Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FOLATE

Facility

$131.00

Service Code	HCPCS 82746
Hospital Charge Code	38479400
Hospital Revenue Code	301
Min. Negotiated Rate	$3.47
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.98
Rate for Payer: Aetna Medicare Advantage	$47.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.06
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: Cigna Medicare Advantage	$14.70
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Medicare Advantage	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

FOLATE

Facility

$667.59

Service Code	HCPCS 82746
Hospital Charge Code	39888003
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

FOLATE

Facility

$131.00

Service Code	HCPCS 82746
Hospital Charge Code	38479400
Hospital Revenue Code	301
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

FOLATE

Facility

$667.59

Service Code	HCPCS 82746
Hospital Charge Code	39888003
Hospital Revenue Code	301
Min. Negotiated Rate	$11.76
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$39.98
Rate for Payer: Aetna Medicare Advantage	$47.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.06
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$14.70
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.70
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	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Medicare Advantage	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$17.69

FOLATE/B6/B12 TAB 2.5/25/1MG

Facility

$2.45

Hospital Charge Code	60629179
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$0.37
Rate for Payer: Qualcare PPO/HMO/WC	$0.37

FOLATE/B6/B12 TAB 2.5/25/1MG

Facility

$2.45

Hospital Charge Code	60629179
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

FOLATE (FOLIC ACID)

Facility

$131.00

Service Code	HCPCS 82746
Hospital Charge Code	38472281
Hospital Revenue Code	301
Min. Negotiated Rate	$19.65
Max. Negotiated Rate	$19.65
Rate for Payer: Qualcare PPO/HMO/WC	$19.65

FOLATE (FOLIC ACID)

Facility

$271.05

Service Code	HCPCS 82746
Hospital Charge Code	3001294
Hospital Revenue Code	301
Min. Negotiated Rate	$7.18
Max. Negotiated Rate	$135.53
Rate for Payer: Aetna Commercial	$39.98
Rate for Payer: Aetna Medicare Advantage	$47.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.06
Rate for Payer: Cigna Commercial	$135.53
Rate for Payer: Cigna Medicare Advantage	$14.70
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.66
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Medicare Advantage	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$7.18

FOLATE (FOLIC ACID)

Facility

$271.05

Service Code	HCPCS 82746
Hospital Charge Code	3001294
Hospital Revenue Code	301
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$40.66
Rate for Payer: Qualcare PPO/HMO/WC	$40.66

FOLATE (FOLIC ACID)

Facility

$131.00

Service Code	HCPCS 82746
Hospital Charge Code	38472281
Hospital Revenue Code	301
Min. Negotiated Rate	$3.47
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.98
Rate for Payer: Aetna Medicare Advantage	$47.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.06
Rate for Payer: Cigna Commercial	$65.50
Rate for Payer: Cigna Medicare Advantage	$14.70
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.30
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.65
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Medicare Advantage	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$3.47

FOLATE RBC

Facility

$390.00

Service Code	HCPCS 82747
Hospital Charge Code	39900330
Hospital Revenue Code	301
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$48.01
Rate for Payer: Aetna Medicare Advantage	$57.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$17.65
Rate for Payer: Clover Medicare Advantage	$16.77
Rate for Payer: EmblemHealth Commercial	$52.95
Rate for Payer: Humana Medicare Advantage	$18.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.65
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	$14.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.65
Rate for Payer: Wellcare Medicare Advantage	$17.65
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

FOLATE RBC

Facility

$89.65

Service Code	HCPCS 82747
Hospital Charge Code	3007390A
Hospital Revenue Code	301
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.01
Rate for Payer: Aetna Medicare Advantage	$57.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.71
Rate for Payer: Cigna Commercial	$44.83
Rate for Payer: Cigna Medicare Advantage	$17.65
Rate for Payer: Clover Medicare Advantage	$16.77
Rate for Payer: EmblemHealth Commercial	$52.95
Rate for Payer: Humana Medicare Advantage	$18.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.89
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$13.45
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.65
Rate for Payer: Wellcare Medicare Advantage	$17.65
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

FOLATE RBC

Facility

$89.65

Service Code	HCPCS 82747
Hospital Charge Code	3007390A
Hospital Revenue Code	301
Min. Negotiated Rate	$13.45
Max. Negotiated Rate	$13.45
Rate for Payer: Qualcare PPO/HMO/WC	$13.45

FOLATE RBC

Facility

$390.00

Service Code	HCPCS 82747
Hospital Charge Code	39900330
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

FOLATE, RBC

Facility

$169.00

Service Code	HCPCS 82747
Hospital Charge Code	38472006
Hospital Revenue Code	301
Min. Negotiated Rate	$25.35
Max. Negotiated Rate	$25.35
Rate for Payer: Qualcare PPO/HMO/WC	$25.35

