Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

HANTA VIRUS

Facility

$218.00

Service Code	HCPCS 86790
Hospital Charge Code	38476231
Hospital Revenue Code	302
Min. Negotiated Rate	$5.78
Max. Negotiated Rate	$459.20
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$459.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.49
Rate for Payer: Cigna Commercial	$109.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.40
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$32.70
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$5.78

HANTAVIRUS ANTIBODY

Facility

$390.00

Service Code	HCPCS 86790
Hospital Charge Code	401086790A
Hospital Revenue Code	301
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$459.20
Rate for Payer: Aetna Commercial	$35.03
Rate for Payer: Aetna Medicare Advantage	$41.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$46.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$459.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$46.49
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.88
Rate for Payer: Clover Medicare Advantage	$12.24
Rate for Payer: EmblemHealth Commercial	$38.64
Rate for Payer: Humana Medicare Advantage	$13.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.88
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	$10.30
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.88
Rate for Payer: Wellcare Medicare Advantage	$12.88
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

HANTAVIRUS ANTIBODY

Facility

$390.00

Service Code	HCPCS 86790
Hospital Charge Code	401086790A
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HAP02

Facility

$6,075.00

Hospital Charge Code	270657205
Hospital Revenue Code	278
Min. Negotiated Rate	$911.25
Max. Negotiated Rate	$1,470.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,215.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,470.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,336.50
Rate for Payer: Qualcare PPO/HMO/WC	$911.25

HAP02

Facility

$6,075.00

Hospital Charge Code	270657205
Hospital Revenue Code	278
Min. Negotiated Rate	$146.41
Max. Negotiated Rate	$3,037.50
Rate for Payer: Aetna Commercial	$2,308.50
Rate for Payer: Aetna Medicare Advantage	$1,822.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,549.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,549.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,215.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,549.12
Rate for Payer: Cigna Commercial	$3,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,470.15
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,336.50
Rate for Payer: Qualcare PPO/HMO/WC	$911.25
Rate for Payer: UnitedHealthcare Community & State	$146.41
Rate for Payer: Wellpoint Medicaid Managed Care	$160.99

Haptoglobin

Facility

$390.00

Service Code	HCPCS 83010
Hospital Charge Code	39888024
Hospital Revenue Code	301
Min. Negotiated Rate	$10.06
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.22
Rate for Payer: Aetna Medicare Advantage	$40.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.58
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	$45.41
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.58
Rate for Payer: Clover Medicare Advantage	$11.95
Rate for Payer: EmblemHealth Commercial	$37.74
Rate for Payer: Humana Medicare Advantage	$12.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.58
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	$10.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.58
Rate for Payer: Wellcare Medicare Advantage	$12.58
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

Haptoglobin

Facility

$390.00

Service Code	HCPCS 83010
Hospital Charge Code	39888024
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HAPTOGLOBIN

Facility

$145.00

Service Code	HCPCS 83010
Hospital Charge Code	38478029
Hospital Revenue Code	301
Min. Negotiated Rate	$21.75
Max. Negotiated Rate	$21.75
Rate for Payer: Qualcare PPO/HMO/WC	$21.75

HAPTOGLOBIN

Facility

$390.00

Service Code	HCPCS 83010
Hospital Charge Code	39900460
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

HAPTOGLOBIN

Facility

$390.00

Service Code	HCPCS 83010
Hospital Charge Code	39900460
Hospital Revenue Code	301
Min. Negotiated Rate	$10.06
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$34.22
Rate for Payer: Aetna Medicare Advantage	$40.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.58
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	$45.41
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.58
Rate for Payer: Clover Medicare Advantage	$11.95
Rate for Payer: EmblemHealth Commercial	$37.74
Rate for Payer: Humana Medicare Advantage	$12.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.58
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	$10.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.58
Rate for Payer: Wellcare Medicare Advantage	$12.58
Rate for Payer: Wellpoint Medicaid Managed Care	$10.34

