Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

ANAFRANIL/25MG/CAP

Facility

$6.00

Hospital Charge Code	60632456
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

ANAFRANIL/25MG/CAP

Facility

$6.00

Hospital Charge Code	60632455
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ANAFRANIL/50MG/CAP

Facility

$6.00

Hospital Charge Code	60632457
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$3.00
Rate for Payer: Aetna Commercial	$2.28
Rate for Payer: Aetna Medicare Advantage	$1.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.53
Rate for Payer: Cigna Commercial	$3.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.20
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.20
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

ANAFRANIL/50MG/CAP

Facility

$6.00

Hospital Charge Code	60632457
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

ANAFRANIL (CLOMIPRAMINE)

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3009073
Hospital Revenue Code	301
Min. Negotiated Rate	$27.25
Max. Negotiated Rate	$27.25
Rate for Payer: Qualcare PPO/HMO/WC	$27.25

ANAFRANIL (CLOMIPRAMINE)

Facility

$181.65

Service Code	HCPCS 80299
Hospital Charge Code	3009073
Hospital Revenue Code	301
Min. Negotiated Rate	$4.81
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$11.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.28
Rate for Payer: Cigna Commercial	$90.83
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
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	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$4.81

ANAGRELIDE HCL CAP 0.5MG

Facility

$30.10

Hospital Charge Code	6017974
Hospital Revenue Code	250
Min. Negotiated Rate	$4.51
Max. Negotiated Rate	$4.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.51

ANAGRELIDE HCL CAP 0.5MG

Facility

$30.10

Hospital Charge Code	6017974
Hospital Revenue Code	250
Min. Negotiated Rate	$0.73
Max. Negotiated Rate	$15.05
Rate for Payer: Aetna Commercial	$11.44
Rate for Payer: Aetna Medicare Advantage	$9.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.68
Rate for Payer: Cigna Commercial	$15.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.03
Rate for Payer: Oxford Commercial	$6.02
Rate for Payer: Qualcare PPO/HMO/WC	$4.51
Rate for Payer: UnitedHealthcare Commercial	$6.02
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.80

ANAL AND PERINEAL PROCEDURES

Facility

$18,370.60

Service Code	APR-DRG 2263
Min. Negotiated Rate	$18,010.39
Max. Negotiated Rate	$18,370.60
Rate for Payer: UnitedHealthcare Community & State	$18,010.39
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$18,370.60
Rate for Payer: Wellpoint Medicaid Managed Care	$18,010.39

ANAL AND PERINEAL PROCEDURES

Facility

$33,193.19

Service Code	APR-DRG 2264
Min. Negotiated Rate	$32,542.34
Max. Negotiated Rate	$33,193.19
Rate for Payer: UnitedHealthcare Community & State	$32,542.34
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$33,193.19
Rate for Payer: Wellpoint Medicaid Managed Care	$32,542.34

ANAL AND PERINEAL PROCEDURES

Facility

$9,677.43

Service Code	APR-DRG 2261
Min. Negotiated Rate	$9,487.68
Max. Negotiated Rate	$9,677.43
Rate for Payer: UnitedHealthcare Community & State	$9,487.68
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,677.43
Rate for Payer: Wellpoint Medicaid Managed Care	$9,487.68

ANAL AND PERINEAL PROCEDURES

Facility

$12,202.79

Service Code	APR-DRG 2262
Min. Negotiated Rate	$11,963.52
Max. Negotiated Rate	$12,202.79
Rate for Payer: UnitedHealthcare Community & State	$11,963.52
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$12,202.79
Rate for Payer: Wellpoint Medicaid Managed Care	$11,963.52

