Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

FRENULOTOMY OF PENIS

Facility

$12,062.25

Service Code	HCPCS 54164
Hospital Charge Code	1600000595
Hospital Revenue Code	360
Min. Negotiated Rate	$1,809.34
Max. Negotiated Rate	$1,809.34
Rate for Payer: Qualcare PPO/HMO/WC	$1,809.34

FRENULOTOMY OF PENIS

Facility

$12,062.25

Service Code	HCPCS 54164
Hospital Charge Code	1600000595
Hospital Revenue Code	360
Min. Negotiated Rate	$290.70
Max. Negotiated Rate	$8,964.44
Rate for Payer: Aetna Commercial	$6,754.93
Rate for Payer: Aetna Medicare Advantage	$8,046.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,964.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,483.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,016.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,964.44
Rate for Payer: Cigna Commercial	$4,978.04
Rate for Payer: Cigna Medicare Advantage	$2,483.43
Rate for Payer: Clover Medicare Advantage	$2,359.26
Rate for Payer: EmblemHealth Commercial	$7,450.29
Rate for Payer: Humana Medicare Advantage	$2,557.93
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,483.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,618.68
Rate for Payer: Oxford Commercial	$4,871.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,809.34
Rate for Payer: UnitedHealthcare Commercial	$8,157.00
Rate for Payer: UnitedHealthcare Community & State	$290.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,483.43
Rate for Payer: Wellcare Medicare Advantage	$2,483.43
Rate for Payer: Wellpoint Medicaid Managed Care	$319.65

FRESH FROZEN PLASMA, SING DNR

Facility

$474.16

Hospital Charge Code	38471052
Hospital Revenue Code	390
Min. Negotiated Rate	$71.12
Max. Negotiated Rate	$71.12
Rate for Payer: Qualcare PPO/HMO/WC	$71.12

FRESH FROZEN PLASMA, SING DNR

Facility

$474.16

Hospital Charge Code	38471052
Hospital Revenue Code	390
Min. Negotiated Rate	$11.43
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$180.18
Rate for Payer: Aetna Medicare Advantage	$142.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$120.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$120.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$120.91
Rate for Payer: Cigna Commercial	$237.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$142.25
Rate for Payer: Oxford Commercial	$666.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.12
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$11.43
Rate for Payer: Wellpoint Medicaid Managed Care	$12.57

FRESH FROZEN PLASMA,THAWING EA

Facility

$126.00

Service Code	HCPCS 86927
Hospital Charge Code	38471093
Hospital Revenue Code	309
Min. Negotiated Rate	$3.04
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.80
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.90
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$3.04
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$3.34

FRESH FROZEN PLASMA,THAWING EA

Facility

$126.00

Service Code	HCPCS 86927
Hospital Charge Code	38471093
Hospital Revenue Code	309
Min. Negotiated Rate	$18.90
Max. Negotiated Rate	$18.90
Rate for Payer: Qualcare PPO/HMO/WC	$18.90

FRESH OSTEOCHONDRAL CORE 10MM

Facility

$12,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270673844
Hospital Revenue Code	278
Min. Negotiated Rate	$300.65
Max. Negotiated Rate	$6,237.50
Rate for Payer: Aetna Commercial	$4,740.50
Rate for Payer: Aetna Medicare Advantage	$3,742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,181.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,495.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,181.12
Rate for Payer: Cigna Commercial	$6,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,018.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,744.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,871.25
Rate for Payer: UnitedHealthcare Community & State	$300.65
Rate for Payer: Wellpoint Medicaid Managed Care	$330.59

FRESH OSTEOCHONDRAL CORE 10MM

Facility

$12,475.00

Service Code	HCPCS C1713
Hospital Charge Code	270673844
Hospital Revenue Code	278
Min. Negotiated Rate	$1,871.25
Max. Negotiated Rate	$3,018.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,495.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,018.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$2,744.50
Rate for Payer: Qualcare PPO/HMO/WC	$1,871.25

FRESH PLUG 16MM

Facility

$21,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270694002
Hospital Revenue Code	278
Min. Negotiated Rate	$526.59
Max. Negotiated Rate	$10,925.00
Rate for Payer: Aetna Commercial	$8,303.00
Rate for Payer: Aetna Medicare Advantage	$6,555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,571.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,571.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,370.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,571.75
Rate for Payer: Cigna Commercial	$10,925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,287.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,277.50
Rate for Payer: UnitedHealthcare Community & State	$526.59
Rate for Payer: Wellpoint Medicaid Managed Care	$579.02

FRESH PLUG 16MM

Facility

$21,850.00

Service Code	HCPCS C1713
Hospital Charge Code	270694002
Hospital Revenue Code	278
Min. Negotiated Rate	$3,277.50
Max. Negotiated Rate	$5,287.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,370.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,287.70
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$4,807.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,277.50

FROCEP FOX BIPOLAR .5MMX20XM

Facility

$946.15

Hospital Charge Code	270664163
Hospital Revenue Code	270
Min. Negotiated Rate	$141.92
Max. Negotiated Rate	$141.92
Rate for Payer: Qualcare PPO/HMO/WC	$141.92