HAPTOGLOBIN

Facility

$145.00

Service Code	HCPCS 83010
Hospital Charge Code	38478029
Hospital Revenue Code	301
Min. Negotiated Rate	$3.84
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.22
Rate for Payer: Aetna Medicare Advantage	$40.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.58
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	$45.41
Rate for Payer: Cigna Commercial	$72.50
Rate for Payer: Cigna Medicare Advantage	$12.58
Rate for Payer: Clover Medicare Advantage	$11.95
Rate for Payer: EmblemHealth Commercial	$37.74
Rate for Payer: Humana Medicare Advantage	$12.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.50
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.75
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.58
Rate for Payer: Wellcare Medicare Advantage	$12.58
Rate for Payer: Wellpoint Medicaid Managed Care	$3.84

HAPTOGLOBIN, SERUM

Facility

$119.25

Service Code	HCPCS 83010
Hospital Charge Code	3001500
Hospital Revenue Code	301
Min. Negotiated Rate	$3.16
Max. Negotiated Rate	$124.00
Rate for Payer: Aetna Commercial	$34.22
Rate for Payer: Aetna Medicare Advantage	$40.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$45.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$45.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.58
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	$45.41
Rate for Payer: Cigna Commercial	$59.62
Rate for Payer: Cigna Medicare Advantage	$12.58
Rate for Payer: Clover Medicare Advantage	$11.95
Rate for Payer: EmblemHealth Commercial	$37.74
Rate for Payer: Humana Medicare Advantage	$12.96
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$35.77
Rate for Payer: Oxford Commercial	$101.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.89
Rate for Payer: UnitedHealthcare Commercial	$124.00
Rate for Payer: UnitedHealthcare Community & State	$10.06
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.58
Rate for Payer: Wellcare Medicare Advantage	$12.58
Rate for Payer: Wellpoint Medicaid Managed Care	$3.16

HAPTOGLOBIN, SERUM

Facility

$119.25

Service Code	HCPCS 83010
Hospital Charge Code	3001500
Hospital Revenue Code	301
Min. Negotiated Rate	$17.89
Max. Negotiated Rate	$17.89
Rate for Payer: Qualcare PPO/HMO/WC	$17.89

HARDWARE REMOVAL KIT

Facility

$2,500.00

Hospital Charge Code	270676086
Hospital Revenue Code	272
Min. Negotiated Rate	$375.00
Max. Negotiated Rate	$375.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00

HARDWARE REMOVAL KIT

Facility

$2,500.00

Hospital Charge Code	270676086
Hospital Revenue Code	272
Min. Negotiated Rate	$60.25
Max. Negotiated Rate	$1,250.00
Rate for Payer: Aetna Commercial	$950.00
Rate for Payer: Aetna Medicare Advantage	$750.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$637.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$637.50
Rate for Payer: Cigna Commercial	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$750.00
Rate for Payer: Oxford Commercial	$500.00
Rate for Payer: Qualcare PPO/HMO/WC	$375.00
Rate for Payer: UnitedHealthcare Commercial	$500.00
Rate for Payer: UnitedHealthcare Community & State	$60.25
Rate for Payer: Wellpoint Medicaid Managed Care	$66.25

HARMONIC ACE 5MM/36CM HANDPCE

Facility

$971.00

Hospital Charge Code	270338800
Hospital Revenue Code	272
Min. Negotiated Rate	$23.40
Max. Negotiated Rate	$485.50
Rate for Payer: Aetna Commercial	$368.98
Rate for Payer: Aetna Medicare Advantage	$291.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.60
Rate for Payer: Cigna Commercial	$485.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$291.30
Rate for Payer: Oxford Commercial	$194.20
Rate for Payer: Qualcare PPO/HMO/WC	$145.65
Rate for Payer: UnitedHealthcare Commercial	$194.20
Rate for Payer: UnitedHealthcare Community & State	$23.40
Rate for Payer: Wellpoint Medicaid Managed Care	$25.73

HARMONIC ACE 5MM/36CM HANDPCE

Facility

$971.00

Hospital Charge Code	270338800
Hospital Revenue Code	272
Min. Negotiated Rate	$145.65
Max. Negotiated Rate	$145.65
Rate for Payer: Qualcare PPO/HMO/WC	$145.65