ANAL AND STOMAL PROCEDURES WITH CC

Facility

$44,436.66

Service Code	MSDRG 348
Min. Negotiated Rate	$13,530.39
Max. Negotiated Rate	$44,436.66
Rate for Payer: Aetna Commercial	$30,790.37
Rate for Payer: Aetna Medicare Advantage	$44,436.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30,239.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14,242.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30,239.30
Rate for Payer: Cigna Commercial	$24,492.88
Rate for Payer: Cigna Medicare Advantage	$14,242.52
Rate for Payer: Clover Medicare Advantage	$13,530.39
Rate for Payer: EmblemHealth Commercial	$42,727.56
Rate for Payer: Humana Medicare Advantage	$14,669.80
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14,242.52
Rate for Payer: Oxford Commercial	$17,603.36
Rate for Payer: UnitedHealthcare Commercial	$30,868.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$14,242.52
Rate for Payer: Wellcare Medicare Advantage	$14,242.52

ANAL AND STOMAL PROCEDURES WITH MCC

Facility

$76,331.67

Service Code	MSDRG 347
Min. Negotiated Rate	$23,242.02
Max. Negotiated Rate	$76,331.67
Rate for Payer: Aetna Commercial	$52,705.88
Rate for Payer: Aetna Medicare Advantage	$76,331.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$59,315.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$59,315.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24,465.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$59,315.55
Rate for Payer: Cigna Commercial	$42,959.86
Rate for Payer: Cigna Medicare Advantage	$24,465.28
Rate for Payer: Clover Medicare Advantage	$23,242.02
Rate for Payer: EmblemHealth Commercial	$73,395.84
Rate for Payer: Humana Medicare Advantage	$25,199.24
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24,465.28
Rate for Payer: Oxford Commercial	$30,875.82
Rate for Payer: UnitedHealthcare Commercial	$54,141.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$24,465.28
Rate for Payer: Wellcare Medicare Advantage	$24,465.28

ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC

Facility

$30,273.27

Service Code	MSDRG 349
Min. Negotiated Rate	$9,217.82
Max. Negotiated Rate	$30,273.27
Rate for Payer: Aetna Commercial	$21,058.48
Rate for Payer: Aetna Medicare Advantage	$30,273.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22,795.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22,795.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$9,702.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22,795.78
Rate for Payer: Cigna Commercial	$16,292.41
Rate for Payer: Cigna Medicare Advantage	$9,702.97
Rate for Payer: Clover Medicare Advantage	$9,217.82
Rate for Payer: EmblemHealth Commercial	$29,108.91
Rate for Payer: Humana Medicare Advantage	$9,994.06
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$9,702.97
Rate for Payer: Oxford Commercial	$11,709.57
Rate for Payer: UnitedHealthcare Commercial	$20,533.10
Rate for Payer: UnitedHealthcare Medicare Advantage	$9,702.97
Rate for Payer: Wellcare Medicare Advantage	$9,702.97

ANAL DILATATION***

Facility

$193.00

Hospital Charge Code	2300796
Hospital Revenue Code	759
Min. Negotiated Rate	$28.95
Max. Negotiated Rate	$28.95
Rate for Payer: Qualcare PPO/HMO/WC	$28.95

ANAL DILATATION***

Facility

$193.00

Hospital Charge Code	2300796
Hospital Revenue Code	759
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: Qualcare PPO/HMO/WC	$28.95
Rate for Payer: UnitedHealthcare Community & State	$4.65
Rate for Payer: Wellpoint Medicaid Managed Care	$5.11

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	38430013
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	39990213
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	3039013
Hospital Revenue Code	301
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.48
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	3039013
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	39990213
Hospital Revenue Code	301
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.48
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

ANALGESICS NON-OPIOID 1 OR 2

Facility

$190.45

Service Code	HCPCS 80329
Hospital Charge Code	38430013
Hospital Revenue Code	301
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.48
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

ANALGESICS NON-OPIOID 3-5

Facility

$190.45

Service Code	HCPCS 80330
Hospital Charge Code	39990214
Hospital Revenue Code	301
Min. Negotiated Rate	$5.05
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.13
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$16.48
Rate for Payer: Wellpoint Medicaid Managed Care	$5.05

ANALGESICS NON-OPIOID 3-5

Facility

$190.45

Service Code	HCPCS 80330
Hospital Charge Code	3039014
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

Know your out-of-pocket cost for care.

All Charges