Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

GIARDIA AG EIA,STOOL

Facility

$178.00

Service Code	HCPCS 87328
Hospital Charge Code	38479086
Hospital Revenue Code	306
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$37.59
Rate for Payer: Aetna Medicare Advantage	$44.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.89
Rate for Payer: Cigna Commercial	$89.00
Rate for Payer: Cigna Medicare Advantage	$13.82
Rate for Payer: Clover Medicare Advantage	$13.13
Rate for Payer: EmblemHealth Commercial	$41.46
Rate for Payer: Humana Medicare Advantage	$14.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.82
Rate for Payer: Wellcare Medicare Advantage	$13.82
Rate for Payer: Wellpoint Medicaid Managed Care	$4.72

GIARDIA AG EIA,STOOL

Facility

$178.00

Service Code	HCPCS 87328
Hospital Charge Code	38479086
Hospital Revenue Code	306
Min. Negotiated Rate	$26.70
Max. Negotiated Rate	$26.70
Rate for Payer: Qualcare PPO/HMO/WC	$26.70

GIARDIA AG,EIA,STOOL

Facility

$390.00

Service Code	HCPCS 87329
Hospital Charge Code	39990054EX
Hospital Revenue Code	306
Min. Negotiated Rate	$9.58
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.24
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
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	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

GIARDIA AG,EIA,STOOL

Facility

$390.00

Service Code	HCPCS 87329
Hospital Charge Code	39990054EX
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

GIARDIA AG,EIA,STOOL, I

Facility

$75.65

Service Code	HCPCS 87328
Hospital Charge Code	39990054A
Hospital Revenue Code	306
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$37.59
Rate for Payer: Aetna Medicare Advantage	$44.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.89
Rate for Payer: Cigna Commercial	$37.83
Rate for Payer: Cigna Medicare Advantage	$13.82
Rate for Payer: Clover Medicare Advantage	$13.13
Rate for Payer: EmblemHealth Commercial	$41.46
Rate for Payer: Humana Medicare Advantage	$14.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$11.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$13.82
Rate for Payer: Wellcare Medicare Advantage	$13.82
Rate for Payer: Wellpoint Medicaid Managed Care	$2.00

GIARDIA AG,EIA,STOOL, I

Facility

$75.65

Service Code	HCPCS 87328
Hospital Charge Code	39990054A
Hospital Revenue Code	306
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

GIARDIA AG,EIA,STOOL, II

Facility

$75.65

Service Code	HCPCS 87329
Hospital Charge Code	39990054B
Hospital Revenue Code	306
Min. Negotiated Rate	$2.00
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.24
Rate for Payer: Cigna Commercial	$37.83
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.70
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.35
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.00

GIARDIA AG,EIA,STOOL, II

Facility

$75.65

Service Code	HCPCS 87329
Hospital Charge Code	39990054B
Hospital Revenue Code	306
Min. Negotiated Rate	$11.35
Max. Negotiated Rate	$11.35
Rate for Payer: Qualcare PPO/HMO/WC	$11.35

GIARDIA ANTIGEN

Facility

$181.65

Service Code	HCPCS 87329
Hospital Charge Code	3009743
Hospital Revenue Code	306
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.24
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.49
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$27.25
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

GIARDIA ANTIGEN

Facility

$181.65

Service Code	HCPCS 87329
Hospital Charge Code	3009743
Hospital Revenue Code	306
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

GIEMSA STAIN

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	3005267
Hospital Revenue Code	310
Min. Negotiated Rate	$10.34
Max. Negotiated Rate	$223.48
Rate for Payer: Aetna Commercial	$168.40
Rate for Payer: Aetna Medicare Advantage	$200.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$223.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$61.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$223.48
Rate for Payer: Cigna Commercial	$124.10
Rate for Payer: Cigna Medicare Advantage	$61.91
Rate for Payer: Clover Medicare Advantage	$58.81
Rate for Payer: EmblemHealth Commercial	$185.73
Rate for Payer: Humana Medicare Advantage	$63.77
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$61.91
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	$92.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$61.91
Rate for Payer: Wellcare Medicare Advantage	$61.91
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

GIEMSA STAIN

Facility

$390.00

Service Code	HCPCS 88312
Hospital Charge Code	3005267
Hospital Revenue Code	310
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

GI PATHOGEN PANEL RT-PCR STOOL

Facility

$495.82

Service Code	HCPCS 87506
Hospital Charge Code	401387506
Hospital Revenue Code	306
Min. Negotiated Rate	$74.37
Max. Negotiated Rate	$74.37
Rate for Payer: Qualcare PPO/HMO/WC	$74.37

GI PATHOGEN PANEL RT-PCR STOOL

Facility

$495.82

Service Code	HCPCS 87506
Hospital Charge Code	401387506
Hospital Revenue Code	306
Min. Negotiated Rate	$13.14
Max. Negotiated Rate	$949.32
Rate for Payer: Aetna Commercial	$715.33
Rate for Payer: Aetna Medicare Advantage	$852.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$949.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$949.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$262.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$224.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$949.32
Rate for Payer: Cigna Commercial	$247.91
Rate for Payer: Cigna Medicare Advantage	$262.99
Rate for Payer: Clover Medicare Advantage	$249.84
Rate for Payer: EmblemHealth Commercial	$788.97
Rate for Payer: Humana Medicare Advantage	$270.88
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$262.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$148.75
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$74.37
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$210.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$262.99
Rate for Payer: Wellcare Medicare Advantage	$262.99
Rate for Payer: Wellpoint Medicaid Managed Care	$13.14

