rate for Payer: Wellpoint Medicaid Managed Care	$8.59

A-METHAPRED/1000MG

Facility

$7.00

Hospital Charge Code	60632382
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.50
Rate for Payer: Aetna Commercial	$2.66
Rate for Payer: Aetna Medicare Advantage	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.78
Rate for Payer: Cigna Commercial	$3.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.10
Rate for Payer: Oxford Commercial	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.05
Rate for Payer: UnitedHealthcare Commercial	$1.40
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

A-METHAPRED/1000MG

Facility

$7.00

Hospital Charge Code	60632382
Hospital Revenue Code	250
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$1.05

A-METHAPRED/500MG

Facility

$193.00

Hospital Charge Code	60632381
Hospital Revenue Code	250
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$28.95
Rate for Payer: Qualcare PPO/HMO/WC	$28.95

A-METHAPRED/500MG

Facility

$193.00

Hospital Charge Code	60632381
Hospital Revenue Code	250
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$96.50
Rate for Payer: Aetna Commercial	$73.34
Rate for Payer: Aetna Medicare Advantage	$57.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.22
Rate for Payer: Cigna Commercial	$96.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.90
Rate for Payer: Oxford Commercial	$38.60
Rate for Payer: Qualcare PPO/HMO/WC	$28.95
Rate for Payer: UnitedHealthcare Commercial	$38.60
Rate for Payer: UnitedHealthcare Community & State	$4.65
Rate for Payer: Wellpoint Medicaid Managed Care	$5.11

A-METHAPRED INJ/40MG/VIAL

Facility

$15.00

Hospital Charge Code	60634279
Hospital Revenue Code	636
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$3.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

A-METHAPRED INJ/40MG/VIAL

Facility

$15.00

Hospital Charge Code	60634279
Hospital Revenue Code	636
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

AMICA PROBE 14GX400MM

Facility

$12,000.00

Hospital Charge Code	270703724
Hospital Revenue Code	279
Min. Negotiated Rate	$289.20
Max. Negotiated Rate	$6,000.00
Rate for Payer: Aetna Commercial	$4,560.00
Rate for Payer: Aetna Medicare Advantage	$3,600.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,060.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,060.00
Rate for Payer: Cigna Commercial	$6,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,600.00
Rate for Payer: Oxford Commercial	$2,400.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00
Rate for Payer: UnitedHealthcare Commercial	$2,400.00
Rate for Payer: UnitedHealthcare Community & State	$289.20
Rate for Payer: Wellpoint Medicaid Managed Care	$318.00

AMICA PROBE 14GX400MM

Facility

$12,000.00

Hospital Charge Code	270703724
Hospital Revenue Code	279
Min. Negotiated Rate	$1,800.00
Max. Negotiated Rate	$1,800.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,800.00

AMICAR/500MG/TAB

Facility

$12.00

Hospital Charge Code	60632431
Hospital Revenue Code	250
Min. Negotiated Rate	$1.80
Max. Negotiated Rate	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.80

AMICAR/500MG/TAB

Facility

$12.00

Hospital Charge Code	60632431
Hospital Revenue Code	250
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$6.00
Rate for Payer: Aetna Commercial	$4.56
Rate for Payer: Aetna Medicare Advantage	$3.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.06
Rate for Payer: Cigna Commercial	$6.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.60
Rate for Payer: Oxford Commercial	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.80
Rate for Payer: UnitedHealthcare Commercial	$2.40
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

AMID STAPLER

Facility

$1,475.00

Hospital Charge Code	270661559
Hospital Revenue Code	272
Min. Negotiated Rate	$35.55
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$442.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$35.55
Rate for Payer: Wellpoint Medicaid Managed Care	$39.09

AMID STAPLER

Facility

$1,475.00

Hospital Charge Code	270661559
Hospital Revenue Code	272
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

AMIFOSTINE 500 MG INJ

Facility

$3,786.75

Hospital Charge Code	60628513
Hospital Revenue Code	636
Min. Negotiated Rate	$91.26
Max. Negotiated Rate	$1,893.38
Rate for Payer: Aetna Commercial	$1,438.96
Rate for Payer: Aetna Medicare Advantage	$1,136.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$965.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$965.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$965.62
Rate for Payer: Cigna Commercial	$1,893.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$916.39
Rate for Payer: Qualcare PPO/HMO/WC	$568.01
Rate for Payer: UnitedHealthcare Community & State	$91.26
Rate for Payer: Wellpoint Medicaid Managed Care	$100.35

AMIFOSTINE 500 MG INJ

Facility

$3,786.75

Hospital Charge Code	60628513
Hospital Revenue Code	636
Min. Negotiated Rate	$568.01
Max. Negotiated Rate	$916.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$916.39
Rate for Payer: Qualcare PPO/HMO/WC	$568.01

AMIFOSTINE INJ 500MG

Facility

$1,731.20

Hospital Charge Code	6017099
Hospital Revenue Code	636
Min. Negotiated Rate	$259.68
Max. Negotiated Rate	$418.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$418.95
Rate for Payer: Qualcare PPO/HMO/WC	$259.68

Know your out-of-pocket cost for care.

All Charges