FROCEP FOX BIPOLAR .5MMX20XM

Facility

$946.15

Hospital Charge Code	270664163
Hospital Revenue Code	270
Min. Negotiated Rate	$22.80
Max. Negotiated Rate	$473.07
Rate for Payer: Aetna Commercial	$359.54
Rate for Payer: Aetna Medicare Advantage	$283.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$241.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$241.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$241.27
Rate for Payer: Cigna Commercial	$473.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.85
Rate for Payer: Oxford Commercial	$189.23
Rate for Payer: Qualcare PPO/HMO/WC	$141.92
Rate for Payer: UnitedHealthcare Commercial	$189.23
Rate for Payer: UnitedHealthcare Community & State	$22.80
Rate for Payer: Wellpoint Medicaid Managed Care	$25.07

FROG******

Facility

$55.00

Hospital Charge Code	8001992
Hospital Revenue Code	279
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

FROG******

Facility

$55.00

Hospital Charge Code	8001992
Hospital Revenue Code	279
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.50
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

FRONTRUNNER XP CTO

Facility

$4,800.00

Hospital Charge Code	270687001N
Hospital Revenue Code	272
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$720.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

FRONTRUNNER XP CTO

Facility

$4,800.00

Hospital Charge Code	270687001N
Hospital Revenue Code	272
Min. Negotiated Rate	$115.68
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,824.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,440.00
Rate for Payer: Oxford Commercial	$960.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00
Rate for Payer: UnitedHealthcare Commercial	$960.00
Rate for Payer: UnitedHealthcare Community & State	$115.68
Rate for Payer: Wellpoint Medicaid Managed Care	$127.20

FRONTRUNNER XP CTO

Facility

$4,800.00

Hospital Charge Code	270687001S
Hospital Revenue Code	272
Min. Negotiated Rate	$720.00
Max. Negotiated Rate	$720.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00

FRONTRUNNER XP CTO

Facility

$4,800.00

Hospital Charge Code	270687001S
Hospital Revenue Code	272
Min. Negotiated Rate	$115.68
Max. Negotiated Rate	$2,400.00
Rate for Payer: Aetna Commercial	$1,824.00
Rate for Payer: Aetna Medicare Advantage	$1,440.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,224.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,224.00
Rate for Payer: Cigna Commercial	$2,400.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,440.00
Rate for Payer: Oxford Commercial	$960.00
Rate for Payer: Qualcare PPO/HMO/WC	$720.00
Rate for Payer: UnitedHealthcare Commercial	$960.00
Rate for Payer: UnitedHealthcare Community & State	$115.68
Rate for Payer: Wellpoint Medicaid Managed Care	$127.20

FROZEN BLOOD EACH UNIT THAWING

Facility

$300.00

Service Code	HCPCS 86931
Hospital Charge Code	3101170
Hospital Revenue Code	302
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

FROZEN BLOOD EACH UNIT THAWING

Facility

$300.00

Service Code	HCPCS 86931
Hospital Charge Code	3101170
Hospital Revenue Code	302
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$730.60
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$730.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$51.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$730.60
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

FROZEN BLOOD FREEZING/THAWING

Facility

$300.00

Service Code	HCPCS 86932
Hospital Charge Code	3101171
Hospital Revenue Code	302
Min. Negotiated Rate	$45.00
Max. Negotiated Rate	$45.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00

FROZEN BLOOD FREEZING/THAWING

Facility

$300.00

Service Code	HCPCS 86932
Hospital Charge Code	3101171
Hospital Revenue Code	302
Min. Negotiated Rate	$7.23
Max. Negotiated Rate	$160.16
Rate for Payer: Aetna Commercial	$120.69
Rate for Payer: Aetna Medicare Advantage	$143.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$160.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$58.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$160.16
Rate for Payer: Cigna Commercial	$88.94
Rate for Payer: Cigna Medicare Advantage	$44.37
Rate for Payer: Clover Medicare Advantage	$42.15
Rate for Payer: EmblemHealth Commercial	$133.11
Rate for Payer: Humana Medicare Advantage	$45.70
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$44.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$45.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: UnitedHealthcare Medicare Advantage	$44.37
Rate for Payer: Wellcare Medicare Advantage	$44.37
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

FROZEN FIBER 10CC

Facility

$15,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270705405
Hospital Revenue Code	278
Min. Negotiated Rate	$2,250.00
Max. Negotiated Rate	$3,630.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00

FROZEN FIBER 10CC

Facility

$15,000.00

Service Code	HCPCS C1765
Hospital Charge Code	270705405
Hospital Revenue Code	278
Min. Negotiated Rate	$361.50
Max. Negotiated Rate	$7,500.00
Rate for Payer: Aetna Commercial	$5,700.00
Rate for Payer: Aetna Medicare Advantage	$4,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,825.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,000.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,825.00
Rate for Payer: Cigna Commercial	$7,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,630.00
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$3,300.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,250.00
Rate for Payer: UnitedHealthcare Community & State	$361.50
Rate for Payer: Wellpoint Medicaid Managed Care	$397.50

FROZEN SECTION

Facility

$390.00

Service Code	HCPCS 88332
Hospital Charge Code	3004935
Hospital Revenue Code	312
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$175.00
Rate for Payer: UnitedHealthcare Community & State	$43.90
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

Know your out-of-pocket cost for care.

All Charges