HARMONIC ACE PLUS

Facility

$1,615.00

Hospital Charge Code	270672323
Hospital Revenue Code	272
Min. Negotiated Rate	$38.92
Max. Negotiated Rate	$807.50
Rate for Payer: Aetna Commercial	$613.70
Rate for Payer: Aetna Medicare Advantage	$484.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$411.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$411.82
Rate for Payer: Cigna Commercial	$807.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.50
Rate for Payer: Oxford Commercial	$323.00
Rate for Payer: Qualcare PPO/HMO/WC	$242.25
Rate for Payer: UnitedHealthcare Commercial	$323.00
Rate for Payer: UnitedHealthcare Community & State	$38.92
Rate for Payer: Wellpoint Medicaid Managed Care	$42.80

HARMONIC ACE PLUS

Facility

$1,615.00

Hospital Charge Code	270672323
Hospital Revenue Code	272
Min. Negotiated Rate	$242.25
Max. Negotiated Rate	$242.25
Rate for Payer: Qualcare PPO/HMO/WC	$242.25

HARMONIC HD 1001 shears

Facility

$3,184.30

Hospital Charge Code	270685509
Hospital Revenue Code	272
Min. Negotiated Rate	$76.74
Max. Negotiated Rate	$1,592.15
Rate for Payer: Aetna Commercial	$1,210.03
Rate for Payer: Aetna Medicare Advantage	$955.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$812.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$812.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$812.00
Rate for Payer: Cigna Commercial	$1,592.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$955.29
Rate for Payer: Oxford Commercial	$636.86
Rate for Payer: Qualcare PPO/HMO/WC	$477.64
Rate for Payer: UnitedHealthcare Commercial	$636.86
Rate for Payer: UnitedHealthcare Community & State	$76.74
Rate for Payer: Wellpoint Medicaid Managed Care	$84.38

HARMONIC HD 1001 shears

Facility

$3,184.30

Hospital Charge Code	270685509
Hospital Revenue Code	272
Min. Negotiated Rate	$477.64
Max. Negotiated Rate	$477.64
Rate for Payer: Qualcare PPO/HMO/WC	$477.64

HARMONIC SCALPEL ACE 36CM

Facility

$19,532.80

Hospital Charge Code	270657206
Hospital Revenue Code	272
Min. Negotiated Rate	$2,929.92
Max. Negotiated Rate	$2,929.92
Rate for Payer: Qualcare PPO/HMO/WC	$2,929.92

HARMONIC SCALPEL ACE 36CM

Facility

$19,532.80

Hospital Charge Code	270657206
Hospital Revenue Code	272
Min. Negotiated Rate	$470.74
Max. Negotiated Rate	$9,766.40
Rate for Payer: Aetna Commercial	$7,422.46
Rate for Payer: Aetna Medicare Advantage	$5,859.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,980.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,980.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,980.86
Rate for Payer: Cigna Commercial	$9,766.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,859.84
Rate for Payer: Oxford Commercial	$3,906.56
Rate for Payer: Qualcare PPO/HMO/WC	$2,929.92
Rate for Payer: UnitedHealthcare Commercial	$3,906.56
Rate for Payer: UnitedHealthcare Community & State	$470.74
Rate for Payer: Wellpoint Medicaid Managed Care	$517.62

HARMONIC WAVE HANDPCE 5MM/23

Facility

$775.00

Hospital Charge Code	270338001
Hospital Revenue Code	272
Min. Negotiated Rate	$18.68
Max. Negotiated Rate	$387.50
Rate for Payer: Aetna Commercial	$294.50
Rate for Payer: Aetna Medicare Advantage	$232.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$197.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$197.62
Rate for Payer: Cigna Commercial	$387.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$232.50
Rate for Payer: Oxford Commercial	$155.00
Rate for Payer: Qualcare PPO/HMO/WC	$116.25
Rate for Payer: UnitedHealthcare Commercial	$155.00
Rate for Payer: UnitedHealthcare Community & State	$18.68
Rate for Payer: Wellpoint Medicaid Managed Care	$20.54

HARMONIC WAVE HANDPCE 5MM/23

Facility

$775.00

Hospital Charge Code	270338001
Hospital Revenue Code	272
Min. Negotiated Rate	$116.25
Max. Negotiated Rate	$116.25
Rate for Payer: Qualcare PPO/HMO/WC	$116.25

Know your out-of-pocket cost for care.

All Charges