FOLATE, RBC

Facility

$169.00

Service Code	HCPCS 82747
Hospital Charge Code	38472006
Hospital Revenue Code	301
Min. Negotiated Rate	$4.48
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$48.01
Rate for Payer: Aetna Medicare Advantage	$57.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.71
Rate for Payer: Cigna Commercial	$84.50
Rate for Payer: Cigna Medicare Advantage	$17.65
Rate for Payer: Clover Medicare Advantage	$16.77
Rate for Payer: EmblemHealth Commercial	$52.95
Rate for Payer: Humana Medicare Advantage	$18.18
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$14.12
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.65
Rate for Payer: Wellcare Medicare Advantage	$17.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.48

FOLATE SERUM

Facility

$271.05

Service Code	HCPCS 82746
Hospital Charge Code	8200311RS
Hospital Revenue Code	301
Min. Negotiated Rate	$7.18
Max. Negotiated Rate	$135.53
Rate for Payer: Aetna Commercial	$39.98
Rate for Payer: Aetna Medicare Advantage	$47.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.06
Rate for Payer: Cigna Commercial	$135.53
Rate for Payer: Cigna Medicare Advantage	$14.70
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.31
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$40.66
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Medicare Advantage	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$7.18

FOLATE SERUM

Facility

$271.05

Service Code	HCPCS 82746
Hospital Charge Code	8200311RS
Hospital Revenue Code	301
Min. Negotiated Rate	$40.66
Max. Negotiated Rate	$40.66
Rate for Payer: Qualcare PPO/HMO/WC	$40.66

FOLATE,SERUM

Facility

$101.05

Service Code	HCPCS 82746
Hospital Charge Code	39900080
Hospital Revenue Code	301
Min. Negotiated Rate	$15.16
Max. Negotiated Rate	$15.16
Rate for Payer: Qualcare PPO/HMO/WC	$15.16

FOLATE,SERUM

Facility

$101.05

Service Code	HCPCS 82746
Hospital Charge Code	39900080
Hospital Revenue Code	301
Min. Negotiated Rate	$2.68
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$39.98
Rate for Payer: Aetna Medicare Advantage	$47.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.06
Rate for Payer: Cigna Commercial	$50.52
Rate for Payer: Cigna Medicare Advantage	$14.70
Rate for Payer: Clover Medicare Advantage	$13.96
Rate for Payer: EmblemHealth Commercial	$44.10
Rate for Payer: Humana Medicare Advantage	$15.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.32
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.16
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.76
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.70
Rate for Payer: Wellcare Medicare Advantage	$14.70
Rate for Payer: Wellpoint Medicaid Managed Care	$2.68

FOLEY 605698****

Facility

$26.75

Hospital Charge Code	270605698
Hospital Revenue Code	272
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$13.38
Rate for Payer: Aetna Commercial	$10.16
Rate for Payer: Aetna Medicare Advantage	$8.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.82
Rate for Payer: Cigna Commercial	$13.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.03
Rate for Payer: Oxford Commercial	$5.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.01
Rate for Payer: UnitedHealthcare Commercial	$5.35
Rate for Payer: UnitedHealthcare Community & State	$0.64
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

FOLEY 605698****

Facility

$26.75

Hospital Charge Code	270605698
Hospital Revenue Code	272
Min. Negotiated Rate	$4.01
Max. Negotiated Rate	$4.01
Rate for Payer: Qualcare PPO/HMO/WC	$4.01

FOLEY CATH 18F TRAY LF 900118A

Facility

$72.77

Hospital Charge Code	270639932
Hospital Revenue Code	272
Min. Negotiated Rate	$10.92
Max. Negotiated Rate	$10.92
Rate for Payer: Qualcare PPO/HMO/WC	$10.92

FOLEY CATH 18F TRAY LF 900118A

Facility

$72.77

Hospital Charge Code	270639932
Hospital Revenue Code	272
Min. Negotiated Rate	$1.75
Max. Negotiated Rate	$36.38
Rate for Payer: Aetna Commercial	$27.65
Rate for Payer: Aetna Medicare Advantage	$21.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.56
Rate for Payer: Cigna Commercial	$36.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.83
Rate for Payer: Oxford Commercial	$14.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.92
Rate for Payer: UnitedHealthcare Commercial	$14.55
Rate for Payer: UnitedHealthcare Community & State	$1.75
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

FOLEY CATHETER 24FR 30CC 2WAY

Facility

$416.00

Hospital Charge Code	270332269
Hospital Revenue Code	272
Min. Negotiated Rate	$62.40
Max. Negotiated Rate	$62.40
Rate for Payer: Qualcare PPO/HMO/WC	$62.40

Know your out-of-pocket cost for care.

All Charges