GIRDLE MID-THIGH SZ LG 110663

Facility

$351.70

Hospital Charge Code	270622256
Hospital Revenue Code	272
Min. Negotiated Rate	$52.76
Max. Negotiated Rate	$52.76
Rate for Payer: Qualcare PPO/HMO/WC	$52.76

GIRDLE MID-THIGH SZ LG 110663

Facility

$351.70

Hospital Charge Code	270622256
Hospital Revenue Code	272
Min. Negotiated Rate	$8.48
Max. Negotiated Rate	$175.85
Rate for Payer: Aetna Commercial	$133.65
Rate for Payer: Aetna Medicare Advantage	$105.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$89.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$89.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$89.68
Rate for Payer: Cigna Commercial	$175.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$105.51
Rate for Payer: Oxford Commercial	$70.34
Rate for Payer: Qualcare PPO/HMO/WC	$52.76
Rate for Payer: UnitedHealthcare Commercial	$70.34
Rate for Payer: UnitedHealthcare Community & State	$8.48
Rate for Payer: Wellpoint Medicaid Managed Care	$9.32

GIRDLE MID THIGH SZ SM 110661

Facility

$348.95

Hospital Charge Code	270625188
Hospital Revenue Code	272
Min. Negotiated Rate	$52.34
Max. Negotiated Rate	$52.34
Rate for Payer: Qualcare PPO/HMO/WC	$52.34

GIRDLE MID THIGH SZ SM 110661

Facility

$348.95

Hospital Charge Code	270625188
Hospital Revenue Code	272
Min. Negotiated Rate	$8.41
Max. Negotiated Rate	$174.47
Rate for Payer: Aetna Commercial	$132.60
Rate for Payer: Aetna Medicare Advantage	$104.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.98
Rate for Payer: Cigna Commercial	$174.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.69
Rate for Payer: Oxford Commercial	$69.79
Rate for Payer: Qualcare PPO/HMO/WC	$52.34
Rate for Payer: UnitedHealthcare Commercial	$69.79
Rate for Payer: UnitedHealthcare Community & State	$8.41
Rate for Payer: Wellpoint Medicaid Managed Care	$9.25

GI STOOL PCR PANEL 22TARGETS

Facility

$780.00

Service Code	HCPCS 0097U
Hospital Charge Code	40130097U
Hospital Revenue Code	306
Min. Negotiated Rate	$117.00
Max. Negotiated Rate	$117.00
Rate for Payer: Qualcare PPO/HMO/WC	$117.00

GI STOOL PCR PANEL 22TARGETS

Facility

$780.00

Service Code	HCPCS 0097U
Hospital Charge Code	40130097U
Hospital Revenue Code	306
Min. Negotiated Rate	$18.80
Max. Negotiated Rate	$390.00
Rate for Payer: Aetna Commercial	$296.40
Rate for Payer: Aetna Medicare Advantage	$234.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$198.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$198.90
Rate for Payer: Cigna Commercial	$390.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$117.00
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$18.80
Rate for Payer: Wellpoint Medicaid Managed Care	$20.67

GLACIAL ACETIC ACID

Facility

$3.00

Hospital Charge Code	60634471
Hospital Revenue Code	250
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.77
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.90
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

GLACIAL ACETIC ACID

Facility

$3.00

Hospital Charge Code	60634471
Hospital Revenue Code	250
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

GLASSES, CUSTOM ENGRAVING ON F

Facility

$10.00

Hospital Charge Code	270667070
Hospital Revenue Code	270
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

GLASSES, CUSTOM ENGRAVING ON F

Facility

$10.00

Hospital Charge Code	270667070
Hospital Revenue Code	270
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$5.00
Rate for Payer: Aetna Commercial	$3.80
Rate for Payer: Aetna Medicare Advantage	$3.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.55
Rate for Payer: Cigna Commercial	$5.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.00
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$2.00
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

GLASSES, FITOVER TORTOISE

Facility

$1,245.00

Hospital Charge Code	270660852
Hospital Revenue Code	270
Min. Negotiated Rate	$30.00
Max. Negotiated Rate	$622.50
Rate for Payer: Aetna Commercial	$473.10
Rate for Payer: Aetna Medicare Advantage	$373.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$317.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$317.48
Rate for Payer: Cigna Commercial	$622.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$373.50
Rate for Payer: Oxford Commercial	$249.00
Rate for Payer: Qualcare PPO/HMO/WC	$186.75
Rate for Payer: UnitedHealthcare Commercial	$249.00
Rate for Payer: UnitedHealthcare Community & State	$30.00
Rate for Payer: Wellpoint Medicaid Managed Care	$32.99

Know your out-of-pocket cost for care.

All Charges